Sunday, October 16, 2011

Hip and Low Back Pain Flare Up

For the past month or so, I've been experiencing an increase in pain daily pain in my left hip and lower back up.  The pain started up before my last visit (late August) to the Fibromyalgia specialist I see regularly.  I remember indicating that the sacroiliitis in my left hip seemed to be acting up since the previous appointment with him, and may be contributing to other pains in my left side, up my back and down my leg and into my foot, depending on the day.  I'd also been having daily attacks of sciatic pain, which favors the back of my right thigh.  The doctor had asked me if I was interested in doing some tests to investigate these issues, and at the time, I quickly remembered how all my tests seem to come back negative no matter how crappy I feel.  (Such is the life of a fibromite.  Test results come back "normal" for almost everything that is checked.)  I thought about the liklihood that nothing would be found while I'd have to schedule and endure the tests, and decided not to bother.

Just about the next day or so after that appointment, I'd begun to regret my decision to forgo hip testing.  I had started to experience new, disturbing pain attacks in my lower back, near and above the left hip.  I would notice them while working diligently, usually late afternoons.  I was always sitting in my office chair in the office when these attacks wold come on and they could not be ignored.  These are the kind of sudden, intensely painful moments that can make you jump a bit or even shriek from the surprise.  The first one, I figured, was an odd moment that would pass after some time and allow me to continue living life in the new normal level of pain I've come to expect.  Fibromyalgia is highly unpredictable and I have come to expect strange, painful surprises as part of the diagnosis.  However, the attacks started forming a daily, troubling pattern.  After a few days of this same kind of agonizing attacks, I started to wonder if something new was breaking in my body.  I called my doctor's office and explained that I was hoping to take the doctor up on the offer for getting some testing done on my hip.  I expected a call back from the office the next day or so, after the message was relayed to my doctor, but I hadn't heard back in weeks.  I ended up calling back again when a few weeks had passed and the pain was still occurring, and evolving into a constant ache in between attacks.  I don't know what happened, but the doctor called me back himself after this call and discussed my pain and concerns with me, to try to determine what kind of test might be most effective.  We settled on a couple of MRI studies of my sacroiliac and hip, which I promptly scheduled with my local hospital.

After finally getting those MRIs done of my hips just last Wednesday, I have received the results, which (drum roll, please) came back "normal" (other than the presence of my uterine fibroid, which I already knew about).

The interesting thing now is that I'm confused about the diagnosis of sacroiliitis.  The doctor who ordered these last MRIs for me (at my request) is the same one who diagnosed sacroiliitis in my left hip.  He made the diagnosis based on my symptoms and physical examinations.  Now I don't know if these MRIs show that I don't have sacroiliitis, or that I never did.  I will be discussing these tests with my doctor in just a few days, during my next regular appointment.  Hopefully, he'll be able to help me understand what is really happening in my hips and give me some kind of advice on how to help alleviate it, or at least reduce it.

By coincidence, the muscle relaxant that I'd been taking twice a day (sometimes thrice a day) for a long time now, to help with my Myofascial Pain problems, had suddenly become back-ordered by the pharmaceutical manufacturer, for no specified reason and for an indefinite amount of time.  That alone was odd, but because of this issue, my refill was switched to a different brand of muscle relaxant to substitute.  I was not happy about that, as my body is sensitive to drug changes and who knows what side effects might result from this change?  I was apprehensive, but given the circumstances, accepted the change and have been taking the new brand since late September.  The pill design is quite awful, but I figured it would do just as good a job as my previous brand nonetheless.  I'd done some research about the effectiveness and came to the same conclusions my doctor probably did - they are very similar drugs and should work in essentially the same way.

The reason I mention all this in this same post is that I started to wonder if maybe the new muscle relaxant might be contributing to my new back pain problems.  Perhaps it's insufficient for my body's needs.  Perhaps my body is going through an adjustment period.  I've been very consistently hurting a lot more in the lower back area for the past few weeks now, not just the left side.  I have more trouble bending and straightening back up, and I have more difficulty trying to get comfortable in any position now. 

After looking at my notes, though, and discovering the timing of these events, I cannot conclusively determine any sort of relationship between this medication change (let's not forget I switched to Savella last July and that was quite the ordeal!) and the onset of this new, odd, back/hip pain stuff going on.  Although, now that I've thought about it, there is still the possibility that the Savella switch could have been some sort of trigger to this new problem.  I have been sleeping a lot better since the Savella settled in, so I assumed it was a change for the better from Pristiq.  However, SNRIs like these meds don't just affect one or two things in the body - they affect things even scientists don't yet understand.

I'm lost right now and full of questions.  This new back pain could have to do with a change in seasons, or just be part of the randomly nonsensical changes that happen with Fibromyalgia.  I don't know.  I don't know if my doctor will know.  I don't know if anyone knows.  All I know right now is that I'm in pain and I need to stop typing and get up for a bit.  I may need to strengthen some of my core muscles.  It's not easy to strengthen muscles with health conditions that can discourage exertion with pain and exhaustion that can stem from a molecular level, in the mitochondria.

I will do my best to remain active as I can and keep living life to the best of my ability, despite these ever-changing health challenges.