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Question / Repeated lower back injuries

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:26 AM in Lower Back Pain
Hi folks,

I just registered and am posting here because, like many people apparently, I have some lower back pain for which I have no answer. So, I'm looking for any and all suggestions.

I'm a 38-year old male, 5'11, about 200 lbs. I've been physically active my entire life, playing sports like ice hockey and soccer. When I was younger (since perhaps college), I've had sporadic lower back soreness. It was enough for me to visit a chiropractor on occasion back then, but nothing debilitating. I'd have general lower back soreness when I woke up in the morning, stuff like that.

About 8 years ago, I "threw my back out," and spent a few days recuperating. It happened again sporadically over the next 5 years. I was still physically active, and started seeing a chiropractor occasionally. I got smarter about lifting things, bending at the knees, and so forth but about 3 years ago, the problem increased in frequency, and I had a span where I threw my back out probably 6 times in 6 months. At this point, chiropractic treatment itself became painful, and the chiropractor I was seeing at the time finally suggested that I get an MRI. I did, and followed up with an orthopedic specialist. The MRI was inconclusive, but there was some suggestion that I had a tear in one disc, and the orthopedic doctor suggested physical therapy.

I did physical therapy for several months, and managed not to injure it again for some time, perhaps even a year or two, but it never really felt "strong." Last May, I finally threw it out again, worse than ever before. I had to go to the emergency room, where I had to be lifted out of the car by the nurse. They gave me drugs (steroids, muscle relaxants, pain killers), but did no further diagnostic tests. Eventually, after 5 or 6 days, I was semi-functional. I went to physical therapy for several months afterwards, but really didn't see any improvement and wasn't at all convinced they knew what they were doing. Since that time, I have no longer been able to play sports, or at least I'm afraid to do so.

Just a few weeks ago, on Christmas Eve, we had an ice storm, and I slipped on the ice and threw it out again, nearly as badly as in May. They sent me for another MRI - the first since 3 years ago. I have an appointment on Tuesday to discuss the results with my regular doctor, but from what I understand, it's "inconclusive" again. I suspect they will recommend physical therapy again.

I suppose I should give a little more detail about what I mean by "throw out." When I've hurt my back, it's typically been due to a bent-over, upward-jerking motion, but it's been pretty varied. Some of the specific ways I've thrown it out include:

- Picking up a sock (without bending at the knees)
- Sneezing
- Throwing my hands in the air after scoring a goal in hockey
- Faking a shot in a basketball game
- Turning over in my sleep

There's a pretty standard progression of symptoms once I've thrown it out. When it first happens, the pain is considerable, and I can't straighten up, almost like I'm frozen in mid-straighten. For the first day or three, I can scarcely stand up, and pretty much have to lie down all day. Driving is absolutely out of the question. None of the drugs I mentioned appear to have any noticeable effect on the pain or my range of motion. I typically use ice when I have first injured it. As it calms down, and I become mobile again, the most obvious symptom is difficulty in transition from sitting to standing and vice versa. For example, even now, 10 days after the last injury, it still takes me 30-60 seconds to straighten up after sitting at my computer for about 20 minutes, with some pain. Across the board, these symptoms all "kicked up a notch" as of my injury last May. The last two times have been more painful, and have lasted longer than previous times.

The symptomns are most obvious with driving. For the first few days, even sitting upright in a car seat is impossible, so I cannot drive, and even being driven somewhere is difficult. (I often have to make the car seat horizontal.) When it has improved enough to allow me to sit in the seat, I literally have to lift my own legs into the car with my hands when getting in, because it's too painful to lift my legs in using the usual muscles. Two weeks or more after the onset, I still need to use my car door to lever myself out of the car and into a standing position when I get out of my car, especially if I've been driving for more than a few minutes.

Occasionally I do get some sciatica down my legs, most typically when I am in a sitting position like driving. I have never experienced any numbness or tingling in my extremities.

The only other physical issue I can think of that some people have felt is relevant is that I have extraordinarily tight quadriceps muscles, to the extent where if I lie on my stomach and try to raise my right foot towards my buttocks, it can only come up to about a 45-degree angle off the floor. The left foot, with help, can reach my butt. Some physical therapists have felt that this is actually the source of the problem, but I'm not convinced (yet).

So, *whew*, that was a lot of stuff. Obviously, I'm incredibly frustrated about this, as it has obviously begun to really hamper my quality of life, and I certainly hope to have 30+ more years of active life! I really don't want it to be like this for the next 40 years. I can't do the physical things I like to do anymore. I've tried physical therapy, chiropractic, and even acupuncture. I've tried stretching regularly, but can perhaps be accused of not sticking with it regularly enough. Admittedly, I find it bewildering, because every one of the eight million people I've seen about this recommends a different routine, and more times than not, says "Oh God, how could (previous person) tell you to do X? That's the WORST possible thing for you!"

At this point, I'm open to any suggestions anyone might have for people to see, tests to try, exercises to perform, sympathy and pats on the back, etc. :)

Thanks very much!



  • Welcome to SH :H

    I hope there is anyway your Ortho doc will set you up with a ct/myelogram. It used to be the gold standard for diagnosing herniated discs and other problems until the MRI came along. MRI's aren't as detailed as ct/myelograms and a lot of times it misses things. Another problem is that MRI's are done when you lie down and the contrast doesn't circulate as well. When I had an MRI, it did spot my herniated discs but it was inconclusive as to whether there was nerve impingement. My surgeon sent me to have the other procedure and the nerve was indeed compressed, and I had decompression surgery (microdiscectomy).
    My symptoms were being unable to sit, difficulty driving, nerve pain down to my foot, persistent back pain, and bad muscle spasms. When you sit, you exert more pressure on your discs, and that can be a telltale sign of a herniated disc. Have you ever had a positive leg raise test? That a test they do in the office when they evaluate you for possible disc problems.
    I really hope that they can diagnose what's wrong with your back. Unfortunately it can be very hard to pinpoint the exact cause and they might have to do further testing.
  • Have you been referred to a pain management Dr. He may be able to help. I hope you find something to help relieve your pain. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I would suggest seeing an ortho doc or a neurosurgeon (or maybe a couple if you're not getting good answers) after you see your primary care doc (PCP) to get a read on the MRIs. I like my primary care doc, but after having dealt with back problems for a while I can see the limits of her knowledge on this topic quite clearly (not her fault, she's a generalist after all). If you do physical therapy again, I'd ask around for someone with good knowledge of and lots of experience with backs. My physical therapist was looking up stuff from his college textbook, so my confidence level in him was not great. In terms of treatment, I might ask the specialist about whether epidural injections would be appropriate for you if they can figure out which disc(s) are causing you problems.

    If you need to vent about your back getting in the way of being active, feel free to shoot me an email. I messed up my disc over a year ago. I'm 35. I try to do a lot of walking, stretching (especially for the legs), safe core exercises, and light weights, but it took me a while to get back to that point due to the pain, and this stuff bores me compared to what I used to do. Sucks how discs wear out with age - I've got a 40 y.o. cousin who just herniated his while playing basketball and a 36 y.o. friend who keeps running even though his herniated disc keeps getting worse.
  • Thanks for your suggestions, everyone. I have my follow-up with my regular doctor tonight, so I'll be sure to bring up some of the suggestions you guys mentioned and let you know what happens!

  • Steve,

    Your story practically mirrors my own back pain.
    I too have incredibly low flexibility that shocked my PT too.
    Sort of put a smile to my face to know that I'm not the only one out there that has "thrown my back out" just sneezing.
    Anyway it took two mri to sort out that I had some sort of disc herniation around the L4 and L5.

    I haven't found a good solution to my problem. My last round of diagnosis...recommended epidural shot. However due to economic hardships...I have lost my health insurance. So I'm planning on getting a tens unit to see if that doesn't alleviate some pain.

    I hope you check back in...I'm curios to see your progress as it seems very similar to my own back pain.


  • When I was 14 years old I threw out my back landing badly on a vault in gymnastics and was in so much pain that I was taken in for an MRI and told that I had herniated a disc around the L4 L5 lumbar vertebrae. I underwent 2 months of physical therapy, but my back felt good as new after about a month.

    However, since that time I've "thrown out" my back continuously a few times a year. It used to happen at least 3 times a year and has since (I'm 24 now) occurred closer to once a year.

    The pain I experience and the stimuli seem to be identical to your. I once collapsed on the floor in pain after picking up keys I had dropped, another time bending over to take laundry out of the dryer. The pain isn't typically brought on by strenuous activity although I do go to the gym 3 times a week and engage in both cardioa nd weight lifting exercises.

    My pain episodes typically last for about 10 days. The first 2 days are the worst and I can't stand or walk very well. I can't straighten my back and when I do have to walk it takes a minute of careful planning to stand up, hunched over like an old woman, and hobble to my new resting place. Curling up in a ball is fine, but any attempt to straighten my back results in excruciating pain that feels like I'm snapping my spine in half.

    After a couple of days I'm usually able to straighten my spine enough to walk, but standing up still takes very careful planning and getting into and out of cars is difficult (even though I still can't drive) because the act of lifting my legs is too much for my back to handle and I have to lift them with my hands. Walking too much or too fast during the first week also results in a lot of pain. Typically it's not until the second week that I can resume my life with just an occassional back spasm to remind me that I'm still not fully healed.

    It has been 11 days since my last injury and the first 15 minutes of standing still hurt and any attempt to arch my back is still very painful, but the pain has subsided enough that I have resumed my normal life.

    Unfortunately, I don't currently have health insurance to throw around as I jump from doctor to doctor like I did when I was younger trying to find someone who could prevent these episodes from occurring. Most of the doctors I went to shied away from trying any sort of diagnosis or treatment because the incidents were so infrequent and they insisted that their physical therapy was working until 4 months later when my back went out again.

    One thing I found to be mildly effective was sleeping on a heating pad. However, if you get any sort of diagnosis or prevention or treatment plan I'd be very appreciative if you posted it on this forum as your case seems to be very similar to my own.
  • rsdruid:

    hey, i'm in the same boat as you. I'm inbetween jobs right now and don't have insurance to explore many options.
    However, when i did go from doctor to doctor...I don't think they know anything unless your back is so far gone that surgery is the only option. To them I think our case are mild inconveniences which they think physical therapy will solve. Stretching does help, but I know it's not a proper cure cause these back throwing episodes keep happening to me.

    Anyway, I invested in a tens machine. I read alot of posts at this website about them and went ahead a bought one. Not sure if your PT sessions ever hook you up to their electro-stimulators or whatnot, but these little portable hand-helds pack the same punch. A few sessions a day and it really helps take the edge off the pain. Although duration of the pain relief isn't "permanent" its better than nothing if you don't have any muscle relaxers or pain killers.

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