Friday, September 19, 2014

Sunday, July 12, 2009 sally, Community Member, asks

Q: vacuous feeling, physical therapy, pain moving around

My pain is changing. It now feels vacuous. is it nerve pain that is vacuous? Why does pain change, is it a good sign? The pain was worse on my left side now my left side is more stable and my right side is worse. I have found a good physical therapist and finally have the right exercises to do. How does the right physical therapy affect long term chronic pain?--A.

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Answers (3)
Karen Lee Richards, Health Guide
7/13/09 6:17pm

I've never heard pain described as vacuous, so I'm not sure exactly what you mean by that.  As for why pain changes, that would depend on what is causing the pain and how it changes.  For example, it is typical for fibromyalgia pain to move around and occur in different parts of the body at different times.  In that case, the change is neither good nor bad – it's just part of the illness.  

 

Again, depending on the cause of the pain, physical therapy can possibly be very helpful. For instance, if the pain is from a herniated disc or pinched nerve in your spine, strengthening the muscles in your back that support your spine can help relieve pressure from the painful area.  

 

Be sure to tell your physical therapist when your pain moves or changes so your therapy can be adjusted as necessary. 

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sally, Community Member
7/13/09 9:08pm

     This is what I know about the cause of my pain. I have a malformed 10th thoracic vertebrae. I suspect it's the malformation that sends pain and spasm either up or down my spine. I also had two babies 14 months apart. 4 months into my first pregnancy the pain was incredible. I work very hard caring for my family and assume I am a high functioning chronic pain person. My children are 36 months and 24 months old, lifting them usually causes days of pain about 40 minutes after I lift them. That's about all I feel sure of regarding the source of my problem. I wish I knew if  the vertebrae was the only cause my condition. How does a person know if they have fibromyalgia ? Do you have any suggestions for me to get a better picture of why I have pain?

     It is very difficult to find other words to describe the vacuous feeling. Its like a whole system of muscles from my sacrum to calf is gone and not functioning. It's  how I would imagine the pain of an amputation. -- Alison

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Karen Lee Richards, Health Guide
7/17/09 2:35am

Thanks for clarifying, Alison.  I appreciate understanding the type of pain you're having.  Of course, I can't know, but I'd guess that the malformation probably has something to do with your pain.  When there's a problem in one part of the spine, often the rest of the spine will try to compensate for it, which can cause additional problems.  Have you seen a neurologist or had an MRI?  A neurologist should be able to give you some idea of what is causing your pain. 

 

It must be so difficult to care for such young children with the pain you're having.  I had twins, then had another baby 13 months later and for several years it seemed like I was always holding a child – but I was healthy and pain free then.  I really feel for you.

 

You asked about fibromyalgia.  Here are two articles I wrote that should answer your question:

 

What is fibromyalgia?

 

Diagnosing fibromyalgia

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sally, Community Member
7/17/09 7:10pm

     Thanks for answering my question. I  get no help from my primary care physician other than drugs. I really want to know the cause of my pain and I suggested to my primary care physician I go see a neurologist and she said "so, you're saying something is wrong with your brain?" I was offended and intimidated by her and I said "no I don't think there is anything wrong with my brain" and I dropped the matter with her. So, my question to you is how could a neurologist help me ? What could I expect from an appointment with a neurologist?-- thank you, Alison

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Karen Lee Richards, Health Guide
7/25/09 7:59am

Alison – I'm sorry to hear your PCP was so rude.  In my opinion, there's no excuse for treating a patient like that.  I can certainly understand why you felt intimidated.  It sounds like she doesn't want to make a referral.  It may be that she feels threatened by your request, or your insurance company may penalize doctors financially for making referrals.  Regardless the reason, she should be putting your needs first.  If she can't help you, she needs to refer you to someone who can.

 

Actually, there are two types of specialists you might consider:

 

Neurologist – Neurologists specialize in problems with the central nervous system, which includes the brain and spinal cord.  If your pain is shooting, stinging or burning, it is probably nerve related (i.e., a pinched nerve).  In that case a neurologist is probably your best bet.

 

Orthopaedic Specialist – Orthopaedic physicians specialize in the musculoskeletal system, which includes bones, muscles, ligaments, etc.  The spine is also part of the musculoskeletal system.  If your pain is more like severe aching, cramping or spasming, an orthopaedic specialist may be more helpful.

 

As for what you could expect from a appointment with either specialist – They would probably physically examine your back; they may ask you to walk or make various movements to see how the problem affects the way you move; they will probably also order x-rays and/or and MRI to get an image of exactly what's going on in your back. 

 

If your insurance doesn't require a referral to see a specialist, you can just call and make an appointment yourself.  If you have to have a referral, you'll have to work up your courage to face your doctor and insist on a referral.  Try to think of it this way – You're a customer, paying the doctor for a service.  If she's not providing adequate service, it may be time to find another doctor.  You wouldn't continue to take your car to a mechanic who kept charging you but never fixed it.  Don't settle for less for yourself.

 

If you find it extremely difficult to stand up for yourself with your doctor (not an uncommon problem), you might try taking someone with you – like a husband or other family member – who will back you up and speak up on your behalf. 

 

Good luck!  I hope you'll come back and let me know how it goes and what you find out.  – Karen

 

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sally, Community Member
7/25/09 10:35am

Thanks Karen, My pain certainly falls under the category of needing an orthopedic specialist. Thank you so much for the advice. Yes, I do need a new PCP but with everything I have going on and the anxiety I have when I see most doctors I have not found a new PCP. I love my OBGYN and maybe she will give the referral. Thanks again for the direction. I will let you know what I find out.--Alison

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sally, Community Member
7/25/09 10:37am

Thanks Karen, My pain certainly falls under the category of needing an orthopedic specialist. Thank you so much for the advice. Yes, I do need a new PCP but with everything I have going on and the anxiety I have when I see most doctors I have not found a new PCP. I love my OBGYN and maybe she will give the referral. Thanks again for the direction. I will let you know what I find out.--Alison

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Cesar, Community Member
10/29/09 8:40pm

It wont hurt to try some alternative medicine such as acupuncture.  Please check to see if thre is a school of Traditional Chinese Medicine, or a community acupuncture clinic and give that a try. It wont cost you at lot of money and sometimes is covered under insurance.  check it out.

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By sally, Community Member— Last Modified: 06/13/12, First Published: 07/12/09