Back pain - speculate, possible treatments

In My Humble Opinion
21

Inappropriate surgery is definitely a concern.

In my case, I’m certain the problem is not just muscle spasms. I’ve had those and they’re unpleasant, but when you get a spazzed-out muscle massaged, it “hurts good”. When my husband tried to massage my sore back, it was “hurts BAD” when he pressed on the sore area - I could feel the spine flexing slightly and it hurt.

Not to say that weak muscles can’t contribute to this issue (and strengthening may help) - I would certainly look into PT as the first line versus jumping for surgery.

22

**MamaZappa : **glad to know you are getting imaging - pics worth thousands of words, etc…

You mention family history of spinal probs - same goes with my 39 yr-old wife who has had to have two unavoidable lumbar fusions over the last decade due to lumbar disc ruptures and her maternal side of family is similar over last several generations. All mostly related to osteopenia (osteoporosis, per se) and vertebrae ‘collapsing’ anteriorly causing pressure to make disc ‘squeeze’ out posteriorly and rupture posteriorly, so to speak. Have you checked your bone density (if you are an ‘older’ female’)? Just a suggestion innocently put forward, but it can cause spinal issues/collapsing as a side-effect. Might be worth checking out as part of your situation and overall health situation. Mention this, if you like, to your provider if you feel it is worthy.

My mother-in-law is a ‘bird-lady’, ie she stands bent forward with her chest towards ground as many of her thoracic vert’s have collapsed on anterior side due to poor posture and low bone-density, etc. She has fortunately avoided any disc issues as she fell in tub about 5-6 years ago and broke her right-side tibial plateau (weight-bearing part of tibia) in a big, big way and has not been able to bear much, if any, weight on that leg, limiting amount of lumar weight to be borne overall since she can only ambualte with a walker. But her thoracic vertebrae continue to worsen even with sitting in wheelchair along with bone-density improving drugs being used. She fell asleep in wheelchair about three weeks ago, fell to floor, and barely hit her lower leg against night stand and now is bedridden (for most part) with ‘simple’ fx’s of both tib/fib on left leg. Its been trying times for us/her, trust me, LOL.

Anyways, good to know you are going the way of getting imaging done. Do it sooner than later, IME. PT is a good start, no doubt, but can only help if structural integrity is there. Hope that is all it takes, but don’t ignore structural malformations if such is present. Surgery is not as bad as many people make it out to be - you usually hear mostly about the lower number/% of ‘bad’ ones (that often have other parts of spine to deal with as well!) than you do the great ones. Over many years, I heard many, many, may more “worked great” stories than “Doc fucked me up” ones. No bullshit on that, I promise you :slight_smile:

BTW - love your nick - big Zappa fan myself… Good luck and a good outcome, I hope!

23

I am indeed “of a certain age”. I had a DEXA scan (I think that’s what it was) 3-4 years ago after discussion with the gyn; I’ve had 3 broken bones as an adult, and with that, my age, the fact that I am a long-term inhaled steroid user, and am on thyroid meds, it seemed like a good idea to get a baseline.

The tech said (unofficially) that she didn’t see any issues, and I was never contacted re any problems, though this is a reminder to confirm what the report really said. The bones were all due to clumsiness-induced falls and I didn’t really think osteo was an issue, but it seemed reasonable to check. I’m also (as noted) sporting a bit of extra tonnage - which lowers my risk (good to know that flab is worth SOMETHING :D).

Sorry to hear about your mother-in-law. It sounds painful on sooooo many ways, and her bones must be about like cheap sidewalk chalk to break that easily :(. I saw a man a few months back who was basically bent 90 degrees at the waist, and had to tilt his head up to walk - I assume similar spinal issues are at play there, even though men are less prone to osteoporosis.

Thanks for all your input - good to hear about it from a professional side.

24

I hurt my lower back and my friend recommended me to a yoga class. The instructor was able to show me specific exercises for the lower back, and they worked quite well. Something along those lines may be useful to your situation.

25

You are most welcome. I just don’t want a person to needlessly fear a surgery if a competent surgeon is saying it is the better of choices/treatments, etc. It obviously is not always the first choice, and shouldn’t be most of the time, but it can be, as in my situation of stenosis - wasn’t going to get better by itself or by stretching/adjusting/whatever, period. Getting them MRI’s will tell a LOT about what is going on (or isn’t) with you. Surgical outcomes on lumbar surgery is better than the ‘general public’ typically perceives IME from what I overhear(d) or ‘through the grapevine’ amongst friends/distant family, but other’s-MMV in their perceptions of being ‘under the blade’ in and of itself.

DEXA is indeed the right term for a type of bone-density scan, fwiw (Dual Emission X-ray Absorptiometry) - done many of them myself (if that matters). Hope all goes well for ya!

26

IMO, you are suffering from a bulging disc. If it were herniated you would know it! A few years ago I herniated a disc and it immediately took out my left leg and dropped me like a rock! It was a couple days before I could actually walk again unassisted. I went to Urgent Care and they misdiagnosed me with muscle spasms and gave me muscle relaxers.

Eventually it got better but never normal and I had constant back pain so I finally had an MRI and found a healed, yet bulging disc. You could still see the remains of the inner disc material in my spine, outside of the disc.

The best thing I ever did is buy an inversion table. I felt better within a few days. The idea is that every joint in your body is “designed” or “has evolved” to support the weight above it. So inverting allows the same weight to stretch it without over stressing the joint. In the spinal column, each disc it stretched proportionally by the weight above that disc and the stretch pulls the vertebrae apart and causes the bulging material to suck back into the disc, which takes the pressure off of the nerves and alleviating the pain. If you are overweight then you may have too much weight to safely invert fully, but with an inversion table you can rotate to where you are comfortable and it will help.

I made the mistake of getting rid of my table after not needing it for a few months. I was performing dead lifts and over did it and felt the familiar pain of a bulging disc. I gave it a couple days to get better and when it didn’t I ordered another table. I remember putting it together in severe pain. I inverted and the next day I felt considerably better. After inverting for 10 minutes a day I was back to 100% within 5-6 days. I learned to keep the table ready. From what I have read after your discs have degenerated to the point where they can bulge, then you are always susceptible. I hope this helps.

27

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Fwiw, that inner material is called thenucleous pulposus and it acts like a shock absorber. Some good info on it and the outer portion of disc (annulus) in that Wiki article, especially on degenerative effects, etc.

A ‘herniated’ disc is when annulus bulges into spinal canal or other direction(s), and a ‘burst/ruptured’ disc is when the nucleous pulposus squirts out of its ‘container’ (annulus), often squishing canal and nerves within and causing immense and/or chronic pain. There’s routine surgery for that - but to each their own :slight_smile:

Having a second episode would cause me to rethink doing heavy ‘dead-weight’ lifting, etc, but I certainly ain’t preaching to you or laying down any judgement, I promise. Hope you don’t get worse, honest. Back pain can ruin quality of life, by all means…and inversion therapy is only a stop-gap measure, not a cure; problem will almost certainly always return :wink:

28

I had severe pain in my fingers and elbows - but I had full use of my arms - they did not hurt in any position. My brilliant GP diagnosed a problem with a disk in my neck, and an X-ray verified it. I was visualizing neck surgery but he sent me to PT. It cleared up in less than a month. I do my exercises religiously and the pain has never returned.

Can’t say it will work, but PT is the least invasive first approach.
My wife had back surgery for her lower back 25 years ago. It worked fine, but she was incapacitated for a long time.

29

My back’s been bugging me for the last month or so. I’m fine when I’m up and around, but in bed I have to be careful when I get up. While we were on vacation it was hurting when I turned over, which is a big problem since I toss and turn a lot. I can turn over in bed without it hurting, but getting up is something I have to be careful with.

30

Give PT a shot, and if you can find a good, non-woo, non-happy ending massage therapist, massage can help you feel better, at least. But to me, it does sound spinal.

31

What if the massage therapist is my wife? Are happy endings allowed then? Seriously, we keep a barrier between any massage therapy I receive and our sex life. Also, I have to make an appointment like anyone else. She also told me it’s probably time to go to a PT.

32

Got my MRI(s) done last week.

The results:
Occasional bulging discs (doc said which ones when she called me but I forget which ones); some mild stenosis around L4-L5 and L5-S1 (I think), though supposedly not enough to explain the symptoms (numbness / tingling) I’m having. Overall a number of places with arthritic changes. No obvious evidence of a traumatic injury (I had a nasty fall about 10 years ago, and saw a bruise right on my spine the next day, which was a bit frightening). And some of the supporting ligaments overall show some shredding (I think that was the word) which is most likely “normal” wear and tear.

So, the arthritic changes are probably what is causing the night-time back pain (my brother has complained of the same thing). Which is good and bad: good in that nothing needs to be done, bad in that nothing really CAN be done. Oh well.

No need to rush to see a spinal specialist at this point, though I presume if the symptoms get worse we could go with injections (steroids?).

The immediate plan is a course of PT to work on strengthening the supporting muscles (plus losing a bit of weight).

A couple of funnies about the MRI. I asked for a script for some happy juice - I’m slightly claustrophobic, and I know those tubes are narrow, and I see no reason to put myself in a position where I might panic. I’d never had Valium before; doc gave me a scrip for 2 5 mg tablets, to take one a bit before, then if I needed it take the second one. So, 10 minutes before, I wasn’t feeling anything, and I popped the second one. Then quite literally as I was standing talking to the tech, they kicked in and I started listing a few degrees off of vertical.

And, she put me in the machine, and stopped it after 10 minutes or so saying “there’s an artifact somewhere around your lower back, are you sure you’re not wearing metal?”. I was not, nor anything with metallic stitching. I said “Hmmm, maybe they left a piece of needle when they botched that epidural 21 years ago”. Anyway, she pulled me out, had me switch positions, and sent me back in the other direction. The artifact was still showing up, but not in the same spot (on me), so she wasn’t sure what it was - machine malfunction or something in the cushion, perhaps. Dunno what that was about. I’m sort of disappointed - I really wanna blame SOMETHING on that botched epidural I had :D.

33

Get the make, model, and SN of that MRI, including the software version, including patch subversions and file a formal complaint with the manufacturer. Please. You are a very important part of medical product postmarketing surveillance. They need to know when something goes wrong.

34

Somehow I missed this post - probably too late to get the info now. Almost certainly related: a week or so afterward, I got a call from the facility; the radiologist read the results and wanted to do a redo on the thoracic part.

I did that a couple weeks ago. Decided to do it drug-free which I suppose was a good thing. I made a point of not opening my eyes once they were ready to slide me in.

I actually had a lot of trouble getting comfortable at the beginning - they had a wedge to slide under my knees, and I wound up having them push it partly under my backside - otherwise it hurt too much lying still.

I zoned out pretty well during it. The thing is of course noisy - but I’d had some contractors at the house that day, doing some jackhammering, which turned out to be good preparation :D.

Upshot: minor disc bulging in T5-6 and T6-7. Almost certainly not enough to warrant treatment, though it does add to my sleep woes.

35

Ah, well, the manufacturer probably knows by now. But, really, you and every one, get the serial number of any diagnostic equipment in case some thing weird happens; you really are an important element in medical product quality.

And I’m glad your problem isn’t too serious. I hope treatment options improve before you need them.

36

I’ve had a variety of back pain relating to sleep. I use yoga and other simple exercises to get things back on track. What I’ve found over the years is that if I let things go then my muscles will slowly pull my back out of wack to the point any sudden movement will throw it completely out. So for me it’s important to exercise it immediately upon the first hint of pain. My most effective exercise is to lie flat on my back, knees up and soles of feet flat. I then arch my back up keeping my feet flat to the floor. Not sure how but this maneuver pushes everything in the right direction.

When I got my cpap machine I tended to stay in the same position most of the night and that has created problems farther up my back. I need to crack my back to relieve pain and a round cylinder does wonders for me. For that I took a page out of Dr. Homer’s Miracle Spine-O-Cylinder. Actually it was yoga but the principle is the same. I also use an inversion table.

There are lots of different therapies you can try. And I’ve gone from “can’t get up” to fully functional in week now that I’ve sorted out what works for me. I’ve learned to work on the problem before it gets out of hand and it’s been 4 years since the last time I threw it out.

37

Also try new pillow. I get discomfort in the thoracic area if I sleep on my back with my head too high (like when I have an asthma attack). It goes away when I can switch to a single neck-support foam pillow.

I get these for the world’s dumbest lower back injury (L5, S1, S2, and now coccyx, etc) and occasionally neck stenosis. They’re given under “light sedation” (I don’t remember much), and they help a lot. Sometimes I need to do a series of 2 or 3, two weeks apart. But they help, and it’s worth it.