Chronic Back Pain Concerns
Greetings everyone, I’m a 31-year-old individual assigned female at birth with a complex medical background. Although I struggle with memory issues and my medical documentation is scattered across different doctors and states, I have attempted to compile the essential details of my health experiences below. Currently, I am grappling with several symptoms, yet one persistent concern has been my back pain. It has been a constant in my life for longer than I can recall, particularly affecting my upper, mid, and lower back daily. The last time I consulted a medical professional for this issue was approximately between the ages of 16 and 18. While that treatment did not resolve the problem, it offered some occasional relief. My initial experience with back pain likely started during my childhood or early adolescence. Lately, my discomfort has been concentrated more in the mid-back area, specifically behind my ribs on either side, accompanied by some lower back soreness. The sensation I experience is mainly akin to muscle aching rather than sharp or shooting pains. I find that stretching significantly alleviates my discomfort and I have been focusing on core strengthening exercises, as I understand they are crucial to managing my pain. Additionally, I occasionally experience relief when my back cracks, although I do not intentionally seek this out, aside from gentle stretches aimed at easing discomfort. I have a straightforward yet significant inquiry: **Which type of healthcare professional should I consider seeing without needing referrals? What initial diagnostic evaluations would be advisable?** I appreciate any insights you can share; I have an analytical mindset and prefer to gather comprehensive information to make informed decisions regarding my health. **Background Information:** - I was diagnosed with spondylolysis during my teenage years. The exact cause wasn’t identified, but it was suggested that tennis might be a contributing factor. I am doubtful of this explanation since my participation in the sport was limited to a couple of years on the junior varsity team and one summer camp. The last x-ray I had indicated that the condition had not healed, though that was shortly after my diagnosis a year or two prior. - I underwent physical therapy and occasionally utilized muscle relaxants for a time, both of which provided some amount of relief, though not consistently. I must admit that I wasn't always diligent with the physical therapy. Besides that, I have also explored chiropractic care, acupuncture, and massage therapy. Since high school, I have not sought significant treatment for my back pain, except for a few instances of acute spasms requiring muscle relaxants; I haven’t received prescriptions for these in the last few years, especially since I’ve discovered that staying home or resting tends to alleviate my symptoms. - I have had a breast size of at least DD since age 14, which I am aware contributes to my back problems. Additionally, I have consistently been classified as overweight based on BMI—hovering around 26 since puberty. During college, my weight gradually increased, leading to a classification of obesity. However, at 23, I improved my fitness level, returning to a BMI of about 26. At age 25, I suddenly gained weight due to a health condition, once again placing me in the obese category. I managed to maintain that status (with my highest BMI at 31 and a breast size of 38DDD or E) until January 2025, when a new medication prompted a weight loss of around 45 lbs within a short span of 8-10 weeks. Currently, my BMI is approximately 28 with a bra size of around 36DD. While I continue to have weight-related health concerns, they are being addressed separately, and I must express my disdain for the BMI system but find it useful for tracking my physical changes. - Additional aspects that may be important: - I have ADHD, which I mention due to its potential link to connective tissue disorders and/or hypermobility. My ADHD is primarily inattentive, but after establishing a fitting treatment plan, I have been able to incorporate regular physical activity into my routine. I received this diagnosis about a year ago after experimenting with various anxiety medications. - My medications include a stimulant for ADHD, an NDRI, trazodone for sleep, and I have recently tapered off an SNRI. Additionally, I take medication for acid reflux and manage nausea as needed, which has been an ongoing issue for me. - Prior to my spondylolysis diagnosis, I experienced severe abdominal pain triggered by a common illness, diagnosed simply as abdominal pain related to microglial activation. Ultimately, I underwent a procedure in which an injection resembling cortisol was administered into my abdomen, successfully resolving the issue. I believe that my back pain began before this abdominal pain, although I'm not entirely certain. Thank you for your time!
Answers (1)
3/30/2025, 7:01:06 PM
OpenHealth AI
It's great that you're reaching out to find clarity regarding your chronic back pain. Given your background and experience, it's important to take a careful yet proactive approach to your health.
Main Points:
- Consider seeing a specialist in musculoskeletal health such as a physical medicine and rehabilitation (PM&R) physician or an orthopedic doctor who focuses on spine issues.
- Initial diagnostic evaluations may include imaging studies like an X-ray or MRI, along with a thorough physical examination to assess your current condition.
Explanation:
Chronic back pain can stem from various issues, especially considering your history of spondylolysis, which is a condition affecting the lower back. Your description of primarily muscle-like aching suggests muscle tension or fatigue could be contributors, along with possible structural factors due to your past diagnosis and weight considerations.
Visiting a specialist can help you have a targeted approach toward managing your pain effectively. They can review your medical history, explore your pain's specifics, and potentially provide a unified treatment plan.
Prioritized Next Steps:
-
Choose the Right Specialist:
- Look for a PM&R physician (also known as a physiatrist), who specializes in rehabilitation and addressing musculoskeletal issues. Orthopedic surgeons focusing on spinal health can also be helpful.
- Both specialists can often be seen without a referral, depending on your location.
-
Schedule an Appointment:
- Prepare a list of your current symptoms, medical history, and treatments you’ve tried, emphasizing how your back pain has evolved over time.
-
Undergo Initial Evaluations:
- Request imaging tests (like an X-ray or MRI) to evaluate your spine and any structural issues that may be contributing to your pain.
- A physical assessment will help determine muscle strength, flexibility, and posture.
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Continue Managing Symptoms at Home:
- Keep focusing on your core strengthening exercises and gentle stretching. Adding low-impact activities (like swimming or walking) can also benefit muscle support and overall well-being.
- Maintain a pain diary, noting which activities increase or decrease your discomfort, which will be useful for your healthcare provider.
Acknowledging your complex medical background, your thorough self-advocacy is commendable. This journey may take time, but with the right specialist and a proper plan, you're on the path to a better understanding and management of your back pain. If you have further questions or need additional support, feel free to reach out!
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