To be at my wits end and hope there's a doctor on mumsnet on a Sunday?

[Whenisright]

I know I am but here goes.... For at least the last couple of months I wake up with horrible aching mid back pain. Every single morning. It means I simply can't lie in or catch up on sleep, despite being exhausted (twins). The discomfort is so bad I have to get up. Nothing I do in bed helps (position change / stretching / moving beds or surface), I have to get up. Within 10 mins of being up I'm absolutely fine. I have a new excellent mattress, have tried a different mattress and memory foam. Tried different sleeping positions. I'm at my wits end as its getting earlier and earlier. By 3am I was gulping painkillers as I desperately needed to sleep and then was up at 5.45 with the twins. Dr said they could refer me for physio and advised to take ibuprofen. Not helpful. Any ideas at all?? It is my whole middle back and comes round to my ribs at the front. Any Drs here? Thanks!

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I have skim read the replies but there is some good advice here.
I'm a doctor but it's impossible for me to give you any specific advice or a diagnosis over a forum without seeing you, examining you etc.
Those who have advised you to go to your doctors and ask for an MRI/rheumatology referral/spinal surgeon referral- please don't.
Your GP should assess you for red flag or worrying symptoms and if there are none then yes most likely it's a mechanical back pain and weight loss/ core strengthening exercises (physio or Pilates etc) is key to improving your symptoms. If nerve involvement is suspected then there are some medications that may help specifically for this.

You can go to websites such as
www.nhs.uk/Livewell/Backpain/Pages/low-back-pain-exercises.asp for simple exercises to do at home but you must do these regularly.
There's a very large psychological component to back pain (most pain TBH) and finding small ways to reduce any stress in your life can often help.
The road to recovery is long and there is no quick fix unfortunately. You need a lot of patience and hard graft but don't lose hope that things will improve. Good luck

I also think gallstones!

Post natal yoga will help. So will exercise that involves pulling weight - rowing, climbing etc

Sounds exactly like gallstones to me

I don't really understand why you shouldn't ask for a referral.

A GP could not have identified my gallbladder problem. That took further investigations.

Have you tried ranitidine or omepraxole for acid reflux?

If there are risk factors for gallstones and the symptoms point that way then your GP should examine your abdomen and do an ultrasound. That's for your GP to assess and decide

Pilates has recently kept me pain free. I started because I kept getting massage and intense pain killer ignoring back pain. My dance mad DS2 looked up and counted me through some yoga exercises, and it was a modern day miracle. Good luck.

I don't really understand why you shouldn't ask for a referral.

Because a layperson (or indeed, a random person talking to you on the internet) is not going to know what kind of referral is necessary. Or would you ask for every possible kind of referral, and hope that the first one just happened to be one that could identify the problem, so you didn't waste hundreds of pounds on the rest?

Haven't posted in ages but gotta echo others.. Rang massive bell with me, was exactly the same, but developed very bad pain in hips and lower back/general pelvic area, like you, only after sleeping in bed, would wake in morning in so much pain, nothing would alleviate it apart from getting up and moving around, then I'd be fine all day. Longer I slept worse it was, no chance of a lie in. Initially Dr advised painkillers every 3hrs, useless, waited an age for physio referral, I even filmed myself one morning in height of despair to show Dr, as of course by the time I ever had an apt I was completely fine. It probably went on for about a year, started when my DS was about 2 so bit late to be post natal, despite the fact he was a 9lber like my Dd 3 yrs before him. Anyway finally got my physio around May, some core strengthening exercises on a sheet of paper(!), I was initially a bit dismissive, but he also said I was hypermobile in my hips, so interesting others have said that too.. Anyway, to cut a long story short, I persevered with the exercises, and then best thing ever, started the gym and weekly pilates classes.. Huge difference! Occasionally a twinge but nothing in comparison. I just relate to you so much as it was like torture being deprived of sleep, and then feeling almost insane as it disappeared once up, and I googled high and low and found absolutely nothing similar..! I resigned myself that this would just be forever.. I do hope you get it sorted, do the physio, try pilates, strengthen your core, mine was non existent along with my pelvic floor, and the hyper mobility in my hips just aggravated the situation. So good luck, I so sympathise!

I'm a GP. Second what mothertobe said.

And just for the record "just a GP", "GP's don't do much with backs" and "GP cannot identify gallbladder problems" (sic), are all quite offensive statements and make me wonder why I bothered doing 5 years at medical school, then another 6 years as a GP in training when everyone thinks we're some sort of idiots. Sigh.

Anyway, it's not about me.

Sorry you're in pain OP.

Op, I have just read your post, don't have time to read whole thread so I hope others have said this too but... it's gallstones! Your symptoms are 100% the same as what I had a year ago. Suffered for two months then had an emergency gallbladder removal, have felt amazing ever since!! It's gallstonesz GALLSTONES!!!!

This was one of the first signs I had of what became quite a horrible hormonal problem. Started early 40s post MC. The pain was right in middle of my mid back and would wake me at night. Made wearing a bra painful some days. The good news is that once I had a correct diagnosis, it was easy to sort with the right medication.

Whatever the cause, hope you get some relief soon.

I'm an NHS occupational therapist, and much of my work is in a specialist hospital with back pain patients.

Chiropractors and osteopaths are absolutely charlatans and snake oil salesmen. Do not go to either. Their 'effectiveness' is largely placebo because they do a very great deal more 'laying on of hands' than a physio does. Because of this, people think they're automatically doing more than a physio who is far more likely to look at you without necessarily making much physical contact and provide exercises and stretches which people don't like doing, but are proven over and over and over again through robust trials to be the most effective treatments for back pain. The line fed to someone upthread by an osteopath that 'physios just look at the joints and muscles but don't treat the root cause' is utter guff.

A referral to physio is absolutely the first and best course of action for any likely musculoskeletal (MSK) problem, so your GP has done exactly the right thing. The reason the GP didn't do 'a thorough examination' then come up with a diagnosis on the spot is because a physio is, by leaps and bounds, the best and most qualified professional to do this. The physio will not hesitate to refer back to the GP if it is clear the issue is not MSK and will also be the best person to advise either your GP or any consultant they may have the ear of, what further investigations may be appropriate.

I agree Pilates is brilliant and weight loss is also essential. And following your GP's spot-on plan, without demanding any additional and likely unnecessary tests which have been suggested here.

I haven't rtft but I'd try an osteopath. I used to suffer with back pain, for me it was sitting down that made it worse, but the osteopath sorted me out.

sorry Elphaba but you are wrong. Osteopaths are very good.

you know what Elphaba I have been literally crippled with back pain, for which my GP would merely offer the same painkillers that I would buy over the counter, and 2 visits to the osteopath has sorted out.
Please do not be so arrogant to suggest that this is a 'placebo effect'. Thank you.

and I am sorry but in my experience the vast majority of "physios" are medically unqualified housewives doing it out of their front room for pin money.

Look, people get help from whatever they get help from.
Properly conducted studies provide evidence that apply to larger numbers.
Which does not invalidate anybody's personal experience.

Physiotherapists are highly trained and know more about functional anatomy than I will ever know.

Just sayin'.
Peace and love

I've been told to go to an osteopath in the past by orthopaedic and spinal surgeons because they are better at treating my condition than physics. They even gave me the names of who to go to. There is an osteopath in my NHS pain clinic, too.

The physios I have seen have been crap, really really crap. Not one has done anything remotely helpful, and I've been treated all over the country. I've actually discharged myself from my current course of treatment because I know she's doing me more harm than good and the exercises she is giving me are not suitable.

DipsyLaLa22 &N mothertobe As I'm sure you may well realise that some GP's are excellent some however are not. I had raging headaches for many years, almost constant they were, he got me almost addicted to Ergotamine and i was taking over the recommended dose to try to stop these damn things. About the only thing that worked was to take a long walk sometimes in the middle of the night it or rather they disrupted most everything i did. I approached him time and time again to get me referred to anyone who could stop them. In the end he said there's no more i can do for you i suggest that you go elsewhere.

Which i did i saw my wife's GP about the first thing she did was to take my BP as there was no mention of it in my notes and yes! you've guessed it simple Hypertension she treated that right away and the headaches stopped, I just could not believe live it was possible that such a simple thing had been overlooked!. Years of bloody misery cured overnight!

Enough said about that but here we have the OP who it seems is starting to despair about any improvement, it is not clear if she did or has gone go back to her GP for further consultation and to escalate it up the chain.

After all isnt this the function of a GP to refer further if need be. Course we aren't certain that that need has come but often times it does seem to me and others I've known over time that you sometimes have to agitate a bit in order to move things along. Least that's what two consultant friend's of mine think too;!

As to your comments Elba can agree with that someone i know had very severe neck pain his doctor said that was nothing much he could do further he was about the see a chiropractor i advised him to see another GP and he did that GP referred him up the chain and then it was discovered he did have a serious problem that was cured with surgery and he's been fine since if the chiro did to his neck what one did to mine once it'd be amazed if he didn't end up in a wheelchair or worse.

And please don't think this is somehow GP bashing! I now have an excellent lady GP who at her surgery will give any of her patients the time they need to see her shes always running late i don't mind as I know that I'll get excellent treatment from her - bless her:-)

I know a Orthopedic Consultant who goes to the same osteopath as I used to go to. My Osteo worked there but then set up his own practice. I liked him so much I left too.

Only those who are unqualified are a problem. Osteopaths train for years and have a degree from The British Ostepathic Council and I imagine Chiropractors have similar. Mine also checked how I walked, asked questions about my job and helped me find ways to improve my posture in my job. My back has improved and so did my shoulder.
I went to the Physio at the surgery and it was the worst treatment I have ever had. She left me on traction and went out of the room for a minute only it wasn't as she got distracted and I was in agony and had no call button ...nothing. I spent the next week off work and in agony.

Another vote for something to strength your core muscles, physiology, sports physiology, Pilates. Worked for me with back pain about 12 months post natal. Good luck xx

in my experience the vast majority of "physios" are medically unqualified housewives doing it out of their front room for pin money.

Which tells me you have had no contact at all with a registered physiotherapist, who trains for a minimum of three years to at least undergraduate degree level and is required to maintain registration with the Health and Care Professions Council because it is a protected qualification, due to the stringent nature of the training and CPD requirements. If osteopathy works for you, for whatever reason, on an individual basis, that's great, but as health professionals we warn all of our patients off it, because the evidence base for chiro and osteopathy is crap, whereas for physio, it's robust. Forgive me for using evidence-based practice.

But what PacificDogwood said, basically.

Elphaba, you are wrong about osteopaths, sorry.
Chiropractors I would agree with you.
I am also talking about evidence based practice.