Why is there no real treatment for pain?

[Jodi5868]

I'm hoping someone can help me. I've been seeng doctors for 10 months. 41 years old... female, post c-section 3 yers ago. developed right arm & wrist/ nerve type pain 3 years ago and swollen glands for 3 years now, swelling in hands and feet. DX: CTS in 8/06. Never got better. Saw a hand surgeon. Had a new EMG in 9/08.  EMG showed "juxta neural inflammatory process. CTS mild. Hand surgeon wouldn't operate b/c he wasn't convinved CTS was causing the pain.  MRI of cervical spine 9/08, 4 disc bulges but not touching any nerves. Neurologist said it was probably a virus. Blood work: high titers for EBV, Herpes Simplex 6 and reubella. Gave me antiviral meds and sent me to pain management. Started rehab.... strength training for 5 months 3x per week. Never missed. Still go once a week for the past 3 months. Was sent to a rheumatoligist, nothing wrong. MRI of brain, 1 lesion of gliosis, not enough for it to be MS.

while doing strength training, my right lower back and leg started to hurt. nerve pain down the legto the foot. Got worse and worse. MRI showed some arthritis and a small disc bulge at L5-S1 to the right encroaching on the thecal sac. DX: right side radiculopathy. EMG of right leg. NCS was normal, but EMG showed right lumbar radiculopathy. No response at popliteal fossa. Had 2 epidurals and a facet injection. Mild short term relief with epidurals but not with facet injection. Doing home exercises faithfully... stretching, walking. Both aggravate pain in my leg but do it anyway. Pain in leg is now disabling, excruciating. Pain meds not working, Norco.... Pain Mgt dr sent me to a back surgeon (ortho). He reviewed MRI report before he would see me. Just got a call from his office. Said to see a neurologist.

Big circle, back at square one. Pain is getting worse. It's all the way down my leg in my right foot. Right now, pins and needles in my rright heel and pain down the back of my leg. Leg feels weak. Right arm still hurts.... wrist and fingers, elbow, fingers on right hand swell.

Negative for rheumatoid arhtritis, sarcoidosis, lupus, lyme's disease, all autoimmune diseases. Rheumatoligist said it was fibromyaglia but it Can't be fibromyalgia b/c there are findings on the tests and swelling. Have EBV but that wouldn't cause a disc bulge, touching the nerve.... would it? Can't find a dr to treat EBV. Called all the infectious disease dr's on my health ins. None of them treat EBV...... ?????

Going to a psychiatrist, 5 years now with the same one, but on and off for anxiety disorder and panic attacks. I'm not depressed ( well, now I am b/c of  the pain but in general, I was fine before this.  Work very hard to manage my anxiety.  I rarely have panic attacks anymore. Lost my job for missing too much work, even though I had dr's notes. Used up all my FMLA time in a year, intermittent disability and got fired

[Jodi5868]

Hi, Tuck,

Thanks for your response. :) I did apply for short term disability while on unemployment. My neurologist was willing to fill out paperwork for permanent disability but I don't want to completely quit the world yet.....as of now, I can't even look for a job. I don't think I can fulfill the requirements. I hate this. I'm missing out on doing things with my 3 year old, basically just laying around in a drug haze.....

I do see a psychiatrist for depression and anxiety. So, of course more meds.... but it's imperative. Being in chronic pain is depressing. There isn't any way around that.

I just had a facet neurotomy on Tuesday at 3 levels. Hoping it works. If not, I'll have to have the disc removed. I'll take your advice and have it done by a neurosurgeon rather than an ortho. The neurotomy isn't working yet. It takes some time. I'm in a great deal of pain and of course took all of my pain meds !! So, back to the dr tomorrow....

I do have sciatica, and the neuro doesn't think it's coming from the disc. He thinks it's a swelling problem due to the epstein barr. So, maybe the neurotomy or a diskectomy wouldn't work anyway....  but he does feel that the disc herniation and Epstein Barr are not related, just that the epstein barr causes muscle swelling which puts pressure on the sciatic nerve and makes it hurt more.

It's difficult when the catalyst of your pain isn't obvious and you end up having to do a lot of your own research. But, I guess in that sense, you are a well informed patient! :)

Take care, Tuck and again, I really appreciate your response.

[Tuckamore]

Hi Jodi,

Welcome to MedHelp's Pain Mangement Forum. I am sorry for all your pain and the pain induced issues you have experienced. You have provided us with a lot of information and some good questions.

Epstein-Barr virus, (EBV) is a member of the herpes virus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. Indeed the percentages are high, as many as 95% of adults become infected in the USA. There is usually no treatments other than the antiviral meds you have already been prescribed. So you have been treated. And you are correct, EVD will not cause a disc bulge.  

In my opinion you should not be distressed at being referred to a neurologist. They treat, among other things, radiculopathy. Often they treat stenosis of the spine or other such conditions because it can be more of a neurological problem than an orthopedic one. If I required spinal surgery I would select a neurologist over a ortho if was appropriate and possible.

I am sorry that you have lost your job. Are you able to fulfill the requirements of a demanding full time career?  If not should you consider applying for SSDI? It may be worth some thought.

Your symptoms do sound nerve related to me. In my experience the pain you describe running down your leg and into your foot is usually referred to as sciatica, which is compression and /or inflammation of your sciatic nerve.

Please let us know how you are doing. We are here to support you. I hope you will find some answers and solutions to your painful condition soon. I wish you the very best.

Take Care,
Tuck