Lower back pain...

[FishrCutB8]

...first, HUGE props to BryanC. Thanks for keeping the post-reply nonsense down--your list is awesome.

1. When did the pain begin? After my bike accident--hit by a pickup truck in late September of last year. I was in physical therapy and this helped/helps (I still do the exercises). I just started riding my bike again, and I have increased discomfort in the lower back.

2. What were you doing at the time? Or did the pain come on gradually over time? See above

3. Where, anatomically, is the pain? In the lower back, on the right side. It feels like it is just above the hip. It looked a little like what Q had posted, but instead of a vertical pain, it seems more horizontal (sacroiliac?). It starts to the side of the spine, not on it, and goes straight across the top of the hip.

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting? It is generally a dull, aching pain, but some movements (bending down and to the side, for example) cause a sharp, shooting pain.

5. Is the pain constant, or intermittent, or only on certain motions? It is a constant tightness/ache, but low grade. Again, some motions cause the pain to become more acute.

6. What motions make your pain worse? Sitting for long periods of time. Bending down, and particularly going to the right side. Took my first bike ride and

7. What, if anything, makes your pain better? Cobra pose and also standing up and leaning back, to look at the ceiling. Ironically, running seems to help. The PT I was seeing explained that upright movements, like running, might relieve tension in that area.

8. Does your pain radiate to any other part of your body? Sometimes it radiates down my right leg, causing a tingling feeling. This can sometimes go all the way to my toes.

9. What things could you do before, that you cannot do now because of your injury? Bend over and to the right. Sit still in my seat for long periods of time. Be generally pain-free. Cycling without pain.

10. What is your main concern regarding the pain and its consequences? That I will have to limit cycling.

11. Have you ever injured that part of your body before? If so, how? No.

12. Is your pain getting worse over time? And if so, how much worse over what time period? It's too early to tell.

[umass]

When it happened did the doctor get x-rays, cat scan or MRIs? if so what was the diagnoses?

I'm sure someone else will chime in with a better answer, but have you raised the handle bars at all so that you are sitting more upright? could help.

[finboy]

I've been working thru a VERY similar sounding injury, Fish. Mine was probably caused by poor form and high reps with deadlifts and squats doing NROL plus a Saturday job where I bend over a lot and lift heavy stuff.

Anyway...I've been going to a chiropractor since early December and, while initially skeptical, I think it's been helpful. If you're not already doing it, foam rolling your hips and glutes may help somewhat...actually any of the hip mobility exercises from Magnificent Mobility (only heard about them, haven't bought it yet).

I've been sticking to the recumbent type bikes in the gym and that seems OK, although I'm going to have to get back on my road bike soon.

I'm sure there are others more qualified who will chime in. You're welcome to PM me or something if you want to chat further.
-Scott

[UConnJulie]

Hip mobility work is always a good idea ... as is glute activation work.

I would also like to know about any imaging and the results/diagnosis from that.

I have two ideas in my head ... did your PT do any manual stuff to your lumbar spine? Any Maitland mobilizations? (I'm not talking about massage here)

[FishrCutB8]

All image work came back normal.

Define Maitland mobilizations...

[UConnJulie]

Ummmm ... hmmmm ... how to explain it .... the therapist would push on your back (either centrally over the spinous process or just lateral to it) in a rhythmical fashion for a short (10-30 second) bout. They might have you stand up and retest limited range of motion in between and would typically do 3-5 bouts of the rhythmical mobilizations. Sometimes the movement is not done with the therapist's hand but you would instead be in sidelying and the therapist would have you all twisted and do more of a rotary motion (rhythmically) ... hard to explain ...

[FishrCutB8]

No. I think I would remember that...

[UConnJulie]

It's possible that you have a facet joint dysfunction ... some of your symptoms indicate that it could be a disc, but if your imaging was normal then that is unlikely. The facet joints are on either side of the spinous processes and are where one vertebra articulates with the one above and below so there are two at every level (ie L4/5 left and right, L3/4 left and right). If you sprain the joint (as they are the same kind of joints as your ankle or knee) it can cause problems for a long while afterward as the other levels of the spine can compensate for that one level that is not moving well. Your best bet would be to find a PT that does manual treatment ... here are some that are in Pennsylvania ... (they are certified in Maitland ... doesn't guarantee a quality therapist but increases the liklihood!)

Matthew Conoscenti Doylestown, PA
Craig Fava Media, PA Craigf@painrelief-pt.com
Chuck Garfinkle Glen Mills, PA Chuckg@painrelief-pt.com
Margery Maile Willow Grove, PA
Brian Mock Pittsburgh, PA
Brian Warenius North Wales, PA

If none of these are close to you, please let me know and I'll find some others ... or if you can't find these ones given their contact info, again, let me know and I'll see if I can locate them.

[FishrCutB8]

Thanks UCJ...