Why does everything hurt so much?
November 26, 2010 6:04 PM   Subscribe

Why does prolonged physical exertion put me in a state of intolerable pain?

It has been brought to my attention by more than a few people that things hurt me more than they should.

As a kid, I tended to avoid anything physically strenuous, although I don't really remember why. My family pretty much forced me to take tennis lessons and hitting an adrenaline rush was the worst goddamn thing. I still wince when I think back to it. I felt like my body wanted to escape from my skin, I couldn't breathe and I pretty much just wanted to lay down and cry until it stopped.

Now I am in my mid-20s, 5"7 and 135 lbs., and pretty out of shape. I can do about five or six pushups in a row, and maybe two pullups if I have eaten enough the previous day. I've had lumbar scoliosis since I was a kid, and my doctor recently took a look at it; he said it is not bad enough for anything extreme to be done about it. If it matters, I take a mood stabilizer, an antidepressant, Ritalin and Nexium. Nothing has changed for the better or worse since starting any of these medications. I've been on all of them for at least two years now. Cutting them out or lowering the dosage is not an option.

Any sort of prolonged physical activity leaves me in its own state of prolonged pain. I can't sit in the same position in a chair because it rubs on my spine. Even something as simple as sweeping the house or shoveling snow for a half hour puts me in a state of miserable back pain that leaves me on the verge of tears. My back feels like it is full of sharp pinpricks when I climb a lot of stairs, although endurance-wise I am fine. And every one of these pains gets to the point where it is almost blinding if I continue the activity. A little while ago, I got sick and the body and head aches brought me to the verge of tears. A few months ago I woke up being unable to move my back without pain shooting through me -- I carried a 30 lb bag of laundry home, slung across my shoulders -- and I was barely able to get to the electric pad I use for when the back pain gets too bad to stand. Sex, for some reason, is exempt from this. I end up exhausted, but not in pain.

Is working out a solution to this? Am I just really, really out of shape? I've had (non-medical) people tell me it is everything from the "nerves being too close to the skin" to my brain amplifying pain signals. That sounds like a lot of bullshit to me, but what do I know?
posted by anonymous to Health & Fitness (17 answers total) 4 users marked this as a favorite
That does sound like crap. Perhaps a rheumatology consult is in order; they're good at chronic pain.
posted by fairytale of los angeles at 6:12 PM on November 26, 2010

If you can email a mod: Is the pain just in your back? Or do you experience pain when other parts of your body are touched or stressed?

Also, shoveling snow is not really a simple task; it's tremendously taxing to the body.
posted by purpleclover at 6:19 PM on November 26, 2010

I get that when I haven't been specifically exercising my back. This, for me, can be as simple as being sure to force my spine to curve properly while I am sitting. I've had poor posture all my life, so this can actually be tiring. But after a while it begins to feel right again. And then I forget to pay attention and it starts all over again.

Also, might be apt, might not: there is evidence that people with one of the red hair genes process pain differently.
posted by gjc at 6:31 PM on November 26, 2010

Mod note: From the OP:
Pain I experience just about anywhere seems to be higher than "normal." My sides (the areas to the left and right of my stomach) are the most sensitive. An open-hand slap there, for instance, is one of the most painful things I have ever encountered.

Also, if it matters, I'm really, really sensitive to changes in heat and cold. I can't take cold or hot showers, they have to be just slightly warmer than lukewarm. In the winter, I wear layers I can strip off as fast as possible because heat makes me incredibly physically uncomfortable to the point of pain. I do not own a single sweater because of this.
posted by mathowie (staff) at 6:36 PM on November 26, 2010

5'7" and 135 while also out of shape sounds incredibly thin. Like lack of muscular support, especially in the abdominal area.

What is your diet like?
posted by Max Power at 6:48 PM on November 26, 2010

I think I can say with a certain amount of confidence that this is not a normal function of being out of shape. I've gone from pretty damn in-shape to pretty reliably marshmallow-y, and it doesn't have the slightest effect on my skin sensitivity or pain tolerance.

When you say your doctor "took a look at" your back - did he/she actually do any tests or scans, or did they just have you take your shirt off and glance at your posture? Have you actually told your doctor all of these things - not just the back pain, but the heat intolerance, the skin sensitivity, etc?

If you're looking for a general baseline here, I suggest that no, this is not normal and you should treat it like a medical issue. It doesn't seem real likely to me that some minor lifestyle changes will help without deeper insight into what's actually going on.
posted by restless_nomad at 6:51 PM on November 26, 2010

I'm a rank amateur, not any sort of medical anything. That said, I have some experience with relatives who have sensory processing disorder, also called sensory integration disorder. You might look around the Web and see if you recognize any of the symptoms in yourself.
posted by purpleclover at 6:54 PM on November 26, 2010

IANAD, IANYD, but it sounds like nerve damage to me. Like you either have too much B12 or too little. It also sounds like it could be some variation on fibromyalgia.

It couldn't hurt to have a neurologist or two give you a full check up. Dittoing the rheumatologist as well. This isn't normal, and your height, weight and age indicate your body should be doing swimmingly.
posted by patronuscharms at 6:55 PM on November 26, 2010 [1 favorite]

IANAD, but I am a patient, with some issues somewhat similar to yours. I ended up diagnosed with a cluster of several autoimmune diseases. There are lots of weird symptoms, but the ones that trouble me most are exercise intolerance and heat intolerance. These are common problems in many autoimmune diseases (others too I'm sure), so I strongly second the suggestion that you be evaluated by a rheumatologist.
Our culture is saturated with messages that exercise is a general cure-all. It's way too easy to give yourself a guilt trip and think "if only I work out more I'll get better." Based on your description, it sounds like you've got some real medical issue going on. Listen to your body--pain means "stop." I made myself sicker than necessary before I learned that trying too hard made things worse, not better. Good luck.
posted by Corvid at 6:56 PM on November 26, 2010

Another vote for "not normal". Seek multiple opinions until someone says something that makes sense or is able to successfully treat you.
posted by jpeacock at 6:57 PM on November 26, 2010

Very interesting question, thanks for asking it.

I think most of what you describe can be laid to your lumbar scoliosis.

When some people do anything which damages their spine, or even which threatens to damage their spine after damage has happened once, programs come into play which serve to stabilize the spine (spasms which hold it rigid) and to make any movement or activity which stresses the spine acutely painful.

Lumbar scoliosis has made your spine very vulnerable to damage by activities which wouldn't bother most people, and your body has come up with some pretty exotic strategies to keep you from screwing it up.

Including, apparently, down regulating your systemic endorphins!

It's often said that endorphins allow people to push through things which would otherwise be too painful ('runners high', for example), and your system has decided not to take any chances that endorphins will encourage you to jeopardize your spine in this fashion by turning the endorphins down. Or not very many chances anyway, since sex appears to bring the endorphins into play enough to exempt it from your usual response to exertion which could stress your spine (which would include the muscle contractions of shivering-- accounting for your reactions to hot and cold water and fever).

That you can have sex offers hope you might be able to re-educate your system enough to experience exertion and pleasure normally if you got your lumbar scoliosis corrected somehow.
posted by jamjam at 7:54 PM on November 26, 2010 [1 favorite]

See a rheumatologist. Pain around the ribcage can be a sign of various issues from arthritis to fibromyalgia to Wegener's granulomatosis to a simple inflammation of the ribcage called costochondritis. It would not be unusual for someone who had had scoliosis to have issues with costochondritis later in life; it's very treatable.

Good luck!
posted by Sidhedevil at 7:55 PM on November 26, 2010

Multiple sclerosis can cause chronic pain and heat sensitivity. I am not saying you have it, I'm saying that's one non-psychosomatic cause that fits some of your symptoms. A neurologist would have to do extensive testing to arrive at a diagnosis since MS is partly a diagnosis of exclusion.
posted by slow graffiti at 7:56 PM on November 26, 2010

I've also read some people saying that cutting out wheat can help with autoimmune issues. There was someone here on MeFi who had wheat-enabled allergies too. Might give it a shot.
posted by Earl the Polliwog at 12:01 AM on November 27, 2010

Yeah, I have what appears to be wheat-triggered rheumatoid arthritis. It was kind of a bitch of a process of elimination, and I'm currently on a bunch of prednisone because I've been sloppier about my diet than I should have been, and also it doesn't appear to be entirely diet-related.

It took me years to find the right doctor who was really interested in diagnosing me, and the secret seemed to be a) laying out ALL of my symptoms and b) firmly insisting that I didn't want and wouldn't accept a prescription for opiates. That may be the right tactic to take for you as well, OP.
posted by restless_nomad at 8:43 AM on November 27, 2010

I've also read some people saying that cutting out wheat can help with autoimmune issues. There was someone here on MeFi who had wheat-enabled allergies too.

I don't know if it was me you remember, but I am in that boat, and I am definitely noticing more rib and midsection pain when I have more than a tiny amount of wheat. Which sucks, because a) pastry, and b) Weissbier.
posted by Sidhedevil at 12:38 PM on November 27, 2010

IANAD. I am a neuroscientist, and I do specialize in nerve injury and mechanisms of chronic pain. Nth-ing seeing a specialist. Because your pain seems to be mostly back pain, because you're experiencing types of pains that are often associated with neuropathic pain (shooting pains, pins-and-needles feelings), and because you have a history of spinal abnormality, my first stop would be a neurologist who specializes in chronic back pain. Although it's also entirely possible that the lumbar scoliosis is a red herring and you might have some sort of autoimmune condition, since you also have a lot of systemic issues going on with you. For that, you would probably do best with a rheumatologist. But you need to go to a specialist -- your primary care physician is NOT optimally trained to help you -- and figure out what's actually wrong and how it can be helped.

You've got a combination of hyperalgesic and allodynic symptoms -- basically, painful things hurt you too much, and some things that aren't supposed to be painful also hurt you. This is not at all normal. What this is, apparently, is a chronic pain syndrome that is affecting your overall quality of life, and you deserve appropriate treatment for it. Whether this has a neurological or an inflammatory/autoimmune origin is impossible to determine on the interwebs, so you need to find a specialist who can help you rule these things out.

Good luck finding the right doctor and the right treatment. I hope things turn out well for you.
posted by kataclysm at 12:47 PM on November 27, 2010 [2 favorites]

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