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low back and the er??
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low back and the er??

So glad I found this site, hope someone can comment.  Been having "low low back problems" since April.  I had a spine xray and a lumbar MRI, went to the ER I was in so much pain (that has never happened to me).  They give me an rx for hydrocodne 10/325 (which I think I'm learning now is the highest dose?)  So, I was taking about 4 of those a day, plus celebrex, which I stopped when I realized that was making me feel worse if I took it more than 3 days in a row.  I got an orthopedic dr, he requested a hip/pelvic MRI and some nerve conductivity tests.  Says there's nothing wrong with me to indicate the level of pain "I say" I'm in and gives me a hard time about the rx, and sends me to a physiatrist (I think that's close to the specialty)  at a very highly regarded rehab facility.  The Dr. specializes in SJ problems, among other things.  

So, I go see this dr, in the hopes of a better diagnosis I don't take meds that morning, though I took a celebrex the morning before and maybe 2 hydrocodone.  Of course, for the first time in 4 months I'm so close to pain free (comparatively of course), and I did tell him that.  He has the report of the pelvic MRI and the results from the nerve test.  Does a lot of pressing and 'does this hurt' looks at me standing and some other stuff.  He says it's not SJ problems because occasionally the pain radiates to my left side, it's low back pain, but does want to see mri files just to be sure.  He gives me more hydrocodone, lower dose, and a different anti-inflammatory, and a PT order.  Then, the weirdest thing happens, the pain KEEPS LESSENING.  And I think, how is this happening?  How is low back pain so bad you are sobbing in the ER, then it just starts to go away a month later?!?!  But I soooo want him to be right.  I start PT in a couple days.

Since I'm feeling fine I stop taking the hydrocodone, was only on it a month.  OK, now I understand withdrawal.  I'm MISERABLE.  I haven't slept in 4 days, other then 15 minutes at a time a couple dozes a night.  I've been told it should start getting better now.  I just want to sleep so bad I could cry, and have actually, and I'm really not the crying type.  But the worst part, the pain has started coming back.  It's beautiful out and I'm in bed again.  Took a celebrex (haven't gotten the other filled yet), and it doesn't hurt really bad, but if I get up and walk around for 10 minutes I get that burning pain in my hip and into my groin area again.  Last night I don't know if it was the withdrawal keeping me up or the pain.  I took 2 herbal sleep helpers around 10, finally felt a little sleepy around 1, but by then the pain in my right hip was so bad I got up and took 4 ibuprofen (bad I know) and then 2 hours later 1 tylenol PM.  I think that's why I got an hour's sleep.  I HATE taking things.  Last night was so bad I considered taking a hydrocodone again.  But I feel like I've gotten through enough of the withdrawal that I don't want to do that again.

I have no idea what I want from this post.  I see I haven't even really asked any questions.  Maybe I'm just venting.  Maybe I need to try a new dr.  I hate this.  I hate that I'm useless.  We bought a house that needs some fixing and we are moving soon and I can't do anything, and my current house is a wreck because I can't clean it.  I'm nearly out of vaca days (sick days used up after ER visit).  I just wish someone would say definitively, this is what is wrong and this is what you need to do to fix it.  I'll do it, just tell me what to do.  And then I feel so guilty because I see much worse problems here then what I'm going through.

I guess I don't think this Dr. is right.  Maybe I should ask him to do the SJ test with the needle in the joint.  Is there something I can do for this pain that isn't addictive?  I guess that's part of what I need.

THANK YOU to anyone who reads and/or comments.
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8 Comments Post a Comment
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356518_tn?1322267242
Don't try and lessen your pain, true there is people with greater problems but that does not make your pain any less. You need to get a new Dr and make sure he/she understands the pain your in and let them know you need some help with your pain and a diagnosis. Ultram is non narcotic though some say it is more addictive even though it is listed as a non addictive med. I think you would be better off getting a second opinion before going through the painful procedure, a more experienced Dr can maybe find a diagnosis without doing the procedure. I think your trying to be brave is great but don't let that get in the way of treating your pain, your not weak for needing help when your in pain and that is what the meds are made for. If you feel you have addiction issues discuss this with your Dr and he can help. Keep us posted and know we are here for you. You can ask your primary care Dr for a recommendation to a good Dr that will help you:)
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547368_tn?1332173665
Hi Lee13,

I am so sorry to hear your story and what you are going through. I don't know if I can help but I do know A LOT about SI Joint Dysfunction. Because I have it. I believe that is what you mean when you say SJ test.

SIJ pain can result from injury, pregnancy, wear and tear or for no know cause. True SI Joint Dysfunction is rare. If caught early and properly treated it may very well not cause you any major discomfort again. Some ppl experience a one or two time incident others have life long issues with it and some to the point of disability. I fit in the last category. Many women experience SIJ pain during second and especially the third trimester of pregnancy.

If they have offered to conduct the only true diagnostic test (SI Joint Injection) for the condition I would encourage you to have it asap.

I will elaborate on the symptoms and treatments if you would like me to do so. I would not want to "assume" you met the SI Joint in error and post a lot of useless information.
There are medications you can take that are not addictive, consult with you physician and I am sure he would be happy to prescribe them for you.

If you have SI Joint pain I can attest to the fact that it is extremely painful and I feel for you. It can get better and the pain becomes less, especially if it is now healing or if you are out of your flare.

Please follow up. Do not ignore this pain. Take care of yourself and if you want additional information please let me know (PM me) and I will be happy to respond to your request. Take care, Tuck
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Avatar_f_tn
Oh thank you both for your replies!  Sandee, unfortunately my GP seemed to me to be useless.  He just said, oh you strained your back, here, take some (a lot) ibuprofen for 6 - 8 weeks and if it's not better make another appt (a 2 - 3 week process) and we'll look into other things.  When I called to see if I could get a minute of his time to ask about a med the ER prescribed (he does call backs) he had a nurse call to tell me to make an appt!  I honestly feel I wasted at least a month.  Thank you for your kind words.  I really wonder if the lack of pain the day I saw that doc (really weird I still think) was a factor and maybe I should see him again when I am actually in pain...  I actually did kind of like him and may want to give him the benefit of the doubt, but only once ;)  you are right, and I think if the pain gets really bad I will take 1.  But only 1 and not until I'm completely through this withdrawal ****.  

Tuck, that's exactly what I meant, and I'd love to hear more about it.  The doc didn't offer the test, I just feel like it would give me a def yes or no at least for something.  I'm so sorry that you are in the disability category, but it gives me hope that there *are* other categories.  I thought if that was indeed the problem I would be in medication pain management for the rest of my life and eventually get surgery.  I also didn't know it could flare like that.  And I'm afraid if that is the issue, will the PT therapy make it worse because it isn't diagnosed?  I was doing PT once or twice a week for the month before it got really bad.  I was wondering if it was just a bad office, (honestly, it felt a little like having a personal trainer - do this stretch for this long, etc) but maybe it was a bad diagnosis and that caused it to get worse?

I know from my xrays and MRIs that I have a slight spine curvature and a slightly bulged disc that is NOT pressing on any nerves, not even close according to the doc I didn't like.  But I wonder, maybe I could have a SI joint problem and the reason my pain 'moves' to the other side is that is when the SI isn't hurting so much I feel the normal low back pain/soreness/achy that I often feel.  Maybe I should just call that new doc back.  Is SI something you can see on an MRI?

I don't know.  There are so many unknowns and I think that is the worst part in some ways.  I've always been healthy and active, and exercise and dance were my stress relief.  Now not only do I not have those options, but I don't even get to participate in my dream of fixing up my new old house.  

And of course ALL of this is taking a toll on my relationship.  The boy is the best, but I can tell how stressed out he is.  And he just sent me a txt (he's over working on our house) that I could eat his ice cream, I am soooo lucky =D

I'm so glad I found this forum.  It really helps to have others to talk to who understand.  THANK YOU!!
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535089_tn?1400677119
You could have strained your back and without strict rest and added activity you could possibly be re-injuring it. Just when you start to feel better you start doing things and before you know it, you hurt it again. This has happened to me and it is a visious cycle. Also, If you don't like one Drs. answers, go see another. Take care, Mollyrae
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572713_tn?1237098502
We have hundreds of muscles in our backs, and unfortunately, some of them can take months to heal.  There is a lot of controversy over what is better - exercising our injured muscles to keep them strong or letting them rest (and risk atrophy).
Regardless of your diagnosis, you need to feel comfortable with your doctor.  If you aren't getting satisfaction, find another one.
Perhaps Physical Therapy would help?  It did for me.
Careful on the pain relievers!  Ultram truly is addictive - I was on it for only a month after major surgery, and at a low dose, and I still went thru withdrawal!
Good luck to you.
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Avatar_f_tn
Thank you Mollyrae and Firemedic for the additional information.  I actually start physical therapy tomorrow after work.  I hope it helps and doesn't hurt me more.  It is a top rated facility, so maybe.  

Right now I'm actually getting by on anti-inflammatorys only, though I didn't go to work today.  That was partly exhaustion from still not sleeping and partly pain.  And I haven't taken anything today because there is honestly no food in the house I can eat without having to stand long enough to cook it, and I'm really just too tired to care.  As long as I stay lying down the pain isn't too bad.

My doc just called me back.  He thinks I should be able to sleep tonight, and it's ok to take some ibuprofen for pain and tylenol pm for sleep, then tomorrow I'll pick up the diclofenac and start that instead of the ibuprofen or celebrex.  He also reminded me that while he doesn't think it's SI joint, he hasn't ruled it out and wants to see the MRI films (which I'm bringing tomorrow when I go for PT).  He says while he does see SI symptoms, he sees others as well and is looking for a diagnosis that fits all of them.  So, I think I will stick with him for now.  While his manner does come across a bit rushed he was willing to call back, listen to me, and give me what answers he could, so I'm not completely put off.  As long as he doesn't become dismissive, ya know?
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483733_tn?1326802046
Since you are saying the pain is coming and going I wonder if you might be having monthly ovarian cysts that are then bursting.  You might want to look into a transvaginal ultrasound when the pain is bad (if you wait it will have burst) to check.  Cysts can cause this kind of pain in your lower abdominals and around the back.  Good luck!
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Avatar_f_tn
Thanks Trudie!  That could def be something to watch for, however I have had that happen before (unfortunately) and while it was excruciating, it was ... different.  However, I will keep it in mind as I go through this 'fun' journey.

I was sort of able to sleep last night.  Hard to fall asleep, even with the tylenol pm, but once i feel asleep wasn't too bad.  Physical therapy starts tonight.  Wish me luck!
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