OpenHealth Q&A

Experiencing Significant Nausea with a Pulled Psoas Muscle?

Age: 37, Height: 5'2", Weight: 177 lbs. Not pregnant. Currently prescribed bupropion, lamotrigine, trazodone, prazosin, and a multivitamin, with these medications taken consistently for over a year. I manage reactive hypoglycemia through diet, without issues of constipation or unusual discharge. On Monday, I woke up with intense abdominal pain that localized to my lower right side, approximately 2 inches inward from my hip. Both Tylenol and ibuprofen provided no relief; the heat from heating pads on high was the only remedy that offered comfort. Additionally, I experienced nausea severe enough to trigger dry heaving at the thought of food. I managed to eat once daily, typically in the evening, consuming very little. After eating, I felt fine unless I overindulged. Pain levels were around 7 to 8, with sharper spikes reaching a 9. Coincidentally, my menstrual cycle began that day, and given my history of debilitating periods accompanied by heavy bleeding, I immediately considered a gynecological issue as the root cause. An ultrasound was performed, revealing no abnormalities. Despite the continued pain on Tuesday, I visited the emergency room, where tests including lab work, urine analysis, and a CT scan returned normal results. I was sent home with prescriptions for zofran and toradol; the latter helped lessen the sharp pains during movement, but overall, the relief was minimal. Unfortunately, the zofran was ineffective, even when taken three times a day in advance of meals. My pain level settled around 6 to 7 on Tuesday. Interestingly, my menstrual cycle was exceptionally light with minimal cramping. On Thursday, I returned to my OBGYN's nurse practitioner, who conducted tests for bacterial vaginosis and yeast infection, both of which were normal, and performed an examination that also yielded no signs of concern. The OBGYN suggested I consult my primary care physician and possibly seek a referral to a gastroenterologist. By that time, my pain seemed better at a 5 to 6, though I wondered if I had simply grown accustomed to it. On Friday, my primary care doctor strongly believed it was endometriosis and prescribed tramadol for pain relief, prochlorperazine for nausea, and meloxicam to address inflammation. It’s important to note that I have a low tolerance for narcotics, and my experience with tramadol six years ago resulted in significant nausea, prompting me to stop using it. My pain hovered around a 5 to 6. Fortunately, my PCP referred me back to an OBGYN, who managed to squeeze me in for a visit the same day due to a cancellation. Upon examination of my abdomen, the OBGYN determined that I have a pulled psoas muscle, as indicated by tenderness throughout that region; however, her examination re-triggered pain to levels reminiscent of Monday. I was prescribed flexeril and referred to physical therapy. The nausea persists, restricting me to just one small meal in the evening. I typically consume a lot of water, but now I must limit my intake to small sips to prevent dry heaving. The current speculation regarding my persistent nausea is, "Maybe it's due to the pain you’re experiencing?" While that seems plausible, I usually have a decent pain threshold and can cope with discomfort, having endured much greater pain with minimal nausea before. Regrettably, my pharmacy is taking an unusually long time to fill my new prescriptions, leaving me uncertain about their potential effectiveness. While everyone appears to be doing their best, I find myself on a lovely Saturday, still reliant on a heating pad on my right side and struggling to eat. Any insights or suggestions would be appreciated. At least my clothes are fitting a bit looser, which is a small consolation.

Answers (1)

7/12/2025, 3:01:54 PM

OpenHealth AI

It sounds like you're going through a very challenging time with your abdominal pain and persistent nausea, exacerbated by what appears to be a pulled psoas muscle. Your experiences and the interactions with various healthcare providers indicate that you're already taking important steps to understand and manage your situation.

Main Points:

1. Your abdominal pain likely stems from a pulled psoas muscle, and the accompanying nausea may be related to this pain.
2. It’s essential to continue with conservative management and self-care while waiting for your prescriptions and further treatment options.

Explanation:

The psoas muscle is a deep muscle that can strain due to physical activity, poor posture, or even stress. When strained, it can cause localized pain, which might also trigger nausea due to the overall discomfort and pain response in your body. While you have consulted multiple healthcare professionals and undergone various tests, it’s crucial to manage both your pain and nausea effectively while allowing your body time to heal.

Next Steps:

1. Pain Management:

   • Continue using heat therapy, as you’ve found that helpful. Apply heat for 15-20 minutes at a time.
   • If you haven't received your new prescriptions yet, consider self-positioning helpful for a pulled muscle, like gentle stretching or modifying daily activities to avoid strain on your abdomen.

2. Nausea Management:

   • Since you are struggling with nausea, focus on very small, bland meals like crackers, rice, or bananas. Avoid rich, spicy, or heavy foods until you feel more stable.
   • Drink water in small sips to stay hydrated but avoid large volumes at once, as they might trigger nausea. Consider ginger tea or ginger candies, which can help soothe nausea.

3. Physical Activity:

   • Once you have your prescriptions and adjust to your pain management plan, consider gentle physical therapy exercises tailored for a pulled psoas muscle, if suggested by your provider. Movement can help alleviate tension but should be guided by your therapist.

4. Reassess Your Pain and Nausea:

   • Keep track of your pain levels and nausea over the next few days. If the nausea worsens or limits your ability to keep any food down, consider reaching out to your healthcare provider again for a reevaluation.

Conclusion:

Your healthcare team is supporting you, and it’s important to maintain clear communication with them about your symptoms as they evolve. Continue to focus on comfort, gentle management of your symptoms, and make sure to address any new concerns as necessary. Your experience is valid, and you're taking thoughtful steps to address your health. Please feel free to reach out again with updates or further questions.