Stenosis or Stress?

I am just short of turning 69 years old. My low back pain started about 7 years ago with minor pain in the right gluteal area. The only formal diagnosis I have for the pain is lumbar stenosis.

About 6 years ago, my husband had a minor stroke. I noticed that my back pain increased as I tried to encourage him to work at getting better while also picking up the slack from him not doing much of anything, even when he could. Of course, there was the additional stress of him no longer working and going through the steps to get him on disability.

About 4 years ago my mother's dementia started to show its ugly head. Pain continued to increase as I took on the additional duties of caring for her and taking care of her financial needs.

I tried doctors, chiropractors, a naturopath (acupuncture included), a pain clinic, had an MRI, physical therapy, massages and finally an injection about a year ago. The doctor who did the injection was so sure that the pain was from the stenosis that showed up on the MRI, that they did not listen to much else I had to say. The injection did help some with the pain that was going down the left leg, but did not fix all the pain. When I went in for my follow up visit, I asked the doctor about the continued pain on the side of my hips, especially when walking up stairs. Doctor told me I was probably just out of shape and it would get better with more exercise. I had, at that time, been doing tai chi for more than 5 years, so I don't believe my quadriceps were too out of shape.

I do need to mention that I have anxiety issues. I was first diagnosed about 16 years ago when my brother was in the hospital with cancer. I have been on and off antidepressants for about the same time. When the anxiety was diagnosed, the doctor put me on Ativan, which I have taken off and on for the last 16 years without addiction issues.

I tried multiple supplements, while working with the naturopath, and a few changes in prescription medications from the doctor; none of which worked and some of which made the pain worse.

I tried explaining to the various providers that the pain was worse when walking and was totally in the muscles on the side of the hips. Only one doctor seemed willing to talk to me about mindbody issues, but that doctor went on to bigger things before we could explore that further. The next doctor did not seem very interested in my opinion, even though I tried to explain all the research I had done about mindbody issues and how that fit my symptoms better than anything else I had found.

As my mother's dementia increased and my husband's participation in the world decreased, I found that I needed to increase my use of Ativan to a daily basis. This helped control my anxiety to a level that allowed me to care for my mom. With all of the emphasis on opioid overdoes nowadays, Ativan was put on the controlled substance list, so you don't dare use more than they give you regardless of how you are doing. Then you hope that the doctor believes that you are suffering due to personal circumstances and not just "drug seeking".

I realize that doctors have been to many years of school so that they can help us, but they need to realize that some of us are very in-tune to our bodies and we are the ones who know where and what the pain is like and when it occurs. It would be much more helpful if doctors would at least consider what their patients have to say.

In June of this year, my husband passed away. Thirteen days later, my mother passed away from her dementia. The first few weeks are now a blur to me with all the details of two funerals and a grave-side service in another state.

Since the loss of mom and husband, I have noticed that the pain has started to subside a bit. It's not that I don't have things I still need to deal with, it’s just that those things are less anxiety-causing than being a caregiver for two people. I have been able to decrease the use of Ativan to an "as needed" basis.  I hope at some point in the future to be able to discontinue the Ativan and maybe the antidepressant, as I have gotten off of them before.  If things go well, maybe I can even be free from the hypertension medication.

So now that I am having some relief from the pain, I cannot help but wonder who is right about the cause. Is it the mental stress and anxiety that makes everything tighten up and hurt, or is it the stenosis? If I had never had the MRI that revealed the stenosis, what would be the diagnosis be?  Makes you wonder. - Raven

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