Worried About Back Pain

The night before I became disabled from back pain last August, it had moved from the right to the left side. Once I finally got an x-ray which showed a fractured vertebrae from metastatic disease, I was hospitalized until a five level lumbar/thoracic fusion could be performed. I wasted half a month thinking it was a muscle strain. The sciatica I had a decade prior presented as numbness and was treated by steroid injections.

All this to say, it's been more than 14 days for you (the oft cited rule of thumb for reporting symptoms) so it is time to go to the doctor. Since it is the weekend, call for an appointment first thing Monday morning. If you have severe additional problems such as loss of bladder or bowel control, get to the emergency room right away. Urgent care is also a possibility although they overlooked my cancer history and caused a delay in diagnosis.

Perhaps it's an aging issue although you look pretty young to me!

Get it checked; most likely it is not BC related since you had a pretty recent clear bone scan. It is most likely related to muscular stuff, but you'll worry until you know for sure. Keep us posted.

Dear Star, while having dexa for bone density evaluation might give you information on osteopenia or osteoporosis, it's not going to tell you much about possible metastases.

Have you had an MRI recently? That type of imaging will be more likely to show a herniated disc or some other reason for your pain. While expensive, it's not quite as costly as a PET which your insurance seems to have good reason to deny since you are not known to be stage IV.

Another option might be CT or a radioactive scan. My spinal mets were clearly visible on an old fashioned x-ray since the tumor had completely eaten away a lumbar vertebrae to the point of collapse. There are many causes of chronic back ailments so perhaps yours is something more benign.

Sciatica pain can change over time. THe inflammed nerve that runs down the leg is affected by many things. To presume things would remain the same isn't possible.

The level of pain im sciatica doesn't indicate "worse" or "better" simply different.

If pain reliever helps and you are not concerned, I personally would wait. My onco said 6 months one way or the other would not alter my outcome. I had hip pain that forced me to hobble around several years ago. It took nearly 4 weeks but resolved completely. We each have different thresholds for waiting and for pain--good luck and the odds are it is not cancer.

Were you able to appeal the insurance denial of your PET scan? Finger metastases is unlikely, maybe you just have good old-fashioned arthritis. Aromatase inhibitors are well known to cause joint pain...

Perhaps you might consider filling in more of your history so we can better understand your situation.

Hello Ladies,

I am no on AI's. I am not taking anything besides pain pills. I had a DEXA scan and it had showed nothing. I am triple positive IDC and had mastectomy 6 months ago. Now there is 3 new growth under my left arm pit. Painful too. I have talked to the insurance and they have denied it. I am not sure what to do at this point. I've called one place to see how much CAT and PET scans cost without insurance they are each over $1000 so that wont work. Insurance is simply saying there is no treatment plan so they won't approve it. What else can I do, I do not know. My lower back hurts a lot, and my joints hurt a lot as well besides the pain in the arm pit and three growing mass.

Thank you so much for all your reply.

you really need to get in to your dr ASAP. Swollen under your armpit does not sound good, especially since you were unable to complete your HER2+ treatment, you aren’t on any hormone therapy, and you had a very aggressive cancer in both of your breasts. Please go to the dr,or ER if you can’t get in to your dr. It sounds like your pain is pretty bad so the ER isn’t out of the question and they may be able to get authorization for testing based on an emergency basis. It’s so ridiculous that having this DX and associated pain, and it’s still impossible to get good treatment! So sorry and I hope you get answers ASAP!

The ER will not be able to do or authorize the proper tests, though they can treat your pain. Go to your PCP or your MO ASAP and have them deal with your insurance to get the proper tests authorized. Hoping you can be seen soon.

Seems like insurance shouldn't be able to deny scans based on prior treatment, and shouldn't be able to deny a diagnostic test because there's no treatment plan -- that is how your doctor will come up with a plan. But I am sending you so much sympathy on how horrible insurance companies can be to deal with!

I had a local recurrence and was given a PET scan to check for metastasis. Also sounds like there are other tests that an oncologist should be able to order to see what's going on. Rib, arm, and finger pain could be related to your mastectomy, nerves being cut or tightness in your body post-surgery can cause all sorts of alignment problems and therefore nerve problems and referred pain. I'm doing physical therapy for many of those same issues right now. However, the swelling in your armpit is more concerning since that is where your lymph nodes are. Are you able to get an appointment with one of your doctors to check out these symptoms? I believe they will feel the lymph nodes which may tell them something. If so, bring in whatever information your insurance provided you about why they wouldn't authorize the test so the doctor can figure out what diagnostics to order and be covered by insurance.

Another idea -- what about going to see a (not-cancer) doctor for the back pain? That doctor might be able to order an MRI. I've had problems with my back pre-cancer that were both so horrifyingly painful I literally couldn't move. First time I had two herniated discs, second time I had a torn disc. Both were treatable. The doctor I see is a rehabilitation medicine specialist.

Last thought is at the cancer center where I was treated there are doctors that specialize in pain management, they are in the anesthesia department. Could your oncologist refer you to one for some pain relief? They can do injections, prescribe meds, etc.