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Need some advice into lower back pain. Pretty much an identical situation as this thread, but unfortunately no "solution" is identified: Lower back injury
1. Pain began about two months ago.
2. Was doing conventional deadlifts, lifting a relatively heavy weight. Had lifted it before, but fewer reps only.
3. Pain is in the lumbar area, mostly in the centre although sometimes worse on one side, which varies.
4. Pain is sharp.
5. Pain is mostly on certain motions.
6. Pain is at its worse when bending at the waist or lifting pretty much anything. Lifting the legs while in a seated position is also difficult and painful (i.e getting in/out of the car).
7. Nothing seems to make the pain significantly better. Ibuprofen seems to provide minor, temporary relief.
8. Seems to radiate to (or maybe from?) glutes and hamstrings.
9. Basic everyday stuff is difficult (i.e. getting dressed!, picking anything up). Can't work out effectively or play hockey.
10. What is your main concern regarding the pain and its consequences? Is this permanent or something??!! I'm a shell of the woman I used to be!
11. Have never experienced this type of injury before.
12. Is your pain getting worse over time? Not really. Seems to be about the same as when it happened, some days are better than others.
I've gone for physio, massage and seen a chiro, but no significant improvements. Physio assessment indicated a muscular imbalance (weakness) in my right hip abductor. The physio did some kind of hip manipulation and poof! Problem solved. However, this did not help the back issue. As a last resort, the physio did some intra muscular stimulation (dry needling). It was just about excrutiating, but didn't really help, either. Bending at the waist when my upper body is supported seems fine, but otherwise it really hurts. Back extensions are mostly fine, as are seated rows unless I bend forward too much while holding the weight.
Have been doing some hip/glute/core focused exercise, but no change. After two months, I am out of ideas! Any insight would be appreciated as this is very frustrating.
I agree with Julie.....your subjective history does sound like a disc injury. I know a person that had accupuncture procedures done to address all the muscle spasms he would have from his herniated disc and he said that he got much better. There are other effective methods to treat your condition....mckenzie (what Julie suggested) seems to be effective for disc problems.
Good luck....it always sucks when someone gets injured exercising.
No, haven't had any imaging done. I suppose that's the next step although I was hoping to see improvement and thus be able to avoid it. Would a physio assessment normally pick up on the possibility of a disk issue, or perhaps eliminate it as a possibility based on the various tests performed? Neither the physio nor the chiro mentioned slipped disk or anything along those lines.
Disks don't slip ... they herniate or bulge.
They might have been able to eliminate it based upon in person examination, I really have no way of knowing that!
From what you describe ... my over-the-internet guess is disk injury (mild/moderate bulge).
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I went back to see the doctor. He doesn't seem to think it's a disk issue, feels it is muscular, but has referred me to another doctor to be sure. Also got a prescription for anti-inflammatories, but I have to wonder if they got switched with placebos as they don't seem to do anything!
The exercises that have been recommended to me have been mostly core focused(tranverse abs and other basic core stuff), glute activation (clams and that type of thing) and hamstring stretching.
The physio was also at a loss to explain/treat the pain at my last appointment. He seemed to think I should be back to normal. Very discouraging...
Obviously merely relating my own experience is of limited value but at least the symptoms you have are almost exactly the same. I've had those symptoms with a diagnosed disk problem and I've had them many times without one - well at least I assume I didn't have a disk problem since I got them about twice a year for many years and each time they went away after a couple of weeks without surgery. So I think you can get very disk-like symptoms from no disk problems.
Anyway FWIW what works for me is: front and side planks, bird-dogs, slow small-range crunches, McKenzie stretches (as per the book recommended above) between exercises and for general ad hoc relief, hip-hinge schooling exercises and a general increase in awareness of back flexion vs hip use.
I avoid long periods in the bath, poor seats (I don't use our couch anymore). I practice sitting or kneeling upright with no support to train my core at that specific activity since it is a problematic one. I avoid any hamstring stretching whilst my back is remotely playing up. I don't do any back exercises in the morning. I will wear a neoprene back belt/brace thing for very long car journeys. It's amazing. I can now travel for like 4 hours without arriving like an 80 year old. I don't use it for exercising or anything else as I want my own musculature to work on its own.
I've designed my personal programme from experience and McGill's books. Also Jolie Bookspan's "Fix Your Own Pain" has been useful from a more general postural POV. I'd certainly recommend getting those books. I suspect you'd find some things in them that would help a fair bit.
...It's amazing. I can now travel for like 4 hours without arriving like an 80 year old...
Hahaha, that one literally had me laughing out loud! AND the laughing didn't hurt my back! Guess those prescription strength anti-inflammatories must be having a marginal effect after all.
This is just my opinion. However, you may want to consider that you have torn or done some serious strain on your iliopsoas muscle. It attaches to the disc and vertebrae of the lumbar spine, and the psoas even has some slips that attach onto the discs themselves. Raising you legs (hip flexion) with stress this. So will bent over attempts at extension as the spine attempts to stabilze. The psoas, as well as the quadratus lumborum will both compensate.
Jenny, I've had no end of lower back problems. The worst came in FEB. 2007 when my back went into spasms due to too much skiing (the wrong way....I put stress on my lower back due to inexperienced technique). The spasms were absolutely the most excruciating pain I've ever experienced besides childbirth! I got to my chiropractor whose treatment alleviated things ever so slightly, but what solved the problem was his recommendation: Yoga. I bought several yoga tapes from Amazon....two from the Yoga zone and one from Rodney Yee, all specifically targeted at the back. These were not complex exercises, easy for anyone to do, and they gently helped my back get a bigger range of motion and it relieved all the stress from my injury. My pain went away within a month and I was back to skiing again. I continue to do these yoga sessions once or twice a week and I haven't had back problems since 2/07. Last season I skied 50 times without a back problem. But I still worry about my back....doing those deadlifts is scary, and I'm very very careful to progress slowly and to never over-do it. I'm very careful and conservative about how I exercise, especially where my back is involved.
These are the main yoga videos that helped me, all cheap:
Yoga Zone: Yoga For a Strong & Healthy Back (two 20-minute sessions).
Yoga Zone: Stretching for Flexibility. (two 20-min. sessions...some overlap with the back video above, but also good)
Rodney Yee: Back Care Yoga. Lengthy, but very very good and gentle, lots of excellent explanation.
I rotated the various exercises around. I usually did both sessions on one of the Yoga Zone DVD's (total of 40 min.), next time I'd do the Yee DVD, and so on. I can't emphasize enough how TREMENDOUSLY these helped my back. I never did any yoga prior to this, but I'm a believer now.
Are you supposed to feel ANYTHING when doing McKenzie extensions? I tried them, but didn't notice any type of sensation whatsoever; no pain, no stretching, no relief, nothing.
Started experiencing back spasms over the week-end - a whole new ball game in the pain department. "Treat Your Own Back" is on its way in the mail.
I think it depends on the state you are in. Sometimes I've felt nothing initially but after a while I've got increasing relief. Other times it's immediate - whilst the extension is being held.
For real insight into your back I'd suggest getting the McGill book.
You might not feel anything during the exercises ... what is important is what you feel when you are done.
So if your pain is a "5" before the exercise ... it doesn't matter if your pain is a "7" or a "2" during the exercise, as long as it is a "5" or LOWER when you are done.
And keep in mind that if your pain is getting worse, there is something else going on, and you need to see a professional.
__________________
Life's a Journey ... Enjoy the Ride!
Thanks all for your input. Since the anti-inflammatories weren't doing anything and since I couldn't tie my shoes without having an extremely painful back spasm, I tried an OTC muscle relaxant/painkiller. Finally, some relief!! Yesterday, I just about felt normal again - definitely MUCH better than I had at any point since the injury. Was still pretty stiff when I woke up this morning, but not as much as most other mornings. Going to keep taking the muscle relaxants for a few days and hopefully they will no longer be required.
Something I'm wondering about, though... The physiotherapist couldn't figure out why I was still experiencing pain. He felt that I should be having normal, pain-free range of motion. Similarly, I had gone for a couple of massages and the RMT said that my back muscles felt completely normal. Is it possible that once a condition becomes chronic, the body fails to recognize that it's no longer necessary to utilise its "protective mechanisms" so to speak (e.g. by signalling pain in order to prevent excess range of motion), even once the original problem has been resolved? Kind of like the phantom pain some people experience in a limb after amputation?
Just curious as I'm not very knowledgeable on the subject.
Thanks all for your input. Since the anti-inflammatories weren't doing anything and since I couldn't tie my shoes without having an extremely painful back spasm, I tried an OTC muscle relaxant/painkiller. Finally, some relief!! Yesterday, I just about felt normal again - definitely MUCH better than I had at any point since the injury. Was still pretty stiff when I woke up this morning, but not as much as most other mornings. Going to keep taking the muscle relaxants for a few days and hopefully they will no longer be required.
Something I'm wondering about, though... The physiotherapist couldn't figure out why I was still experiencing pain. He felt that I should be having normal, pain-free range of motion. Similarly, I had gone for a couple of massages and the RMT said that my back muscles felt completely normal. Is it possible that once a condition becomes chronic, the body fails to recognize that it's no longer necessary to utilise its "protective mechanisms" so to speak (e.g. by signalling pain in order to prevent excess range of motion), even once the original problem has been resolved? Kind of like the phantom pain some people experience in a limb after amputation?
Just curious as I'm not very knowledgeable on the subject.
I'm in no learned position to comment but I fail to see how a physio could confidently proclaim that you should be pain free. Sure your symptoms might not coincide with the common causes the physio is aware of but there appear to be quite a lot of non-obvious reasons one can continue to get pain. I've been to physios who were surprised at the movement ranges I was capable of and couldn't work out why I was still in pain. Likewise the NMR showed nothing that would explain it. Yet by doing the right exercise the pain goes away, and when I slouch about or "pull" my back doing something stupid the same supposed nerve pain comes back.
In an email conversation I had with Stu McGill he said that when clinicians tell you that you have reached the end of the possible treatment options, sometimes they mean they have reached the end of their own particular abilities!
Anyway, the phantom pain hypothesis doesn't sound like the most likely answer to me.
In an email conversation I had with Stu McGill he said that when clinicians tell you that you have reached the end of the possible treatment options, sometimes they mean they have reached the end of their own particular abilities!
Lower back pain - I'm at my wit's end!!
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