I've been truamatized by this back problem and seeking help, has been a ordeal . When you admit that, pain, stiffness, tight muscles that seem to be making simple things harder. I blamed myself, am I too lazy, am I really this out of shape it didn't make sense. The condition cause you to become less physical and you lose conditioning not muscle weakness causes the condition. Disc bulges effacement of conus, mild foraminal stenosis, disk bulges L4-5,central canal stenosis, bilateral facet joint hypertrophy and ligamentum flavum. I certainly have had little understanding of other peoples back pain, of course I have back pain it seemed normal, but this weakness is harder for me to deal with and now I am looking for answers and curious about other experiences.
I was a very active person before my back problems started up. It drives me nuts that I can't do the things I use to without even thinking about it. While I didn't work out, my jobs and work were my work outs.
I've felt guilty, felt like this was my fault, and other things as well. Facet arthritis, SI joint dysfunction, disc degeneration, and a transitional vertebra are not my fault, and I am fed up with doctors that can't figure things out. I am at the point where I am going to find a doctor that can tell me whether they can fix me or not. I need to know, so I can plan the rest of my life. If I am going to live with this the rest of my life, fine, just tell me!
For my facet joints, I had a pair of diagnostic injections (numbing agent only), which were conclusive, and that was followed up with RF Ablation. I have had 5 months pain free there, which has been nice. My pain management doc is the only doc who ever looked at those.
With my right SI joint, I had a pair of cortisone injections back in 2010, which were followed up with one round of prolotherapy, which put me in major pain for over two months. Doc didn't do any more of that. Just had another injection to the SI joint on Monday. I thought doc was just going to use the numbing agent, but he did cortisone, even though he knew I had that before and it didn't really work then. According to the notes from when the injections were done, the diagnosis is that I have SI joint dysfunction. The first 8 hours following both were pain free.
I return to see my pain management doc in just over a week, and he will probably be sending me to a surgeon for the SI joint. It's been a very rough week to say the least. The cortisone didn't do me any good what so ever, and I have flared back up really bad the last couple of days. I also called the surgeon I had seen a couple weeks ago, and am waiting to hear back from them on Monday to see if he wants to have me come back and discuss my treatment options.
I have tried physical therapy in the past as well, but that only works for a short period of time, and then I get hit with a flare up, and can't do anything again. The disc degeneration isn't really a factor at this time. I have a couple of small bulges and a small tear, but those aren't messing with any nerves or anything else.
The one other thing that I have is a transitional vertebra that is half lumbar half sacral, unfused, and that sits right over my right SI joint. Not sure what is going to happen with that yet. I have 6 lumbar and only 4 sacral vertebra.
Feel free to ask me anything specific!
The Following User Says Thank You to peps90436 For This Useful Post: Serial (04-01-2012)
How much do you do during the good times. I get conflicting information that is shoveling, lifting, pulling, pushing. Am I making it worse. My instinct is not to do as much and I frequently expect more pain when I lift for instance and it isn't as bad as I expected, but it seems like there is a rebound effect.
Location: San Francisco, California, United States
Hi there, welcome. It can be hard to avoid blaming yourself, but I was a very active athlete, elite swimmer when younger, good core strength, etc., and still have back problems, even with no known major traumatic injuries. Sometimes, life just happens. It sounds like all of your pain is in your back (no shooting leg pain?), which could be a good sign.
One of the problems with "let pain be your guide" is that the pain will often come in later. Avoid lifting, bending, twisting, etc. You will probably have to figure out new ways to do many regular activities. For example, if you have to vacuum, hold the vacuum at your side and propel yourself with your legs, rather than pushing the vacuum out in front of you. Or get a robot vacuum. If you are standing to wash dishes, open a cabinet door and prop your foot in the bottom of the cupboard.
Many doctors, hospitals, and even chiropractors offer back classes to show you how to sit, how to carry, etc. They are often free, but the provider will try to sell you their services. Physical therapy can be helpful to show you exercises that will strengthen without aggravating.
Have you received any treatment for your condition? The typical course of treatment for a pure back problem is; physical therapy, oral short-course steroids, epidural injections under fluoroscopy, and then evaluate for surgery.
Many chiropractors think they can fix disc problems, but I would avoid going to a chiro for an adjustment, unless your back doctor advises to do so. There are some chiros who do not manipulate, but use percussive techniques to activate nerves and muscles. I saw one for a while, and felt great after every treatment, but couldn't afford to pay cash every week for his treatments. Again, make sure to coordinate with your back doctor.
I realize that physical therapy on its own often does not resolve the issue, but it can be valuable in not allowing the injury to become worse. When my surgeon went in to fuse my L4-L5, he was surprised by the amount of scar tissue, indicative of long-term spinal instability. My flexion and extension X-rays did not reveal any instability, which my surgeon thought was due to good core strength.
My primary dr, i told him I had pain in my back and right hip and weakness . My reflexes are strong. He said back pain is the most common complaint to the dr. and recommend a stationary bike I had put on some weight. A exray revealed mild arthritis and a slight narrowing. Average 50 year old Mild arthritis condition. It was hard to take I feel like I am being crippled by 50 year old arthritis. I rode that bike I found, the pain in my hip, started down my leg and got worse. The dr advise was I must not have the seat adjusted properly. By this time I am seeing a spine specialist and starting PT . Which was in it self at times was very frustrating. When I spoke to the dr, my hip was giving me the most pain would they exray it . Normal oh maybe not so normal he sent me to a surgeon , congenital abnormal or previous injury could be accelerating arthritis. More PT for hip and lower back. When I graduated from PT I went back to my primary dr and asked for a MRI he rotated my hip it seemed to him to be refered pain and he insist the hip looks normal to him on the exray. The MRI revealed the bulging disc and nerve interference the mild stenosis and a old compression fracture of T12and L1. I recently purchased a elliptical because it give me a chance to exercise with minimal percussion and it forces me to stand and move in pelvic neutral. Thank you ,
Location: San Francisco, California, United States
It sounds like you currently have a plan to stabilize the hip joint and back issues, and get back into shape without aggravating any injuries. Hip problems and/or back problems can be really tricky to identify and must be treated in tandem. I have both.
As far as a stationary bike, I sit upright on mine, no leaning forward. If you do have a hip issue, the closer you come to a "deep seated" position -- hip joint at 90 degrees -- the more it will aggravate your hips. So, I have my bike seat very elevated and just sit upright and pedal. It helps to keep the synovial fluid moving around in the hip joint. I am too clumsy for an elliptical, but I hear they are great.
If you have pain in the "groin" area, it is more likely to be coming from within the hip joint itself. If the pain is in the buttock area, it could be sciatica or piriformis syndrome. The problem is that a lot of these problems can show up in one person, and it's hard to know which one is causing which.
The piriformis is a muscle whose only job is turn the thigh outward. So, if you have a hip problem, your body will often turn the thigh outward to alleviate the pressure in the hip and the piriformis gets aggravated from overwork. The piriformis runs near the sciatic nerve, sometimes entangled with it. So, you can end up with sciatica from piriformis and perhaps the other way 'round, as well.
The back problems can be aggravated by an unhappy hip joint, as your body compensates for the hip pain. In turn, your back can make it feel as though you have a hip problem, because the nerves for the lower extremities pass through the lower back. If the nerve that corresponds to your hip is pinched in your back, your hip will hurt, even though it has no damage.
I would suggest keeping up with whatever exercise does not give you pain and any conservate treatment your doctors recommend. The exercise will help to keep blood flowing to the discs, which can heal themselves. There are some good reference books out there on how to self-heal your back.
Once you are closer to your target physical fitness, then assess how your back and hips feel. Maybe one will need more immediate, aggressive treatment than the other. If any of your symptoms increase or you experience weakness in the legs or loss of bowel or bladder control, then seek immediate medical treatment (signs of cauda equina syndrome, which is rare but a medical emergency).
It sounds like you are frustrated with your current doctor and lack of coordination by your doctors. You might want to book an appointment with a physiatrist to oversee your conservative care. Physiatrists are doctors who focus on restoring and maintaining functionality, with more of a holistic, overall view of the body. They will often arrange for appointments at two-three week intervals to closely monitor your progress, and may be better at coordinating various orthopedic specialists than a family doctor.
The Following User Says Thank You to SweetPeainSF For This Useful Post: Serial (04-06-2012)
[QUOTE=Serial;4953878]How much do you do during the good times. I get conflicting information that is shoveling, lifting, pulling, pushing. Am I making it worse. My instinct is not to do as much and I frequently expect more pain when I lift for instance and it isn't as bad as I expected, but it seems like there is a rebound effect.[/QUOTE]
I'd keep a journal of the things you do when you are having your 'good days', and what happens afterwards. That way, you can eliminate things that cause you to flare up. I tried keeping mental notes of that sort of thing, but it didn't really work for me. Keeping written notes will help your memory when your pain level is up.
I have found that I can't really carry anything heavier than a gallon of milk, even on good days will bring on pain and flare ups. Squatting and kneeling are two other things that don't mix well for me. I have learned to keep my activities down even during the good times. I will do a bit more, but I do still limit myself. That rebound effect can really kick you in the back side!
I have now put together a very good listing of my symptoms, what brings them on, and other relevant things. I have been keeping a daily log or journal of what I have done during the day, my pain level and what symptoms I have that day. I don't note each thing, such as trips to the bathroom, but I am noting other things like trips to the store up the street, walking the dog, and other things. I wish I had done this a long time ago.
I have an appointment coming up with my pain doc in a week, and he may be referring me to a surgeon (not the first time I have seen a surgeon either). The notes will help me explain things to him. I also plan on inducing a flare up, as too often, by time I get in to see a doc, the symptoms have mellowed too much for them to really see what is going on.
Start with your regular doc, get referred to an orthopedic surgeon or neurosurgeon who specializes in the spine, and go from there. Definitely hold of on chiro until the docs say it's OK. I use to be a regular with chiro adjustments, but those started increasing my pain, so I stopped that.
The Following User Says Thank You to peps90436 For This Useful Post: SweetPeainSF (04-01-2012)