Lower back pain - when to worry?

[bejuce]

Hi HER-2ers,

I had a wonderful Thanksgiving with my friends, but may have overdone it a bit. The Friday after my cooking marathon I started having some lower back pain. The pain seems to be on and off and worse in the morning or before I go to bed. It doesn't wake me up.

I thought I was getting better after I did a massage at work last Tuesday. I was also able to keep up with my spinning class last week. Yesterday I went on a somewhat strenuous hike (about 3.5 miles with lots of hills) during which I jogged a bit at the flat/downhill parts. I felt fine the rest of the day but at night I could feel the pain again.

It's been bothering me all day today. I emailed my oncologist last week and she said to wait a couple of weeks. She's currently at the San Antonio Symposium and won't get back till next Monday.

How concerned should I be? Should I go to my primary care physician this week to get it checked? What's the likelihood of it being mets given I had a clear bone scan and a clear CT a couple of months ago? I'm also feeling some discomfort on my right hip joint. The discomfort started before Thanksgiving but I figured it was just a sprained muscle/tendon or something. Now that I have this lower back pain, I'm getting a little concerned about it.

By now you probably know that I freak out over every little thing. I have to say that this time the pain/duration has been the worse of all my freaking out moments.

Can anyone tell me anything that may calm me down?

Thanks!

Marcia

[tricia keegan]

Marcia I'd give it a few weeks yet but if it persists then I'd have some some scans!!

I learned the hard way last year of asking for a bone scan too too soon due to back pain, it showed a hot spot, had an inconclusive mri then clear pet/ct but too small to biopsy so waited two months to repeat the mri which was clear phew!!!! In the meanwhile I learned I had sciatica and with some PT exercise's the pain lessoned so I think I'd hold off for now and see if the pain lessons and take it from there as you dont need the extra stress of scans until really necessary!

[lkc Gumby]

Hi Marcia. I agree. mets pain does not come and go. and with the amt of exercise you have had recently, sounds like good ole back pain. try to relax and if it's the SAME intensity in a few weeks ( which I doubt ) get it checked out.

[BonnieR]

Let me see, cooking marathon, spinning, hiking and jogging.....the answer may lie in there somewhere! I am aching just thinking about it all!
As someone mentioned, sciatica is a good possibility too. Just because we have cancer doesnt mean we are not elegible for other things too. Which seems all kinds of wrong!
You are allowed to freak out but do consider all your options and keep the faith.

[KristinSchwick]

Marcia,
I figure I'd better chime in because I did have bone mets in my hip and you should hear both sides of the story. First off- I could NOT jog with the pain in my hip- It drove me to tears to try and jog. Second, I limped everywhere I went. The pain did not come and go- it was constant and got progressively worse over time (in a matter of weeks). Some positions did not cause much pain, but pretty much anytime I was standing or sitting and sometimes even lying down- I felt discomfort. My pain did respond to advil, but it would always come back once the drugs wore off. It was painful to the touch- and the spot never moved. Unlike sore muscles- it did NOT feel good to massage it and heat or ice on the area did NOT provide relief. It was a very sharp and stiff feeling, not achy and no amount of stretching helped either.
Hope that helps- from what you describe- I very much doubt you have bone mets. :)

[bejuce]

Thank you so much, ladies!!! You're the best! I actually just finished my hour-long spinning class here at work and was able to do it. I did feel the pain when I was standing on the bike, but not when I was stretching it at the end of the class.

As my husband said, it could just be the weight gain and different center of mass I have been carrying since having 3 kids and going through treatment. I'm trying to exercise more to increase my metabolism, which seems even slower after Tamoxifen. My body could just be feeling the strain of it all.

I'm too much of a worrier so anything I feel makes me go online to search for answers. After being diagnosed the way I was, I'm much more conscientious about my body and about what odds/probabilities really mean. If there's a 10 % chance that it could be A, B, C, or D, it takes me a while before I convince myself that I'm in the clear. I was told I had a 1% chance of having breast cancer before being diagnosed...

I'll watch the pain for the next week or so and keep you posted. I have another cooking marathon coming up on Christmas, so let's see how it goes. And by cooking marathon I mean standing up all day in the kitchen cooking rather than eating :) Although I did a fair amount of that as well!!

Thanks!!

Marcia

[bejuce]

BTW, forgot to mention that my new insurance (UnitedHealth) has a $500 deductible for certain things, including scans. I got a bill on Saturday for $539 for the scans I did recently. I called them up to investigate and they told me that Stanford charged them $8K for the bone scan and CT. I was shocked scans cost that much...

[ElaineM]

You may want to ask your PCP for an xray if it still bothers you and your oncologist doesn't get back to you or doesn't order an MRI or bone scan.
We get other things besides cancer in the bones and/or muscles. Maybe you twisted something or you have osteoporosis. Have you had a Dexa scan lately?
I had similar back problems, especially the pain in the evening after running around all day. My PCP did an xray and followed it up with a dexa scan. I had osteoporosis. !!!!!!!! Oh the aging body is interesting !!!!!!
It does all kinds of stuff we never had to worry about when we were kids !!!!!!!

[her2lisa]

Marcia, I have also been having strong lower back pain -- like all over my back -- early in the morning.

I talked to my onc's PA and she said basically this is the kind of pain she would worry about:

It was painful to the touch- and the spot never moved.

Kristin, that was such a good description -- thank you for putting that here.

I wondered if Tamoxifen was involved in mine. My cycles are all messed up but it seemed a bit like PMS cramps.

[Hopeful]

Marcia,

When is the last time you replaced the shoes you wore for the cooking marathon or exercise? I developed osteopenia with aging & AI's, and found that standing or walking on a surface with no "give" (i.e., cement vs. wood) started giving me back pain after a set number of hours on my feet, something totally foreign to me. I invested in a pair of good sneakers for exercise (to the tune of $100) and it was very well worth it - I was not getting the proper support in my old shoes, and my back alignment was off, creating fatigue and pain. Your problem could be something as simple as that.

Hopeful

['lizbeth]

Wow,

I can relate - I have a pain that pops up near my right scapula and I start to worry. But typically I've overdone it on the rowing machine, etc.

Did you do a lot of lifting or leaning in a position that is not typical for the cookoff? Bending over and straightening up frequently might have overworked your Erector Spinae muscles - which extend the back.

When you go downhill on the hike do you typically turn your feet out for more stability? My husband does this and his deep lateral rotator muscles (from the sacrum to the "hip bone") hurt afterwards. Especially bothersome at the attachment at the hip for him.

Maybe you could try a session with an experienced massage therapist while you wait on your doctor's return. If it is muscle pain they could relieve the pain, and help reduce the stress of worrying about a re-occurence.

Hopefully its just too much active living!

Happy Holidays.

[pibikay]

Hi All
I think this thread helps me to worry less.On and off Hema gets a pain which starts near the anus and spreads to the lower abdominal region.Those are met free areas.The Onc's view was that it is a part of the side effect of the treatmenr.But on going through this thred I recollect that she had aheavy cold and caough.After the coughins spells the pain started or (as I have noticed but she won't admit) she does a little extra in the kitchen or around the house

[bejuce]

Thank you all for your comments! My back is still sore, and I feel it most when I bend down or stretch it during the day. I'm trying to not worry as much but I'll get it checked next week if the soreness/pain continues.

One thing mentioned above regarding shoes. I'm usually barefoot at home but was wearing my mid/high heeled sandal/mule on Thursday as I had guests over and was wearing a nice dress. Maybe that was too much stress on my back given I was standing almost all day on Wed without shoes on? Not sure.

I didn't exercise yesterday and won't again today but will be back at my spinning class tomorrow. I'll also try another massage on Friday. Hopefully the massage will make it better then.

Thanks!

Marcia

[JillaryJill]

My symptoms were the same. Onc ordered MRI of lower back and spine. MRI results, 2 bulging disks, L4 & L5, hip fine for my age (53). Hip pain is a result of the bulging disks. Never been so happy to hear bulging disks. I am also very active like you.

[MJo]

Recently I had MRIs of my cervical and lumbar spine and XRays of my hips due to chronic back and hip pain. It's age and arthritis related changes. I don't think Femara helped! I go to the gym and I've got more strength and stamina, but the pain comes and goes. I also had to get more supportive shoes for my workouts.

[alex212]

Hello--this is my first post. I have not previously participated in on-line chats. But I would like to know if
anyone has experienced joint pain while on herceptin.
I am HER2 pos, had 8 rounds of chemo that ended in Sept. and have now been on herceptin since Aug. About a month
ago I started having joint pain in hands, hips, knees but most especially at the base of my skull. Can hardly turn my head sometimes. There are arthritis issues in my family but this is systemic and rather sudden. Exercise and massage helps. I am scheduled for a PET scan in about a week to check things out.
Has anyone had this experience?

[Ellie F]

Hi Alex
Joint pains are a commonly reported side effect of herceptin.Some ppl seems to have them in one or two areas whilst others seem to have most joints affected. If you go on the herceptin/tykerb thread and then search joint pain you will see that many others experience this.Some onc's believe that these effects are cumulative and become noticable the more rounds of herceptin you have.
Hope this helps
Ellie

[alex212]

Ellie--thank you so much for your reply. I have looked over the
other relevant posts and they are helpful. It is good to know
this is a common side effect. I will be checking in with my onc soon
and will discuss further. Again, thanks.

[bejuce]

Hi everyone,

I went to my primary care yesterday to get my pain checked and she said I have "lumbar paraspinal muscle spasms" probably caused by overuse or some kind of injury. She gave me a referral to physical therapy and prescribed a muscle relaxant. She's pretty sure it is not in the bones as I didn't feel any pain when she was pressing on them. The consensus seems to be that bone mets would cause pain in the bone itself. I know this is not always the case, but it's probably a good rule of thumb to abide by.

I was very happy to hear "muscle spasms" especially since my pain seemed to get worse last week and I was getting worried.

Another very, very exciting thing that happened at my doctor visit was that when I talked to the doctor about not having had a period since August, she suggested a blood test to check my hormone levels and I asked her to add the Alkaline phosphatase test. I headed down to the lab and told the nurse that I had a port. She said she couldn't access a port there, but I said no problem, you can always use my hand. She asked me if I wanted her to try my veins in my arm and I said sure, go ahead. No one has been able to get any blood from there since 2009. But guess what?? She did!!!! I was never happier to see blood flowing freely through my veins :)

I'll now consider removing my port :)

['lizbeth]

Wonderful, so glad its most likely muscle spasms. LOL, I suspected that when you said marathon cooking followed by hiking with hills.

Personally, I'm a huge fan of my physical therapist. He whipped me back into shape after cancer treatment. Im learning massage therapy - so if you were closing to me I'd volunteer to do some gentle circulatory (Swedish) for you.

Hey what's the Alkaline phosphatase test for?

[Jackie07]

I understand how you felt when the blood flew to the syringe...

Glad it's 'just' a muscle spasm. :)

Here's a link to the test (I had to look it up to learn what it is - might as well share it here with everyone):

http://www.webmd.com/digestive-disorders/alkaline-phosphatase-alp-test

[Savta]

Hi,

I haven't posted in quite a while, since I have been living in the uphoria of being NED for the last three and a half years. In fact, in two weeks is my cancerverary--4 years since diagnosis.
But, of late, I too, am experiencing pain in my lower back, right hip and buttocks. My physio-therapist thinks it's nothing to worry about--but that's what we do, right?
The pain is the worst at night, when I am laying in bed. It wakes me when I move in my sleep--but, once I'm up and walking around, I seem to be fine. This does not occur every night, but several nights a week.
My onc told me to watch out for pain that doesn't go away--but I can't help but worry. I don't want to overlook something that might be worth looking into.
What do you think?
I'd be glad for your input.

['lizbeth]

I had a pain like that, right between my shoulder blades. At night the muscles would tighten around my ribcage and I would wake up in pain and hardly breathing. Then I would get up and walk around and the pain would ease significantly. I was taking 10 Advil a day.

After 2 years of chiropractic treatment I tried accupunture out of desparation. Amazing - in 6 treatments the pain disappeared and I was sleeping through the night. Best money I ever spent.

I'm no doctor, but in my experience a majority of people suffer from low back pain. Is this the area in your body where you store tension? Does work or other activities affect your back and hips? My husband suffers from similar pain - he needs to stretch regularly and workout to keep it pain free.

Have you tried receiving bodywork, such as circulatory (swedish) massage or deep tissue sculpting? Thai massage and Sensory repatternings techniques can also help relieve pain and muscle tension. I use several of these techniques on my husband and he is always amazed at how easy it is for me to help him become pain free.

Before and during cancer treatment I would spend too much time worrying - now if I have a problem I procrastinate less on seeking help to resolve it. But I hear you, every prolonged ache & pain can be stressful until we hear the all okay from our medical team.

Congratulations on your 4 year cancerversary. Wishing you many, many healthy years.

[Hughe]

Hi Marcia,
For lower back pain lose weight if needed by regular workouts and avoid doing exercises that put pressure on your spine. Therapeutic exercises, stretching and massage are also effective to cure lower back pain and during all exercises, practice the drawing in technique. Have good posture and take rest properly.

[Mary Jo]

Key words..."come and go!" Cancer does not come and go. Cancer does not "get better!" Sad, but true.

I, too, suffer from lower back pain....it, too, comes and goes. It's a pain the butt (literally) but it comes and goes, for which I am thankful.

Hope you can get to the bottom of this (no pun intended - haha) and find some relief AND peace.

Blessings,

Mary Jo

[BonnieR]

I have been having the very same issue. Pain that is much worse in bed. Right hip. But enough to have me limping Had hip X-rays and then MRI of spine. That was the culprit! Arthritis and pressure on discs in lower back. Receiving great relief from PT!!!! Pain went after first session of having spine "stretched" by hand
Keep the faith. Hopefully this is your solution too!

[mimi1952]

Can you have bone mets with normal blood work?

[jellybean]

Yes, you definitely can have bone mets with normal labs. When I was first diagnosed, I had mets in almost every bone in my spine, and all my labs were perfectly normal. And I felt fine!