OpenHealth Q&A

How to Address the Root Cause of Chronic Back Pain with a Specialist

I’m a 27-year-old woman from Texas and have been struggling with persistent lower back pain for nearly 13 years. It all began with mild discomfort during my menstrual cycles, first emerging with my initial period. Over time, the pain intensified alongside the severity of my cycles. During my early teenage years, around 14 or 15, I experienced an exceptionally painful menstrual episode. After taking Midol and using a heating pad before heading to school, I felt an unexpected and acute pain that rendered my legs immobile, overwhelmed by intense agony. You'd expect my parents to seek medical help, but instead, I was given a hefty dose of hydrocodone and ibuprofen, piled on top of the Midol I had already taken. This combination eventually subdued the pain sufficiently for me to regain mobility, though it did little to alleviate my ongoing back issues. As the years rolled by, my back problems escalated to a daily struggle. I became reliant on heating pads, back pops, and over-the-counter pain relief, but eventually, I developed a tolerance so high that even extreme pressure felt like a gentle massage. The heating pad, even at its highest setting, barely registered more than warmth for me. I’ve tried various methods like massage guns, but they no longer provide ease. In seeking medical advice, I frequently encountered dismissive responses, often being told that I was too young for back issues, or worse, that nothing was amiss. This narrative permeated my experiences with pain. I find it increasingly difficult to remain on my feet for long, as any prolonged standing leads to excruciating pain. Stretching and exercise fail to yield relief, and after a demanding work shift, my back is left in a state of distress, especially combined with foot pain. To cope, I have unfortunately adopted poor posture, as slouching seems to offer some temporary solace while sitting. This year, after an episode where my back locked up painfully while washing dishes, I returned to my primary care physician. Concerned, he prescribed me gabapentin and orphenadrine. After enduring 30 hours without sleep due to the pain, my situation became unbearable. Initially, the medication didn't alleviate my back pain significantly, but over the following days, the intensity reduced from a level 5 to around a 2. However, that relief was fleeting; after a couple of hours of regular activity, I found myself back at a level 7 pain. The added supplements, like glucosamine HCI and BC powder for arthritis, failed to provide any substantial effect, making everyday tasks a harrowing experience. Even moderate exertion leads to debilitating pain and sometimes vomiting. This has gone on for far too long. Imaging tests like X-rays have yielded no answers, and blood work revealed nothing unusual. An MRI conducted for a different issue also didn't clarify the source of my back discomfort. The frustration of being told that nothing is wrong is overwhelming. Given the advances in medical technology, one would hope for answers. I am not seeking drugs or dark diagnoses but merely want to uncover the underlying cause of my distress. How can I approach a specialist to ensure they delve deeper into my condition? What key points should I communicate to elicit a thorough investigation into my ongoing back pain?

Answers (1)

3/20/2025, 6:20:51 AM

OpenHealth AI

It’s clear that you’ve been through a frustrating and painful journey with your chronic back pain, especially given the history related to your menstrual cycles and the lack of effective treatment. Your desire to uncover the underlying cause of this pain and find a more effective solution is completely valid. Here’s how to approach a specialist and ensure a thorough investigation into your condition.

Main Points:

1. Prepare for Your Specialist Appointment: Gather your medical history and document your symptoms.
2. Communicate Clearly: Share detailed information about your pain and its impact on your life.
3. Ask Specific Questions: Engage the specialist with targeted inquiries about potential causes and treatments.

Explanation:

1. Gather Your Medical History: Collect all relevant medical records, including past imaging tests, blood work, and any treatments that you have tried. Consider creating a timeline of your symptoms, when they occur, their severity, and any positions or activities that worsen or relieve your pain. This documentation can help the specialist understand your history and the evolution of your pain.

2. Communicate Symptom Details: When you meet with the specialist, clearly outline the following:

   • The nature of your pain (sharp, dull, constant, intermittent).
   • The onset and what has occurred since (any specific injuries, activities, or changes in your life).
   • How the pain affects your daily activities, work, and mental health.
   • Any associated symptoms (like foot pain, vomiting during pain episodes) and how medications you’ve tried have helped or not helped.

3. Ask Targeted Questions:

   • What could be causing my chronic back pain considering the imaging tests showed no abnormalities?
   • Is there a possibility of underlying conditions like endometriosis or muscular conditions that may not show on an MRI?
   • What treatment options, aside from medications, do you suggest for long-term pain management?
   • Should I consider physical therapy, or are there specific exercises that must be avoided given my situation?
   • Are there any specialized diagnostic tests or procedures that could provide further insight into my pain?

Next Steps:

• Request a Referral to a Pain Specialist: If you haven’t already, ask your primary care physician for a referral to a pain management specialist or a pain psychologist who can address both physical and psychological aspects of chronic pain.
• Consider Physical Therapy: A specialized physical therapist can work with you to develop a personalized plan aimed at strengthening back muscles and improving posture.
• Explore Possible Conditions: Consider asking about conditions that might be less obvious but still affect back pain, like pelvic floor dysfunction or sports injuries.
• Document Everything: Keep a diary of your pain levels and the effectiveness of any new treatments you try, including lifestyle changes, to discuss at future appointments.

Your concerns are important, and being organized and proactive during your visit can increase the chances of finding a solution that works for you. Remember that persistence is key in advocating for your health, and seeking a deeper understanding of your pain is a crucial step toward relief.