Need help identifying source of pain

[SoShonika]

This is kind of complicated, so please bare with me for the long post.

Diagnosed Pain Problems: M.E. / CFS, Fibro, Hypermobility Syndrome, back problems, anal fissures, and haemorrhoids. The latter two don’t tend to cause problems often, but may be relevant to this problem.

Treatment History:
– Was on Tramadol 600mg daily. GP didn’t want me on it, so reduced to 50mg daily – which isn’t helping much. Note; I’ve been through withdrawal.
– Tried Amitryptiline; it turns me into a zombie.
– Have been on 300mg Gabapentin daily, which didn’t do anything.
– Went to pain clinic last week – Gabapentin is to be increased to 1800mg daily over a 6 week period. I do suspect it’ll turn me into the same zombie that Amitryptiline does – I already have double vision from the 600mg dose.
– Have been using Ibuprofen to take the edge off the pain.
– Have been using Paracetamol (Acetaminophen) at night, because it has a sedative effect on me.

The Problem!
In coming off the high dose of Tramadol so quickly, I’ve been hit all in one go with all of the symptoms from the pain conditions described above, at once. Previously, obviously, they’d had years to creep up on me, and for me to get used to them. So, I’ve been having trouble coping with it, and with identifying what symptom belongs to each illness.

It has come to my attention that I am experiencing a pain that I’ve never had before. The problem feels like it is in the muscles around my abdomen, torso, back – whatever you wish to call the main area of your body. It feels like a constant niggling, sort of wiggly, squirmy feeling. I cannot cope with it. When I remain stationary it increases in intensity, so I am needing to change my position every ten to fifteen minutes. I haven’t slept properly for weeks – the most I’m able to sleep in one go is 50 minutes – I wake up in incredible pain.

I am finding that three things might alleviate the pain each time I wake up; but I can never tell which one will help on each occasion, until I try them. These three things are:
– going for a pooh!
– eating
– taking the dose of 50mg Tramadol

The problem is that I have great difficulty going to the toilet. So, if I eat, when poohing was the problem, it makes the pain worse. Similarly, if I take the Tramadol, when eating or poohing was the answer on that occasion, the Tramadol doesn’t work – and since I only have the one dose to give me a couple of useful hours a day, I don’t wish to waste it.

My suspicion is that my brain is misinterpreting the signals from my colon and stomach (ie, hunger, and the need to pooh) as pain. I am aware that the haemorrhoids were causing me quite sharp pains at the side of my abdomen last year, so I’m wondering if when my intestines are full they are pressing on nerves, which are not reacting the way they should do.

Can someone with more of an understanding of pain than myself, give me some ideas as to what may be going on inside of me please. If anyone can suggest alternative ways in which I can alleviate the pain I’ll be even more grateful.

Incidentally, the pain clinic I attended last week, had never heard of what I’m describing, which is why I’m seeking help online.

[Dr. Diana]

Hi SoS, I’m so sorry for your pain — I understand how rough that can be. While I am pulling together the updated version of The Driscoll Theory, and recovering from my hospital stay, I have limited time to help, but wanted to suggest a couple of things. I believe that some pain can be misdiagnosed, and objective measures are important to try to find the root of the pain, right? I experienced something similar, but was (very) reluctant to be labelled with the vague “chronic pain syndrome”. Tramadol, morphine didn’t even touch the pain. I strongly believed I had some tissue destruction causing the new onset pain, but this is a new concept for most physicians. Tissue destruction causes inflammatory cells to come to the site of destruction and can magnify the pain, but is tricky to measure. I asked for an MRI, and the extent of inflammation was easy to document. With some objective testing, you “may” be taken more seriously, and pain may be better targeted. For many of us, opioids make things worse (and interfere with cognition). We are working on addressing the pain focally now (topicals, mild steroid, Epsom salt baths, antihistamines for a week, Ketotifen, ice/heat) while I try to measure the inflammatory agents. I will keep you posted, and we’ll announce potential testing for those of us with this type of pain (hopefully soon). Big hug,

[Barbara]

I’ve had some of the pains you describe (having to keep adjusting position) and I’ve not found a pharmacological ‘painkiller’ that helps. Most painkillers deplete Magnesium, so you really do need to take the Epsom Salt baths, to help replenish this. The body takes up the Magnesium it needs from this through the skin and it helps relieve pain.

Other things I’ve found that relieve certain types of pain are:-

* Marmite/Vegimite, made into a warm drink and stir in a quarter of a teaspoon of Turmeric.

* Pour boiling water on a small spoon of Cinnamon in a cup, cool with milk and drink like tea.

* Take Vitamin D and Calcium

* Get a Massage over the troublesome area.

Take B Vitamins to keep the bowel active.
Barbara
(UK)

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