Army Veteran With Chronic Back Pain

For my story.. I originally developed mild back pain in the summer of 2000 in Airborne School for the United States Army. At the time i just figured it was from the constant jarring motion and repetetively striking the ground feet first from a height of 3-4 feet. The pain was managable but pretty severe. The pain came and went for the next two-three years until approximately the end of 2002/2003.

During my first deployment to the Middle East(Fall 2001-Winter 2002) I again developed moderate lower back pain but once again figured it was from the long distance patrols and such that my daily duties had me doing. But, between my 1st and 2nd deployment, I had a parachute ‘accident’ while on Ft. Bragg. The Army pretty much refuses to admit anything happened that night, although when my time ended, the VA did find my history of back pain and put me on a disability rating.

A little more info on my problem.. For the last two years, and progressing since the incident in 2002, my lower back, exactly on the spine, is under constant, non-stop severe pain. I have general weakness in the legs.. Any type of physical activities(and even some non-physical activities) will cause severe weakness in my lower body. Walking up even a slight incline will leave me unable to lift my feet to walk without shuffling. Activities such are running, carrying any weight, sitting too long, standing too long, laying down too long etc cause SEVERE pain on top of my normal pain and weakness.. Initially after the injury, i lost all feeling and control in my lower body on two occasions 1 day a part. That has not happened since however.

My ‘everyday’ pain on the scale 1-10 is about a 9.5 without pain medications. By a 9.5 i mean i cannot function.. I literally stay in the fetal position, tears running down my face, trying to stretch my lower spine out to no avail.. The severe pain i talk about is a pure 10 out of 10.. I cannot imagine a pain that would be greater then what i experience. I believe i have a high tolerance to pain.. During my first deployment oversea’s, I was stabbed in the upper left thigh, appromixately 2 1/2″ from the groin area. It was a rather dull and rusty knife that penetrated aproximitaly 4-5″ into the thigh muscle and stopping on a bone. During the time that it happened and during the recovery, i managed the pain with no pain medications.

The type of injury would be a compaction of the spine in general. However, i have no pain above the area that I would approximate to be my L5.. maybe 8″ above my buttocks. All of my MRI’s come back ‘negative’ for abnormalities. I have had MRI’s on several occasions starting just after the injury and the most recent being at the end of 06′. I suffer from a constant burning directly on the spine. I can literally feel the points on my spine that are in pain.. I can feel that it is in 2-3 different spots and directly on the spine. The lower spine is also very painful to the touch. It almost feels like it is severely bruised, although there is no discoloration of the skin, and it has felt that way for a few years. A ortho diagnosed me with “Facete Syndrome” and passed me off to a pain center where i recieved several injections and RF burns on the locations they believed to be the source of pain. I recieved no noticable relief from the injections, and the burn did alleviate about 30% of the pain overall for a period of 2-3 weeks at most. Also, I have been to physical therepy a total of 3 times, and have not had relief.

I am currently taking Methadone and oxycontin twice a day for pain management with moderate success on most days.

My question is, what on earth could be causing such severe pain and not show up on a MRI? It feels like several severe toothaches located on my spine combined with my entire lower back being in a charly horse 24 hours a day. The pain never subsides… it ALWAYS hurts. What could cause this? Any information you may have, or idea’s you want to share would be a HUGE help.. I am completely out of idea’s. I have researched for conditions simular to my own on the internet for a few years with no luck.

Over the last few years, my medications have been changed and increased with no huge amount of pain relief.

I started off in 2002 taking tramadol and got very little relief.. After gettng out of the Army and seeing a civilian doctor, they put me back on Tramadol.. Once i was taking the maximum dosage they switched me to Vicoden.. And then to Oxycontin.. and then to Oxycontin and Vicoden.. and then too Fentynel.. and then now to Methadone and Oxycontin.. I slowly get more pain relief but the medications arent enough to mask enough of the pain where i can function in day to day life.

Doctor Joshua’s Answer:

Your description strongly suggests neuropathic pain. I’m sure you understand that I cannot diagnose your symptoms over the internet, so I’m only presenting this as a talking point for your next visit to the doctor.

Please see the following previous answers to get more information on neuropathic pain. While they are not specific to your case, they contain relevant discussion:

Chronic Pain in Thoracic Region

Chronic Pain Syndrome - Tired of Pain

There are some medicines that are useful especially in the treatment of neuropathic pain, such as Lyrica (pregabalin), Neurontin (gabapentin), also amitriptyline and carbamazepine. Discuss with your doctor the possibility of trying one of these.

There are also other treatments for neuropathic pain, including TNS (transcutaneous nerve stimulation) and spinal cord stimulation (SCS), although spinal cord stimulation is usually reserved for cases where the cause of the pain has been determined. Also, spinal cord stimulation has very limited effect on back pain.

Local anaesthetic products have been used with some success, when the pain is superficial.

Also, as a war veteran you may be prone to post traumatic stress disorder (PTSD), which may exacerbate such symptoms in some cases, even if the connection is not apparent to you. (of course, I am talking in general terms, and cannot say whether this is relevant in your case)

Please see a pain specialist - and if you were my patient I’d want you to see a psychiatrist as well to account for the possibility of PTSD.