Overcoming Chronic Pain and Anxiety: A Path to Normal Life

Q: Overcoming Chronic Pain and Anxiety: A Path to Normal Life

Hello： Here are some personal suggestions regarding the issues you raised： <br>1. <br>Anxiety disorder + hypochondriasis + autonomic nervous system dysregulation with palpitations + left-sided headache and numbness： - It is recommended to continue taking psychiatric medications t

Long-term pain in the hands, feet, waist, and neck, along with anxiety and psychosomatic issues, how can one return to a normal life?

Hello doctor, I have been suffering from various ailments for 5 years and have not worked for 3 years.
It started with numbness in my left leg due to prolonged sitting, which later progressed to pain in my left knee.
The entire leg felt numb, as if blood was not circulating, and this numbness persisted throughout the day.
Then I began to experience lower back pain.
After several months of various treatments including stretching, rehabilitation, and chiropractic care, I was unable to improve and became bedridden.
X-rays and MRI confirmed a slight disc protrusion in my lumbar region, but the doctor said the symptoms did not appear to be that severe.
After various conservative treatments failed, the doctor injected hyaluronic acid and possibly steroids into my knee, which gradually improved my condition, alleviating the back pain as well.
However, due to the prolonged suffering (almost a year), I developed health anxiety and cervical spondylosis.
I started to notice pain in my left hand, left shoulder, and scapula, with soreness lasting half the day.
In my state of health anxiety, I would investigate any discomfort, fearing unexpected events, which led to frequent insomnia.
My mother believed I had depression and unilaterally gave me her antidepressants, urging me to return to work.
After taking them for a few months, I realized I had little memory of that time and eventually stopped taking them, as I had various ailments and each time I sought medical attention, it was either minor issues or no problems at all.
Gradually, I lost the desire to see doctors and remained unemployed at home.
Then the pandemic hit, and rehabilitation stopped.
I endured left shoulder and neck pain for 2 years, during which I also developed abdominal pain, constipation, left-sided headaches, ear pain, temporomandibular joint disorder, toothaches, and various joints producing creaking sounds.
Initially, I could cope, but two months ago, my pet was nearing death, which led to obsessive thoughts about death and panic attacks, along with symptoms of autonomic nervous system dysregulation, including palpitations, headaches, loss of appetite, a feeling of unreality, and chest tightness.
Within two weeks, I saw doctors over ten times and was diagnosed with anxiety disorder.
Now, I rely on sedatives, painkillers, and traditional Chinese medicine to manage my condition.
However, I have noticed small bubbles in my urine that last almost half a day, possibly indicating proteinuria.
Yet, after two visits to the hospital for blood and urine tests, both results were normal.
Currently, I am experiencing urinary issues, and every time I see it, I feel uncomfortable.
Additionally, I sense the return of the lower back pain and left leg numbness I experienced years ago.

The current symptoms and medical situation are such that no significant issues can be identified, yet I feel very uncomfortable.
I can only rely on painkillers for my anxiety, health anxiety, panic, autonomic nervous system dysregulation, palpitations, left-sided headaches, and numbness (psychiatric medications, temporomandibular joint disorder—3 years of treatment with no improvement, occlusal splint, left shoulder, neck, and scapula pain, severe soreness in the left neck (X-ray shows slight straightening of the neck), mild lower back pain, left leg numbness (small protrusion found on MRI 5 years ago), small bubbles in urine with frequent urination (cause unknown), abdominal pain, constipation, and sharp pain in the buttocks (gastrointestinal endoscopy 4 years ago showed no issues, treated with gastric medication).

Hong, 20~29 year old female. Ask Date: 2023/10/11

Dr. Lin Zhebin reply Family Medicine

Hello: Here are some personal suggestions regarding the issues you raised:
1.
Anxiety disorder + hypochondriasis + autonomic nervous system dysregulation with palpitations + left-sided headache and numbness: - It is recommended to continue taking psychiatric medications to alleviate psychological discomfort.
Patience is essential, as psychiatric medications typically require some time to show significant improvement.
2.
Temporomandibular joint disorder: - It is usually advised to start with analgesics and anti-inflammatory medications.
If there is no improvement over time, it is recommended to consult an otolaryngologist.
3.
Pain in the left shoulder and scapula + severe soreness in the left neck (X-ray shows slight straightening of the neck): - Initially, analgesics and anti-inflammatory medications should be used.
Additionally, physical therapy can be beneficial.
If there is still no improvement, further evaluation with an MRI to check for nerve compression and consideration of surgical treatment may be warranted.
4.
Mild lower back pain with numbness in the left leg (MRI five years ago showed a small herniation - previous MRI indicated a herniated disc): - If it is not severe, the initial approach typically involves analgesics and neuropathic pain medications, along with physical therapy.
If symptoms persist, follow-up MRI and consideration of surgical intervention may be necessary.
5.
Foamy urine + frequent urination: - Given your age, prostate enlargement is unlikely to be an issue.
It is more concerning to rule out potential kidney problems, so it is advisable to consult a nephrologist.
6.
Abdominal pain + constipation + sharp pain in the buttocks: - Based on your symptom description and the absence of issues in the gastrointestinal endoscopy, it is suspected that chronic constipation may be causing abdominal pain.
The sharp pain in the buttocks may suggest the presence of hemorrhoids.
It is recommended to see a colorectal surgeon.
Generally, long-term use of gastrointestinal medications and stool softeners does not significantly burden the body.
Lastly, I suggest you engage in outdoor group activities (work can also be included) and develop a regular exercise routine, as these can be beneficial for your overall mental and physical health.

Reply Date: 2023/10/11

More Info

Overcoming chronic pain and anxiety can be a daunting journey, especially when it feels like a cycle of discomfort and distress is relentless. Your experience highlights a complex interplay between physical ailments and psychological challenges, which is not uncommon in individuals dealing with chronic pain.
Firstly, it’s important to acknowledge the impact that chronic pain can have on mental health. The body and mind are intricately connected; when one suffers, the other often follows suit. In your case, the initial physical symptoms—numbness in your leg, knee pain, and subsequent back issues—have understandably led to heightened anxiety and health concerns. This is a common response, as chronic pain can create a sense of vulnerability and fear about one’s health, leading to a cycle of anxiety and physical discomfort.

From a medical perspective, it’s crucial to address both the physical and psychological components of your condition. While you have undergone various treatments, including injections and medications, it may be beneficial to explore a multidisciplinary approach. This could involve a combination of physical therapy, psychological counseling, and possibly medication management tailored to your specific needs.
Physical therapy can be particularly effective in managing chronic pain. A skilled therapist can help you develop a personalized exercise regimen that strengthens the muscles around your affected areas, improves flexibility, and reduces pain. Additionally, techniques such as manual therapy, acupuncture, or even mindfulness-based stress reduction can be beneficial in alleviating pain and anxiety.

On the psychological side, cognitive-behavioral therapy (CBT) has shown great efficacy in treating anxiety and chronic pain. CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to your distress. By working with a therapist, you can learn coping strategies to manage anxiety, reduce fear of pain, and improve your overall mental health.
Moreover, it’s essential to address the fear of illness that you mentioned. This condition, often referred to as health anxiety or hypochondria, can exacerbate your physical symptoms and lead to a cycle of seeking medical reassurance that may not provide lasting relief. A therapist can help you develop healthier coping mechanisms and challenge the thoughts that fuel your anxiety.

In terms of medication, while it’s understandable that you may have concerns about the side effects of antidepressants or anti-anxiety medications, it’s important to have an open dialogue with your healthcare provider. There are various classes of medications available, and sometimes it takes time to find the right one that balances efficacy with manageable side effects. If you are experiencing significant distress from your symptoms, it may be worth revisiting the idea of medication with your doctor, especially if it can help stabilize your condition.

Lastly, consider incorporating lifestyle changes that promote overall well-being. Regular physical activity, a balanced diet, adequate sleep, and mindfulness practices such as meditation or yoga can significantly improve both physical and mental health. Engaging in activities that bring you joy and fulfillment can also help shift your focus away from pain and anxiety.

In conclusion, overcoming chronic pain and anxiety is a multifaceted process that requires a comprehensive approach. By addressing both the physical and psychological aspects of your condition, seeking appropriate therapies, and fostering a supportive environment, you can work towards regaining control over your life. Remember, it’s okay to seek help and take small steps towards recovery. You are not alone in this journey, and with the right support and strategies, it is possible to find relief and improve your quality of life.

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