severe lower back pain @ night, "large, bilateral, multoloculated ovarian cysts"

[amyd1970]

hello dr. and other members...

it's hard to know where to start. so i will list my current symptoms & brief past medical history.  i'm just curious if you have any thoughts or suggestions.  I'm 39 y/o.   this back pain is really getting the best of me and affecting my sleep, therefore affecting my job and other daily activities.  thanks in advance.  amy

Current problems – not in any particular order
- Severe lower back pain:  has gotten progressively worse over last 2 – 3 months;   with the past 2- 3 weeks really affecting sleep, pain with sneezing, etc.
      o Mostly VERY low-back:  radiating to hips; very recently radiates to mid-back (1-2 days)
      o Much worse at night – cannot turn over; keeps me awake or wakes me up
      o Sneezing makes me fall to floor
- Headache:  ranging from moderate to severe over past several months
- Dizziness:  very “faint” feeling; sometimes even while laying in bed X 1 -2 weeks
- Severe muscle cramps/spasms over my entire body; progressively worse over past 2 months with 3 -4 episodes this past week
- Nausea:  Zofran seems to help; this seems to be an ongoing symptom for me, though is worse when my pain is worse or I am driving; X several months
- Fever:  very low grade – comes and goes; ranges from normal to 99.5 to ~ 100; has done this for almost a year
- Swollen inguinal lymph node:  goes up and down in size (pea-size to grape size) x 1-2 weeks
- Loss of bladder/bowel control two times in past 2 weeks:  was in bed
-       Alternate constipation/ diarrhea for several months
- Bleeding in between periods:  very light
- Occasional minor night sweats/chills;  ~ once a week for past 2 -3 months
- Insomnia:  basically because of such severe back pain or headache
- Pins and needle feeling in feet legs:  sometimes one leg, other times both; anywhere from 3 – 4 times a week to once a day for past 1 -2 months
- Itching over entire body:  usually at night or after a shower; for almost a year
- Mild shortness of breath

NOTE:  had recent blood work done including re-check on thyroid, CRP, ESR,and no reported problems....

Current meds:
1. Levothyroxine 125 mcg qday (hypothyroidism)
2. Maxzide 75/50 qday (HTN)
3. ASA 81 qday
4. Nitro 0.4 mcg prn (prinzmetal angina)
5. Tramadol 50 prn (degenerative disc disease/ headache/ undifferentiated connective tissue dz)
6. Skelaxin prn
7. Midrin prn (migraine)
8. APAP prn

HERE'S the reason I'm posting in this community (bet you were wondering!  lol)

I had an MRI done last week.  It showed 1) worsening of my degenerative disk disease 2) abnormal signal intensity between L4 & L5 – suspicious of Diskitis and 3)  incidental finding of large (>7 cm) ovarian cysts, multiloculated, bilaterally – suspicious for possible solid areas on right ovary
As stated by MRI, I have degenerative disk disease as well.  That was diagnosed a few years ago.  So I totally understand the horrible pain you have as well!  Also, obviously due to the degeneration, I’ve had severe back pain before, but not this severe, and not at night – it was usually relieved by rest or laying down.  This is what it driving me insane.

I have a transvaginal and pelvic ultrasound scheduled for tomorrow to further investigate the cysts more thoroughly.  I suppose this could theoretically be the cause of the back pain as well.  I had some major trouble with cysts in the past – but nothing so painful as what I’m experiencing now.

Unfortunately, I am allergic to most narcotics.  In that I have to go to ER due to shortness of breath, lips/tongue swelling, etc.  The meds I CAN take for pain don’t even come close to touching it – but I guess it would be worse if I was not taking them.  I’m seriously considering finding a good chiropractor, but have been putting it off because of horror stories.  I understand that there are wonderful ones out there – I just don’t want to end up with the QUACK!  lol

Sorry for such a long “question”  - just seems to need some background info.  I guess I'm just wondering if anybody from the community has had similar symptoms???  Any thoughts in general?

[amyd1970]

my ultrasound (pelvic AND transvaginal) results came back this week:

BILATERAL OVARIAN CYSTS found
uterus measures:  9.2 x 3.8 x 4.9 cm
endometrial stripe:  echogenic, measuring 1.0 cm
right ovary measures:  4.9 x 1.9 x 3.1 cm
left ovary measures:  6.9 x 4.0 x 5.1 cm
left ovarian cyst:  complex, containing septation, measuring - 6.1 x 4.0 x 5.1 cm
normal appearance of right ovary w/ small follicles (< 4.5 cm) identified
comparison is made to prior ultrasound (10/22/08) same complex left ovarian lesion was present at that time - only smaller
cystic neoplasm needs to be excluded.

so i now have an appointment with a cancer center here in town for friday to find out when i will be having surgery for the cysts.  i believe they will be removing the cysts on both sides, and doing a biopsy on the complex one found on the left ovary.

i'm a little nervous, but i'm also hopeful that perhaps these cysts are the cause of my back pain that is causing me such turmoil at night.  maybe when they are removed, i will get some relief!

thanks again for your replies.
amy

[MarieMichele]

Those cysts could easily be contributing to back pain and some or all of your other symptoms.  Maybe some are side effects from those medicines and thyroid issues, but I cannot say for sure.  Cyst symptoms mimic those of thyroid problems.

It sounds like you need those cysts surgically removed as soon as possible.  They could be benign and still cause that much trouble.  

I don't know enough about what choices the anesthesiologists have for those that cannot take narcotic pain killers but there must be something else they can use during and after surgery.  This will not cure your back problems but those cysts could be adding to them to the point the pain is much worse than it should be.  

As for chiropractors, try getting word of mouth recommendations from people that have a doctor they truly like.