Back Pain: Insights for New Moms with SLE

Q: Back Pain: Insights for New Moms with SLE

Hello： If your symptoms of pain persist, you may want to consider fibromyalgia syndrome. <br>Statistically, individuals with systemic lupus erythematosus (SLE) have an increased risk of developing this condition. <br>Although the pathogenic mechanisms remain unclear, it may be re

Back problems

Hello, doctor! I have systemic lupus erythematosus (SLE), and my levels are currently normal.
I just gave birth 13 months ago! However, due to my child's significant weight, I find it challenging to carry and care for them, as my physical strength is quite limited.
When my child was over 6 months old, I began to notice intermittent pain in my left upper back and shoulder blade, accompanied by numbness and tingling.
I felt quite anxious for a while, so I decided to see a rehabilitation specialist.
After an X-ray, they found no issues with my bones and suggested that my posture might be the cause.
I then underwent physical therapy with electrical stimulation for about three weeks, but it seemed to provide only temporary relief.
I took the X-ray results and sought a referral to a larger hospital's neurosurgery department.
They performed additional imaging and concluded that my symptoms were due to muscle strain, advising me to carry my child less, but they couldn't identify the underlying cause.
After that, there was no further progress.
I often feel exhausted, and the pain flares up intermittently.
I use pain relief patches to alleviate the numbness, but I rarely hear about others experiencing numbness in their upper back.
Later, during a follow-up for my SLE, my attending physician noted that my back pain was affecting my quality of life.
In addition to prescribing pain medication, they conducted a nerve conduction study, which revealed that only the nerves in my hands showed some compression, likely from carrying my child.
There seemed to be no neurological issues related to my back.
After that, there was still no resolution.

Doctor, I hope you can provide some advice.
I really don't want to rely on pain medication to get through my days.
This numbness and pain in my back have been uncomfortable for three to four months now.
Is there really no way to heal? Doctor: Is there hope for me? I hope to find out why my back is experiencing numbness and pain.

Zhenzhen, 30~39 year old female. Ask Date: 2020/08/15

Dr. Jiang Junyi reply Neurology

Hello: If your symptoms of pain persist, you may want to consider fibromyalgia syndrome.
Statistically, individuals with systemic lupus erythematosus (SLE) have an increased risk of developing this condition.
Although the pathogenic mechanisms remain unclear, it may be related to an imbalance of neurotransmitters in the central nervous system that regulate pain, including serotonin, dopamine, and catecholamines.
In fibromyalgia, this dysregulation of neurotransmitters may alter the excitability of the central nervous system, thereby affecting the perception of peripheral pain.
Additionally, psychological stress or environmental factors such as infections and trauma may also be potential causes.
The clinical diagnostic criteria, based on the 1990 American College of Rheumatology definition, require that widespread pain affects both sides of the body and the upper and lower regions of the back, with more than 11 tender points out of 18 specific sites, and must persist for more than three months.
It is recommended that you consult with a neurologist or a rheumatologist for discussion and treatment.
Wishing you good health and peace.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2020/08/15

More Info

It sounds like you are going through a challenging time with your back pain, especially as a new mom managing the demands of caring for your child while also dealing with systemic lupus erythematosus (SLE). Your experience is not uncommon among new mothers, particularly those with underlying health conditions. Let’s delve into some insights regarding your situation.

First, it’s important to understand that back pain, especially in the context of lifting and carrying a child, can often be attributed to muscle strain or poor posture. Given your description, it seems likely that the pain you are experiencing in your left shoulder blade area could be related to the physical demands of motherhood, particularly if you are frequently lifting your baby or holding them in a way that puts strain on your back.
The fact that your X-rays and neurological evaluations have not revealed any significant structural issues is a positive sign, indicating that there may not be any serious underlying pathology. However, it does not diminish the discomfort you are experiencing. Muscle strain and overuse can lead to inflammation and pain, which may manifest as the symptoms you are describing, including the numbness or tingling sensations.

Here are some strategies that may help alleviate your back pain:
1. Posture Awareness: Pay attention to your posture when lifting your child. Use your legs to lift rather than bending at the waist, and try to keep your child close to your body to reduce strain on your back.

2. Strengthening Exercises: Engage in exercises that strengthen your core and back muscles. A strong core can provide better support for your spine and reduce the risk of injury. Consult with a physical therapist who can tailor a program to your specific needs, especially considering your SLE.

3. Stretching: Incorporate gentle stretching into your daily routine. Stretching can help relieve tension in the muscles and improve flexibility, which may alleviate some of the discomfort you are experiencing.

4. Heat and Cold Therapy: Applying heat to the affected area can help relax tight muscles, while cold therapy can reduce inflammation. Alternating between the two may provide relief.

5. Ergonomic Support: Consider using ergonomic baby carriers or slings that distribute the weight more evenly across your body, reducing strain on any one area.

6. Physical Therapy: Since you have already seen a physical therapist, you might want to explore additional sessions focusing on manual therapy techniques, which can help relieve muscle tension and improve mobility.

7. Mindfulness and Relaxation Techniques: Stress can exacerbate pain perception. Techniques such as mindfulness, meditation, or gentle yoga can help manage stress and improve your overall sense of well-being.

8. Regular Follow-ups: Continue to communicate with your healthcare providers about your symptoms. If your pain persists or worsens, further evaluation may be necessary. Sometimes, a multidisciplinary approach involving rheumatologists, pain specialists, and physical therapists can yield better results.

9. Medication Management: While you prefer to avoid pain medications, it’s important to discuss with your doctor the possibility of using non-steroidal anti-inflammatory drugs (NSAIDs) or other alternatives that may provide relief without long-term reliance on stronger pain medications.

10. Support System: Don’t hesitate to lean on family and friends for support. Sharing the responsibilities of childcare can help alleviate some of the physical strain you are experiencing.

In conclusion, while it may take time to find the right combination of treatments and lifestyle adjustments to manage your back pain effectively, there is hope for improvement. Your proactive approach to seeking help and understanding your condition is commendable. Remember, you are not alone in this journey, and with the right support and strategies, you can work towards alleviating your discomfort and enhancing your quality of life as a new mom.

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