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  • Upper Back Pain With Reflux, So Painful

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    Old 07-02-2006, 09:39 PM   #16
    tm3912
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    Re: Upper Back Pain With Reflux, So Painful

    karen,

    I hope I'm not out of line here but want to make sure there is not a misunderstanding. The xanax has no analgesic properties (that I know of I take lorazapam when needed) and will not help with the spasms in that way. Xanax is used to help alleviate anxiety, which comes with these spasms. (You think you are having an heart attack so you become anxious). (This information comes from a government site but I don't think we are allowed to post addresses on this site)

    I use tramadol for the pain I have in my back and chest. Tramadol works on the CNS. I start out in the morning fine but by noon my back and chest are screaming. when I get home I have to take a tramadol which has worked wonders. (I've been on for 1 week) problem is tramadol can be addictive so I only use one tablet a day instead of the 8 you can take.

    So I didn't want you to take a klonopan thinking that it would stop the pain. What it might do though is to calm you some. I think what happens to a lot of us is we have this pain all the time so when it starts we obsess on it and worry about it and it becomes worse and worse because of our worrying. (not saying it's not there or all in your head but in my case I know i can compound by obsessing about it)

    Try an experiment, the next time you have the pain take a klonopan, if it helps that tells you that some of the pain is from tense muscle etc from worrying. If it does nothing then you have your answer...oh yea only do this when you are in for the night it might make you very tired, etc.

    Let us know what happens

     
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    Old 07-03-2006, 06:19 AM   #17
    karen7
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    Re: Upper Back Pain With Reflux, So Painful

    Thank you so much for clarifying that. Yes, I did think you meant it helped the pain. I know that xanax is for anxiety and thought perhaps it has some muscle relaxant properties I wasn't aware of. When the pain gets bad, I usually take two tylenols so as not to upset my stomach further. If this continues, I'll have to really restrict my diet 100% (no chocolate or LES muscle relaxing things, etc.) or consider surgery which to me would be a last result. I heard there are newer techniques since Nissin that are more effective. Also trying to lose 10 pounds which may help the hiatal hernia that's partially responsible for this mess! Thank goodness I only get that back pain occasionally.

     
    Old 07-03-2006, 08:36 AM   #18
    Vickie306
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    Re: Upper Back Pain With Reflux, So Painful

    Karen.....the Xanax is not a pain reliever. What it does is relax the muscles of the esophagus and chest wall. Spasms cause pain. When the spasm stops so does the pain. My recent problem for what ever reason, the xanax which has worked for 16 years....did not stop the spasm. This is why I ended up with a hospital workup.

    Maybe I should also explain that the first episode 16 years ago that landed me in the ER, was diagnosed as esophageal spasm, when the doc found out that I had been sitting in a movie theater eating buttery popcorn.
    Blam.....out of no where with no previous symptoms of any kind.....my chest felt like an elephant stomped on it. It bore thru to my back and the pain was so intense I could barely breathe.

    EKG was normal.....other tests were as well. They gave me a GI cocktail of maalox and xanax......almost immediately (not more than a few minutes)......pain totally gone. That confirmed the doc's diagnosis. The rich popcorn had caused stomach acid to splash into my esophagus and my body reacted by sending the muscles of my esophagus into a severe spasm. I didn't even know the acid had splashed into it.

    Within a few months I started to have "water brash". And spicey food...citrus....and tomato based foods started giving me indigestion. That's when the acid reflux diagnosis was added to the esophageal spasms.

    As I said in my OP....I am now still to take the xanax when the episode hits...as I have always done, but if the pain continues or increases, obviously the spasm is not stopping, and they have now added a pain med to my medical management for those episodes.

    Sorry if somehow you thought the xanax would control the "intense" type pain. My situation may be quite different from others here with basic acid reflux. I have a combo of acid reflux plus diffuse esophageal spasms.

    Last edited by Vickie306; 07-03-2006 at 09:00 AM.

     
    Old 07-03-2006, 09:09 AM   #19
    moesciphish
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    Re: Upper Back Pain With Reflux, So Painful

    I too suffer from horrible esophageal spasms... I thought I was having a heart attack also and had a nuclear stress test and echocardiogram to rule out problems with the heart. I get HORRENDOUS back pain and chest pain... really bad episodes seem to come on with anxiety and stress and have been completely debilitating and along with back and chest pain my whole upper body seems to clench and tighten up. I was given diazepam (valium) for anxiety reasons and when I took it, I noticed it relaxed my esophagus also... benzo's are muscle relaxants and they really don't know why diazepam causes anxiety relief, because it was originially used as a muscle relaxant. Unfortunately, the diazepam caused my heart to race and pound really hard, so I'm scared to take it again, and do not want to become addicted to it. I'm starting to think my whole problem is psychological in nature, ie stress I've been going through is causing my reflux and my esophagus to clench all the time. Vickie, did your GI mention anything about an low-dose anti-depressant to help? I know both my GI and GP have mention putting me on a low dose AD, one, because of my anxiety and two, because my GI said it would help with the esophageal spasms. I'm always reluctant to try new drugs, especially psychotropic ones, but I'm getting desperate. Also, you should try nexium. I've tried protonix and aciphex... both gave me horrible side effects... I started nexium a couple of days ago and it's been a god-send... no effects of ANY kind.

    Last edited by moesciphish; 07-03-2006 at 09:11 AM.

     
    Old 07-03-2006, 10:59 AM   #20
    tm3912
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    Question Re: Upper Back Pain With Reflux, So Painful

    Moe,

    I have a similar situation in that the pain was consuming my every thought and I became depressed (mild no suicide thoughts,etc just kind of defeated by the whole thing) by the constant worry. My Doc wanted to put me on a low dose AD but after researching the side effects I just couldn't do it. Well I have a very forward thinking doctor and she suggested SAM-e (pronounced sammy has a very long scientific name). It is an amino acid but has been used in Europe for 20+ years to treat mild depression. The nice part is that it has a very low side effect issue (really none) and seems to work faster than the AD's. I could go on and say alot more about it but would probably get some of it wrong. So go to any search engine and type in "SAM-e" and do your research. I will say that in some of the studies they did they used 1600mg of the stuff. I find that to be WAY too much and I use 400mg a day. It took about 3 weeks for it to really kick in. Also to let you know it will not help the pain but what it did for me was to help calm my mind so the pain doesn't consume my every thought any more. Let me know what you think.

     
    Old 07-03-2006, 03:51 PM   #21
    moesciphish
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    Re: Upper Back Pain With Reflux, So Painful

    I have actually have read alittle about SAM-e and was debating on trying it... I haven't read enough, but I will... it's over the counter... well you can get it at like GNC... but has it been FDA approved? I've thought about alternatives to AD's because I really don't want to get on them... but it's come to the point where I need something... I've even thought about St. John's wort...

     
    Old 07-03-2006, 05:36 PM   #22
    tm3912
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    Re: Upper Back Pain With Reflux, So Painful

    No I'm almost sure it is not FDA approved for depression. (which means nothing to me) Please continue your research, I think you will find that St John Wart is not near as effective as Sam-e. In my opinion there is little downside as the side effects are almost nil. the one thing that I hear about is cost, 2.00 dollars a pill. That is crazy talk and if you look on the internet enough you can get 30 tablets for 20.00 bucks or .67 a tablet.

    Remember it's not a miracle but does help. Good luck

     
    Old 07-03-2006, 08:19 PM   #23
    Vickie306
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    Re: Upper Back Pain With Reflux, So Painful

    Hi Moe. My GI suggested the Xanax .05mg. That was 16 years ago. I have never had to increase the strength or frequency. I have had zero side effects from the xanax. I am exquisitely chemical sensitive. Many many drugs I cannot tolerate. I thankfully do not suffer from anxiety or depression.

    My esophageal spasms are a result of nerve damage. I can only imagine how awful it must be to have this problem and then have it compounded with anxiety disorder.

    My spasms are very much like yours. Thank God they do not happen every day. In the past the Xanax would relax the esophageal muscle, and that would stop the pain. Think of it like a severe spasm in your calf muscle, ya know. Then it all makes sense. Once you stop the spasm....the pain goes away. However....I have evidently taken a downward step. Most esophageal spasms are due to either acid reflux, and/or damage to the nerve endings in the esophagus. I have both.

    None of my Dr's have suggested use of AD's, since I don't suffer depression. The CNS (xanax) as I have said, took care of the problem for 16 years. Evidently the nerve damage has gotten worse, so now I'm going to occasionally need a narcotic along with it to handle the severe pain that now is going to accompany the worst of the attacks.

    Over the years as they have been approved, my GI has tried me on many PPI's. Everyone has caused awful side effects. So I basically did a total lifestyle dietary change. No citrus, tomato based foods, greasy foods, spicey foods, no caffeine. It really was not hard to do.....because as you well know.....the attacks are so horrible, it was actually easy to eliminate them from my diet.

    Last edited by Vickie306; 07-03-2006 at 08:30 PM.

     
    Old 07-04-2006, 06:00 AM   #24
    moesciphish
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    Re: Upper Back Pain With Reflux, So Painful

    Actually.. before I was experiencing alot of anxiety, my GI suggested the AD and said it has helped with some people and that nitrates don't really do much... also.. honestly, I would really give nexium a try. I had horrible side effects on protonix and aciphex, but the nexium has done absolutely nothing as far as side effects and has done exactly what it's supposed to do for reflux...I wouldn't even know I have taken it except for the relief... the thing is, if reflux is causing more and more nerve damage, you really need something to control it.. I know diet isn't good enough... I tried changing my diet, and while it helped, it didn't give me the relief I have found with nexium. Have you been scoped? Not to scare, but if you are having constant reflux I would worry about Barrett's... I have a patch of it very high up in my esophagus for some reason ...anyway, I hope they find something if the xanax is wearing off.. have they suggested another benzo maybe? Klonopin or Activan? Or something like skelaxin or flexeril? Except that I guess there is a difference between smooth muscle relaxants and things for like your legs and such...

    I'm so scared about using benzo's though to cure it because the feeling of not having my esophagus constricted constantly would be too addicting and the drugs are so addicting as is... Has anyone talk to you about esophageal stretching?? I think I read somewhere that this may help for esophageal spasms and contriction....

    Last edited by moesciphish; 07-04-2006 at 06:03 AM.

     
    Old 07-04-2006, 06:57 AM   #25
    karen7
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    Re: Upper Back Pain With Reflux, So Painful

    moesciphish, you ask some good questions. I don't have the answers as far as flexiril but I can't imagine being on flexiril when I have to function...it makes me very sleepy! My feelings about antidepressants are that I would rather go through the reflux pain than go through withdrawal from antidepresssants (I once did and it was a nightmare). Some people say that you can be on antidepressants forever but there's not enough research on that and the day may come when we are unable to get them for some reason and then what?

    I have better luck on Prevacid than Nexium so it's a very individual thing, trial and error. I would rather give up every culprit food than be on a benzo or antidepressant consistently but I respect other's choices if that's all that works for the spasms. I am curious about your questions as far as which muscles are relaxed and will ask my GI doctor. If anyone finds out the answer, please post it on this thread. It feels like someone is drilling a hole through my upper back when I get this pain. I am soooo miserable when it happens, I take Tums, simethicone (Gas-X), ginger tea, anything to break it up. I usually burp a lot when this happens so think it's gas. Does anyone else see a correlation with the burping and that pain?

     
    Old 07-04-2006, 08:05 AM   #26
    moesciphish
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    Re: Upper Back Pain With Reflux, So Painful

    Yes, I belch like crazy when I get the pain in hoping that it will stop the spasms... I have slow gastric emptying.. so I think my reflux and spasms occur because of food sitting in my stomach and weighing it down with no muscle movement to support itself.. like a limp heavy bag... though the belching really doesn't do anything but allow for more reflux to come up (LES opening constantly).. it's a catch 22 unfortunately... either sit there in pain from being bloated... or belch to relieve it and cause more reflux...... nothing I have found relieves the problem at all except exercise... I make it a point now to try and walk around briskly or jog after I eat... especially big meals, which I stay away from but honestly, it's really hard to do, I find it hard to eat 6 small meals a day... especially at work or if I'm trying to have an active social life.. I can tell through the day though my symptoms get worse and worse as more food seems to collect down there... it really stinks... I really don't want to try reglan because of the side effects and I'm already depressed about my condition and the pain... anyone have a good story with domperidone? I will pay the extra to have it imported if I have to... cause this just isn't very fun anymore... and what's worse.. my favorite foods were spicy foods and pasta

    btw.. about the nexium... I've just seen/heard several comments about how nexium is supposed to be metabolised by the body better and that's why people think it works better for some people and not cause as many side effects... I'm not trying to push it.. I just had severe side effects with the others I've taken and nexium hasn't bothered me in the least bit and seems to be working correctly...I was about to give up all hope on using PPI's when I gave nexium a try...and am so thankful it worked

    Last edited by moesciphish; 07-04-2006 at 08:09 AM.

     
    Old 07-04-2006, 07:44 PM   #27
    Vickie306
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    Re: Upper Back Pain With Reflux, So Painful

    Hi Moe. Yes I have been scoped 3 times over the last 16 years, with the latest one being done this past Saturday morning, at the hospital.

    Believe it or not.....the lining of my esophagus is a beautiful healthy pink. I have no lining damage or scarring. It has been that way on all 3 scopes. One in 1995, next one in 2002, and the one I just had. All 3 revealed a small hiatal hernia that has not gotten any larger.

    Prilosec worked for me for several years, and then suddenly in 2002, I started having horrible stomach pain upon taking it. That's when they tried me on Prevacid and my face and lips swelled up. Next was Aciphex which made me live in the bathroom.

    Sat., they sent me home with a scrip to fill for Nexium. I have not done that yet. I know it's just a newer generation of Prilosec and one of it's common side effects is "abdominal pain" which is why I had to stop Prilosec.

    I completely stay away from rich fatty foods, but I guess the loaded potato soup must have been to rich. Or at least....I guess that's what wound me up in the hospital for 36 hours.

    So....my problem is spastic esophageal motility disorder. According to specialists, chest pain that bores into the back is the "hallmark" symptom of spastic esophageal motility disorders, and also patients commonly report difficuly in swallowing. The chest pain mimics angina. Patients also commonly report heartburn, regurgitation, and other complaints of reflux disease due to ineffective acid clearance from the esophagus.

    I've never tried Pepcid. I'm thinking of trying a bottle of it.

    The gastro that scoped me Saturday morning, said that treatment protocol, called for Xanax and even adding Bentyl, because Bentyl, treats GI motility disturbances. It blocks action of acetylcholine parasympathetic sites in secretory glands, smooth muscle and CNS. So he told me the next time I had a really bad attack, to take the Xanax/Bentyl together. I filled the bentyl scrip. We'll see what happens, and then I'll report.

    Last edited by Vickie306; 07-04-2006 at 07:54 PM.

     
    Old 05-01-2008, 08:23 AM   #28
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    Re: Upper Back Pain With Reflux, So Painful

    Quote:
    Originally Posted by karen7 View Post
    I have been taking Prevacid for 3 years. I had an endoscopy last month and still have slight irritation. I follow most of the rules and have my bed raised. I know when I eat chocolate and the other offenders, it acts up. However, even when I am eating correctly sometimes I get a lot of burping...nothing comes up but the pain is worse in my upper back between the shoulder blades. When I burp it improves so I am almost sure it's from gas. I also get the gas pains in my face and jaw. SO uncomfortable. I'd like to know if anyone else gets this awful back pain and what you do for it and if you are on any medications, if so, which one. Thanks.

     
    Old 05-01-2008, 08:29 AM   #29
    roxiehart1
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    Re: Upper Back Pain With Reflux, So Painful

    h

    have similar systems except not in the jaw just across the upper back and have a lot of gas. The pain is relieved when i force myself to burp. What could be some of the causes of this. I do take prilosec otc once a day because i had an extensive about of dental work and implant surgery and for the first time in my life got acid reflux and my doctor suggested that i take prilosec otc and it seemed to cure the acid reflux, but recently i started getting these gas like pains across my upper back.

     
    Old 05-01-2008, 08:38 AM   #30
    Vanessa74
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    Re: Upper Back Pain With Reflux, So Painful

    It could actually be a side effect of the Prilosec (suppresing the acid in your stomach).

    Look up some of the side effects of the medication - that may be one.

    Good luck to you!

     
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