Chronic upper left quadrant back to abdomen pain

by Michelle E.
(Winamac, IN, USA)



Hello, I have had pain that started out on the left side back near the kidney area 2 years ago. An ultrasound was done on the left kidney without any presence of any issues. From there nothing has been done until in December 2014 the pain radiated to the front abdomen in a wrap around affect. No rash of any kind present. Present doctor had sent me to do and MRI of the spine which showed an mild bulging disc at T8. Was sent to a neurosurgeon for evaluation and was told this is not the cause of the pain. I can not sit in one position for a more that 15 minutes and the same for sleeping. I can not lay on my left side for very long either. Seems like I can not find an answer to this. I am worried since it seems to be getting worse and I think I feel as if I am just being pushed on to another doctor to see what they think. If you have any suggestions I would appreciate it. Thank you.

HISTORY:
Gallbladder removed 2013 - was running at 7% and scarred so much it attached to my colon no stones
Tubes tied 2011
Colonoscopy 2014

Medications
Cymbalta 60mg for suspected Fibromyalgia for double leg pain and seems to be helping. Started in 2013 after gallbladder removal.

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Dear Michelle,

From your story - a left loin pain that radiates in a "wrap around" fashion to the front of your abdomen, it certain does sound like your pain is originating from a nerve root compression as a result of the bulging disc at T8. That is the same nerve root that supplies or "wires" that part of the body you have pain in.

It is however always important not to jump into conclusions because I do not have all the details and information available to the neurosurgeon.

Was it just a spinal MRI that was done? Did they report any soft tissue findings in that area?

If you could anonymize your report and send it to us, or better still copy and paste it without your details here, I would like to go through the details and see what exactly they found.

Having said that, if it is a mild nerve root compression, there is unfortunately not a lot that most neurosurgeons would do by way of surgery or operative intervention.

The good news nonetheless, is that certain medications could be tried to help. You are already on Cymbalta. That is good. What you can also try in addition to that is Lyrica (or Pregabalin, which is the generic name of this medication). This is another medication that millions of people worldwide use for nerve pain.

Sometimes, we combine Lyrica and Nortriptylline or Cymbalta and Lyrica and very very rarely all three medications. Why not speak with your Family doctor about this possibility?

Some physiotherapy could also be tried for a few months and see if it would help.

Should the pain continues to be a problem, then I would strongly recommend that you request that you be referred to a pain clinic to see a pain specialist. Spinal (Intrathecal) injections at around the Th8 vertebra every 3 to 6 months or so might be the solution. If you are in a lot of pain currently, you could consider this option right away, though I would think that trying Lyrica for a few weeks or months is a better choice, as it is non invasive.

I know I have provided lots of information here. Please if there is anything that is not clear to you, do not hesitate to ask me to clarify.

Thank you for stopping by to use our free online consultation services here at abdopain.com.

Dr Omatseye Edema MD MRCGP CCFP MSc DRCOG
Family Physician, Emergency Medicine Practitioner and WebMD
Abdopain.com.

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Feb 19, 2015
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MRI results
by: Anonymous

This is what is says on the report.

MRI Spine W/O Contrast
Technique:
1. Sagittal T1, T2 and STIR Sequences
2. Axial T2 Sequence

Findings: The thoracic vertebral bodies are of normal height and there is a moderate degenerative disc narrowing at T7-8. There are hemangiomas within the vertebral bodies of T3, T7 and T8. There is a moderately large central disc protrusion at T7-8 with mild compression of the thoracic cord. There is no myelomalacia. The conus medullaris ends at the top of the L1 level.

Impression:
Moderate degenerative disc disease at T7-8 with a central protrusion which is mildly compressing on the thoracic cord. No myelomalacia.

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