22 year old just left in pain with no diagnosis

[Ruralrural]

Apologies for putting this in chat but I desperately need opinions on how to help this 22 year old.

My DD’s partner pulled his back last October. A physio said initially it seemed like a protruding disc. The pain was presenting like that. Two MRIs have ruled this out. He had a private EMG (very short, done on his legs not back) as there was a long wait for the EMG on the nhs. That came up negative. The GP has now cancelled the upcoming nhs EMG saying he will put him forward for a pain therapy group to meet once every 6 weeks. The poor lad spent the night on his back and couldn’t get up to make food after one day back at work last week. He made meals for 2 days today as he knew after another day at work he wouldn’t be able to move tomorrow.

He is diagnosed coeliac ( definitely cannot eat gluten) but no other known health problems except hayfever. Until 10 months ago, no back problems. Not overweight. He has had some blood work done (don’t know what) and it has come back negative.

Dd and him are so upset. How can the GP just say you’re just going to have to live like this? He’s 22! They’ve even said there’s no point carrying on with his prescription pain medication as it’s not doing anything. It’s as if they think he’s imagining it - I can see the pain he’s in. He’s desperate to get back to work as he’s skint.

Any ideas what he should do next? He has no diagnosis.

Could he afford to see a chiropractor?

How did the injury happen?

Other than that it’s just chasing down the GP for a referral and stressing that he can’t work and it’s affecting his everyday life.

Yoga. Preferably an experienced Iyengar teacher. Or Pilates.
What part of the country? Most cities/towns will have one or the other.

A good physio.

He should put in a formal complaint to the practice and request a second opinion and be referred to an orthopaedic specialist. If this is refused he can go to the Health Ombudsman. Very best of luck x

Yes agree he needs a full assessment of his pain by a specialist back physio. Ask around and get a local recommendation of a private physio who specialises in back problems. Really important to get someone recommended by others who've had good results

So looking at this guide

www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take#:~:text=As%20with%20MRI%2C%20CAT%20scans,with%20the%20muscles%20and%20nerves.

He's had the MRI which is looking at soft tissue, and the EMG which is looking for nerve and muscle. Has he had X-rays and blood tests to look for bone problems or inflammatory issues?

Other than pain killers have they tried any medications or physio treatments?

Thank you so much for your suggestions. I will tell him your ideas. He is in so much pain he can’t advocate for himself.

The EMG was annoying done in his legs not back. He has back pain that sometimes goes into his legs. So the back EMG being cancelled just made him weep because he thought that may give him some answers (nothing else has). I will keep you updated and get some idea about what blood work he’s had done.

Regarding the EMG, there isn’t really such a thing as a ‘back EMG’. Testing the muscles and nerves in the legs gives the doctor information about whether there is an issue in the spine.

Has the GP referred him to a specialist previously? It isn’t usually a GP that would refer for an EMG, (and therefore they wouldn’t usually cancel it) although it may vary between trusts.

I recommend this book about back pain. It is about the mind/body connection and has a really high success rate in helping back pain. I know of two people who had previously been bedbound who are now living normal lives. This is not to say that he's making it up or its all in his imagination. The pain is real but caused by the brain shutting off oxygen to certain areas/muscles. Its hard to explain and I have to say I was extremely sceptical about it but having seen the effect its had on these two people I would say you can't lose anything by trying it.

https://www.amazon.co.uk/s?k=john+sarno+healing+back+pain&adgrpid=121644737230&hvadid=606276767992&hvdev=m&hvlocphy=9045143&hvnetw=g&hvqmt=e&hvrand=8606132023288022650&hvtargid=kwd-304846852953&hydadcr=21608_2291927&tag=hydrukspg-21&ref=pd_sl_22vo47tmvv_e

Ask for them to scan his spine - my dad’s collapsing c5 got missed for ages and left him disabled. Push hard for it - it’ll take a bit of a fight so ask for a referral and a second opinion.

Do not see a chiropractor they are not approved or licensed as an NHS treatment, get him to see an osteopath. I have seen an osteopath and pain in my hip reduced about 90%. At one point I had to use a walking stick.

Is the pain on one side only and what sort of line does it follow, mine was sciatica plus a congenital spine issue. Footwear actually assisted greatly with pain levels as well as gentle manipulation and exercise.

Thanks for this. This info may help with the disappointment of missing out on the EMG for his back. From what I remember, the GP put a referral in but he spent some savings getting it done privately to speed in up as he was in pain and wanted to get back to work quicker.

Lots of questions to ask him tomorrow from you all. Will update tomorrow. I have told him there will be solutions - he can’t just be left in pain without anything other than a pain therapy group once every 6 weeks.

Poor lad. Hopefully he’ll get some answers soon. He who shouts loudest gets heard. He needs to push and push, until they take him seriously.

Has he seen a physio? I had awful shoulder and neck pain, I couldn’t move, even lying in bed was agony, luckily my wife is a physio and after doing the stretches she demonstrated for me the pain was gone within a few weeks. Most of the time it really is just tense muscles and inflammation rather than anything sinister.

Chiropractor or osteopath. Both are musculoskeletal specialist, both are primary health care level practitioners in UK. Both are insured and regulated professions - very highly trained, but unfortunately rarely available through the NHS.

Physio as alternative, but I’d go chiropractor as the look at muscles, joints and nerves (Nervous System).