Back Pain Guys, Info Needed (1 Viewer)

[Corporation]

I do not have chronic back pain, but 5 times over the last 5 years (including last week), I have an attack that comes out of nowhere and leaves me immobile and in extreme pain. I do have some "discomfort" from time to time, but not rising to the level of back or neck pain that I see others struggle with. I had an MRI a few years ago, and the doctor said I had mild degeneration of discs which were in line with a nearly 50 year old man. When the attack occurs, it is so extreme that I collapse to the ground and if I move my foot an inch, the pain is searing. I've had to be transported by ambulance twice (out of the 5) to get relief. This back pain is typically in the lowest part of my back on the right side, although this latest attack (which did not require a hospital trip) was in the middle of my back.

I went to a new doctor to try to find out what is going on with my back, as the prior doctor said it was muscular and recommended back exercises. A good conservative treatment, but just wanted to get another opinion as we couldn't really find the trigger point of these attacks (I'm never lifting anything when it happens, just standing, or bending slightly). The new doctor ordered MRIs of my upper and lower back. Without discussing the results of the MRI, I received a call from his office to schedule a deep spine injection. I told him I would like to discuss the results of the MRI first, which they were fine with. He said normally people are looking for relief quickly, so they try to get it scheduled ASAP. I just want to know what the MRI says and make sure he knows I'm not in chronic pain. That seems to be a big jump to me.

I don't like to second guess doctors, and this doctor is part of a world renowned practice. I haven't actually spoken with him, only his P.A. and I will be meeting with her again (though he has discussed the MRI results with her). She also seemed very capable. Wanted to see if others have what I would describe as non-chronic back pain and if you jumped straight to injections. I'll provide more info on the MRI results after my meeting on Friday. Thanks for any feedback.

 

[ChiefD]

I'm with you. I need to know the why first.

 

[Captain Cranks]

Not sure if this is helpful but an ultrasound of my abdomen found I have severe stenosis in the lower spine. The symptom is pain that runs from my lower back to my left butt cheek. My doctor suggested I try physical therapy to balance the muscles in my core which would reduce the compression in my spine that is causing a pinching of the nerve.

 

[dgreen]

I had my first back pain in years just a few weeks ago. Prior to that, I've probably had like 5 or 6 times of some pretty bad pain. Some have been the pain shooting down the leg and others have been more like what you describe. The latest was as you described. I was squatting on the floor to grab some trash that missed the trash can and that motion of leaning forward to grab the trash sent me to the floor. After several hours, I was considering a trip by ambulance because I wasn't going to be able to get to the car for my wife to drive me. But, we decided to do a video doctor visit. They put in a prescription, my wife picked it up, and I gradually improved over the next few days, mostly back to normal in less than a week.

I do think my problem is that I don't regularly stretch, and I think I should just use some ice and heat from time to time when things feel a little off.

 

[SWC]

i have had four injections and 1 worked for about four months so i would want to know that the mri says there is a reason before i went and got shot up that is just me talkin but honestly let your pain and your physicians and not a bunch of wierdos on the internet be your guide on this take that to the bank brohan

 

[Bob Loblaw]

I've had horrible, "can't move" back pain twice.

First time, turned out to be a kidney stone moving its way through my system. Started in my mid-to-lower back one morning in the shower. I went to work, moving gingerly. At the time, my drive time commute was 45 mins both ways. Made to work fine, some soreness throughout the day, but was still manageable. Got in the car to drive home, made it about 20 mins when my back just started tensing up super tight. Had to pull off the freeway, and just sit for about 15 mins (lots of deep breathing and praying that I could make it home). When the pain subsided a little, I found a CVS for some Aleve and water. Made it home, took a leak, and then slept or laid in bed for the next two days. Pain went away, and I never was able to see the stone when I passed it. Lesson learned: drink more water, and apparently some lemonade every now and again.

Second time, it was sciatica that caused horrible pain across my lower back that also affected my left buttock, down my leg, and ended around the bottom of my calf. This occurrence kept me away from work for 3 weeks. I could barely stand without immediately needing to brace something and/or sit down. Most comfortable position was when I was balled up in a fetal position but lying on my back. Went to the ER on the second day, and was given some painkiller (maybe morphine), and then prescribed 800mg ibuprofen (could've been 1000). Went to physical therapy, and was given some exercises that I should do daily (basically for the rest of my life). Horrible experience. One good thing that came out of it is that I lost about 25-30 lbs due to not wanting to take a poop. It hurt too much to be seated in an upright position.

Maybe you're experiencing one of those two things.

 

[TripItUp]

I have scoliosis and degenerative disks in my lower back and began having lower back pain in my mid 30s.

I now have an expensive bed, no longer sit down at work and stretch daily and the back pain goes away and or is manageable. I'm able to play sports at a pretty high level again.

Stretching and the bed surprised me, I thought I was doomed, but these made a huge difference. Also, if you sit down at work a lot consider working from a recliner or any other position that puts less strain on your lower back.

ETA: I also lost a little weight that I have kept off which has made a huge difference too.


So for me it was a multi pronged approach.

 

[Jayrod]

I've been leveled by back pain twice in the last 10 years.

1st time I was in my late 30's and became "crooked" where I leaned sideways all the time with severe sciatica. After months of everything from physical therapy to acupuncture, I found relief when a chiropractor (#2 btw) told me to do 50 squats every day to retrain my muscles to be properly aligned. Within 2 weeks and 2 visits to him, I was back to 90% functionality and almost no pain.

Fast forward to last Summer (I was 46) and I'm suddenly leveled after work and unable to manage any position but laying flat. For 2 weeks I barely was able to sleep because the back and sciatic pain was so severe. Went to urgent care twice just for pain meds. Spent 3-4 weeks lying on the floor 24-7. Finally the pain subsided and I was basically told I have a degenerative disc and to do what I could to keep from aggravating it or have surgery.

The issue this time was my new desk/chair setup was not giving me good lumbar support and I was twisting sideways too much. Got a new desk/chair combo and I've been good enough to play basketball again over the last 6 months without incident.

 

[Judge Smails]

Wouldn’t wish it on anybody. The worst debilitating pain. I had brutal sciatica. Took 2 epidurals to get it to relax enough where I could move and start PT. Haven’t had it since and never want to. Good luck.

 

[Corporation]

Thanks all for the feedback! I really just want more info from the doctor and think that is a reasonable request. I almost certainly will get the injection, I just want them to know that I don't think this is chronic, I just don't know what triggers the events. I was literally just standing (not even bending) talking with someone at work when this last one hit.

For the previous issues, they have said there were no structural issues and that it is muscular. They mentioned exactly the things that @TripItUp mentioned. We have a good bed, and I did the exercises for awhile. I will need to be more diligent on that. I sit way too much at work and at home.

For those who mentioned sciatica, that's the first thing they looked for as well, but oddly I have no pain radiating down into my legs so they ruled that out. The 2 times I had to go by ambulance, they had to give me a torodal shot into the lower right back. Taking oral medication does not relieve it.

 

[Terminalxylem]

Most likely your pain is from degenerative disk disease*, where even minor changes in position can pinch a nerve/nerve root. This causes discomfort that is compounded by spasm of the muscles adjacent to the spine. In the absence of neurological deficits (weakness, numbness, impotence, loss of bladder/bowel control), the pain is managed with analgesics like Tylenol, ibuprofen, etc. +/- muscle relaxers like Flexeril (less data to support this).

More importantly, you need to strengthen the muscles supporting your spine and pelvis, and work on flexibility/alignment of your back, hips and pelvis. Physical therapy and yoga go a long way here.

And losing weight will certainly help.

Steroid injections are usually reserved for intractable pain. No way I’d have someone inject me, unless I’d failed all the above, as there are risks with any invasive procedure, including infection and nerve damage. I’d also avoid systemic (pill) steroids (eg. Prednisone).

Complementary medicine approaches like acupuncture may have a role in treating recurrent pain, as may massage therapists or chiropractors. I definitely would exhaust conventional treatments before entertaining the latter.

FTR, I have lumbar degenerative disk disease, set off initially by poor weight lifting technique. It's flared up a handful of times over the years, and I frequently can feel a slight twinge at the back of my thigh. I manage it by core strengthening via rock climbing. I also won’t sit for prolonged periods. As a general rule, the more active I am, the less discomfort, though I avoid things which abruptly load my spine like jumping, or carrying heavy loads on my shoulders. I’m neglecting the flexibility side of the equation, but I keep telling myself I’ll do yoga.

*There are other considerations, but absent “red flag” symptoms like unexplained weight loss, fever, genitourinary issues, trauma, or neurological deficits, or unrelenting pain over weeks, no further work-up is indicated.

 

[Gatorade]

Last Saturday I was doing yoga when I had a slight but sudden cough. The lower back pain took me straight to my knees. Playing pickleball for two and a half hours earlier might have had something to do with it. This is the second time a cough has caused my back to go out. The pain was all the way across my lower back and then stiffness came later up into my neck. Was able to go to the chiropractor Monday morning for an adjustment. Neck felt better right away and pain went away over my left hip. Still some pain and stiffness over my right hip, but will go back for another adjustment tomorrow. The last time this happened almost a year ago, two trips to the chiropractor fixed me up. Hope you feel better soon without having to take shots.

 

[Corporation]

Most likely your pain is from degenerative disk disease*, where even minor changes in position can pinch a nerve/nerve root. This causes discomfort that is compounded by spasm of the muscles adjacent to the spine. In the absence of neurological deficits (weakness, numbness, impotence, loss of bladder/bowel control), the pain is managed with analgesics like Tylenol, ibuprofen, etc. +/- muscle relaxers like Flexeril (less data to support this).

More importantly, you need to strengthen the muscles supporting your spine and pelvis, and work on flexibility/alignment of your back, hips and pelvis. Physical therapy and yoga go a long way here.

And losing weight will certainly help.

Steroid injections are usually reserved for intractable pain. No way I’d have someone inject me, unless I’d failed all the above, as there are risks with any invasive procedure, including infection and nerve damage. I’d also avoid systemic (pill) steroids (eg. Prednisone).

Complementary medicine approaches like acupuncture may have a role in treating recurrent pain, as may massage therapists or chiropractors. I definitely would exhaust conventional treatments before entertaining the latter.

FTR, I have lumbar degenerative disk disease, set off initially by poor weight lifting technique. It's flared up a handful of times over the years, and I frequently can feel a slight twinge at the back of my thigh. I manage it by core strengthening via rock climbing. I also won’t sit for prolonged periods. As a general rule, the more active I am, the less discomfort, though I avoid things which abruptly load my spine like jumping, or carrying heavy loads on my shoulders. I’m neglecting the flexibility side of the equation, but I keep telling myself I’ll do yoga.

*There are other considerations, but absent “red flag” symptoms like unexplained weight loss, fever, genitourinary issues, trauma, or neurological deficits, or unrelenting pain over weeks, no further work-up is indicated.

This is where I am. I know I need to do better with stretching and strengthening and will make that a real focus. I was surprised when he jumped straight to injections. For chronic, constant pain I understand, but averaging 1 attack a year it seems a little invasive. I'm definitely going to ask for the more conservative route first (and they were open to that, saying they would easily write a script for PT).

 

[Corporation]

Last Saturday I was doing yoga when I had a slight but sudden cough. The lower back pain took me straight to my knees. Playing pickleball for two and a half hours earlier might have had something to do with it. This is the second time a cough has caused my back to go out. The pain was all the way across my lower back and then stiffness came later up into my neck. Was able to go to the chiropractor Monday morning for an adjustment. Neck felt better right away and pain went away over my left hip. Still some pain and stiffness over my right hip, but will go back for another adjustment tomorrow. The last time this happened almost a year ago, two trips to the chiropractor fixed me up. Hope you feel better soon without having to take shots.

Hope you get to feeling better as well! Back pain is misery. Getting old is not for the faint of heart!

 

[TripItUp]

For the previous issues, they have said there were no structural issues and that it is muscular. They mentioned exactly the things that @TripItUp mentioned. We have a good bed, and I did the exercises for awhile. I will need to be more diligent on that. I sit way too much at work and at home.

Two of my best friends are highly regarded orthopedic surgeons. Trust me, the key for most back pain is stretching, not exercising(unless you are overweight).

Find the right stretches and do them religously every day...it can change your life, it changed mine.

Also on the sitting,, Buy a recliner, standup and/or work on a reclinable bed. Avoid sitting in a chair as much as possible.

 

[Dezbelief]

Most likely your pain is from degenerative disk disease*, where even minor changes in position can pinch a nerve/nerve root. This causes discomfort that is compounded by spasm of the muscles adjacent to the spine. In the absence of neurological deficits (weakness, numbness, impotence, loss of bladder/bowel control), the pain is managed with analgesics like Tylenol, ibuprofen, etc. +/- muscle relaxers like Flexeril (less data to support this).

More importantly, you need to strengthen the muscles supporting your spine and pelvis, and work on flexibility/alignment of your back, hips and pelvis. Physical therapy and yoga go a long way here.

And losing weight will certainly help.

Steroid injections are usually reserved for intractable pain. No way I’d have someone inject me, unless I’d failed all the above, as there are risks with any invasive procedure, including infection and nerve damage. I’d also avoid systemic (pill) steroids (eg. Prednisone).

Complementary medicine approaches like acupuncture may have a role in treating recurrent pain, as may massage therapists or chiropractors. I definitely would exhaust conventional treatments before entertaining the latter.

FTR, I have lumbar degenerative disk disease, set off initially by poor weight lifting technique. It's flared up a handful of times over the years, and I frequently can feel a slight twinge at the back of my thigh. I manage it by core strengthening via rock climbing. I also won’t sit for prolonged periods. As a general rule, the more active I am, the less discomfort, though I avoid things which abruptly load my spine like jumping, or carrying heavy loads on my shoulders. I’m neglecting the flexibility side of the equation, but I keep telling myself I’ll do yoga.

*There are other considerations, but absent “red flag” symptoms like unexplained weight loss, fever, genitourinary issues, trauma, or neurological deficits, or unrelenting pain over weeks, no further work-up is indicated.

This is where I am. I know I need to do better with stretching and strengthening and will make that a real focus. I was surprised when he jumped straight to injections. For chronic, constant pain I understand, but averaging 1 attack a year it seems a little invasive. I'm definitely going to ask for the more conservative route first (and they were open to that, saying they would easily write a script for PT).

I agree with not going the injection route at this stage. I agree with the stretching advice.

Get a back brace/weight belt and wear it when doing physical chores and activities. Avoid locking your knees. Heat feels good on sore backs but if you have inflammation/swelling ice is better. Diet can cause inflammation.



My back is hurting a little bit just reading this thread.

 

[Chemical X]

being old men, degenerative spine issues and compression will be a thing for us. first, read your MRI report. most facilities allow online access to pics and the report. know the 4 regions in order, cervical, thoracic, lumbar, sacral. is it nerve or muscle? if it’s nerve, take the shot….imo nothing else will work. i battle daily a c5-c7 nerve issue and have battled sacral issues that shots have also helped. heat helps for sacral, stretching too. i take cyclobenzaprine for muscle spasms and tramadol for pain. aleve seems better than tylenol. fyi, pain and spine centers have their own PAs and staff and they really are the ones to best administer an epidural. and i have found them a bit next level from an orthopedist…..a spine doctor and neurologist are also for opinions.

like i said, imo, if this is nerve, avoid a cuckoopractor, massages, PT and get a shot, even 1-3.

 

[Corporation]

Yeah from all indications, mine is a muscular issue that sometimes irritates a nerve, rather than having the nerve issue you described. Of course that’s why I want to see the MRI results and discuss to make sure it isn’t more nerve related.

In their defense, when I requested the consult they were quick to oblige. The clinic said many people are looking for relief ASAP so that’s why they jump to scheduling (which again makes me think that they believe I’m in constant chronic pain).

@TripItUp or others: Do you have a link to stretches you like to do? I’ll likely be going to PT and getting some from them, just curious. I have some from prior where I’m on my back with knees up and slowly move them all the way left, to the right, repeat. Also bring one knee into my chest while other flat, then alternate. There’s one called the cat or something where I’m on all fours and kind of arch my back, but that one is sometimes uncomfortable.

 

[TripItUp]

@TripItUp or others: Do you have a link to stretches you like to do? I’ll likely be going to PT and getting some from them, just curious. I have some from prior where I’m on my back with knees up and slowly move them all the way left, to the right, repeat. Also bring one knee into my chest while other flat, then alternate. There’s one called the cat or something where I’m on all fours and kind of arch my back, but that one is sometimes uncomfortable.

My wife goes to a PT, and I actually got many of the stretches through her via her communication with her PT. I'll post what I think are the most effective ones. Most Doctors are not great at this part of the prevention...so I wouldn't expect much from the Docs on stretching.

 

[Gatorade]

@TripItUp or others: Do you have a link to stretches you like to do? I’ll likely be going to PT and getting some from them, just curious. I have some from prior where I’m on my back with knees up and slowly move them all the way left, to the right, repeat. Also bring one knee into my chest while other flat, then alternate. There’s one called the cat or something where I’m on all fours and kind of arch my back, but that one is sometimes uncomfortable.

My wife goes to a PT, and I actually got many of the stretches through her via her communication with her PT. I'll post what I think are the most effective ones. Most Doctors are not great at this part of the prevention...so I wouldn't expect much from the Docs on stretching.

Once the PT is over, try yoga. Some similar stretches as described, to keep you limber

 

[Terminalxylem]

Yeah from all indications, mine is a muscular issue that sometimes irritates a nerve, rather than having the nerve issue you described. Of course that’s why I want to see the MRI results and discuss to make sure it isn’t more nerve related.

In their defense, when I requested the consult they were quick to oblige. The clinic said many people are looking for relief ASAP so that’s why they jump to scheduling (which again makes me think that they believe I’m in constant chronic pain).

@TripItUp or others: Do you have a link to stretches you like to do? I’ll likely be going to PT and getting some from them, just curious. I have some from prior where I’m on my back with knees up and slowly move them all the way left, to the right, repeat. Also bring one knee into my chest while other flat, then alternate. There’s one called the cat or something where I’m on all fours and kind of arch my back, but that one is sometimes uncomfortable.

This guy seems decent

 

[Corporation]

So I got the MRI results for the upper and lower back. As she was talking she mentioned the results weren't surprising for someone with arthritis in their back. I told her no one ever told me I had arthritis, but it wasn't surprising, and she just said "Oh, well you do" . Disc spaces still seem good for a 51 year old. For the Thorasic the T1-1 said it was preserved, then the rest all said "small disc bulge produces mild narrowing of the right lateral recess" which she said was fairly mild. T9-10 actually says small left disc bulge. Lumbar had one (L4-5) that seems worse than the others: "large midline annulus tear approaching the proximal left L5 nerve root. Underlying disc bulge produces mild bilateral foraminal stenoses. Moderate to severe facet hypertrophy." The L5-S1 said "small midline annulus tear with modest facet hypertrophy".

The shot they were going to give is in the lower back near L4-5. I told her I'd rather try PT first with these exercises and stretches and she totally understood. She said the shot order would be good for 3 months if I determined I wanted to go that route later. She did say if I had another attack to contact them as soon as possible, so when they gave the shot they could validate that was the spot causing the infrequent pain.

So, I'm going to go to at least a few sessions of PT, get exercises and stretches from them and kind of "perfect" the routine, then just have to be dedicated to it. I meant to ask if she would write a script for a standing desk and/or a new chair at work.