To not understand why back pain is so dismissed?

[Saz432]

I posted a few days ago about a recurring issue with my back and worries about being fobbed off by a doctor - my fears were of course completely right. I had a strong suspicion it was going to happen so put it off until this morning hoping it would improve.

I damaged my back a few years ago when I was exclusively pumping. I have had constant upper back pain ever since. I also have a large patch on my back that has altered sensation. This is all in my notes. I’ve had two courses of physio. I’m now just accepting it’s always going to hurt because nothing makes much difference.

In December I seriously messed up my back lifting my son out of his cot. I spent five days in awful pain and barely able to move before seeing a doctor - they gave me a very low dose of diazepam for a few days. They said I could take up to four at a time - I built up to that I was worried about being drowsy but I wasn’t even slightly drowsy even on the maximum dose. It did help me get mobile again so I was very pleased. Haven’t seen a doctor about my back since as I was back to having just the normal level of daily pain.

On Sunday I did it again, putting my son in his cot. I’ve been in so much pain ever since and I am seized up. I can barely lift my children. I can’t sleep because of the pain.

I managed to get a phone consultation with a GP and explained what had happened and that what I was given last year really helped. She said she would prescribe me some naproxen - I didn’t realise until after I got off the phone that this is another anti-inflammatory. I’ve been using diclofenac suppositories that I have left over from a surgery I had and they’ve helped the pain a little but made no difference to my mobility so I know this isn’t going to help much, if at all. Is a few days worth of very low dose muscle relaxants really so bad that they won’t prescribe it 8 months after they were last needed? I’d understand if I were asking every month.

I’ve been a patient at this practice for over 3 years (and actually this doctor I spoke to was my GP throughout my childhood until I went to university) so they know I’m not some random drug seeker.

I am reasonably certain that if the doctor themselves were in this much pain, unable to sleep or work / look after their children, they’d take whatever worked.

It seems like back pain really isn’t taken seriously at all. I don’t bother seeing the doctor when it’s worse than normal because what’s the point? This is different though, I can’t bloody move!

What do I do now? Assuming the medication makes little difference (I’ll be delighted if it does), do I just have to tough it out and hope it improves on its own? I don’t want to be taking strong medications but I need to be able to lift my children and sleep!

When there’s something available that will actually work and they only need to give a few days worth, why won’t they do it?

Also where I am an osteopath appt is cheaper than a gp visit.

Valium is highly addictive and there are studies showing that it is no more effective than a placebo when combined with naproxen for back pain.

www.ncbi.nlm.nih.gov/m/pubmed/28187918/

I'm sorry you're suffering but back pain is very hard to treat. Doctors are IMO right to be very wary of handing out opioids, especially when they are unlikely to be effective.

Also I got a lot of the expected back pain from breastfeeding etc, this was all dealt with by my osteopath, deep tissue massage and then yoga and proper support cushions etc at home. I never would've considered gp for it as I know they'll just fob me off with pain meds whereas the osteopath and massage will actually loosen and fix it.

I am so sorry you are having this experience. If you aren't getting any help through the NHS, I wonder if you could get help through a different route, that is, by CBD oil or oral CBD or some other form of marijuana. I don't know how legal it is in the UK.

I have had back problems since a car accident in my early 20s
No one took me seriously until I had an MRI scan in my late 40s for something unconnected and it showed up such serious damage they were surprised I was still walking
I ended up with various ops, steroid injections, treatment to destroy nerve endings, physio etc
I still have problems intermittently but at least don’t get fobbed off with low strength painkillers and anti depressants any more
I feel your pain - hope things improve soon for you

Well here it’s expensive to see one, and those I know with back pain have very mixed reviews of seeing osteopaths and chiropractors, so I’m sorry I’ve seen a doctor instead.

Cohle That study is about low back pain. I have upper back pain. My shoulders have seized up, I can’t turn my head. I’m getting pins and needles up my neck and into my chin.

It’s a muscle relaxant, specifically used for this sort of injury. And it’s not an opioid - I know opioids won’t help because I have them, I take them for my gynae issue and they don’t make the slightest difference to the mobility issue because my muscles are in spasm.

And I know it’s likely to be effective because it has been the one time I’ve taken it before.

I’m not asking them to treat or fix it, and if I were asking for a constant supply then that would be another matter - you honestly believe that a strip of 2mg tablets, enough to last a couple of days, is an insurmountable risk?

The GP who prescribed it to me the first time clearly did not, and the fact that I haven’t asked for any in the 8 months since despite constant back pain proved him right. I don’t want it because I’m in pain, I’m in pain all the time. I want it because I’ve injured myself and from previous experience it’s the only thing that worked, and call me demanding but I want to be able to move, to care for my kids and to sleep.

I'd contact the GP again requesting an appointment and stating this:

My shoulders have seized up, I can’t turn my head. I’m getting pins and needles up my neck and into my chin.

I'd also request an MRI and referral to a pain clinic. Don't be brushed off.

Poor you. You do really need to get a referral for an MRI. I was seeing a private chiropractor when my back first "went" and he was adamant I had a slipped disc. He wrote to my GP and I had an MRI 4 weeks later, and yes it is a slipped disc.

I think it's hard for you to treat your back, without knowing what's wrong with it.

Loss / change of sensation shouldn't be ignored. Ask your doctor for an MRI.

Yes I know it's not an opioid, my point is that combining opioids with benzodiazepines can be dangerous. Although presumably you know that if you are already taking opioid painkillers?

The fact that it was effective for you before doesn't prove anything unfortunately - that's why studies are controlled for the placebo effect.

I’m on Zappain, Morphine MST, Gabapentin, Amitriptline, and oramoph for my back. This is over 8 years now. But even they don’t take away all the pain. I feel for you.

I agree it’s very low risk to take a low dose diazepam for a few days.

Long term back pain here. Heat helps enormously with muscle spasm. Heat pads are great (try John Lewis website), hot water bottles and stick on patches (Wilkes are fine).

Do take the other meds as they will help a bit. Google Constructive Rest and try to do it twice a day, if you do it well it’s fantastic for releasing tension from your spine and body. Breathe well. Tension an top of spasm is the worst.

Sounds obvious but try to find any ways you can to not pick up your DC. Find alternatives wherever possible. I agree with PP about finding an exercise specialist. I see a rehab therapist who does massage followed by spinal exercises and I always come out feeling better. Chances are the sensation changes are nerves being pinched by spasm in the muscles.

And go back to the GP and ask really directly for a short course of diazepam. If it continues ask for an mri though our GPS can no longer prescribe them.

When it improves start a rehab Pilates class and keep to all of the above. It’s most likely a condition you will have to manage long term.

I was lucky and mine was an emergency so I was operated on and I was already drinking morphine as it was SO painful

My relative wasn't as lucky and died age 33, probably from too many accidental painkillers trying to get relief whilst waiting for an MRI

The majority of back pain is due to postural issues - over tight muscles, underused or not working muscles, poor posture etc. It's largely because of the sedentary lifestyles we have, lots of sitting etc. This isn't everyone, just a lot of people.

OP can you look at an appointment with a soft tissue therapist, ideally level 5. It's massage and releasing techniques for the muscles, they can also refer you if there's things not in their remit, so to an osteopath or if they think you really need a doctor. Physio is great for building the strength of a muscle, but if the body isn't working as it should, asking it to do more in the form of physio exercises isn't going to help and will generally make the person feel worse

That’s awful YesQueen - absolutely awful. I’m so sorry.

I’m on oramorph and zomorph for my gynae issues. Yes, I discussed the risk with the GP who did prescribe them for me - he pointed out that at such a low dose it wasn’t a concern, but that’s why he gave me 2mg and told me me to build up to a maximum of 8mg as needed, just in case it made me drowsy. It didn’t, and I took it exactly as directed. It helped me get moving again, which is what I needed.

I don’t believe it was a placebo effect, but frankly I don’t care if it was - ah least it was something, and that something helped. Just because it’s been shown to be no more effective than a placebo for a completely different back problem doesn’t mean it wasn’t effective for me.

I’m taking the naproxen alongside my existing meds, it makes the pain more bearable but it’s not helping with the muscles being so tense or the altered sensation. I’m pretty sure the pins and needles is down to the weird position I’m stuck in.

I will see how it goes today and call again tomorrow if it’s no better. I’ll ask about the pins and needles and an MRI too but not holding my breath. I’ve enquired at the local private hospital to find out what a scan would cost (it seems to be the only option round here).

I’m trying not to do any unnecessary lifting but sadly that’s tricky with two toddlers - you don’t realise how much you have to lift them until you have a problem like this!

Neron that’s what I paid for privately, it was at a physio clinic but it was soft tissue manipulation / massage as that’s what they said was most likely to help. Didn’t help much but I was still pumping at the time so maybe I should try it again. Money is very limited so need to figure out what to try first.

Please check out the Gokhale Method. There are youtube videos by Esther Gokhale which give you the gist, and the book 8 Steps to a Pain-Free Back. Seriously, it's made a huge difference to me and my back pain.

Valium is highly addictive and there are studies showing that it is no more effective than a placebo when combined with naproxen for back pain.

Addictive - yes, to be prescribed and used with caution and only per specific need. Placebo? Absolutely not. It's massively effective in providing relief for a locked, stiff and painful back. Hugely relieving. Not appropriate for all types of back pain or situation though. It provides rapid and overwhelming relief for particular back situations.

Lose the weight up. You say yourself you are too heavy. And then join a gym. Do plates or body balance. Built your back strength up. Instead of just treating symptoms you should treat the cause..

If you can find the money, I'd go private.

I was struck down twice with sciatic pain so bad that my husband had to all but carry me to the surgery. I was twice dismissed with codeine, iirc. I stopped going after that. I ended up with permanent nerve damage in my leg, causing a dropped foot, which I now regularly fall over because of. I also was later diagnosed with arthritis in my spine and 3 prolapsed discs. I believe the trauma of all this I was the trigger for Fibromyalgia, too.

I'm pretty much bedbound now and quite bitter about my experiences. I wish I could have done things differently. If you can get a private MRI & interpretation, please do. It could make a huge difference to your future.

You can buy Valium off the internet just google.
I keep a couple spare for this exact reason.

Also, if you're in spasm you can go to A&E for an injection.

Men do it all the time, it's only us women who are expected to tolerate this substandard crap.

I say this as an NHS worker and devotee however, the world of medicine is highly misogynistic.

My local Chiroprator has an X-ray machine in it's premises. Get yourself a course of treatment and an X-ray if you can afford it.

Well here it’s expensive to see one, and those I know with back pain have very mixed reviews of seeing osteopaths and chiropractors, so I’m sorry I’ve seen a doctor instead.

Where are you in the UK op? Just asking as maybe someone could recommend someone good.

Can you ask for an MRI? You need to go back if this keeps on- you shouldn’t have to put up with pain and not knowing why you have it. It’s one thing having pain and all investigations done and finding out a) you need surgery or finding out there’s no obvious cause but even then if the pain continues then you need a plan. If you have a disc prolapse and it goes on for more than three months then it won’t fix itself and you may need surgery- discectomy. Sometimes disc prolapses fix themselves within 3 months.

I should add my physio stopped treatment and sent me for an MRI, she's in Lancashire and is excellent

Withholding benzodiazepines (A very effective, but also very addictive, drug group) is a current NHS obsession, so you won't easily be prescribed diazepam on the NHS. Worth seeing someone privately to get them if you can afford it.