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New Member - looking for any ideas

AnonymousUserAAnonymousUser Posts: 49,671
Greetings Spine Health forum members! I have been reading a lot of your forums and thought this would be a great place to get some outside counsel. I must say that my condition doesn't sound nearly as serious as most of you, and I hope that you all continue to fight valiantly against your conditions. Here's my wrap up:

I am currently a 31 yo male. I experienced low back pain for the first time in my life on 10/12/08. In depth lumbar x-rays taken by my primary care physician are all completely normal. Even though my low back pain is now pretty much gone, I have been fighting either sciatica (right leg) or a pulled hamstring? for almost two months. I will try to explain my condition (sciatica) clearly and with brevity:

-I have been very active my entire life...competitive year round swimmer from 5-19.
-Ran A LOT (a few miles several times per week) in the army and stayed in great shape. Continued to run until just recently after getting out of the army in 2005.
-I have taken up swimming again (April 2009). We're talking about one mile per day.
-Jumped out of airplanes 5 times in the army, 2x per year 15 mile road marches, etc.

Sequence of Events leading up to sciatica:

Since leaving the army in 2005, by Oct 08, I unfortunately gained 30-40 pounds and was not exercising as frequently (core became weaker)...maybe a clue, who knows. I am 6' tall, and when my back pain began I was probably somewhere between 220-225 lbs. I am now down to 205 lbs. and want to get to 175-180. So, here's what I think happened that led to the low back pain (again, i never had back pain before all of this):

September 27, 2008: took my son to six flags. he was tall enough to ride a couple "grown up" roller coasters. as a concerned father, during the ride i literally leaned over and held him as i was facing the same force of the coaster from the front. No back pain yet but I do remember some upper neck pain that only lasted a couple days after that...on to the next weekend...

October 6, 2008 - Did some pretty intense gardening by removing 5 or 6 eight year old bushes. A lot of downward force to remove root balls, etc. I even cracked the shovel in the process. Again, no back pain yet.

October 12, 2008 - Pruned a Japanese maple by squatting, twisting, and then finally shearing for about 10-15 mins. Not 30 mins after pruning, I began the trip to take my son to an Atlanta Falcons game. We stopped at McDonald's. As I was walking out to my car, I noticed just a tiny bit of pain in my back and thought nothing of it. When we arrived at a rapid transit station, I got out of my car and had terrible pain in my low back...I literally could not really straighten my back to walk. It was bad, but somehow I made it through the game. I even stood up for touchdowns and big plays, etc.

I didn't think much of the pain since I never had experienced back pain. I tried to tough it out for a few days and even went to work (i haven't missed any work due to any of these problems).

After the pain did not go away, I saw a chiropractor.
He said that my x-rays looked good, but noticed my right hip was a little higher than my left hip.

After a few adjustments, I was able to start going to the chiro only once per month by February. I did continue to run about 1 1/2 mile a few times per week from Dec-Mar or so. The extent of low back pain was simply that I was sometimes not able to straighten my back as quickly as I would like and bending over was a little difficult. This was not excruciating or constant. Still no sciatica pain yet...only mild back pain.

From 31 Jan to 5 Feb 2009, I drove down to Orlando with my family to Disney World....I drove the entire 400 miles or so one-way from Atlanta to Orlando both ways. Walked around Disney, etc. Also walked around the Atlanta Zoo on 7 Feb. Still no sciatica pain yet...

In mid to late Feb 2009, I noticed that after rising from a seated position, it would take me about 10 steps before I could take a normal stride with my right leg (it was like it was tight). After I reached the full stride, everything was normal.

I did consult with my chiropractor and he thought the stride issue was from the piriformis and gave me some stretches to do. These really didn't help much.

April 2009 - I gave up running to start swimming again (a mile or more per day) as I was still a little scared of running and its purported impact.
Early May 2009 - Attended a concert in which I stood most of the time (maybe a clue).
Mid to late May 2009 - Got lost on some hiking trail with my wife and what started out as a 1-2 mile hike turned into a 3-4 mile hike up and down a small mountain (less than 3-4K ft). Again, maybe a clue. I did not stretch much at all before or afte the hike.
In late May-June 2009 is when what I call the true sciatica pain began. By this time, I didn't have much lower back pain and it was mostly non existent. I am a property manager for high rise office buildings, so I sit a lot throughout the day. During this time period I noticed that when I would walk or stand, I would get a pain that started where my butt meets my thigh, down the back of the leg to the knee. It was painful (a "5" or "6"), but not excruciating. What is key here for me and differs from what I have read about sciatica is that my "sciatic" pain absolutely does not start in the low back or butt. It starts precisely where there hamstrings start at the bottom of the hip and top of the high. I do not have pain when I sit or lie down (have not lost sleep over it, thank god).

July 2009 - I went in to see the chiropractor for a normal monthly visit and he thought it was the hamstring. That didn't make total sense, so I decided to see my family doctor last week who I have seen since a child.
He said it was sciatica and I am currently on Day 11 of a 15-day tapered prednisone prescription, as well as meloxicam. He said if the pain did not go away after that regimen that he would order an MRI. Again, he had a series of lumbar x-rays taken and absolutely no abnormalities were found. I have experienced instant relief with the prednisone and for 10 days life has really been back to what it was before all of this crap began. I have been stretching 2-3 times per day, as well as using McKenzie Method exercises, and have continued to swim.

I even went to a podiatrist to rule out foot problems/misalignment since I wore orthotics as a kid. She said my feet were fine, but that my right calf was really tight and that my hamstring could be stretched a little more.

So, that's my story. Again, my lumbar x-rays turned out to be completely normal for a 31 yo male. The optimist in me says that due to a series of unfortunate events and not serious conditions like disc herniation, I tweaked my back, didn't lay off of it enough, and then have something tweaking my sciatic nerve, or maybe that's something else altogether. Maybe it's a pulled hamstring? I have no idea. I have been filling my mind with too much stuff by searching the internet, so I thought this forum would be a good idea to get some insight.

Any help is truly appreciated!




  • i think youve done the right thing by going to you dr. instead of chiro guy. i'm glad the steroids help. some people get relief for years after taking the steroids.
    you just dont know whats going on until you get mri.
    and even with a mri the problem disk may not show up if in fact it is a disk.
    in the mean time no heavy lifting or twisting. treat your body as if there is a disk problem. i like your switch to swimming. another good exercise might be bikeriding.
    best of luck...pete
  • You have checked with doctor and treating sciatic pain as if is a bulging or herniated disk pushing on the nerve with the McKenzie exercises. These exercises will strenghen your core muscles so the disks are not taking the load your muscles should be anyway. In short the Back strengthening (forever) can only be a good thing and excellent preventative action!

    My personal experience is that my tight muscles (particulary hamstring and quadriceps were due to pressure on sciatic nerve (by the herniated disk) so I would keep an eye on the unexplained muscle tightness and keep stretching them until under control.

    Hopefully this will not get worse and you can treat as a warning to look after your core muscles!

    Note I am not a member of the medical profession so please treat this as an opinion.

    Welcome and kind Regards
  • That was a great description. I'm sure when you go to a spinal specialist, he/she will be able to pinpoint exactly what is causing your pain.

    In all probability it sounds like you are in the beginning stages of a lower lumbar disc herniation. That feeling of a tight hamstring is almost a classic symptom.

    Nerves are very quirky little parts of our bodies and do not necessarily react in predictable ways. However, from the nerve root exit in the spine, there is a predictable path that runs out through the extremeties. If you search for a dermatome map or chart, you will find an illustration and explanation of this part of our anatomy.

    The back of the thigh pain is usually caused by the sacral 1 or 2 (S1 or S2) nerve. These nerves exit each spinal segment and them kind of bundle together at an area below the actual spinal cord, which is called the cauda equina. These form into the large sciatic nerves which branch into each leg, and from here the signals go to various parts of the legs. For example, if you cannot lift up your big toe, the doctor assumes you are having some sort of compression of the L4 nerve. If it were the little toe, s/he would assume it was the S (for sacrum) 1 nerve...etc.

    Many years ago, my husband (who is a runner) kept complaining about his right thigh...I'd catch him rubbing it like it was a tight hamstring. We drove about a 100 miles to a nearby city in a car he was not used to...and about a month later, on the morning of Christmas Eve, he awakened to find he could not get out of the bed. He went to bed OK and awoke with a ruptured disc (as we later found out). But for several months (3-6 -- we can't remember any more) he thought it was a tight hamstring. So when you mentioned that, it immediately sent off the warning bells. Just so you know, my husband was able to heal up without surgery...that was 16 years ago and he still runs, but he did give up playing ice hockey and skating.

    Anyway, back to you...I think it is likely you are on your way to having a disc problem. The fact that the oral steroid is helping is a good sign. Now you must be very vigilant to protect your back and give the disc time to heal. For now, avoid all activities that involve bending, twisting, reaching, pulling or pushing and do not lift anything heavier than about 10 pounds (for now!). Twisting + bending, reaching, pulling or pushing is especially damaging so do not do!!

    Drink lots of water, walk for exercise. I would also suggest a couple times a day doing the following: lie on your back on the floor with your knees bent, feet flat on floor. Try to keep your legs from sprawling to each side -- try to keep them straight and parallel to the floor, toes pointing up toward ceiling. Put your arms by your sides, palms facing up. You can use a small pillow if necessary. Keep chin in neutral position -- do not point it up toward ceiling. Then breathe slowly and deeply from the belly, letting it rise and fall slowly. Try to do this for up to five minutes at a time. This is a natural form of traction that will allow the discs to unload and the soft tissue has a chance to kind of relax back into place. (The soft tissue will tense up in an attempt to protect the discs.)

    I would suggest meeting with a fellowship trained spinal specialist. This can be either an orthopedic spinal surgeon or a neurosurgeon who devotes his practice to issues of the spine and back. This way you will have an accurate diagnosis and in the event your problem would get worse, you would know who to call and you would be able to get in faster than if you were a new patient. Also, if you had an emergency, you would have a specialist and would not be at the mercy of whomever is on call.

    I wasted over a year relying on my beloved internist and his insistence that I would be fine if I lost some weight and strengthened my core. I finally insisted on an MRI and again, he told me everything looked good. Finally I made an appointment on my own with a specialist and discovered that nothing would help my condition but a fusion. I was in pain over two years when I didn't need to be and I probably have some permanent nerve damage as a result. So now I suggest to people to not rely on their family doctors if their pain does not resolve in six-weeks time.

    Good luck to you. Be proactive in your search for answers. Please post often with your questions and comments! We are here to help, if we can.

    xx Gwennie
  • Gwennie is on the spot in that it definitely looks like you are in the beginning stages of a disc herniation.

    You said, "It (the pain) starts precisely where there hamstrings start at the bottom of the hip and top of the high. I do not have pain when I sit or lie down (have not lost sleep over it, thank god)."

    I had this same exact thing occur to me a 2-4 weeks before my sciatica hit me head-on. It felt as if my hamstring was just incredibly tight. Also, just like you, for those few weeks I could sit down comfortably and sleep comfortably. However, when I stood up after sitting for longer than a few minutes I'd have a lot of trouble straightening my back--again, just like you. This is because sitting down causes causes increased pressure on your lumbar intervertebral discs. This results in any already bulging discs to bulge out further. These disc bulges limit the space your nerve has to move. When you stand up, the nerve is caught up until the disc settles back.

    From your description, I'm almost certain your issue is the result of a bulging disc in your lumbar spine somewhere around l2-l3 and l5-S1. That tightness you feel is called nerve tension. Nerves are only meant to stretch a couple of centimeters, and your sciatic nerve is already being stretched as one of the spinal nerves that eventually becoes part of your sciatic nerve has to travel over a bulging disc. When you go to stretch your hamstring, your are stretching your sciatic nerve further than it's stretching point.

    My advice: strop stretching your hamstring IMMEDIATELY. Most, if not all, hamstring stretches require you to bend your spine past a 30 degree angle. This bending can cause your disc to bulge out further. By bending down, the anterior(stomach side) of your lumbar vertebrae squeeze down on the anterior of your your lumbar discs. This causes the disc to push out posteriorly(towards your back), which if held or done several times could eventually cause the annulus holding the disc in to tear, and the disc to herniate and compress a spinal nerve.

    Your PM asked about one of my posts and I'm not sure which you were referring to. If you were referring to my 2nd to last post in: http://www.spine-health.com/forum/sciatica-leg-pain-radiculopathy/l5-s1-impingement-herniated-disc
    then the extensions I was referring to when I said I do 1000's of them are figure 3 and 4, the cobra and standing back extension. I don't actually do thousands of them daily, I slightly exaggerated. I do more like 50-100, although when my sciatica first started and I was in chronic pain, 200-300 daily was not out of the question..about 15-20 every hour until the pain was gone.

    Please get an MRI as soon as possible to confirm and pinpoint your problem disc(s). Call up your doctor and demand one. In the mean time find a good McKenzie certified physical therapist and, as Gwennie said, ask your doctor to refer you to a spine specialist.

    Remember, nerves are gentle. If you treat them right, they wont bother you. However, if you treat them with disregard, you'll regret it. I wish I had sought out my doctor earlier, when I was in a similar stage to where you are--my life would probably be a lot different. You are in great position for a full recovery in a few weeks if you do things right. I don't want to scare you, but if you neglect your problem you can look forward to a full-on disc herniation, compressed nerve, and all. Expect the best, but be sure to prepare for the worst.

    Thank you for serving our country, and I hope you have speedy recovery. Please keep me updated.
  • Thanks a lot, I really appreciate all the help. You all are great.

    Here's one problem with our healthcare system...why in the hell do we not go stright to MRIs at the onset of back pain? And why are MRIs so expensive still? When lumbar x-rays cost an ins company $650, something is wrong. Seems like an immediate MRI would ultimately save more time and money than doting along with the "conservative" treatments. It shouldn't be, "if the prednisone doesn't work, then we'll order a MRI."

    Anyways, I need to clarify something with Gwennie. I never really felt a tight hamstring. To tell you the truth, I have always had a very inflexible body, even when I was a teenager swimming 3+ miles per day. That hamstring idea came from my chiro. I know this sounds dumb, but my whole guess with this sciatica crap is that it is not a herniated disk, but rather an uncommon cause of sciatica. I say this b/c again, my "sciatic" pain does not radiate from my back or butt. It only starts precisely at the top of the thigh and insertion of the hamstring muscle group. The pain then terminates where the hamstrings end at the knee. Does anyone know of any other tendons/muscles/nerve insertions, etc. at the top of the thigh that could be an "uncommon" cause of the sciatic pain? The sciatic pain began as just a tiny bit of difficulty taking a full stride after standing up. Only after the botched hike where I hardly stretched beforehand and ran a little bit did the sciatic pain transform into the radiating thigh pain as I walked or stood. That's why the chiro was thinking some tweak of the hamstring causing the sciatic nerve along the muscles to become inflammated. Again, the prednisone is working wonders. Thursday is my last day on them...we'll see.

    I really believe that my Six Flags incident and gardening mishaps that occurred within three weeks of my back pain enflamed my back, not degeneration or a herniated disk. Like I said, the day my back pain started, it wasn't so excruciating that I could not make it through attending a NFL game. I made it through the game and stood up with each touchdown, big catch, etc. It was a bit painful, but made it. I would call my tolerance of pain herculean, but who knows.

    But...again, this all points to the fact that any sort of back pain, especially for people older than 30, should immediately be evaluated via MRI.

    Thanks again, everyone.

  • hahah, I need to correct something in my last post...my tolerance of pain is NOT herculean.
  • I am stumped! There are lots of muscles and ligaments that tie into the "hip" area, that cause pain to run down the thigh...but I can't think of anything that is just in the back of the thigh.

    But I still am betting on a disc...I just think for whatever reason, so far, it only causes pain in your thigh! (optimist that I am!!)Hopefully it won't go any further.
  • McKenzie method has a big following. HOWEVER, if you have spondylolisthesis, it is absolutely contra-indicated. You will do more harm than good doing anything with the back in extension.
  • Thanks gwennie...since my coworker has spondylolisthesis, I think am good to go there. McKenzie is great.

    If I do have a slight disc herniation, I wonder if it's possible to "push it back in" with chiro/exercise/McKenzie/weight loss/good posture. I hear and read that, but wonder if it is really true.
  • Just wanted to make the comment that when my issues started I had absolutely no back, hip or butt pain. All back of thigh pain -- didn't know what was going on until the MRI confirmed bulging disk. It was probably six months of leg pain before the pain was felt in my buttocks, hip and back. My back is still the least painful -- I can feel the nerve twinge at L4/L5 if I move a certain way.

    So from my perspective, you can have true sciatica without back pain initially.

    Take care,

  • thanks a lot, deltalady. do you feel your nerve pain when you walk/stand or sit/lie down? i feel mine only when i walk/stand. my pain level is probably in the 4/5 range, so not what i would call excruciating.

    well, today is my last day of prednisone, and i really haven't had any pain walking or standing during the 15 day pred prescription. we'll see if the pain returns...if it does, the doc said he'd order the MRI.

    until then, i continue with my mckenzie exercises and my daily 1+ mile swim...i am convinced i can correct this by crushing it with low impact exercise.
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