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6 weeks of lower back pain and pelvic pain (and have Health anxiety)
Betsy0610 posted:
I am looking for some advice and perhaps reassurance. First, I should mention that I suffer from health anxiety and panic disorder since childhood. I am 34, female and 119 lbs. Have had no prior health problems. The anxiety has been under control until the past six months. The anxiety has increased upon my mother in law's ovarian cancer diagnosis in December and she has recently passed away.
Starting almost 6 weeks ago, I noticed lower back pain while sitting at my desk at work. A week later, we had to take a road trip from Seattle to Wisconsin for my MIL's funeral. The 3-4 days in the car increased the back pain and I also started to notice pelvic pain (which felt like cramping and sharp pains on both ovaries). I tried ignore the sometimes intense pain for most of the week, but went to the ER because it became unbearable. There, they performed a pelvic exam, abdominal and transvaginal US and tested for UTI and other infection. Everything was normal, except for a small ovarian cyst which I was told could not be the cause of this pain.
When we returned home, I saw my gyn, who again said she felt this was not a gyn issue and to see my internist. My Dr. decided to make sure there were no internal issues causing the pain and I had an abdominal/pelvic CT scan performed. Again, the results were normal but there was still a 'normal' small ovarian cyst which there was no concern about.
I have seen the chiropractor a few times which has significantly improved my back pain. It has almost disappeared — but does bother me after sitting at my desk all day. The chiro adjustments also seem to help the pelvic pain BUT, the pelvic pain returns when I'm wearing non-loose fitting clothing (like tight jeans or pants). The dr's have no more answers for me. Due to my health anxiety and panic disorder, I am fearing the worst, and that they have missed something. I'm not sure what can be missed with the tests' I've had, but when the pain returns I am sent into a panic.
My family and friends believe this is mostly 'all in my head' due to my health worries and anxiety. They feel that if I can stop focusing on the pain, it will disappear. I am seeing a therapist and take medication for anxiety — but the pain and the fear continue.
I have no family history of almost any diseases. No cancer, no heart disease. My uncle does have crohn's disease and apparently back pain is common in my family. Otherwise everyone is rather healthy and most family members live well into the 90's.
Has anyone else had an experience like this? Any ideas of other tests I should have or specialists I should see?
Thanks for any input J[br> [br>
Starting almost 6 weeks ago, I noticed lower back pain while sitting at my desk at work. A week later, we had to take a road trip from Seattle to Wisconsin for my MIL's funeral. The 3-4 days in the car increased the back pain and I also started to notice pelvic pain (which felt like cramping and sharp pains on both ovaries). I tried ignore the sometimes intense pain for most of the week, but went to the ER because it became unbearable. There, they performed a pelvic exam, abdominal and transvaginal US and tested for UTI and other infection. Everything was normal, except for a small ovarian cyst which I was told could not be the cause of this pain.
When we returned home, I saw my gyn, who again said she felt this was not a gyn issue and to see my internist. My Dr. decided to make sure there were no internal issues causing the pain and I had an abdominal/pelvic CT scan performed. Again, the results were normal but there was still a 'normal' small ovarian cyst which there was no concern about.
I have seen the chiropractor a few times which has significantly improved my back pain. It has almost disappeared — but does bother me after sitting at my desk all day. The chiro adjustments also seem to help the pelvic pain BUT, the pelvic pain returns when I'm wearing non-loose fitting clothing (like tight jeans or pants). The dr's have no more answers for me. Due to my health anxiety and panic disorder, I am fearing the worst, and that they have missed something. I'm not sure what can be missed with the tests' I've had, but when the pain returns I am sent into a panic.
My family and friends believe this is mostly 'all in my head' due to my health worries and anxiety. They feel that if I can stop focusing on the pain, it will disappear. I am seeing a therapist and take medication for anxiety — but the pain and the fear continue.
I have no family history of almost any diseases. No cancer, no heart disease. My uncle does have crohn's disease and apparently back pain is common in my family. Otherwise everyone is rather healthy and most family members live well into the 90's.
Has anyone else had an experience like this? Any ideas of other tests I should have or specialists I should see?
Thanks for any input J[br> [br>
1 Replies |Watch This Discussion | Report This| Share this:6 weeks of lower back pain and pelvic pain (and have Health anxiety)I am looking for some advice and perhaps reassurance. First, I should mention that I suffer from health anxiety and panic disorder since childhood. I am 34, female and 119 lbs. Have had no prior health problems. The anxiety has been under control until the past six months. The anxiety has increased upon my mother in law's ovarian cancer diagnosis in December and she has recently passed away. <br /> <br />Starting almost 6 weeks ago, I noticed lower back pain while sitting at my desk at work. A week later, we had to take a road trip from Seattle to Wisconsin for my MIL's funeral. The 3-4 days in the car increased the back pain and I also started to notice pelvic pain (which felt like cramping and sharp pains on both ovaries). I tried ignore the sometimes intense pain for most of the week, but went to the ER because it became unbearable. There, they performed a pelvic exam, abdominal and transvaginal US and tested for UTI and other infection. Everything was normal, except for a small ovarian cyst which I was told could not be the cause of this pain. <br /> <br />When we returned home, I saw my gyn, who again said she felt this was not a gyn issue and to see my internist. My Dr. decided to make sure there were no internal issues causing the pain and I had an abdominal/pelvic CT scan performed. Again, the results were normal but there was still a 'normal' small ovarian cyst which there was no concern about.<br /> <br />I have seen the chiropractor a few times which has significantly improved my back pain. It has almost disappeared — but does bother me after sitting at my desk all day. The chiro adjustments also seem to help the pelvic pain BUT, the pelvic pain returns when I'm wearing non-loose fitting clothing (like tight jeans or pants). The dr's have no more answers for me. Due to my health anxiety and panic disorder, I am fearing the worst, and that they have missed something. I'm not sure what can be missed with the tests' I've had, but when the pain returns I am sent into a panic. <br /> <br />My family and friends believe this is mostly 'all in my head' due to my health worries and anxiety. They feel that if I can stop focusing on the pain, it will disappear. I am seeing a therapist and take medication for anxiety — but the pain and the fear continue.<br /> <br />I have no family history of almost any diseases. No cancer, no heart disease. My uncle does have crohn's disease and apparently back pain is common in my family. Otherwise everyone is rather healthy and most family members live well into the 90's. <br /> <br />Has anyone else had an experience like this? Any ideas of other tests I should have or specialists I should see? <br /> <br />Thanks for any input J[br> [br> <br />
Jane Harrison Hohner, RN, RNP responded:
Dear Betsy: Alas, that is one of the problems with having a diagnosed anxiety disorder---people can conclude that a physical pain is a product of the anxiety disorder. You have done the correct thing in seeing both your GYN and an internist. It is good that you received several imaging studies (ultrasound and CT of abdomen) in addition to other lab tests.
Obviously I cannot give you any kind of diagnosis, but I can share some impressions based upon your stated history, OK? That the back pain onset with the long car drive, worsens with sitting at the desk (?and computer?), and was improved with chiropractic treatment it would seem most likely that it was an orthopedic issue. The stress of your mom-in-law's untimely demise can impact musculo-skeletal tension which could be a kind of exacerbating factor.
In terms of the pelvic pain, if the cause is not GYN it might be caused by bowel or neurologic conditions:
Bowel caused pain:
? Irritable bowel syndrome ("IBS") can start up after eating, or during stressful events. Bloating, gas, and constipation or diarrhea may be present. Excluding GYN causes, IBS is the most common cause of chronic pelvic pain.
? Diverticulitis is a localized infection in a pouching out section of the bowel.
? Appendicitis pain may manifest with a fever, loss of appetite, and pain focused in the right lower part of the abdomen.
? Crohns disease or inflammatory bowel syndrome may have bloody diarrhea along with the pain.
? Hernias may be evident and uncomfortable when the woman is standing upright, then not apparent when she is lying flat on the exam table.
? Cancer of the bowel, while not a common cause of pelvic pain, needs to be ruled out with a sigmoidoscopy. This is especially important if there are other bowel symptoms such as blood in the stool.
Neurologic sources:
? Myofascial pain creates abdominal wall pain along the lines of major nerve pathways. The area of pain can often be identified very specifically with a finger tip. It is believed that the pain can be instigated by a deeper organ which then refers the pain to the area served by the shared nerve. Performing a straight leg raise (tightens the abdomen) can make the pain worse. Treatment involves injection of the shared nerve with a local anesthetic at the specific site of pain identified by the finger tip.
? Neuroma is a mass, or thickening, of nerve tissue. Often these can arise where there has been trauma to a nerve. In pelvic pain a neuroma can occur in the area of a hysterectomy scar (including inside the vagina), or other surgical scars.
? Pudendal neuropathy results from damage to the pudendal nerve. Women may experience vaginal pain with sex, rectal pain with bowel movements, bladder pain with urination, and pain with sitting.
Less common sources of chronic pelvic pain can include:
? Systemic lupus erythematosis
? Low back injury with pain referred to the abdomen
? Acute intermittent porphyria
Bottom line Betsy, if the pain persists you might consider being seen by a gastroenterologist. If your chiropractor thinks the pain might be from the muscles of the pelvic floor they can refer you to a physical therapist specially trained in women's pelvic pain. As always, is is best to ask your current care providers if they have any referral ideas.
In Support,
Jane
Obviously I cannot give you any kind of diagnosis, but I can share some impressions based upon your stated history, OK? That the back pain onset with the long car drive, worsens with sitting at the desk (?and computer?), and was improved with chiropractic treatment it would seem most likely that it was an orthopedic issue. The stress of your mom-in-law's untimely demise can impact musculo-skeletal tension which could be a kind of exacerbating factor.
In terms of the pelvic pain, if the cause is not GYN it might be caused by bowel or neurologic conditions:
Bowel caused pain:
? Irritable bowel syndrome ("IBS") can start up after eating, or during stressful events. Bloating, gas, and constipation or diarrhea may be present. Excluding GYN causes, IBS is the most common cause of chronic pelvic pain.
? Diverticulitis is a localized infection in a pouching out section of the bowel.
? Appendicitis pain may manifest with a fever, loss of appetite, and pain focused in the right lower part of the abdomen.
? Crohns disease or inflammatory bowel syndrome may have bloody diarrhea along with the pain.
? Hernias may be evident and uncomfortable when the woman is standing upright, then not apparent when she is lying flat on the exam table.
? Cancer of the bowel, while not a common cause of pelvic pain, needs to be ruled out with a sigmoidoscopy. This is especially important if there are other bowel symptoms such as blood in the stool.
Neurologic sources:
? Myofascial pain creates abdominal wall pain along the lines of major nerve pathways. The area of pain can often be identified very specifically with a finger tip. It is believed that the pain can be instigated by a deeper organ which then refers the pain to the area served by the shared nerve. Performing a straight leg raise (tightens the abdomen) can make the pain worse. Treatment involves injection of the shared nerve with a local anesthetic at the specific site of pain identified by the finger tip.
? Neuroma is a mass, or thickening, of nerve tissue. Often these can arise where there has been trauma to a nerve. In pelvic pain a neuroma can occur in the area of a hysterectomy scar (including inside the vagina), or other surgical scars.
? Pudendal neuropathy results from damage to the pudendal nerve. Women may experience vaginal pain with sex, rectal pain with bowel movements, bladder pain with urination, and pain with sitting.
Less common sources of chronic pelvic pain can include:
? Systemic lupus erythematosis
? Low back injury with pain referred to the abdomen
? Acute intermittent porphyria
Bottom line Betsy, if the pain persists you might consider being seen by a gastroenterologist. If your chiropractor thinks the pain might be from the muscles of the pelvic floor they can refer you to a physical therapist specially trained in women's pelvic pain. As always, is is best to ask your current care providers if they have any referral ideas.
In Support,
Jane
Report This| Share this:6 weeks of lower back pain and pelvic pain (and have Health anxiety)Dear Betsy: Alas, that is one of the problems with having a diagnosed anxiety disorder---people can conclude that a physical pain is a product of the anxiety disorder. You have done the correct thing in seeing both your GYN and an internist. It is good that you received several imaging studies (ultrasound and CT of abdomen) in addition to other lab tests.<br /><br />Obviously I cannot give you any kind of diagnosis, but I can share some impressions based upon your stated history, OK? That the back pain onset with the long car drive, worsens with sitting at the desk (?and computer?), and was improved with chiropractic treatment it would seem most likely that it was an orthopedic issue. The stress of your mom-in-law's untimely demise can impact musculo-skeletal tension which could be a kind of exacerbating factor.<br /><br />In terms of the pelvic pain, if the cause is not GYN it might be caused by bowel or neurologic conditions:<br /><br />Bowel caused pain:<br />? Irritable bowel syndrome ("IBS") can start up after eating, or during stressful events. Bloating, gas, and constipation or diarrhea may be present. Excluding GYN causes, IBS is the most common cause of chronic pelvic pain.<br />? Diverticulitis is a localized infection in a pouching out section of the bowel.<br />? Appendicitis pain may manifest with a fever, loss of appetite, and pain focused in the right lower part of the abdomen.<br />? Crohns disease or inflammatory bowel syndrome may have bloody diarrhea along with the pain.<br />? Hernias may be evident and uncomfortable when the woman is standing upright, then not apparent when she is lying flat on the exam table.<br />? Cancer of the bowel, while not a common cause of pelvic pain, needs to be ruled out with a sigmoidoscopy. This is especially important if there are other bowel symptoms such as blood in the stool.<br /><br />Neurologic sources:<br />? Myofascial pain creates abdominal wall pain along the lines of major nerve pathways. The area of pain can often be identified very specifically with a finger tip. It is believed that the pain can be instigated by a deeper organ which then refers the pain to the area served by the shared nerve. Performing a straight leg raise (tightens the abdomen) can make the pain worse. Treatment involves injection of the shared nerve with a local anesthetic at the specific site of pain identified by the finger tip.<br />? Neuroma is a mass, or thickening, of nerve tissue. Often these can arise where there has been trauma to a nerve. In pelvic pain a neuroma can occur in the area of a hysterectomy scar (including inside the vagina), or other surgical scars.<br />? Pudendal neuropathy results from damage to the pudendal nerve. Women may experience vaginal pain with sex, rectal pain with bowel movements, bladder pain with urination, and pain with sitting.<br /><br />Less common sources of chronic pelvic pain can include:<br />? Systemic lupus erythematosis<br />? Low back injury with pain referred to the abdomen<br />? Acute intermittent porphyria<br /><br />Bottom line Betsy, if the pain persists you might consider being seen by a gastroenterologist. If your chiropractor thinks the pain might be from the muscles of the pelvic floor they can refer you to a physical therapist specially trained in women's pelvic pain. As always, is is best to ask your current care providers if they have any referral ideas.<br /><br />In Support,<br />Jane
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