Pancreatic duct

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What Is Pancreatic Cancer?
Extract - Take mg up to twice daily. The treatment and outlook for pancreatic NETs depend on the specific tumor type and the stage extent of the tumor , but the outlook is generally better than that of pancreatic exocrine cancers. I know pain quite well. I have consciously decided that my pain is like a confusing "traffic jam" of brain signals, that I cannot seem to turn off. Chest pain is one of the most common reasons that people visit the emergency room. Erica, thanks for your comments.

Benign and precancerous growths in the pancreas

Natural Remedies for Stomach Bloating

The remedy may cause a fear of public speaking and even the inability to stand up for oneself in a conflict. It has been reported that some people have experienced sensitivities or allergies to shell fish when taking this remedy. Swelling, redness and itching around the mouth or throat, and painful tenderness of the right breast may be present. Stop taking the remedy if you experience these symptoms. Boericke points out that in most cases, too much Lycopodium causes a strong modality with reference to symptoms and side effects being felt more strongly on the right side, or starting on the right moving to the left, with the right side always feeling worse.

This applies to all bodily systems, such as sore throats or pain in the musculoskeletal system. Effects of Lycopodium are felt most strongly between 4 and 8 p. In other words, all side effects and symptoms are worse at these hours of the day and night. Video of the Day. Side Effects of Sepia 6C. Strengths of Arnica Montana. Side Effects of Homeopathic Remedies. Homeopathic Sore Throat Remedies. What are Homeopathic Remedies for Sleep Apnea?

Homeopathic Remedies for Weight Loss. Side Effects of Bryonia Alba. What Are the Medicinal Uses for Ignatia? The extreme pain I was feeling was my liver I hardly think this is referred pain from anywhere else??

Hi Ro, I'm not sure what you mean by pain in the right iliac fossa - is the patient experiencing pain in the right lower quadrant of the abdomen, or right flank pain, or deep pain that seems to be centered on the iliac fossa, or something else?

My first thought is musculoskeletal pain, since as you know the iliac fossa is filled with the iliacus and psoas major muscles, but there are many other possibilities, including appendicitis, kidney stones, IBS, IBD, herniated disk, abscess, etc I have suffered from referred pain for over 20 years.

I have had every type of test done, and all results were negative. As my doctor once said, "the good news is that we didn't find anything, and the bad news is that we didn't find anything". I have consciously decided that my pain is like a confusing "traffic jam" of brain signals, that I cannot seem to turn off. I know that some day there will be a simple "reset" button for the nervous system. Until then, thank you for trying to explain the unexplainable.

Hi Anonymous, my best guess is that something perhaps related to the inflammation of your biceps is irritating or compressing your musculocutaneous nerve. As its name implies, the musculocutaneous nerve innervates both muscle and skin. The muscles controlled by the musculocutaneous nerve include two major muscles that bend the elbow: The skin innervated by the musculocutaneous nerve is a patch on the lateral forearm from the base of the thumb to the elbow, as you described.

If I were examining you, I'd want to figure out what's bugging your biceps and, perhaps, your musculocutaneous nerve I should clarify that I don't know whether it's referred pain or not. To figure that out, your orthopedist needs to get a detailed history and perform a careful physical exam.

An EMG might help. Brad, What a brilliant article. Referred pain is such a hard concept to grasp and diagnose. I have had left shoulder pain for a year. After clearing my heart angio , neck mri and shoulder injections, xrays ; I am sure it is referred pain. I also have a lap band with a hiatal hernia on top of the band.

I have terrible L shoulder pain and my surgeon who did the lapband refuses to attribute this to referred pain from the phrenic nerve from lapband and hiatal hernia. I am trying to convince him that maybe the band is misplaced. Good Luck finishing up Med School!!! As a nurse we need more good Docs. Have you chosen a specialty? Erica, thanks for your comments.

I'm most likely heading into radiology. Pain just below the umbilicus is certainly consistent with an ovarian cyst - in fact, that would be a nice example of referred pain - but cysts aren't always painful and something else more serious could be the source of pain. I wrote you back in November of Since the second catscan, I had a huge mesenteric cyst removed and my referred pain has gone away.

The Florida Hospital South surgeo was familiar with referred pain. Thanks for your blog I am now in good health. I have abdominal pain, swelling, and burping which can be triggered by my physical therapist working on the lower left quadrant of my back.

I am assuming from your diagram that I need to see a Dr. By the way, abdominal CAT scans, xrays, and stomach emptying tests have shown nothing.

This is why I am trying to follow the referred pain to find the answer. Hi anonymous, I haven't heard of abdominal symptoms being triggered by physical therapy. Have you experienced other symptoms that suggest kidney problems, like blood in the urine? Any fever or other symptoms suggesting an infection? The absence of findings on abdominal CT is reassuring, but it's still a good idea to see your doctor if you're concerned. I was very interested to read this blog post. For months Ive been suffering with pain in my right shoulder area, and lower right back area exactly where you diagram shows the livers referred pain to be.

I paid a fortune to see an osteopath thinking it was back trouble. But eventually I got so ill that I went to hospital and tested positive for hepatitis in my liver. So the referred pain was exactly spot on for your diagram.

Although by the time I got to the hospital stage I was also experiencing a lot of chest pain too. Hi, Can you help with an explaination for this type of refered pain Pressure is applied to the region of the peroneous longus and brevis, resulting in localised pain obviously and an "itchy, prickly" type pain in the lateral chest wall in the rough vacinity of the 12 rib, to the lasing extent tat it needs to be scratched by the subject.

Would be evry inteersted in some theries and if possible, some follow up articles. Does it have something to do with embyonic developmnet of the feotus inutero? Just grasping at straws! Hi Alex, interesting observations that I haven't heard before, and I don't have a good explanation for them. Probably related in some way to embryological development, but I could only speculate. Have you seen this finding in more than one subject? Hi Brad, The subject is me in this case, but I have seen this in other subjects also.

Still baffled by this. We discuss dermatomes but agree we may be close, but no prize yet. The only thing I can find courtesy of Google is on a website discussing "Axon Reflex" What is you thought on this though process.

It does not involve a complete reflex arc, and therefore it is not a true reflex. Perhaps a crossed neuron or synapse. Maybe, consider something a little more off base like a reflexology type response.

Very interesting and helpful. I had cancer, surgery followed by radiation through the intestines and ended up with celiac disease that was undiagnosed for a long, weak, declining, scary year. Three years later, energy continues to return, although slowly. If I get tired or eat something that has been gluten contaminated, it's between the shoulder blades that I'll feel it first, and then in the ball or big toe joints of my feet.

Three to five days later, things will have settled down, but the last thing to go will be the dull, throbbing pain in my feet and between those shoulder blades.

So glad I'm not crazy, and that it's all likely related to the same original difficulties. Groin pain can actually indicate a problem with the hip: Brad, I have a question for you like everyone else. I am having deep pain on my left side more towards the front than back just below my rib cage for 3 days. I hurts when I breathe.

Hard to say without a little more information and probably a physical exam, too. Where is the pain? How would you describe the pain? Does the pain radiate to other parts of the body?

How bad is the pain on a scale of ? When did the pain start? Was the onset sudden or gradual? Does it come and go? Is it getting worse or better? Anything make it better? Anything make it worse? Anything else related to the pain? For now I'll say that left upper quadrant pain i. If you're young and basically healthy, it could just be a simple musculoskeletal problem e. As always, if you're concerned, I'd go see a doctor. Thank you for the blog.

I had a lap nissen fundoplication almost 7 weeks ago. I had the usual general shoulder pain for a few days from the gas used in inflating the abdomen. That dissipated, but I continue to have pain in my left shoulder actually my upper trapezius in an area that is about the size of of silver dollar. On palpation, the area feels like a muscle spasm in that it is a painful lump.

The surgeon that did the fundoplication doesn't have any kind of answer. Its sort of a "in some people the pain lasts longer" answer, with more pain meds.

It has gotten worse over the last 2 weeks, and is affecting my shoulder joint; I had a shot for AC joint bursitis last week. The orthopedist who did that has referred me to a chiropractor to see if he can figure it out, as well as to PT.

I'm not sure why it is my left shoulder, since your illustration said it was the right. All three doctors my GP, too don't seem to register a problem when I say it's my left shoulder. Does all this just sound like referred pain from the diaphragm? Gretchen, what you're describing doesn't sound like a typical case of referred pain, but I can't rule it out. Certainly the timing and location of the pain make me suspect the pain is related somehow to the Nissen. You might talk to one of your doctors about getting a CT or MRI of the surgical site and maybe the shoulder too to make sure they aren't missing something.

Hello, and thanks for the information. I have had pain in my left shoulder for well over a year. It comes and goes and nothing I do makes it feel better or worse. I have tried to find some kind of pattern or cause and nothing that I can find makes it start or stop. I went to multiple doctors and got an MRI of my shoulder, and multiple x-rays and there is nothing structurally wrong with my shoulder except some extra mobility or looseness in the joint.

I also tried physical therapy which didn't have any effect on the pain. When the pain hits its peak, it sometimes make my vision go out of focus. It feels like the pain is coming more often, and staying longer, and getting worse, I feel like I am going to lose my mind!! The pain definitely gets to a 10 often, and I have tried heat, ice, icy hot type items, advil, tylenol, and nothing helps.

What should I do next? Any help would be great! Unfortunately there is currently no safe, inexpensive, effective way to screen for all cancers. Screening is only recommended in certain age brackets for a few relatively common, treatable cancers e. Your pain has several concerning features, including its intensity, resistance to conservative treatment, localization to one region, and trajectory getting worse.

Given the lack of findings on shoulder imaging, I would definitely think about referred pain from another site like the base of the left lung or the left upper quadrant of the abdomen. Have you discussed this possibility with any of your doctors? It appears that my shoulder pain is only indirectly because of the fundoplication surgery. It seems I have had a trigger point in that shoulder for years and yes, I have had some muscle spasms there before, but never this bad.

I think that the post surgical shoulder pain activated the trigger point in a way that it has never been before. It has basically been in non-stop contraction for 2 months. Understandably, this very painful condition has affected my shoulder joint as well. I am finally getting some relief with acupuncture, but I am holding out the possibility of a trigger point injection if I can't get total relief through more conservative means.

Thanks for your input. All input helps when you are trying to solve a puzzle. For the last 3 months I had pain between my shoulder blades now my whole back hurts from my neck to my hips my doctor has sent me physical therapy but no help at all.

Any ideas what this could be? Also my sciatica is getting worse. Hard to say without knowing more about your history. One condition that comes to mind is polymyalgia rheumatica Found your site when doing a quick refresher on referred pain for an MI 1 site that came up on bing search.

Your post was very helpful, thanks. Also, from what I have read, angina pectoris doesn't seem to produce referred pain like an infarction. Is this simply because the pain is less severe? Is it because angina pectoris results from lactic acic buildup whereas an infarction is from tissue death? Do they both result from lactic acid buildup? Interesting question about the pathophysiology of angina pectoris vs. I'm not sure if anyone really knows the answer: I was reading an article online about brain disease.

I don't understand the cause of the spinocerebellar degeneration disease. If the cerebellum is slowly decaying, how does that directly correspond to comas? I'm currently considering to enter med school. Do you think this software would be helpful? I am a 56 year old male and for the last 3 months I had pain between my shoulder blades now my whole back hurts from my neck to my hips my doctor has sent me physical therapy but no help at all.

My doctor also sent me to a Hematologist at a cancer center and they found nothing out of the ordinary on my blood work. I have also had a CT Scan of my brain and it was normal. And I have also had nuclear heart stress test while walking on a treadmill and was normal. They have taken x-rays of my back and found arthritis in the upper and lower parts of my back. Also I am seeing a kidney doctor at this time. I have seen a chiropractor after a few x-rays he adjusted me and I have had some relief from my back pain and have helped my sciatica a little.

I have smoked off and on for 30 years. I may cough maybe once or twice a day or on a bad day 3 or 4 times a day. So could COPD be the cause of my back pain or maybe something worse.

To the man with pain between your shoulder blades. The vagus nerve, connects from the stomach to the spine. I had an ulcer hurt in that place, referred pain, no doctor could find out what was wrong and two months later the ulcer perforated, Causing peritonitis. Ask for an indoscopy to find out if you have an ulcer. I had to have explorotory surgery. Anonymous, do you ever experience that pain after a meal? Your description is consistent with a bad case of gastroesophageal reflux disease GERD.

However, it could be something else - I'd strongly recommend seeing your doctor. In general, somatic pain is sharp or burning and easy to localize. Visceral pain is more dull, diffuse, and harder to localize. However, these are just general patterns; there may be exceptions. Also, other types of pain like neuropathic pain may not fit neatly into either category Post-hysterectomy suprapubic area pain that is episodic in nature.

Described as "deep", "dull". Gets worse with stress. What are your thoughts? Referral from lower thoracic segments? As far as I know, deep dull lower abdominal pain after a hysterectomy is most consistent with surgical injury of pelvic tissues including visceral nerve fibers, and perhaps, as you suggest, post-surgical scarring.

I doubt the degenerative disc disease is related unless the history is suggestive. However, I could be wrong. I came across this article while researching referred pain I have a question that I would love if you could answer. For awhile, almost 5 weeks, I've had back pain on my left side right next to my shoulder blade, in between the spine and shoulder blade.

It's in a very specific place that I can pinpoint. And it comes and goes with different levels of severity usually a dull pain that sometimes, not too often, becomes a stabbing pain when I breath in deeply. Occasionaly I have a dull ache in my chest that moves around left side and sternum I've also had a cough for the past 9 weeks. The cough hasn't gone away The antibiotics were each about three weeks apart due to respiratory infections.

I also had a chest x ray which came back negative. I was wondering if you could give me your opinion of what this might be and if I should be worried? Ashlee Premed student btw: P And I just finished anatomy class This was awesome but I have one question. If the pain in my sholder is in fact referred pain, would pusing on the spot where I feel the pain make it worse?

I know pain quite well. Wow, 20 years of it. Cut wide open 3 times and I guess a thoracotomy surgery. There is where my problem lies I believe. Cut from my back, under left arm ending at my breast. Post thoracotmy syndrome, intercostal nuerolgia, and symphatetic nerve dystrophy.

Obviosly, I can't spell medical terms. I have finally laid down that absolute bottle. Hoping to begin again with the doctors. Some days my hair touching my neck or my clothing being on my back raises my pain level. They used me as a text book in the trauma ICU. I believe if they would have been interested enough to follow through with my "long" recovery they perdicted, they may have been the wiser.

My pain doctor told me he would always be there, he would never throw me out in the streets untreated. He lied and I found my medicine at the liquor store. Keep up the studies and I have a feeling you have dreamed the best dream for you.

I appreciate this site and your info. Good Luck with Medical School. Consider yourself invited to Uganda for an elective especially on Family Medicine. I've had the same shoulder pain for over 10 years and had my gallbladder removed last year, but my pain persists. Now I also have pain in my lower right abdominal area. What is going on? Ashlee, sorry for the delay - I've been out of town.

Part of your description sounds like pleuritic chest pain, i. There are many causes of pleuritic pain - such as pneumonia, rib fracture, lung cancer, pneumothorax, pericarditis, and pulmonary embolism - but most of those would show up on a chest x ray.

I can see why your health care provider gave you antibiotics - in a young, otherwise healthy person with your symptoms and a negative CXR, a respiratory infection seems like a good bet pneumonia doesn't always show up on CXR.

I would also think about gastroesophageal reflux disease GERD and maybe pericarditis. See your doctor if things aren't getting better! KHKuhl, hard to say what's going on without more information. Right lower quadrant pain has many possible causes, including appendicitis, gastroenteritis, irritable bowel syndrome, pelvic inflammatory disease, various ovarian conditions, diverticulitis, etc. I am contacting you today in hopes of developing a relationship with your website; we have seen your site and think your content is great.

I hope you show some interest in building relationship, please contact me at annie. My mother has intense left shoulder pain that has persisted for about 3 weeks now without relief. When she stands or sits it hurts the most and she can't sit or stand for prolong periods of time without lying down for awhile.

She's been to the doctor but he didn't examine it and said it was Wry neck. Something I've come to understand that doesn't involve any of her symptoms.

She's had problems with her gallbladder gallstones in October and liver problems a few years back which was never diagnosed. The pain pills only take the edge off. She wants to know if this pain could be referred pain since she had the referred pain briefly with her first child. Thanks this article was very helpful and easy to understand. I wanted to thank you for your reply!

The coughing has stopped. I think it was probably due to stress, but the back pain is still there. Hi Brad, Was wondering if you could clarify if my pain I had today was referred pain. Today, about 4 hours after I ate breakfast, my abdomen, especially below the rib cage hurt like no other.

It got worse with walking, sitting straight and breathing. Shortly after my ab started to hurt, my R shoulder started to hurt too. This went on for about an hour and since then, I have not had any other probs nor have I before today. Is this a classic case of referred pain due to my gallbladder? Thanks so much for all your help! Based on your limited description, referred pain is one possibility, although it's on the wrong side for gallstones or liver problems, which usually cause pain on the right side.

Musculoskeletal problems are much more common causes of shoulder pain than diseases of abdominal organs, so statistically the diagnosis of wry neck seems like a good bet. It's hard to know what's going on without a more detailed history, physical exam, and possibly some imaging or other tests.

If you're not satisfied with the current diagnosis, consider following up with the doctor or getting a second opinion. How long have you been experiencing this pattern of pain? Is there an associated rash or other skin changes, or just pain? Ashlee, I'm glad things are improving a bit. I haven't heard of a swollen lymph node causing back pain, although I suppose it's possible.

There are posterior mediastinal nodes that theoretically could grow large enough e. That said, I think the other possible causes I mentioned earlier are much more likely. Erin, your description sounds like referred pain from a gallstone attack biliary colic , although there are other possibilities.

Risk factors for developing gallstones include obesity, being female, increasing age, and a history of multiple pregancies. I have a lot of back issues which I have successfully ignored for a number of years--high pain threshold! Nothing helped, I actually started running a low grade fever. Sent to the ER. They were concerned about cardiac, hepatic, gastric, cholecystic, pancreatic, even splenic issues.

I've pushed a lot of MS but never received any. It is a good, good drug for pain. Anyway, I finally got to go home around 3, it was an hour's drive, my gut is already hurting again half way home. I'm thinking again, and it didn't work last time I'm just hungry. I ate, it didn't help, but I was seriously exhausted, and finally slept around 5.

Went to the kitchen and mixed my own GI cocktail. Worse EW than at the clinic! Woke around noon convinced I was going figure this out one way or the other and after an hour or two of reading, found this entry in your Anatomy Notes. It makes incredible sense. I am going to do a few things now to lower C spine and see if that helps at all with the gut pain. Hi, stumbled across your website. Just a little worried about the shoulder pain that I have now.

It didnt felt like anything before - the pain is more toward the upper part of the chest rather than close to the heart.. The pain lasted consistently till now, with no change in intensity.

I foudn out actions that worsens the pain. When I take inhale, the pain comes. Exhalation seem ton ot bring the pain. Also, the pain returns after I eat - especially so if it is a large fill. There is no pain when I am idling - just slight discomfort during normal inhaling. I would test for the pain by taking big inhales. Hi Questle, Obviously I can't give you a diagnosis or medical advice but in someone your age the most likely causes of the pain you're describing which, similar to a previous reader, sounds like pleuritic chest pain are musculoskeletal or pulmonary.

I'd think about things like costochondritis, pneumonia, and spontaneous pneumothorax, to name a few. It could also end up being idiopathic and self-limiting, in other words, a mysterious problem that goes away on its own. Gastric cancer seems very unlikely because it usually affects the elderly Hi, This is the assistant editor for Hospital. We also cover a wide variety of medical issues, one of which being Pain Management. You will notice one of the many articles on this topic on our homepage.

If possible I would like Hospital. Please let me know if this addition can be made. Please email me back with your URL in subject line to take a step ahead and to avoid spam. Thank you Mary Miller, may. I had to come back by here and tell you how much you helped me after I had surgery a little over a year ago. I required a distal pancreatectomy, a cholesectomy and a splenectomy due to a 15cm mucinous cystic neoplasm attached to my pancreas.

When I was once again allowed to drink fluids I was hit by horrendous pain in my left shoulder whenever I would swallow. The pain was horrendous! That is the only way I can describe it. Any time I swallowed either liquid or food I was hit with pain like a huge thunderbolt that would actually cause me to lurch or try to leap from the bed I couldn't move a whole lot. My doctors could offer no answer or help.

Although I was still on morphine and it controlled the pain from the surgery, whatever this was, it over-rode the drugs! I almost felt I wasn't being believed and when I spoke with my physiotherapist a few weeks later she mentioned something to me called 'referred pain'. I googled and found this site and your wise words. They gave me some comfort- here was someone who was talking about pain that sounded similar to mine.

So maybe I wasn't imagining the pain. I WAS really feeling it despite the incredulous looks I received from my doctors. The surgeon did state that both my stomach and diaghram were 'traumatized' during the surgery due to the procedure and the tumour being 'glued' to them as well.

The pain when lasted a good 6 months. What made it bearable? Knowing it would go away in time and it wasn't 'in my head'. Thank-you and enjoy your profession! Interesting information about Referred pain This theme serves to educate people in their daily life, thanks to people like you we have more knowledge about this important issue.

Brad, I have been searching for my answer for 6 months, I have never come accross a website as useful as yours. I am a 44 yr old woman, had upper abdominal pain, it took doctors months to diagnose that I had more than one inch and a half size stones.

My gallbladder was removed in September. Couple of weeks prior along with my upper stomach ache I started feeling poking pain on the right side of my left shoulder blade. Two weeks after my surgery I started feeling the same pain and then it traveled to my upper back, between both shoulder blades, then up to my shoulders and neck.

My arms started gatting numm too. My doc sent me to orthopedic dr, did xray of cervical, thoratic spines all is normal, he recommended to give a cortizone shot from my spine - I refused.

The findings were - dialation of my bile duct 11mm in size, black spot on my liver per doctor it is highly likely to be a blood vessel.

My pain in the upper back is for four months now, between shoulder blades and sometimes severe, although I sleep well at nights but the pain is there daily. Now for the last two months I have been having upper stomach pain, chronic ones. Gastro dr did endoscopy in December and due to a thick foldon my stomach a biopsy result came as inflammation and he prescribed me Nexium. Stomach pain is there but not every day. No hearburn, no bloating, although a lot of gas. They can not find the answer, now the dr recommends doing EUS or ERCP to check why my bile duct is dialated as it is 10mm per dr norm should be 5mm for my age.

Just to mention the doctor is very respected in the hospital and does not think my upper back has any relation with my organs, as he thinks it is all musculatory pain as I have worked 25 yers mainly in front of the computer and a very stressful job n IT.

The doctor did leave the option of having EUS to me if I agree. As I am sitting now and typing this hoping to have some answer from you and some suggestion or advise. My pain is constant in the upper back. To mention one interesting fact, when upper stomach hurts, upper back does not, when stomach pain stops upper back then starts hurting.

Most likely will be scheduled in couple of weeks. Thank you so much in advance. Your feedback will be hugely appreciated as I am sufferrng for 4 months with no results Worried and Hopeless, Sounds like your case is very challenging, both for you personally and for the doctors who are trying to sort things out.

The key question seems to be whether the pain in you back is referred pain from your abdomen stomach? The pain you describe doesn't fit clearly into either category; in fact, it could be both. Perhaps an initial episode of referred pain triggered a back spasm that led to pinched nerves and arm numbness.

If the pain is primarily due to muscle spasm, you'd expect some relief with exercise, physical therapy, and ibuprofen. However, you may want to clarify what he is looking for, since your abdomen has already been imaged extensively.

I'd also be interested to know if anything in your physical exam or labs shows evidence of biliary obstruction http: I wish there were an easy answer I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. I will keep visiting this blog very often. It's true that heart attacks in women can feel different from heart attacks in men, adding to the challenge of accurate diagnosis.

Check out this link for more info: I just learned about referred pain So intense I thought he was having a heart attack. We chalked it up to a muscle spasm. The second drain was a partial drain and he experienced no pain.

The third drain was a total drain and the pain returned right at the end of the drain. So intense he was writhing on the bed. After reading the information of referred pain it is so obvious the pain is referred from his lung area.

I had my EUS and ERCP last night and the result was narrowing of bile duct, therefore the doctor dialated my bile duct, pancreas and the rest was normal with no complications. I am releived and happy that there were no complications or sad surprises.

I have no stomach pain for almost two weeks. Unfortunately my pain between my shoulder blades is still killing me daily. I am going to physical therapy as well as a chiropractor, the pain is since September I am in pain every day and the pain is mainly around my choulder blades and sometimes on the spine as well. Have had cervical mri all came normal. I am hoping it is nothing serious therefore am trying to search the body parts to be tested to rule out any dangers.

Please advise and Thanks again, Worried and Hopeless If you area medicalStudent this is for you!!!!!!! Clinical Cases For Medical Students. Invite medical Students to join with us!!!! Worried and Hopeless, my impression is that you've undergone all the standard tests to rule out life-threatening conditions.

Painkillers can also have some benefit although they come with their own risks as I'm sure you know. I wish I had more ideas Which professional you think would be best for my situation orthopedic or neurologist? Thaks again for your time.

At this point a neurologist might be more helpful, especially if they have experience with pain management. Another option to consider is a pain clinic where they can do interventional pain procedures like facet and medial branch blocks. Here's a nice FAQ: I have read your blog more than once and have found it to be very interesting and useful. I am a 28 year old female and I myself have had back pain for awhile now.

I first started feeling the pain about a year ago. The pain was mostly felt in the right shoulder area and middle right back. I seen my family doctor for this problem and he suggested physical therapy. I did not follow through with the physical therapy because the pain had went away. I never really felt that the pain was just typical back pain Now the pain is back and I feel it sometimes just in the right shoulder area and sometimes just in the middle right back. The pain is dull and persistant but does not affect my day to day life.

Could the pain I am feeling in my back be related to my pain in my upper stomach? Is the pain I am feeling referred pain and is something that I should be worried about? I would suggest for you to see your family physician again and ask him if it could be stomach acid, inflamation some sort of, or it could also be due to your muscles,personally do not beleive in Physical therapy for every pain.

Your body knows if the pain is a muscle pain. If you feel it is not helpings, then do not waste money, work closely with your doctor to rule out any organs refferred pain. Please let me know the outcome. Your back pain could indeed be referred pain related to a problem in your gall bladder, stomach, etc.

Talk to your doc again and express your concerns. Brad, I have been scheduled for epidural shots on my neck for upper back pains. My upper stomach chronic pain every other week or so is still there. It is more on the upper stomach and comes 4 days in a row and them no pain for 10 days, then it comes again.

I have a lot of gas as well in between the days. I can eat any food it does not bother or hurt, not heartburn or nausea. The pain seems has its own schedule comes and goes regardles. Have gallbladder removed last year. What could be the possible cause? Hopeless and Worried, unfortunately there are many causes of abdominal pain, and not all of them show up on lab tests or imaging studies.

One very common example is functional dyspepsia: Brad Thank you for the link. By reading the symptoms it is very similar to mine. Will keep you posted of the diagnoses. Thanks for your time. About the best blog I've found in a long time, the only one I've wanted to leave a comment at.

Now I have a question that's stumped the doc's I've seen. Had an epidural this morning; the anestheologist who performed it did not think it would do what the neurologist did who ordered it.

Intense enough that I take Ambien 5 when I am not working 12 hour nights so that I can sleep. I am 67 years old, have bundles of energy, had breast cancer 11 years ago and again a year ago. I say I am a member of the empty cups runneth over club.

Thanks for such an informative blog. Lucky for your patients! Hi Nightnurse, My apologies for not responding sooner - it's been a busy time with Match Day on the 18th i. Anyway, let me make sure I understand your story. You've experienced persistent tingling that started suddenly almost 4 years ago.

Beyond that I'm not sure I have a clear picture. Where exactly is the dinner-plate sized patch of tingling? Centered on the midline or off to one side? The tingling doesn't change in intensity, yet you notice it more when you're lying down - could you clarify that? Is there any numbness or other associated symptoms? Does anything exacerbate it or relieve it? And why did you get the epidural? So far I don't have any good ideas I see lots of questions on the internet never answered about the same pain as me.

That is a tight pressure feeling in my left upper arm just like a too tight BP cuff. I just learned from some of my friends,that they had the same thing diagnosed as referred pain from a gastric ulcer. WOW - I had that on and off for ten years and when I had a gastroscopy for another reason, they found a gastric ulcer. Why is this missed in so many people? I've had 2 complete cardiac work-ups at considerable cost telling me my heart is OK and my arm pain must be something wrong with my shoulder.

Have you heard about this type of pain in an ulcer? This blog is heaven sent. I have been searching for a cause of my constant lower back pain and RUQ pain. Had every test known to man. The lower back pain presented first. I've been on a heating at night for several years.. Am I correct in thinking that my lower back pain above sacrum center and right may be caused by my gall bladder?

I have yet to do the Hida Scan a bit chicken and the pain is now constant for 18 months. The only thing the scans showed was an hemangioma which they tell me cannot cause my pain.

The doctors say in no way are the lower back pain and gallbladder related! I'm confused and in miserable mmost of the time. Back pain and abdominal pain can be among the most vexing diagnostic challenges in medicine - in many cases no definitive cause is ever identified. Could your gall bladder be the source of your back pain? It seems unlikely, but it's hard to be certain. If your doctor recommends the HIDA scan, I'd probably do it after resolving your concerns with a doctor or getting a second opinion - it may be your best chance to rule out gall bladder disease.

Thanks for getting back to me so quickly. I am going to do the Hida Scan. I did read on a number of other posts from people with gall bladder issues, that they had low back pain. However, I don't know how low I do know in oriental medicine where the gall bladder meredian runs along the body and some oriental medicine websites say that even knee pain popliteus muscle to be exact can be affected due to gall bladder and cause a weakening of the knee joint thus creating instability and pain.

Don't know how reliable that is. It just seems strange that my left knee has Baker's Cyst now and swells frequently. I just know the RUQ pain is constant dull ache and I have other gall bladder symptoms as well. It's all very interesting albeit frustrating when it's you with the pain! Do you believe there is any merit to the oriental meredian theory? I haven't heard of an association between gall bladder disease and weakening of the knee joint or a Baker's cyst I don't know much about meridians, but according to one physician-scientist, meridians are often located between muscles, where connective tissue planes converge: Ive had pain in my left shoulder for the past 16 years.

My doc said I have fibromyalgia. My pain is so severe, I am on the fentanyl patch, and am still in pain! Can I have the nerve deadened?

I wish I could rip my entire are of shoulder off! It started as soon as I woke up from csection and never stopped. Dear Brad This is most informative. Thank you so much for the free information. It has helped to diagnose what is going on with my sister. She was previously obese and had her stomach banded 2 years ago. Up until a year ago she was able to eat normally although not in large amounts.

Now protein dense foods such as beef sit in her stomach and cause her referred pain between the shoulder blades. She ends up vomiting the food after an hour or so as she can't take the pain not that she has ever had a high threshold.

At least this aspect of her problem has been highlighted through this article. Hi All I have recently had a laparoscopy to explore right sided ovarian pain I get every month from the start of my ovulation cycle until about the 2nd day of my period.

I have a history of polycystic ovarian syndrome and an ultrasound prior to my surgery confirmed cysts on the left ovary. My Gyn thought that I may have adhesions on my right ovary causing the pain. Instead of this, my doctor found the right ovary in "perfect" condition and the left in a mess. Endometriosis has fused the left ovary to my bowel. The doctor has freed as much tissue as he is able however, further surgery will need to be conducted by a bowel surgeon.

The doctor believes my right sided pain which can be described as a dull ache as referred pain but almost unbearable at times. It hits my right sciatic nerve and travels halfway down my thigh. I have had this pain for about four years. Unfortunately, 9 days after the surgery I began to ovulate and the right sided pain returned only much, much more painful.

I haven't seen the doctor yet but I think this confirms that it is referred pain as the doctor did not touch the right ovary. Thanks for this great site, it is comforting to hear of others with similar experiences.

Terri Perth, Western Australia. The lowest edge of the area of tingling lies about an inch below my waist at the midline up to the middle of my shoulder blades and out towards the sides, as if you'd placed a large dinner plate against my back with the rim just below the belt line.

I say tingling for lack of a better term. It's like when you put your hand on the casing of a well-tuned motor and you feel the hum, the vibration, of the motor. I can't put my hand on my abdomen or back and feel it; it's deep inside.

At times I feel there is something there that moved in on that night in June that has a life of its own. Tonight it's almost throbbing. There's no numbness, no pain with movement.

I went to see a neurologist who had advertized a forum he was giving entitled "Do you want to feel like you used to feel? He prescribed neurontin; he was disappointed it only helped the neuropathy I suffer in my feet due to chemo x 2 for the breast cancers I had. It did nothing for the tingling. I do not have headaches. The massage therapist, physical therapist, chiropractors have all been stumped at why I feel this way When I finally shared this with my physician a couple of years ago, I told her that I would not be in her office if everything was all right, I was only there because something was wrong and to please not pat me on the head and send me on my way As a nurse I have seen patients who kenw for certain that something was wrong and eventually the cause was found but those patients put up with physicians not believing them for a long time and suffering discomfort and distress as well.

Do you have any ideas? I hope these blogs will help you in your practice of medicine and I sincerely appreciate your time and interest. God bless you for the help and hope you've already given others.

I wonder if you can help. I had a colonoscopy after a CT scan suggested uncomplicated diverticular disease and incidentally a renal cyst three days ago. I was sedated and watched it. No nasties, but confirmed the CT.

What causes chest pain?