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?

I’ve been on opiates for many years for endometriosis plus obviously now the stronger anti inflammatories - the fact it’s still so bad should despite all this should tell them how bad it is. One of my shoulders is stuck up near my ear and I just can’t relax it. Yet i still feel like I’m going to go in and get told off! It’s ridiculous - I’m an assertive person but after years of being fobbed off by doctors I am just unable to express myself properly in front of doctors. I get so anxious about seeing them. I shouldn’t feel like this when I’m in pain and just need help. No one can come with me sadly so I’m on my own.

Sorry, that sounded churlish Redannie! Really pleased it helped you. Different conditions though. As I understand it, sciatica is nerve generated so I see how manipulation could help that.

So sorry Saz: are any of your appointments hospital based? If so, PALS will be able to provide an advocate.

Queen that’s exactly what the physio I saw said. And I do the exercises but not much improvement, and then rarely something like this happens where my back messes up totally. I’m not even sure it’s related but I expect it is as it’s the same area.

Don’t take 2 types of anti-inflammatories at the same time (ie do NOT take naproxen as well as diclofenac. Do NOT take ibuprofen as well as naproxen/diclofenac).
If you have no liver issues and you are not very low body weight and are ok with paracetamol, then you can take this as well as the anti inflammatory. Do NOT take paracetamol at the same time as co-codamol (the latter contains paracetamol). Always follow the instructions at the back of the packet and do not exceed minimum dose.

I guess it’s sensible to take the painkillers regularly at the intervals stated at the back of the packet (even if the pain is lessened at the current moment). This is because it will take time for the drug to be absorbed into the system, so if you delay, the pain may return in the meantime. It is helpful if you mention to the doctor that you have followed this regular painkiller regimen and it still doesn’t work. This means they may have to suggest something else.

Note - anti-inflammatories are not suitable for everyone. People who are older, have heartburn/gastric ulcer or kidney problems should speak to dr first.

Sorry - should have said: do not exceed maximum dose of painkillers (on the back of packet).

Don’t worry - I know not to take two of the same type at once. I’m unfortunately well versed in these things! Sadly I’m out of diclofenac suppositories because they worked much better than the naproxen. I’ve only been prescribed those after operations though, they’re probably expensive!

I agree with you, it’s rubbish OP.

When I put my neck out once in a blue moon l literally cannot turn my head without excruciating pain and spasms so I go to my regular private GP and am prescribed a box of 50 x 5mg diazepam. I have never been prescribed or offered an anti inflammatory but I am yet to become addicted benzodiazepines.
I don’t live in the UK but we do have free doctors, I choose to pay the additional money (approx £17) and see a private GP. My dad who also lives here does see the free GP and he is given a bottle of 10 x 2mg diazepam for virtually the same problem.
It feels like you are treated like scum for accessing public healthcare sometimes.

If it’s muscle spasm diazepam will help and will enable you to stretch it out etc to heal. There’s no risk of addiction after a week of a low dose. For many people there’s no addiction to opiates either. Sadly most GPs have little understanding of pain management.

Best course of action - GP appointment for diazepam and a referral for an MRI, if the latter is refused ask for a referral to the pain clinic or go private. In the meantime try relaxation such as mindfulness meditation (find body scans on YouTube), light stretching and heat. Longer term you’ve probably lost muscle strength in response to the pain. This can make it worse long term so build back the muscle with weight training and general exercise.

Aside from surgery (lower back disc) I found exercise to be the most effective thing to manage the pain and prevent flare ups. I’m now back to work full time and only need pain relief at night. I wouldn’t particularly recommend physio or osteopathy, nor massage unless you just enjoy it which I do on occasion.

Namenic - patronising much?

Sorry. some people aren’t aware of pain guidelines and you see some bad stuff like kidney failure, liver injury due to unintentional overdoses.

Don’t worry I wasn’t offended - I know it’s not always obvious enough especially when you’re in pain.

Well the doctor took one look at me and said “your muscles have gone into spasm - you had a little bit of diazepam last time so let’s give you that again” 🤦‍♀️

Would have been handy if they’d trusted me to reach that conclusion two days ago but never mind - hopefully I’m in for a more mobile weekend!

Glad the doctor helped. Does the doctor have a follow up plan or just to see if the diazepam helps?

She’s referred me back to physio, appointment is in about 6 weeks - hopefully they can refer me on if they think it’s more than a muscular issue

I really empathise OP, Ive had similar back problems but I have to point out that chiropractic and osteopathy are pseudo sciences which can drain your money at best and be sometimes dangerous. The practitioners are not medically qualified. It's been likened to 'Emporers New Clothes' placebo effect. They make a LOT of money out of getting people to go back week after week.
www.theguardian.com/lifeandstyle/2015/oct/18/osteopaths-chiropractors-back-pain-whose-spine-is-it-anyway

Hopefully you get a good physio like I did who was able to figure out the issue quickly, and if they can't then a swift referral.

I hope so too. The woman I saw about my foot was miraculous - I went in limping and came out walking. She identified a load of scar tissue which she worked to break down - hurt like a bitch but it really worked. Hasn’t been perfect since but nothing like it was. I’ve also found the drug is miraculous for my awful period pain. Maybe something similar could help

@Jillyhilly Thanks for recommending Dr Sarno's book. I absolutely do sounds like this personality, and I know my back pain issues were originally triggered around an anxious time. My DH is a psychologist, and a while ago mentioned to me whether the pain was psychosomatic but I dismissed him at the time.

I've tried lots of different routes over the past 18 months and feel quite desperate, so I'm going to see how I get on with the book.

@ritzbiscuits

I’m glad you’re going to try it.

Desperation is what leads most people to Sarno. You exhaust every other possibility until there is nowhere else to turn. I saw myself in every page of that book and his method is what led to a largely pain-free existence. Good luck!

Thanks, I’ll report back!