I'm a 20 year old active duty Army female with a history of lower back pain x5 years.
When I was around 15, I started having very severe stabbing pains in my lower back that kept me lying down unable to move. X-Rays revealed very minor scoliosis (14 degree levocurvature) and they concluded I was probably having muscle spasms. I started physical therapy for core strengthening, muscle relaxers, and custom soft orthotics once the PT realized I also had severely flat feet.
Physical therapy (did about 6 months then insurance said no more) left me relatively pain-free up until I enlisted when I was 18. During my first few months in the military I did have some back pain but chalked it up to it being from all the heavy loads and constant running and walking everywhere. I'm a medic, so dragging people twice my size around also didn't help. I would get regular massages on weekends from a spa place during my AIT training and that seemed to help some.
Maybe about a year into my service, when I was stationed in South Korea, my pain suddenly began to get a lot worse. It was a burning, searing pain. I worked for a pretty knowledgeable PA, so I went to him. He sent me for X-rays and a scoliosis survey, it showed my curvature had progressed to 19 degrees. He put me on a regiment of acetaminophen, meloxicam, tramadol, and cyclobenzaprine. Nothing worked. My body didn't even react to the medications (cyclobenzaprine never made me sleepy, neither did the tramadol, even at fairly large doses for my 120 lb, 5'3 frame). At this time I continued to get regular massages at a spa on post and did stretches, used a foam roller, etc.
I then began experiencing what I first thought was shin splints. Taping, icing, and NSAIDs didn't help, so I finally gave in and saw a Doc after I realized the pain was in my calves and feet; he suspected exertional compartment syndrome. While running my feet would go numb and my calves would burn and ache horribly, though it was noticeably worse in my right leg. I was given a no running profile for two weeks and told to follow up at my next duty station, as I was on my way out of Korea.
Once I was at my next duty station, I began experiencing burning pain localized to the soles of my feet. It happened when I stood for too long, and it rapidly progressed over two months to me being unable to stand for more than five or ten minutes without having to shift my weight around or lean on something to take the weight off my feet. All the while the pain in my back continued to worsen, still that burning pain only now it had begun to sort of "connect" to my leg. I saw a podiatrist who recommended me for custom hard plastic orthotics with lifts and that was it. While the orthotics helped me be able to stand a little longer, my symptoms in general only got worse. It started to feel like someone was twisting my leg off, or like someone had grabbed my tendons and stretched them out like a worm out rubber band and put them back in like that. Soon it was shooting pains down my entire leg and occasionally but rarely episodes where my leg felt like it was on FIRE. I mean, it was horrific. Sitting down made it worse, and standing temporarily relived it. But there was no position that would relieve my pain.
Again I sought out help from a doctor at work who I knew was top notch (Westpoint graduate) and he put me in for a scoliosis survey. At this point it showed a levocurvature of 22 degrees with a thoracic dextrocurvature of 10 degrees (which doesn't technically count as scoliosis since it's only 10 degrees but it is worth noting that it was not there before), pelvic tilt on the right side of 8mm, and mild lumbar twist. A drastic worsening in about a year. He then put me in for an MRI and started me on physical therapy again.
The MRI showed no herniated disks, but it did show two fairly large Tarlov cysts on either side of my S1 nerve root. Doc said he thinks one of them might be compressing the nerve a bit, but given that the cysts tend to fluctuate in size and don't show up too amazingly on imaging, he could not be sure. By this time I had been given lidocaine patches for relief, but they did absolutely nothing. Physical therapy just ended last week, and improvement was minimal, I'd say 3/10, but it is better than nothing at all. During therapy we noticed a steady weakening of my right leg with minor atrophy as well. Simple things like balancing on that leg had me wobbling and falling because I was unable to support my body weight.
I've come to a point where sitting is a Russian roulette type of deal because if I don't sit just right, my entire left leg gets that weird pins and needles feeling and I have to constantly shift around or sit in weird ways like almost on my back...kind of in a fetal position, if that makes sense, which isn't good for my back either. Going upstairs is a nightmare, walking anything further than 1/4 mile at a normal pace makes the soles of my feet completely numb and my left ankle will hurt so bad from compensating. The pain is now constant and unrelenting. On a good day it is. 4/10, but then it has its days where it's a steady 7-8/10 and things like bending over to tie my boots in the morning is excruciating. My body is starting to become deformed due to scoliosis, my right shoulder sits lower than my left, and I have to stand with my hip out to compensate for the pelvic tilt.
Being a medic, I have an array of meds and supplies at home, and once in a blue moon I resort to 30 mg tramadol IM to take the edge off the pain. I have been on gabapentin as well before for unrelated reasons, and it did not affect my nerve pain. A long time ago when I was given hydrocodone after my wisdom teeth were removed, I remember I cried because the medication did absolutely nothing and I was in so much pain. I basically consider things like tramadol and all that fancy Tylenol, because it's worthless to me
Doc says we've pretty much run out of options. I just want to not be in pain, or at least take the edge off. I owe it to my patients to be 100% mission capable!! Anybody care to share your experiences with pain management, or anything that you guys do to manage your pain? Any and all suggestions, questions, etc., are very much welcomed and appreciated. Thank you!