[glennn2000]

Hi,
Any advice would be really appreciated. I am a 44 year old male and have had a lower back problem for years (as long as I can remember really). I suspect it might have started from weight training when I was about 21 which included reasonably heavy squats and never having a trainer so, no doubt, bad technique.
About five months ago I had a serious crisis which kind of came out of nowhere: I just finished swimming and a little yoga, was putting my pants on in the change rooms, straightened up and felt “something change” in my lower back; a kind of feeling of “not being aligned” and loss of strength there, it didn’t hurt particularly at that moment though. I managed to ride the motorcycle home, but within two hours, I couldn’t stand, couldn’t sit, couldn’t move. Luckily, I had one position in bed on my side (the position we learn to put people in in first aid courses) that wasn’t giving me excruciating pain, so long as I didn’t move, I was okay. That first 24 hours, was pretty tricky and I was very worried. Though our toilet is only about three steps away from the bed, it took me about ten minutes to negotiate the trip and only possible by heavily leaning on my girlfriend. The bathroom has a step down that is about two inches high and I couldn’t even perform this without a few minutes of psyching myself up for it.
The previous year I was doing a lot of silk screen printing which involves being bent over a table and the few months before the crisis, I was spending all day everyday bent over a table drawing (I have since learned to sit up very straight when I’m drawing for long periods). Anyways, five months later, I still have pain everyday and can’t put my pants on in the way that I used to (I now have to lower the pants a lot more whilst trying to keep my back as straight as possible so I don’t hook the left leg up too much). About 6 months prior to the crisis, I had been doing about three yoga classes a week and last year for some months, about three tennis classes a week (the tennis trainer commented that I look unbalanced when I jog around the court for the warm up; also, as much as I love it, the tennis was giving me constant back pain and I eventually tore a calf muscle and gave it up).
I am still doing yoga classes once or twice a week but have decided to stop these classes because last weekend I hurt my back during the class and had extra pain for two days after which included an ache running down my left leg.
As I said, I have a history of lower back pain so: mid 2010 I had a cervical spine x ray which, according to the chiro shows nothing major, just some degeneration and calcification probably normal for my age and mid 2012 I had an MRI lumbar spine scan, the report of which said the following ( I don’t understand most of it but I suspect L5-S1 is the culprit):
“The alignment of lumber spine is normal. The marrow signal of vertebral bodies is normal. No evidence of compression fracture, osseous or paraspinal mass. Conus terminates at above level of L1 vertebral body. Sacralization of the L5 were observed.
D11-12, D12-L1, L1-L2, L2-L3 is normal.
L3-4 and L4-5: There is disc desiccation with central posterior disc protrusion with an associated annular rent. The disc protrusion measures approx. 2X14mm in size. Normal central canal, lateral recesses and both side intervertebral neural foramina.
L5-S1: There is disc dessication with a mild loss of disc space height. There is central posterior disc tear measures of 10mm. There is a central posterior disc herniation measures approx. of 5.0mm with broad base. There are facet arthrosis. There is moderate stenosis at the lateral recesses and intervertebral foramina with radicular impingement of the bilateral nerve roots.
After this crisis, I was seeing a massage therapist a couple of times a week for about a month, a chiropractor a few times (hugely expensive and did nothing but pop a few joints…it would be a lot more help if we sat a smoked a few joints), an osteotherapist once (who did some realignment work with me, a little reiki and pronounced me cured), a physiotherapist about a year ago a couple of times a week for two months, two years ago an acupuncturist a few times a week for a couple of months. If someone tells me that eating a large dog will cure my back pain, as much as I like dogs, I will eat one (I live in Vietnam so this wouldn’t actually be a problem).
My exercise regime right now is about 6 days a week, 30 minutes freestyle swimming in the morning (I try to make my body long when I swim), followed by some light yoga and stretching for an hour (I suspect I have been doing some stretches that I shouldn’t have been, ie trying to touch my toes with my legs straight out in front as this is very very uncomfortable. It may be that these stretches have been aggravating the condition). Then in the afternoon, I’m back at the gym and walk on the machine for 30 minutes and do some light (ish) weight training (Im always careful that my back is supported.) and I do a stretch class two times a week for an hour which I find can help a lot. I have been following this schedule for about a month but my back is not improving. I don’t have a job right now so I am also worried about my financial situation a lot (I’ve no doubt that this psychological tension adds to the problem). Between exercise, I spend most of the day now working on the computer. I am an Australian living in Vietnam so I don’t have access to cheap good medical (its outrageously expensive here for international medical clinics). Acupuncture is a cheaper option here so I am thinking to give that another go though it never helped when I tried it in Korea two years ago.
So, my back pain has become such a part of my life, I’m thinking of changing my name to Mr Back Pain. It’s always been like this but lately it’s really affecting my quality of life which…you know…sucks. So far I have steered well clear of surgery or even steroid injections.
I know this is a lot of information and I thank anyone to took the time to read it and can give any advice.
Thanks,
Glenn

[Leesa]

OMG Glenn. You should NEVER have gone to a chiropractor, not knowing what was wrong with your back! Your could have done some permanent damage..

Your MRI shows some herniations at L4-5 and L5-S1. At L4-5 the protrusion is pretty good sized!

At L5-S1, you have a disc tear of 10mm!!! Plus you have moderate spinal canal stenosis (narrowing of the spinal canal) and impingement of the nerve roots, and that HURTS!

I'd be careful with the stretches -- don't do ANYTHING that hurts. Therapy isn't supposed to hurt. So if it hurts, don't do it. You can still stretch, but if it hurts, back off. You may have been aggravating things. Swimming is great for the spine. Just "hanging" in the deep end with water wings is wonderful too. Stay that way for about 1/2 hour or so. I think I'd back off a bit on the weight training for awhile. You shouldn't be lifting anything right now. Not until you see a doctor who knows his stuff.

Is there any way you can get another MRI since yours in a year old? I know you're not working -- do you have insurance? An updated one would sure be good to see.

Does your pain go down into one leg or another? I suspect it probably does.

You could use a pain management doctor. Trouble is, they always want to do injections which sometimes work, but lots of times don't. Do they have pain mgt. doctors there? Acupuncture might work for you -- I really don't know, but it's worth a try.

I wish you the very best. Let us know what happens. I hope you can find some relief SOON. God bless and please take care. Hugs, Lee

[KnitKnut]

Originally Posted by glennn2000

Hi,
Any advice would be really appreciated. I am a 44 year old male and have had a lower back problem for years (as long as I can remember really). I suspect it might have started from weight training when I was about 21 which included reasonably heavy squats and never having a trainer so, no doubt, bad technique.
About five months ago I had a serious crisis which kind of came out of nowhere: I just finished swimming and a little yoga, was putting my pants on in the change rooms, straightened up and felt “something change” in my lower back; a kind of feeling of “not being aligned” and loss of strength there, it didn’t hurt particularly at that moment though. I managed to ride the motorcycle home, but within two hours, I couldn’t stand, couldn’t sit, couldn’t move. Luckily, I had one position in bed on my side (the position we learn to put people in in first aid courses) that wasn’t giving me excruciating pain, so long as I didn’t move, I was okay. That first 24 hours, was pretty tricky and I was very worried. Though our toilet is only about three steps away from the bed, it took me about ten minutes to negotiate the trip and only possible by heavily leaning on my girlfriend. The bathroom has a step down that is about two inches high and I couldn’t even perform this without a few minutes of psyching myself up for it.
The previous year I was doing a lot of silk screen printing which involves being bent over a table and the few months before the crisis, I was spending all day everyday bent over a table drawing (I have since learned to sit up very straight when I’m drawing for long periods). Anyways, five months later, I still have pain everyday and can’t put my pants on in the way that I used to (I now have to lower the pants a lot more whilst trying to keep my back as straight as possible so I don’t hook the left leg up too much). About 6 months prior to the crisis, I had been doing about three yoga classes a week and last year for some months, about three tennis classes a week (the tennis trainer commented that I look unbalanced when I jog around the court for the warm up; also, as much as I love it, the tennis was giving me constant back pain and I eventually tore a calf muscle and gave it up).
I am still doing yoga classes once or twice a week but have decided to stop these classes because last weekend I hurt my back during the class and had extra pain for two days after which included an ache running down my left leg.
As I said, I have a history of lower back pain so: mid 2010 I had a cervical spine x ray which, according to the chiro shows nothing major, just some degeneration and calcification probably normal for my age and mid 2012 I had an MRI lumbar spine scan, the report of which said the following ( I don’t understand most of it but I suspect L5-S1 is the culprit):
“The alignment of lumber spine is normal. The marrow signal of vertebral bodies is normal. No evidence of compression fracture, osseous or paraspinal mass. Conus terminates at above level of L1 vertebral body. Sacralization of the L5 were observed.
D11-12, D12-L1, L1-L2, L2-L3 is normal.
L3-4 and L4-5: There is disc desiccation with central posterior disc protrusion with an associated annular rent. The disc protrusion measures approx. 2X14mm in size. Normal central canal, lateral recesses and both side intervertebral neural foramina.
L5-S1: There is disc dessication with a mild loss of disc space height. There is central posterior disc tear measures of 10mm. There is a central posterior disc herniation measures approx. of 5.0mm with broad base. There are facet arthrosis. There is moderate stenosis at the lateral recesses and intervertebral foramina with radicular impingement of the bilateral nerve roots.
After this crisis, I was seeing a massage therapist a couple of times a week for about a month, a chiropractor a few times (hugely expensive and did nothing but pop a few joints…it would be a lot more help if we sat a smoked a few joints), an osteotherapist once (who did some realignment work with me, a little reiki and pronounced me cured), a physiotherapist about a year ago a couple of times a week for two months, two years ago an acupuncturist a few times a week for a couple of months. If someone tells me that eating a large dog will cure my back pain, as much as I like dogs, I will eat one (I live in Vietnam so this wouldn’t actually be a problem).
My exercise regime right now is about 6 days a week, 30 minutes freestyle swimming in the morning (I try to make my body long when I swim), followed by some light yoga and stretching for an hour (I suspect I have been doing some stretches that I shouldn’t have been, ie trying to touch my toes with my legs straight out in front as this is very very uncomfortable. It may be that these stretches have been aggravating the condition). Then in the afternoon, I’m back at the gym and walk on the machine for 30 minutes and do some light (ish) weight training (Im always careful that my back is supported.) and I do a stretch class two times a week for an hour which I find can help a lot. I have been following this schedule for about a month but my back is not improving. I don’t have a job right now so I am also worried about my financial situation a lot (I’ve no doubt that this psychological tension adds to the problem). Between exercise, I spend most of the day now working on the computer. I am an Australian living in Vietnam so I don’t have access to cheap good medical (its outrageously expensive here for international medical clinics). Acupuncture is a cheaper option here so I am thinking to give that another go though it never helped when I tried it in Korea two years ago.
So, my back pain has become such a part of my life, I’m thinking of changing my name to Mr Back Pain. It’s always been like this but lately it’s really affecting my quality of life which…you know…sucks. So far I have steered well clear of surgery or even steroid injections.
I know this is a lot of information and I thank anyone to took the time to read it and can give any advice.
Thanks,
Glenn

The spinal stenosis makes it hurt more when on your feet standing or walking. They recommend that you find an exercise routine that is sitting down, maybe one of the easier bike exercise machines, or there are sit down crosstrainers. I was already sedentary when I got my diagnosis, severe stenosis, so they equipment was too painful for me. The swimming is good, I use a jogging belt and go to the deep end and swim or just jog in place. It takes the pressure off your back.
Ice is your best friend when pain is bad. sometimes people prefer heat, I find ice more uncomfortable but more effective for pain relief.
don't push yourself too hard like someone just said, if it hurts, DONT DO IT. That is what my physical therapist said. Good luck.

[Dr. Smith]

Originally Posted by glennn2000

If someone tells me that eating a large dog will cure my back pain, as much as I like dogs, I will eat one (I live in Vietnam so this wouldn’t actually be a problem).

ROTFLMAO! (I like this guy!) I hear you, but if I did that, I'd be without a therapist! (Therapy Dog )

Try putting your pants on from a seated position -- chair or edge of bed.

I agree with what the others have said. Have you tried Tai Chi for stretching? I found a routine that folks like us can do from a seated position -- less stressful on bad backs.

If you can find one there, a certified myofascial trigger point therapist may be of help. Have your girlfriend go with you. If the therapist can help, your girlfriend can learn what to do to continue to save money & visits (that's what my wife & I did.)

Generally, muscles like heat; nerves like ice/cold. Use ice only for 20 minutes at a time, no matter how good it feels.

Doc

[KnitKnut]

Dr Smith can you give me a link to those excercises? Also there are specific excersices for the back, depending on what is wrong. These are supposed to ease the pain by strengthening the surrounding muscles and what not. If you are having sciatica pain going down from your back to your butt and legs, there are specific excersices for that. Just google sciatica excersices. I think you are pushing your body farther than it is comfortable doing. Liston to your body. You don't want to just become a lump on the couch, but there are more comfortable ways to work out and not as often. I Need to take this advise too, to keep moving at least.

[Dubious]

Originally Posted by Leesa

OMG Glenn. You should NEVER have gone to a chiropractor, not knowing what was wrong with your back! Your could have done some permanent damage..

Your MRI shows some herniations at L4-5 and L5-S1. At L4-5 the protrusion is pretty good sized!

At L5-S1, you have a disc tear of 10mm!!! Plus you have moderate spinal canal stenosis (narrowing of the spinal canal) and impingement of the nerve roots, and that HURTS!

I'd be careful with the stretches -- don't do ANYTHING that hurts. Therapy isn't supposed to hurt. So if it hurts, don't do it. You can still stretch, but if it hurts, back off. You may have been aggravating things. Swimming is great for the spine. Just "hanging" in the deep end with water wings is wonderful too. Stay that way for about 1/2 hour or so. I think I'd back off a bit on the weight training for awhile. You shouldn't be lifting anything right now. Not until you see a doctor who knows his stuff.

Is there any way you can get another MRI since yours in a year old? I know you're not working -- do you have insurance? An updated one would sure be good to see.

Does your pain go down into one leg or another? I suspect it probably does.

You could use a pain management doctor. Trouble is, they always want to do injections which sometimes work, but lots of times don't. Do they have pain mgt. doctors there? Acupuncture might work for you -- I really don't know, but it's worth a try.

I wish you the very best. Let us know what happens. I hope you can find some relief SOON. God bless and please take care. Hugs, Lee

Oh Leesa, there you go again!

I know you and your neurosurgeon hate chiropractors (many neurosurgeons now refer to chiropractors) but......while chiropractic manipulation was probably not going to cure a problem of this magnitude, manipulation is actually recommended in a medical orthopedics textbook (two volumes each about 2 1/2" thick) by Samuel Turek, MD, for lumbar disc herniation as a last ditch attempt to keep one out of surgery as manipulation sometimes has amazing results. You are just beating a dead horse on this one!

Be that as it may, the MRI reads a little strangely (terminology wise) which is perhaps due to non-US radiologists lingo, but it would appear that Glenn's problems are largely at L5-S1 and perhaps to a lesser degree the two levels above that. The therapeutic progression would include conservative modalities such as PT, exercises, acupuncture, chiropractic, oral meds followed by more invasive procedures like epidural steroid injection (60-70% success rate) and ultimately....surgery. Because a conservative modality failed, does not make it a "bad" modality, rather Glenn just has a "bad" condition! At this point I agree with "doc" that exercises may still prove valuable, specifically MacKenzie (sp?) Extension protocol. Waiting it out according to the medical literature is also a thought so long as there is not neurological compromise or progressive neurological loss. As pain may not be the primary symptom, Glenn should continue to be followed by an ortho or neuro for a reality check. Good luck Glenn!

[Dr. Smith]

Originally Posted by KnitKnut

Dr Smith can you give me a link to those excercises?

DW bought a DVD, which (of course ) I can't find, but there's lots out there, and we found it worthwhile borrowing from the library to find one we liked before investing in one.

seated tai chi

Doc

[ginnie]

I must say that Leesa is very correct. Don't go to a chiropractor at all! Back issues can be made much worse, even though the attending may state other wise. Get clearence from a neruologist before ever doing any more. I made the same mistake, and it made me ever so much worse.
Get a good consult with a neurologist, and then another opinion. You do have some issues that need to be addressed. Acue puncture is something you can try, without doing more harm. I am sorry you are going though this. Many of us here have back issues, myself included. I hope you can find some resolution, to make your life more bearable. ginnie

[Dubious]

Originally Posted by ginnie

I must say that Leesa is very correct. Don't go to a chiropractor at all! Back issues can be made much worse, even though the attending may state other wise. Get clearence from a neruologist before ever doing any more. I made the same mistake, and it made me ever so much worse.
Get a good consult with a neurologist, and then another opinion. You do have some issues that need to be addressed. Acue puncture is something you can try, without doing more harm. I am sorry you are going though this. Many of us here have back issues, myself included. I hope you can find some resolution, to make your life more bearable. ginnie

Hi Ginnie,

Nice to hear from you!

Wow, I think I agree on this one with you and Leesa! Manipulation; chiropractic, osteopathic, medical, by a physical therapist, witch doctor or otherwise would probably not help this situation and perhaps even aggravate it. In the wrong situation could even complicate it. For other situations, there are just too many citations in the medical literature recommending manipulation for various joint dysfunction and associated neurological issues to ignore it altogether. And while I am perfectly comfortable with a neurosurgeon diagnosing my condition(s) and have done so personally including cervical fusion and multiple therapeutic injections to name a few, I would not at all appreciate for the same to decide whether I did or did not need manipulation. They unfortunately do not have ANY formal training in physical medicine therapeutics. It would be comparable to my hairdresser being the gateway provider who decides whether or not to send me to a neurologist if I have a headache, am vomiting and passing out.

I do like the logic of it though personally......I could then blame the neurosurgeon who sent me to the orthopedic surgeon, who blew my shoulder surgery, permanently damaged the joint and brachial plexus and left me with CRPS and permanent disability. Yeah, I've been looking for someone other than the ortho surgeon to blame!

Way out here in the "wild west," most MD's (especially the specialists, i.e. neurosurgeons and ortho surgeons) have a chiropractor or three that they refer their patients to. Strange, I admit; must be something in the air or water, I think!

[ginnie]

Good to hear from you too. Keep hanging in there. I am sorry doctors messed you up like that. I am sorry you have CRPS due to the surgery. I have PN due to surgery as well. None of this is fun, and back issues can lay a person very low. I am glad we can come back here and talk, vent, try to help. Keep in touch. ginnie