Evil Back Pain

[Eve]

Started about weeks or so ago, a very acute type of pain in the upper right quadrant in my back, I suppose to the side of where I imagine my kidney to be but more to the right edge of my back, just under my ribs. Apologies in advance for the essay!

It's a bit like a severe stitch/shooting/shock kind of pain that radiates out, the freeze, hold your breath type, and I can feel other muscles around the diaphragm area clenching when it goes off. The closest thing I can link it to is when I had sciatica once but it's higher up and doesn't go down my bum or legs. It was more manageable more occasionally initially but it's driving me distracted at the moment

It is mainly aggravated by movement, changing position, stretching up or to the side, bending etc... It has started to be painful most of the time when I'm "leaning" against it, when I'm on the sofa and in bed, I unfortunately usually sleep on that side. Strangely (to me) if I buffer it a bit sometimes it can help, like putting a V pillow or firmer cushion that side, it's been a nightmare trying to get in a comfortable position on the sofa and in bed (and preferably not move). It's been ok mostly sat in my work chair, when I'm not moving.

I get a lot of back pain generally but this is quite different. I'm on a fair whack of painkillers generally for other pain conditions (RA/OA/Fibro mainly) but they don't touch it. I can't take many NSAIDS as they affect my kidneys. I've taken some in desperation but they haven't really helped..

I'm trying to work out what is causing it to try and find something to help it. My GP surgery said pain relief wise I'm on my max pain relief without going on to morphine and similar, which they don't like to prescribe for non-cancer pain. I've been referred to a Pain Clinic but that will probably take a while.

It's near the kidney area but I haven't had any fever or chills or pain when going to the loo, passing more water than usual, but no obvious kidney infection symptoms and it does seem to be aggravated more by movement.

I don't have a gallbladder any more, it was taken out about 9/10 years ago. I had an MRCP scan a few years back in case I had more stones (that pain was more to the front) but no stones found, had the scan at a private clinic (via NHS) so no ongoing care, just ruled out more gallstones and suggested it could be a sphincter issue but that was it.

Thanks for reading, if you got this far, and for any help!

[choux]

As a fellow sufferer you have my sincere empathy, Eve. I always have recourse to a good chiropractor and cold treatment following simple exercises. Shame you are on max pain killers. I hope you get a diagnosis and treatment pdq. Getting in and out of bed is a nightmare but without the sleep.

[Sqad]

It sounds like Herpes Zoster ( shingles) to me even without a rash.
I would contact your Dr's surgery and diplomatically suggest that you feel that it is a nerve pain, possibly might he suggest a pain killer such as Gabapentin.
Good luck.

[Eve]

Thanks Choux, fingers crossed and you have my sympathy too.

Thanks Sqad, I really appreciate your advice. I'm already on a fairly high dose of Pregabalin already :( I can ask though.

I've had shingles diagnosed twice before, but on my arm/hand and with the more obvious rash/blisters. I was given anti virals (as I'm on a biologic for RA) but that was quite early on, I'm guessing far too late now for that to be an option? I think they have to be taken very early on to have any effect?

[Sqad]

You always give a clear and helpful clinical history which is much appreciated.
Your pain is what is called neuropathic pain.

[Eve]

Hi, just a quick update. The pain settled down quite quickly but came back very suddenly and badly a few nights ago. My GP said to come in so she could check it out. Shingles without a rash was mentioned first. She said she'd have expected me to have a very large/noticeable rash with my medical history.

She listened to my chest and said something didn't sound right around where the pain is, she was concerned it could be a blood clot or fluid on my lung. So I was sent to A&E, blood clot ruled out thankfully. I had a chest xray which (I assume) ruled out fluid on my lungs. I was that exhausted by the time everything was finishing up, I wasn't at my best to ask a lot of questions.

The doctor I saw thinks it's severe muscle spasms. He said to follow up with my GP about whether I can have muscle relaxants with my other meds/conditons. This was late on Friday evening, so I need to wait until Monday to do that.