pain and anxiety help? Or will I just feel like this forever?
February 19, 2020 3:55 PM   Subscribe

For about 5 years I have had issues with both anxiety and body pain that come and go, that I've done a lot of things to try to deal with, but the pain is getting debilitating. I don't know what to do or what I'm supposed to do anymore. Any advice from you, if you've been here? so many details below the fold.

Some of the big pieces of info:

I've had pain in my lower back (and sometimes, shins/feet) intermittently for about 5 years. Right now, it is so bad (primarily in the back/hips) that I can barely walk. Like, I go out for a walk, and I need to stop every few minutes to stretch/breathe. It's a tense pain rather than a shooting pain or numbness. But, while it's excruciating to walk, I'm a pretty dedicated powerlifter and have no problem lifting twice a week (I'm a woman, 32, deadlifting 180 lb and benching 120 right now. I can do a 500lb leg press no sweat. I'm very strong). If anything, I feel better after I lift. I do a little bike-based cardio, but lately the back pain has been making that difficult. I currently have some kind of overweight BMI, but weight gain came AFTER the chronic back pain, I think because I was less active. I have a history of disordered eating, please don't tell me to lose weight; even if it is true, the suggestion will lead to self-harm. Yes I'm in therapy.

The back pain: It's not sciatica, it's not related to discs or nerves, I've had X-rays and evaluations that confirm this. It's probably some kind of hip flexor thing? I have a GP appointment (he's a DO) next week to try to confirm this, or find if there's anything else physical happening. I've done some PT for my back in the past, but stopped about a year ago and if anything, clamshells and dead bugs and bosu step ups and bird-dogs don't feel like they're doing anything for my muscles, like they're a penance I need to go through to prove I'm doing what I'm supposed to even though they have almost no physical effect. I've done some yoga in the past, but have generally found it somewhere on the scale of meh to anxiety-inducing.

My lifting coach notices a change in my hip posture (tilted way back/lordosis) when I'm stressed or anxious. My husband has also noticed this postural change. It's definitely correlated to my back pain. It's very difficult to release.

So, anxiety, just deal with that, right?

I'm in therapy, twice a week, with a CP, and have been meeting with her for 2 years.
I have....anxiety (GAD), definitely. Perfectionism related to trauma, but emotional trauma, not physical or sexual abuse, which makes it feel Not Traumatic Enough even thought it can be debilitating. The professional jury is still out in a definite maybe about ADHD/high functioning autism? definitely, fatigue from constantly masking. Not on any meds but not opposed to them. I'm an ongoing psycho-clinical project.

I've tried the curable app (for the psychological aspect to chronic pain) and the CBT-like exercises it has just made me feel worse about myself, that my pain is my fault because I can't reframe it in positive terms, which then makes me more anxious/tense and in more pain. Xanax just makes me tired and in pain, not relaxed. I don't really want to smoke or vape weed, but at this point I'll kind of try anything? I'm in NY, so medical cannabis is a thing, but it doesn't seem like I am likely to qualify.

My amazing lifting coach has given me some moves to do that help, somewhat—a hamstring activator and a funny kind of opposing-muscle stretch. But I can't really lie down in public to do my special stretches, and they only last a few minutes if then I have to leave the house, or walk somewhere, or perform some other task hat gives me anxiety. I sit a lot for work (writer/self-employed/contractor) and of course taking a walk break would be both physically and mentally useful...but walking hurts too much, and now I'm also anxious about walking, because it hurts my back so much. I dread every weekend because I'll have to leave the house and try to have a nice time out with my husband, and walk and then spend all of my effort and concentration trying to keep walking and trying to reorient my hips into a more correct position and tiring out my hamstrings and abs.

So, have any of you been here? What have you done? What can I do? Is this just how I'm going to feel, forever? Taking taxis and cars everywhere because I'm afraid of the pain of walking is getting financially untenable, among everything else I stream-of-consciousness'd above.

Thanks for the help, or even just the commiseration.
posted by socktastic to Health & Fitness (11 answers total) 3 users marked this as a favorite
 
I don't know if this is too weird or out of left field, but if you have anxiety and you're not opposed to trying meds...

I have back pain (although not so severe that I can't walk) except when I'm on antidepressants. I don't think it's psychosomatic pain, although it might be. There is some evidence that serotonin is involved in how the brain processes chronic pain. (It might also help from the standpoint of anxiety -> posture issues -> back pain.)

Definitely talk to your doctor and try to figure out if there's anything physical going on, but if that doesn't yield anything... might be worth a shot?
posted by Jeanne at 4:17 PM on February 19, 2020 [2 favorites]


Three thoughts, just from my own observations about my own walking-related pain that appears to be largely soft/connective tissue and not joint/bone or nerve:

1. My pain is related to core strength, and pilates helps. (Yoga helps me too, but it clearly doesn't sit well with you and I get that, I think pilates is better for targeted work anyway.) I don't know if lifting alone provides the full range of core strength you need for standing and walking. Might be worth looking into.

2. This seems to be harder and harder to get assessed without some quack making up a bunch of fake tests to sell you things you don't need, but I wonder if it's worth having your gait and feet and shoes assessed. Maybe by a podiatrist, possibly there's another specialist that might be better. Shoes matter for me, and the kinds of shoes that work for most people make the pain (including shin splints) worse for me.

3. I don't know if normal cities have Alexander Technique/Method classes like LA does (actors/dancers/singers are big on Alexander) but I know some people who swear by it for postural correction. Examples on youtube are sort of creepily popular with ASMR lovers but it will give you an idea of what it's like. I think you really have to do it with an instructor, it's not really a "instructional videos at home" thing.
posted by Lyn Never at 4:21 PM on February 19, 2020


I've been where you are and this is not how you're going to feel forever!

For me there was a very strong link between overexertion in the form of intense exercise as a numbing factor that let me avoid facing my trauma. Weightlifting was the one place where I felt emotionally powerful and strong and that feeling positive mental feeling transmitted to my physical body, leading to feeling amazing (temporarily) after lifting heavy. But after a while it kind of made things worse and aggravated many of my mechanical body issues.

What ended up working best for me was backing WAY off of exercise and kind of learning to feel subtle physical sensations again. I found a great somatic therapist and consistently doing the relaxation and breathing exercises, along with things like baths and lymphatic massage, really helped regulate my nervous system, which in turn helped my back pain decrease.

I would also absolutely try to find CBD gummies, you sound like a perfect candidate for medical marijuana. I wrote about my experience using CBD for back pain here, and one thing I didn't mention in that comment that is relevant to your situation is that for many people, CBD releases anxiety--so if you are having anxiety about back pain (which I totally was), CBD not only helps with the pain but helps break the pain/anxiety/more pain loop. It's legal where I live so I don't know what it takes to qualify but I think "excruciating pain that is wrecking my quality of life and causing me deep despair" counts!

One other thought--not to diagnose you but one of my issues is SI joint instability. It manifests in a lot of the ways you describe and is triggered by asymmetric motion, such as in riding a bike where one leg might be a little stronger than the other. It's hard to diagnose but there are some good videos on how to reset your SI joint--and actually, a deep isometric squat is one way to reset so if you're doing that when you lift and it helps, that's another clue! If the videos help, then start trying to identify what triggers SI pain for you and look for ways to avoid those triggers. For me even though it feels SO good, I don't allow myself to starfish on my stomach when I fall asleep anymore, because it works my SI out of joint in the night. Similarly, I try to be really mindful and slow with my gait-- I picture leaving perfect footprints on a damp beach rather than allowing myself to use my usual striding, heel-striking walk.

Sending you all the internet hugs if you want them--I feel like I could have written this myself at one point. It's a really hard spot to be in, but it won't last forever. There is no continuum of what counts as Enough Trauma--your trauma counts, and you deserve care and relief from pain. I hope you can work through what hurts and be patient and kind to yourself as you do so--I know you're trying really hard! And please know that the above are the steps I took at the beginning of my journey, and are the ones I return to when I get a flare--but now I can also walk, run, weightlift, and do all kinds of other physical activity mostly pain-free. There is hope for you!
posted by stellaluna at 4:48 PM on February 19, 2020 [3 favorites]


My lower back and hips were messed up from sleeping on too soft of a mattress.
posted by gryphonlover at 4:59 PM on February 19, 2020


Hi. I was you for most of my 20s. I could barely walk and everything hurt, and my anxiety was through the roof. It was awful and I really feel for you. You can get past this!!

Seconding pilates (I am not a yoga fan). I also have VERY tight hips (partially due to too much sitting, but mostly just how my bones are), which get tighter from stress. It causes me a lot of pain if I don't maintain a regular regimen of stretching and strengthening. I did one on one pilates sessions (the kind with machines and other equipment) twice a week for a few months to understand what was happening and how to address it. She gave me a good program I can do on my own without machines or too much extra equipment that really helps. If you're lifting already, try incorporating the stretches and exercises before you start. The best part is a lot of it was careful lunging, which is something you can do in public as needed without attracting undue attention. When your hips get tight you overuse your lower back to stabilize because among other things, your glutes and quads aren't properly engaged and giving you support. Hence, lower back pain. It is NOT just your core. A strong core is a good thing, but lots of back pain PTs focus on that and ignore the hip alignment and its associated issues.

I'm sorry that CBT made you feel like your pain was your fault. IT IS NOT YOUR FAULT. CBT is good for spiraling thoughts, or negative self talk. Maybe focus on that as a separate issue, preferably with a therapist with experience instead of an app. I am pretty sure you would qualify for medical marijuana, so trying a CBD tincture could be really helpful for both anxiety and pain. If you have a good therapist / psychiatrist, there are other meds than xanax for anxiety.

Please remember that there is no such thing as Not Traumatic Enough. You have trauma, it's affecting your life, and that is a real and important thing. Be kind to yourself, be patient. It does get better.
posted by ananci at 5:09 PM on February 19, 2020 [3 favorites]


I believe your pain is real and not somehow your "fault" and even if it isn't, it doesn't matter. I think you should ask for more imaging--an CAT scan with contrast or an MRI or both. A friend of mine dealt with debilitating back pain for years and did all the PT etc. until five years later, they finally let her get imaging. Turns out she had a birth defect in her kidney. I think women are much more often told that our pain isn't real or that we should just do the exercises, so push for imaging.

Re: the theory of hip flexors: how does your back pain and everything in that region feel if you lay on your back on the hard floor for a bit? Is there a stretch in the front where your flexors are? What if you raise a knee toward your chest while laying down? Do you feel a pull in front of the other leg? If so, your flexors are tight! And congrats, you're already doing one of the easiest stretches for it. (Don't do this if you think it'll make everything worse though!!)

Sleeping--if you're a side sleeper, try sleeping with a pillow between your knees. It will help keep your back and hips in alignment.

Also, I think your anxiety is making it harder for you to see a path forward for dealing with your pain, and in my experience, pain naturally heightens anxiety. (Makes sense from an evolutionary standpoint--if you were injured, you'd need to be on higher alert for dangers.) I'd encourage you to consider other medications for your anxiety if you haven't before--Zoloft was life-changing for me. But for right now? Go see that doctor and ask for their help. List out ahead of time your symptoms and what you have done before and how it didn't work. That way if the doctor makes you anxious, you don't have to rely on your memory.

Good luck and be gentle with yourself. Literally and figuratively.
posted by purple_bird at 5:12 PM on February 19, 2020 [2 favorites]


If it hurts to walk it's OK not to walk for a while or just to do something else for cardio. I have found that I cannot run when my hip flexors are tight but I can dance because you're more up on your toes and it's less repetitive so your muscles don't get tense. So I dance. Another friend of mine has taken up hula hooping to possibly an unhealthy degree after injuring an ankle injury derailed her running addiction.

As far as getting a diagnosis you'll need to keep a good record and try to figure some stuff out yourself too, doctors are pretty useless at that, imho. Is it a slow twitch/ fast twitch thing? Can you swim or do other endurance sports or can you only do quick moves? Is it positional, does the pain go away if you lie down and move your legs or no? Is it associated with other symptoms like bloating, fatigue, rashes, tiredness, shortness of breath etc? Does stretching religiously every morning help? Did you have any medical events or sicknesses or anything when it started? Do massages make it better or worse? I 10000% believe you something is wrong here and sadly you'll have to make any associations yourself because no regular American MD will do that for you.

Also low back pain, weird lordosis and anxiety (totally abnormal for me) is how my B12 deficiency manifested. I had none of the normal blood related issues, just neurological which is uncommon but not rare. Have it checked, especially if you're hungrier than you think you should be all the time, have heavy periods or if you're taking a PPI or other medication that reduces stomach acid in any way.
posted by fshgrl at 7:35 PM on February 19, 2020


Have you tried any foam rolling-ish exercises? I had lower back pain that, unexpectedly, was caused by my glutes being too tight (and also of differing levels of tightness, causing my gait & sitting to be slightly lopsided). A 75 minute sports massage with an experienced practitioner could only slightly relieve it, but rolling on a lacrosse ball for 15 minute stretches at a time per side gave long lasting relief as the muscles finally released.
posted by Jaclyn at 9:28 PM on February 19, 2020 [1 favorite]


If I felt the loss of life you've described I'd be depressed too. Your doctor probably doesnt know the severity of your depression. Or is just wanting to tackle one problem at a time. There is a medication on the market called Abilify that is supposed to help with nerve pain and also depression. I think the serotonin theory makes sense. Sometimes I'll be in a state of panic for no reason and a few days later I ache like a truck hit me backed up and then fished me off slow. I know medication is unpopular for pain because it can become habit forming, causeweight gain etc but the problem could be fibromyalgia which has no direct cause treatment or cure. The best way to heal your body is to clear your mind. You should not be in that state. Wish you luck!
posted by The_imp_inimpossible at 5:42 AM on February 20, 2020


I don't have experience with it but a trusted friend (who says she doesn't even have any 'real' trauma) has been doing EMDR sessions with a therapist and says that this has gotten rid of some of her pain. It makes sense to me that if it's pain from anxiety and stress, then this should help. I have been having awful back pain for a few years now and I want to try it.
posted by kitcat at 12:31 PM on February 20, 2020


Some of your symptoms are in line with rheumatological and/or autoimmune issues. Worth a look if that hasn't been explored before.

Dealing with chronic pain issues can be extremely depressing - and even more so if you're a woman. And having mobility problems certainly can trigger anxiety! This is a major impact to your quality of life. Consider pushing for further testing and imaging - and consider seeking a second opinion if your doctor is resistant.
posted by Orrorin at 1:53 PM on February 21, 2020 [1 favorite]


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