Back pain every morning and waking me up at night

Bones, joints and muscles
1

hi,

I'm new to the forum so hopefully someone can help as im getting slightly lost in the NHS medical system .

Since August last year I've been suffering from extensive back pain which is at its worst after sleeping in the morning, to the point where it's started waking me up at night. Originally when it started happening I would get the pain every other day or less but it's now becoming a daily occurrence and nothing seems to be relieving the pain now. The pain is mid and upper back primarily, if I take a deep breath in the morning I get a sharp pain in my back then as well, the main pain stays until I get up and start moving around but I can still feel a loosely through the day, not to mention it is constantly clicking. I was seeing an osteopath who was manipulating my back for about 6-7 weeks which generally provided about a days relief then would return back to how it was. I learnt that my dad has AS and was diagnosed in his mid twenties (I'm 26), I've had the blood test and tested positive for the gene, however an X-ray of my thoracic spine showed nothing and I've also had an MRI which I've posted the results summary below but again nothing conclusive there. I was referred to a rheumatologist who immediately just referred me back to the GP as he described it as a mechanical issue and that I should see a Physio which given I've seen 2 different osteopath for the best part of 2 months didn't fill me with a ream of confidence, I've also tried acupuncture which Gave some relief during the first session but nothing else since so we stopped this.

I have a foam roller at home which I've been using but am not seeng any benefit yet likewise stretching hasn't helped so far. I'm on naproxen which hasn't helped at all. I've been through 4 mattresses with different firmness ratings but nothing seems to be making a difference. I've started Pilates however this has only just started so haven't seen a result yet. Likewise I'm starting yoga this week to see if that helps to.

Hoping that someone else has an experience like this and can recommend a route forward, it's incredibly frustrating and really makes me exhausted all the time. I'm just looking for any answers and sort of pain relief.  

MRI results;

MRI Thoracic / Lumbar spine and sacro-iliac joints

Sag T1W/T2W/STIR and Ax T2W sequences, supplemented with coronal/axial T1 W/STIR sequences through the sacroiliac joints were obtained.

The vertebral alignment is normal and there is no spinal canal stenosis.

Within the thoracic spine, there is no significant disc herniation /foraminal narrowing/neural impingement. A tiny

noncompressive left paramedian focal disc protrusion at T11/T12 is noted.

Minor end plate irregularities from T7 to T12 vertebral level are noted.

There is a small focus of STIR hyperintensity in the dorsal aspect of the inferior endplate of the T7 vertebral body.

Within the lumbar spine, loss of disc T2 signal (disc dehydration) with minor loss of disc height at L5/S1 is noted. There is a

tiny noncompressive posterocentral focal disc protrusion at L5/S1.

The remainder of the intervertebral discs are normal in height and signal and no significant disc herniation / neural

impingement is shown. End plate infraction/Schmorl's node at L1/L2 is noted

The spinal cord / conus medullaris appear normal and no bone marrow signal abnormality is shown. There is no facet

overgrowth / flaval thickening.

The sacroiliac joints appear symmetrical and no intra-articular/periarticular signal about is shown. There is no presacral

abnormality.

Conclusion: There are minor changes in the thoracic spine and lumbar spine (tiny noncompressive disc herniations, endplate

irregularities and disc dehydration) as described, which are more likely to be degenerative in aetiology.

There is no sacro-ililac joint abnormality.

There is a solitary dorsal end plate lesion at T7 level as described. This in isolation is of doubtful significance, particularly in

the absence of sacro-ililac joint change. However verterbal end plate / corner lesions have been described in ankylosing

spondylitis.

 

2

Hiya I've had really bad lower backache for the last 5 months I've tried everything nothing eases the pain at all I also have upper backache between my shoulder blades waiting in an mri have this done Monday the only thing that has helped me is a hot water bottle my pains worse of the morning then ok through the day then back down hill again bye night time I coulded live with out my hot water bottle it's horrible to have to live with pain like that try hot water bottle see if it helps u x

3

I suffer from lower back pain and have for 10 years and sometimes they don't find any reason but it doesn't mean you don't hurt. So please don't let the fact that the MRI didn't show anything frustrate you that's not that uncommon. All that being said I don't know why you wouldn't do physical therapy. I think it's extremely important that you do it. The Pilates and yoga that you're doing that's excellent too you want to be sure you stay limber and flexible. But nothing can take the place of physical therapy.

4

Try acupuncture it does work

Alternative medications

Your a young person 26 a life full of pain awaits if this is not addressed

45 had back pain since early 20s now I have nerve damage small fibre neurophathy

All teats show normal can't find a course

You don't say If your in the UK ?

If you are my experience with the NHS is mixed

You need to find a very good doctor who will listen

A very good specialist who will do action and sort this out

An operation could make it worse or good

Write too your MP ask for attention too your problems

I wish I could help more

5

Hi marshall,

I tried acupuncture with my osteopath and it worked the first time but then the second and third has no effect on me so we abandoned it as a route that would work.

I am based in the uk, and you're right it is all about the doctor you get.

I do have private healthcare so could pursue that route if it really doesn't get any better.

Thanks for your advice

6

Hi

I likely will do the physical therapy however given that I've done over 8 weeks of an osteopath now wouldn't have thought that it would make much difference as they were manipulating my back muscles at least once a week with a TENS machine as well to try and release the tension. hopefully I'm wrong and the Physio helps.

7

hi,

Finger crossed your MRI gives an indication of what's going on to help you doctors sort it. I just hate being stuck in this limbo with no direction or definitive answers.

I'll try the hot water bottle, I did try a personal TENS pack and that did help relieve some of the pain for a short while but it's not very practical for sleeping with because you wake up tangled in the wires.

Thanks for taking the time to respond.

8

It is not the job of a physical therapist to release your muscles. Physical therapist will give you exercises that will help to strengthen other muscles around the injured area to help support the injured area so that it can Aid in pain relief. For example I have lower back issues so the idea is to strengthen my core muscles. It will be important that you do the exercises at home just like the physical therapist will tell you. And some people have said that physical therapy hurt them too much which is absolutely ridiculous. Because Physical Therapy should never hurt. If it hurts to do the exercise tell your therapist and they will change the type of exercise you're doing so that it does not hurt you. So be sure to work with your therapist very closely.

9

Hi jcr1990

How do you feel after 4 years?
I am very curious because I have the same middle /higher back pain in the morning and sometimes I just need to get up from the bed because I can’t stay because of the pain.
I did a radiography of my lungs because I had covid but nothing, I recently tried a topper but nothing.
I really don’t know what else should I do.
I was surprised that I have the same simptomes that you do “The pain is mid and upper back primarily, if I take a deep breath in the morning I get a sharp pain in my back then as well, the main pain stays until I get up and start moving around but I can still feel a loosely through the day”.

I would like to know more about your evolution.

Thank you!

10

Hey jcr1990,

just wanted to connect because some of your symptomatology is similar to mine and was wondering if you have had more answers regarding a possible AS diagnosis.
I too have been suffering from back pains varying in location. It started back in July with night time back pains around my sides. i did a cycle of muscle relaxant in January and that seemed to take care of that pain but I developed a new more painful area in my upper back in between my shoulder blades (around T5 level there’s a sore spot that hurts to touch and all the area around there kind of hurts and pulls when I bend forward or move in a certain way). I’ve been doing adjustments and physio but the relief has been minimal and the muscle relaxant i was taking for the mid-low back pain did NOTHING for this upper one.
I don’t think anyone in my family was ever diagnosed with AS but we do have autoimmune disorders of some kinds running.
My back specialist is ordering a bone scan (!!!) and after that we’ll see but I think I’d request the HLA 27 gene test as this seems to be more like an inflammatory condition at this point. My spine MRIs were all negative. and my ESR and other bloodwork didn’t show inflammatory process. I’m scared and so frustrated to be dealing with what seems to be an “invisible” pain…

What has been the update for you? I hope you managed to figure it out and that your pain got successfully reduced!!