I am a massage therapist, and I’ve been trained in neuromuscular therapy with Doug Nelson. PLEASE, PLEASE, PLEASE try to find a therapist trained in this technique. It’s based on classic trigger point therapy (Dr.Travell and Simmons.) I would be in a wheelchair right now from sciatica and back problems without this. It’s the only thing, and I mean the ONLY thing, that will help. The only problem is that it can be hard to find these therapists… the best self-help resource I’ve ever found is Clair Davies’ Trigger Point Therapy Workbook.
No offense and YMMV, but trigger therapy can suck a bag of dicks. I went to a highly recommended person in Chicago and all they managed to do is completely fuck up my piriformis muscle.
I’m quite familiar with propofol (colonoscopy frequent flier) but why do they need that to administer an epidural?
In fairness, I’ve only had them when giving birth (and those simply do not work for me, which can be… unpleasant), so I imagine there are nuances involved in their use for your kind of pain.
Thanks for the link, rysdad! Very helpful in visualizing the issue.
Mama, they said they use propofol because they are sticking a big ass needle into my spine and don’t want me squirming around:) plus you come out of it a lot clearer than versed or other anaesthetics.
Feeling somewhat better this morning but thankfully this is my day of work so I’m gonna rest as much as possible. Been using a heating pad, might switch to a nice pack and see if it helps.
It sounds like you have more serious issues than I do, but let me put in my usual word for physical therapy. Even if you have an underlying problem they can’t fix (I have some degeneration in my S-I joint from an old injury), they can work wonders lending support to the problem area, making sure it’s as flexible as it should be, but also as strong as it should be.
My husband and I both have problems with fascia and muscles kind of getting stuck. We both tend to the inflexible side, and when we have pain and start guarding (clenching the muscles around the painful area and avoiding certain movements), everything can get really tight and bound up. Then no amount of stretching will do a damn thing until a therapist digs her Fingers of Doom into the bound up area and releases it. I even have some suction cups I’m supposed to use to pull my tissue up off my spine!
Anyway, doctors are wonderful, but they often don’t know all the fine nuances of treatment a good PT can figure out. Sometimes a person’s neck can hurt because of the way their foot tilts when they walk, for instance. A doctor will probably prescribe meds and neck stretches, but a physical therapist can ferret out the stride issue that’s causing the whole skeleton to be out of whack.
I’d expect it to work as well as a copper bracelet.
Lumbar spine discs are kind of like a jelly donut. Sounds to me like the jelly in the donut between your 5th lumbar and your 1st sacral vertebra is squished out the back side and is pinching the spinal cord in the center and on the left sides where your nerves exit the spinal cord. This is generally from bending foward at your waist too much and/or sitting with your spine rounded forward with poor low back support (sacral sitting) Also sounds like part of the jelly has gone up the top and/or bottom of the donut into the lumbar and/or sacral vertebra itself through the endplates (the top and bottom junction between the discs and the vertebral body bone above and below), all of which results in a donut that more or less deflated such that the facet joints (behind the donut and the vertebra) are banging together getting beat up (the mild facet hypertrophy).
I’ve see the epidural cause near miracle like relief and I have seen them do nothing at all.
Probably what you want to do is think about what caused you to blow out that disc in the first place and remove that stress from your life. Even if the epidural works great if you still have the same habits you will get the same problem again.
General advice I would give for your problem is to sit straight, keeping the spine “neutral” with good lumbar support, ALWAYS. Improve your lifting, bending and sit to stand dynamics so you get your movement from your hips rather than at your spine, and improve strength and endurance of your core and LE muscles to allow you to do all that. Stretching your hips and hamstrings may help a little. Stretching your knees to your chest and twisting at the waist might feel good on tight muscles but the former is the exact stress that causes posterior disc herniation in the first place, and the latter helps it a long, and would likely irritate your already hypertrophied facet joints, thus MAKING YOU WORSE IN THE LONG RUN. Extension (backwards) stretches of the spine are are unlikely to help at this point since the jelly has left the donut and would likely just further irritate your facet joints. Everyone’s a bit different but that’s how I generally treat it.
If you correct your posture your body should reabsorb the jelly that squished back into the spine and the pain should lessen or go away completely, but your donut will always be a little flat so you will always want to be extra careful how you sit and lift. Think of it as a lifestyle change. Once you get your “awareness” up with regards to what are bad positions you should be able to avoid bad positions without thinking about it, but you will probably have to think about it a lot in the near term.
Stuart McGill material is really good if you want to learn more about spine mechanics, not IMO terribly technical but not all for laymen either. http://backfitpro.com/
If by stretching you mean flexing the spine, rounding the back or otherwise increasing tension on the rear of the disc while at the same time increasing compression on the front the reason is because that’s generally the exact motion that causes the disc herniation and the “pinch” in the first place. This model displays it really well:
It’s hard to beat just laying down to lessen stress, and standing erect is better most positions. Sleeping at night however causes the discs to hydrate and get thicker, making them more prone to injury in the first hour of the morning. IIRC if you stay in bed 2 days they continue to hydrate beyond normal and that might be why continued bed rest would do more harm than good.
Also in general people who stay active in spite of the pain tend to recover better, I think so long as that activity does not include a lot of bending forward at the waist. Also I think contributing to activity being better, is that when people lounge around the house while in pain they do so in chairs and couches that have no lumbar support and let the spine flex. Sitting isn’t really so bad so long as you support the low back, and standard throw pillows do a good job, you can just pile them up until it looks and feels right (generally where the pain is least with the low back slight to moderately concave.
This is a pretty good intro on low back pain with a couple staring exercises that have been shown to start improving core muscle strength and endurance while putting minimal stress through the spine. The ball exercise he shows is a bit more advanced though.
Just to add a note…I’ve had several epidurals, and I’ve never had any anesthesia (other than numbing the skin at the injection site). I’ve assisted the radiologists on many epis, but the hospital where I worked almost never used any sedation. The only times we did use it were when the patient took a mild oral sedative beforehand.
Hanging upside down was a regular part of my physiotherapy when I had the exact same situation (although I went to a physiotherapist where they had a special board they strapped my feel to and then inverted). Luckily, due to where I live, Oxycontin and an operation were never a question of cost. Good luck to you mate, I hate to think how it is feeling.
Aaaannnd it’s back.
Twisted my back at work about 8 weeks ago. For some reason I got it in my head that it was piriformis this time so I worked on stretches for that. I think either sprained or tore it asnif severe pain in my left butt.
Found a pain dr from a friend. Got meds, an mri and a steroid shot
Cutting a bunch of text
Pain is back but unbearable first thing in the am. I’m getting up and taking meds 2 hrs early so can hobble to bathroom with a walker. Left ass feels like constant spasm. As norco and flexeril and gabapentn and naproxen start to kick in I can stand and limp to work. It gets progressively better throughout the day but when I get home I’m exhausted and want to sit or lie down.
BIG MISTAKE.
Within ten minutes I feel the muscles starting to clench and pain returns
Waiting for dr to answer calls hope to get another shot of cortisone.
That’s really interesting. I’ve spoken to well over a hundred people who have had lower back surgery and you are the third one that had anything positive to say about it!
Did you have fusion, a microdiscectomy, or something else? How long was recovery?
Sorry if I’m asking a lot but I’m really hoping I don’t have to go that route.
