Because chronic pain can be such a complex and all-encompassing problem, we often recommend that patients be provided an interdisciplinary or multidisciplinary team of providers that can work together to optimize treatment and recovery. Evidence-based outcome studies also support this more comprehensive approach for better outcomes.
A pain specialist or physiatrist may be the best type of specialist to help put this together for you. Other specialists that they would want to work with to better serve you could include a pain psychologist, physical therapist, and occupational therapist, as well as the spine surgeon who did your past operations. By doing this, one primary doctor can help coordinate your care by providing you valuable help in dealing with all of the many different complex but interrelated aspects of your pain condition. For example, a patient at my center would have access to psychologists, physical therapists, exercise trainers, art therapists, life coaches, and yoga teachers that could become a part of the treatment team to provide the best and most comprehensive care possible. Sometimes a team approach works best as opposed to relying on just one doctor. View Thread
I think it is important that you follow up with your obstetrician and internist about your condition. Certainly, there is a lot of discomfort that can be experienced during a pregnancy, including back pain, but what you are describing may suggest a need for more testing.
For example, pregnant women are especially susceptible to an infection from listeria, which is a bacteria found in water and in soil that often occurs from eating contaminated foods. Listeria infections can cause flu-like symptoms, muscle aches, and a stiff neck, much like you have described, and it is treated with antibiotics. Listeriosis is diagnosed with a blood test. I suggest you follow up with your doctors right away to discuss testing for this and other possible infections.View Thread
If your shoulder is flared-up and painful and you aren't able to see a physician at the moment, then I think there are some basic measures that you could take to help calm things down. The ice treatment that you mentioned is probably a really good idea. Icing your shoulder multiple times during the day for a period of 1-2 weeks can hopefully calm down the inflammation and a lot of the discomfort. Supplementing that with over-the-counter anti-inflammatory medications for a few weeks also seems reasonable.
Simple shoulder stretches and avoiding over-head activity can help while you try to calm things down. At the same time, calming down the acute symptoms doesn't mean the underlying problem has been solved. In order to consider more specific treatments, you would probably either need more of a diagnostic work-up or at least a consultation with a doctor who has a lot experience with shoulder problems.
One basic shoulder stretch that I sometimes give my patients is to stand at a door way with the door opened away from you. Place your upper arms perpendicular to the floor and your elbows bent at 90 degrees so that your forearms rest comfortably on the doorway. Gently leaning forward can stretch the shoulder joint. Avoid leaning if it feels uncomfortable.View Thread
It is often difficult to know what truly causes a person's back pain, and I think it is frequently the byproduct of more than one factor. If your prior doctor recommended a further work-up of the trace blood found in your urine, then it would be important to try to follow through with that. While we don't know at this point if your symptoms are related to your kidney, I do think that in general when one part of the body is not functioning well, then this often impacts other parts of the body in some way.
I know living with pain can many times leave a person feeling like they are on an island with their problem. They often don't realize how many other folks out there may have a very similar problem, but chronic pain, including back pain affects the lives of millions Americans.View Thread
It sounds like you are really frustrated with this problem, but even though you don't have insurance, I thought I would try to come up with some basic tips to help. Many times, chronic low back pain is poorly understood and can often be related to a number of different factors including genetics, lifestyle, specific injuries, stress, smoking habits, and to some extent body weight, just to name a few. I thought I would pass on a few basic principals that could help:
Avoid prolonged sitting. If you work at a desk or drive a lot, stand up and move around frequently.
Walking has been shown to reduce back pain. Try to come up with a daily walking program for yourself.
Stress aggravates pain. You are a soon-to-be-dad with a lot on your plate. Learn techniques to help you manage stress. That may include breathing exercises, meditation, or exercise. Check to see if there is a Minfulness-Based Stress Reduction program in your area.
Look at your body mechanics. Is there somebody at your job who can help assess your workstation? Learn about proper spine alignment and the neutral spine position.
Gravitate toward a plant-based diet. The high levels of antioxidants in these foods lower inflammation in the body and because they are typically lower in calories than processed foods, they can help reduce extra body fat if that is an issue.
Try to come up with your own special program that will help take care of your back, by using some of these tips and other things that may help like stretching, as an example.
I am sorry that you have had such a difficult time with your neck problem, and you sound really frustrated. Unfortunately, medications often don't work well in treating complicated chronic pain symptoms like nerve pain. You mentioned that your quality of life is poor, and I thought it might be helpful to think about things that could be done to improve that aspect of your life.
Three major areas that can significantly be impacted by chronic pain include a person's mood, their ability to move and stay physically active, and their social connections start to drop due to the first two problems. Consider looking for help to work on these three areas as a way of improving quality factors. Some examples would include consulting with a pain psychologist, taking a mindfulness meditation course, going for daily walks, trying something gentle like tai chi, and finding a support group or club that has people that you can connect with. These actions may not cure the nerve pain, but they can help stop the pain from keeping you away from a more fulfilling life.View Thread
In my own practice, I work very closely with a number of physical therapists. Some of whom I actually work with directly at my center and others who are in my community that I refer patients to because I value what they can offer. I think the best way to view the patient-doctor-physical therapist relationship is one that should be synergistic and one of those things where the whole is greater than the sum of the parts. What that means is that both the physical therapist and the physician can gain from the perspective of the other to provide better care to the patient. Certainly, there are aspects of a patient's physical condition that a physical therapist can pick up on that a physician may not be in tune with and visa versa. What is important is that the two communicate and work together for the benefit of the patient.
One of the challenges that physical therapy training programs need to address is that they spend very little time teaching new physical therapists about chronic pain. There is a lot of emphasis given to acute injuries and sports injuries, but not nearly as much to working with the body that is struggling with chronic pain. As a result, not all physical therapists offer the same benefit, just like not all doctors are the same. Finding the right physical therapist who can best help you with your particular problem may be a challenge in some cases but worthwhile in the end.View Thread
In my own practice, the most common cause of pain symptoms that spread up from the hands to the arms and then to the neck are repetitive strain injuries usually seen when folks work long hours in a fixed position doing things like repetitive keyboarding. There may be a number of factors that contribute to repetitive strain problems like workstation ergonomics, repetitive use of certain nerves and muscles, too much sitting, and stress either at work or elsewhere. That situation may not fit your own life circumstances, but there may be some parallels in how to approach managing the pain.
In general, I like to recommend a whole person approach for complex chronic pain problems so consulting with some different folks who can give you feedback about how your body is moving and functioning as well as a look inside about how you are dealing with things like stress or emotional challenges can be helpful in coming up with management strategies. Some of this information could come from consulting with a physical therapist or occupational therapist and with a pain psychologist, as examples.
Some alternative approaches to painful conditions like fibromyalgia that seem positive include mind/body approaches like tai chi and gentle yoga. Vitamin D deficiency can increase muscular pain and gets worse in the winter time, so consider having your levels checked if that hasn't been looked at yet. Another supplement for fibromyalgia symptoms that is being looked at is coenzyme Q10. Here is a link to a blog that I recently wrote on that subject: http://painreliefrevolution.com/article/fibromyalgia/fibromyalgia-may-be-linked-other-diseases . If inflammation and allergies seem to be part of the problem, it may be helpful to consult with a nutritionist to talk about anti-inflammatory foods and foods that you maybe need to be avoided.
My heart goes out to you and your husband. You both need all of the support that you can get as you work through this challenging and complex situation. There may be at least two significant factors contributing to your husband's physical limitations. One factor may be neurological deficits related to all that his spine has been through over the years. But another factor limiting his function may be the pain itself. Your doctors may have a sense of how much nerve damage exists that they could discuss with you.
One way to work through a situation where pain severely limits a person's function is through a very comprehensive interdisciplinary rehabilitation program. This type of treatment can potentially be delivered in either an outpatient or inpatient setting depending on what is available and what would be best for your husband. For example, I help run an outpatient program where patients come in for several hours every day for six weeks. They get a lot of education and guided rehabilitation to learn how to function better and manage their pain more effectively. In some cases, patients dependent on things like walkers or canes and even wheelchairs are able to learn to walk without them once they learn to retrain muscles and better manage their pain.
I would suggest looking into seeing if your husband is a candidate for a very comprehensive program. Caregivers need lots of support, too, and I hope your doctors can also help connect with you support while trying to help your husband at the same time. Best of luck.View Thread
When a problem like this has persisted as long as it has and at this level of intensity, then often a nerve pain problem can be part of the equation, especially since the shoulder joint itself checked out OK. For example, if a stretch injury may have occurred to your left shoulder and neck region, then this could have potentially irritated a large group of nerves, also referred to as a plexus. You may want to talk to your doctors about the possibility of injuries to your cervical plexus (neck region) or brachial plexus (shoulder region) to see what they think.
The muscle tightness and spasming that you describe may respond to other treatments like botox injections, acupuncture, and special types of physical therapy. You can talk to your doctors about these options and see if they think it may help your situation. Part of overcoming this problem may require re-training the muscles in your body to break some abnormal movement patterns that have developed.View Thread