Severe Pain When Lying Down On Back

Question

Asked by LJ

Severe Pain When Lying Down On Back

When lying down on my back to sleep I awake to excruciating pain that starts from the thoracic area to my lower back~my right shoulder blade extends outward to a great degree while my left shoulder blade is flat. It takes my breath away and can take anywhere from an hour to 3 hours to stop. My medical history: have severe Fibro for 30 yrs that started from 3 auto accidents within 18 month(was 23 at 1st accident), multi level severe disc degeneration, bulging and herniated discs from cervical to lumbar spine, TMJ, IBS, arthritis in spine at various locatons, osteoarthritis in my hips, 'slight' scoliosis, along with a host of other health issues.
I have had same rheumatologist for almost 17 yrs and am on a pain management program through his care. Recently had outpatient (what is called spinal surgery) meaning I had 12 injections under a fluoroscope to relieve this agonizing pain-it didn't help at all.
For far too long I have been reduced to sleeping upright on couch with a foot stool...most nights I don't sleep. Insomnia has now become a way of a non life for me~I get some slight sleep and then I am awake for the rest of the night. I am on all kinds of medications for pain control and nothing stops this unknown pain that I get from lying down on my back-now I can't lye on my left side without it happening. My medications are dosed 4 times a day and I have break-though pain meds that keep me somewhat out of pain during the night.
I am sleep deprived and will eventually get sleep from taking my meds during the day from their side effects. I am exhausted and fatigued all of the time and my life has basically come to a standstill. Before I had some semblance of a life-it was not what a normal person lives but it was my life.
Now I have no idea what is happening to me and wonder if anyone has any ideas about my complicated case. Recently noted after many weeks after the 12 injections that when I bend over to do a light stretching that my shoulders and the section of arm below this to my elbow starts this type of 'puckered skin' look to it and this also shows in the muscle area about where the diaphragm begins. When I stand back up it slowlygoes back to its normal looking weakened muscles. I haven't been to the rheumy about this yet but will be seeing him soon.
I truly am at my wit's end!!!! Arghh-I feel as though something is going on with my adrenal glands or thyroid and I say this because after all these long years, one does get in touch with your body. Have had thyroid tested by rheumy and it shows normal but I haven't had a complete and total workup.
To add to the whole pile, I have anxiety and panic disorder...hmm, I wonder why? Little joke there. Btw, all of what I describe is documented by medical testing.
God Bless Each and Every One and May All of Your Health Issues Be Healed!!!

Answer

Blessings to You too!

I read your story and I keep going back to the first line:

"When lying down on my back to sleep I awake to excruciating pain that starts from thoracic area to my lower back ~ my right shoulder blade extends ouward to a great degree..."

What you describe reminds me of "scapular winging". Knowing that the serratus anterior and rhomboids both get their innervation from the cervical nerve roots (C5 rhomboids, C5-7 serratus), I can imagine how the position of lying supine (on your back) could pinch those nerves. If your pillow is too flat, then lying supine will cause your neck the extend as the head reaches for the pillow. Extending the neck increases the cervical curve or arch and can potentially cause nerves to be temporarily pinched. This happens to those who have cervical stenosis and look up for a prolonged period of time (picking fruit or painting ceilings). Sometimes temporary paralysis will result. In your case, maybe temporary paralysis of serratus anterior or rhomboid muscle is causing scapular winging.

I suggest to those with cervical spine issues like yours to avoid neck extension. Try a thicker pillow.

" We glory in our suffering because suffering leads to perseverance, perseverance to character, and character to hope" ~ Romans 5: 3-5

Dr. Christina Lasich, MD

Answered by Christina Lasich, MD