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Bad back....ideas?

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GoneFishing111 23 Jul 2017
So I've had chronic lower back pain for the best part of ten years, brought on by general abuse and probable incorrect lifting technique on building sites.

Anyway, i hurt it again (significantly more than the baseline pain) the other week whilst switching a cement mixer on, something clicked and that was pretty much it. After a few days the pain subsided and i was ok(ish)

Went to see a physio a few days later and she suggested some exercises that might help. This was around a 6 weeks ago.

Fast forward to thurs/friday last week and I've really hurt it this time building a wall, i can't straighten up, my legs and feet are killing me and i generally feel ill and sore all over with pain spreading from my lower back.

I don't know what to do? Im thinking of seeing either a chiropractor or an osteopath or even a private specialist at a local clinic.

Any ideas?

P.S. the GP said years ago that i have a herniated disk. I have another 2 weeks to go then I'm done in the building trade for a good while if not forever.
 WildCamper 23 Jul 2017
In reply to GoneFishing111:

Id strongly recommend getting an MRI scan before having any therapy done, i popped one of my discs 3 years ago permanently damaging my sciatic nerve (i work in the construction industry too btw).

Get the ball rolling now as it can take months to get an appointment btw

Good luck
 Stichtplate 23 Jul 2017
In reply to GoneFishing111:
I had 15 years of chronic back pain . Chiropractor did me no good (though a mate swears by them) . A physio sorted me out after a particularly bad bout saw me hospitalised, I found the exercise routine she recommended boring and onerous so, a month after I let the routine lapse, so did my back.
Three years ago I started making my trips to the mountains more regular rather than sporadic. The effect was miraculous. After 6 weeks of spending a day scrambling once a week my back was completely sorted.
As long as I get out at least once every 2 weeks , I'm completely fine. Another upside of this is that as a result I was introduced to the joys of winter climbing (something I'd never fancied much before). I now spend an inordinate amount of time every winter scanning weather reports hoping for snow.

Edit: you've got to get proper medical advice first, but for most lower back problems, resting it will often make it worse.
Post edited at 20:54
 John Kelly 23 Jul 2017
In reply to GoneFishing111:

Go climbing, seems to cure all my aches and pains, great for my back - forgot to add ' after consulting medical prof......blah blah blah blah'
GoneFishing111 23 Jul 2017
In reply to Stichtplate:

I think its the awkward positions i find myself in on the building site, hunched over laying a 100kg flag probably doesn't do it much good.

But i am very cautious nowadays about how i lift things, try to use a machine etc but i think the damage has been done.

Im loathe to go to the GP, I've been a few times and the response is always the same "nothing we can do". I may push for an MRI scan, just out of curiosity.

 Stichtplate 23 Jul 2017
In reply to GoneFishing111:

You have to really push your GP for anything other than pills. I was fobbed off with anti inflammatories and tramodol (vile, binned them). When I finally got an MRI it was in a period when my back was ok, so nothing to see. In my own case keeping active was very good but any heavy lifting was very very bad.
I feel for you. Back problems are a nightmare , both to live with and to solve. Good luck.
 Fraser 23 Jul 2017
In reply to GoneFishing111:

I feel your pain, literally! Had a bad back too for years, exacerbated more recently after decking at Kilnsey. Much physio, manipulations, opinions, acupuncture and an MRI later, the'expert' consultant thinks it's a muscle spam. Thanks dude, Here's your £500 for the scan and same again for a 5 minutes chat! What a carve up.

Funnily enough I'm just swatting for my CSCS card renewal. You'll no doubt be all too aware that you shouldn't be lifting a100kg flag unassisted, that's just crazy. Your boss should also know this, they are responsible for ensuring your welfare. Unless you point this out to them, they'll keep taking advantage of their employees by scimping on the appropriate equipment to help you.

Re the actual injury and treatment, get as many different opinions and therapies as possible. My advice would also be to keep it mobile and stretch as much as you can. But see some more pros first. Good luck.
 Timmd 23 Jul 2017
In reply to GoneFishing111:

> Im loathe to go to the GP, I've been a few times and the response is always the same "nothing we can do". I may push for an MRI scan, just out of curiosity.

I sometimes think the more persistent people get better responses from doctors, and generally in life. One friend seems to accept the first 'knock back' when seeking help about things, and not get very much further, while another one can have more success by (in a nice way) pushing for what they're after.
 Billhook 23 Jul 2017
In reply to GoneFishing111:

I'm a drystone waller.

I sometimes too get a bad back. Sometimes just by doing something simply like you did.

I've been to GP's. (I'll save you going - their advice is always the same. "Take some time off and take these painkillers".

and I've been to Osteopaths and Chiropractioners. Like all tradesmen - including doctors, there is naturally a wide variation in skills. I found a Chiropractioner who sorted my back, mostly in one session of around an hour. Over the course of ten years I've seen him around six times with generally quick results. But it took a couple of visits to other ones to find him.

GoneFishing111 23 Jul 2017
In reply to Fraser:

I work for myself and have done for a decade. I wish i did have a boss! When i say lifting i mean more like thrutching it in to position lol....still crazy.

The exercises seem to work, right up until i twinge it again, half of me wonders whats the point if flicking a switch on a cement mixer doubles me over like an old man, I'm 28 for gods sake!!

Im going to give the GP one last chance which is wholly dependant on getting past the secretaries at my local surgery.
GoneFishing111 23 Jul 2017
In reply to Dave Perry:

I may give one a try, any suggestions for a chiropractor in lancashire?
 Y Gribin 23 Jul 2017
In reply to GoneFishing111:
Bad luck - sounds horrible. At least your jobs ending soon as that's obviously not helping.

The latest guidance is that MRIs are of little use for the vast majority of back problems so I'd ignore any advise to pay for one. MRIs have become a macho response to backs ("have you had an MRI....you must have an MRI!"). But their results bear little relation to the actual pain people feel. In other words your scan might show nothing; while someone with no symptoms at all might have a prolapsed disc.....you wouldn't suddenly start operating on the second person as a result, nor ignore the first.

Everyone's different but my own experience is that chiropractors add little (and the latest NICE guidance agrees). After an immediate spasm, rest until it eases but then - as quickly as you can - get moving. Even if it's just gentle walks, some movement will help. I found a specialist yoga course for bad backs and now swear by yoga. I also have a daily stretching routine. But most of all, I keep active. A physio can be useful but find the right one - someone positive and motivating will do wonders.

There's light at the end of the tunnel but I know how shit it feels right now. I lost complete movement in one leg for six months due to my back........but now I can run, ride and climb


Edit: as I've quoted it, here's that NICE guidance. It's worth reading as it's what your GP will (should!) be using. It says, "Do not routinely offer imaging.....do not offer acupuncture" and, interestingly, emphasises the psychology of back pain (e.g. recommending CBT) - I think this is really important, hence what I said about a motivating physio!
https://www.nice.org.uk/guidance/ng59/chapter/Recommendations
Post edited at 22:30
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 Dave the Rave 23 Jul 2017
In reply to GoneFishing111:

Woah woah woah woah! Don't have any therapy! Bilateral leg symptoms are a sign that you may develop cauda equina. Gp tomorrow and if he won't send you for urgent MRI, please present at A and E and say that you also have difficulty passing urine. MRI guaranteed and don't feel guilty.
5
 Dave the Rave 23 Jul 2017
In reply to Y Gribin:

Bullshit! He's got bilateral, neuro leg symptoms!
 Stichtplate 23 Jul 2017
In reply to Y Gribin:
CBT! If my GP had suggested that I think I would have been tempted to give his nose a good tweak and then told him he must have imagined it!
Post edited at 22:53
1
 johncook 23 Jul 2017
In reply to GoneFishing111:

Don't let uneducated GP's fob you off. If they even bothered to research it they would have you booked for a scan. Unfortunately in some areas many of the 'bad backs' are money tickets so doctors have become too cynical.
Push for a referral to a specialist and a scan. It is your back and your NHS!
1
 SenzuBean 23 Jul 2017
In reply to GoneFishing111:

I've only very very briefly had back pain, a few months ago. Excruciating stuff. Anyway my advice is to think deeply of the consequences to the rest of your life that a truly broken back would bring. In my case, half of the things I love doing would not be possible, and the other half would be significantly affected. Do not take your back for granted. Hope you get it sorted
 John Kelly 23 Jul 2017
In reply to GoneFishing111:
I'm not sure doctors or indeed medical science holds out a lot of hope for back problems, the diagnostic stuff rarely provides a cure, manipulation sometimes seems to help, surgery from what little I know is difficult and not always very successful.
I think the hard word is you're probably doing a job that is damaging you and you need to find an exit strategy after that it's time, excessive and pain killers, sorry
(The good news is many people seem to recover from bad backs but heavy lifting may not be an option)
Post edited at 23:06
 Timmd 23 Jul 2017
In reply to Stichtplate:
> Edit: you've got to get proper medical advice first, but for most lower back problems, resting it will often make it worse.

It can be a funny one to tweak your lower back, I had to rest mine after pulling a heavy sack of earth across my garden, and then seemed to find I had to gradually do weight exercises and increase my activity to try and help stop it from happening more easily another time. It depends on what one does I guess, sometimes being pain free by not going back to doing certain physical things is the answer.
Post edited at 23:45
 Stichtplate 23 Jul 2017
In reply to Timmd:

Spines are so complicated , there seem to be endless combinations of cause, effect and cure. It's certainly no fun until you find something that works for you.
 Ciro 24 Jul 2017
In reply to Dave the Rave:

Sciatic pain in both legs is unusual, but cauda equina is very rare, and generally indicated by bladder/bowel problems, severe muscle weaness in the legs, and/or loss of sensation around the buttocks, genitals and inner thigh.

To the OP: if you experience any of those get straight to A&E, otherwise don't let dave the rave stress you out, and don't bullshit the doctors to try to jump up the queue ahead of people with a genuine need. That's an asshole move.

Chronic back pain takes a lot of sorting out but your disks can regenerate up to around 60 years of age and surgery doesn't come without risk, so once emergency procedures are ruled out (and until you've reached the point where the pain is too much and you want to accept the risks of an operation), an MRI scan doesn't really do much.

Poor posture and lifting technique causes the wrong muscles to do most of the work, and after years of this the resulting imbalances take a long time to fix... the six weeks since you started the physio exercises is an insignificant timescale so don't think this shows it wasn't working.

You'll likely have a combination of three issues - muscles that are too tight, muscles that are too weak, and muscles that are chronically overworked. This means you need three different therapies - stretching, strength building, and myofacial release.

A lot of physios think the myofacial release is their job, which is bullshit - for sure it's better to have someone else manipulating you but there's only so much that can be done in an hour a week, so unless you're wealthy enough to afford a daily massage, a good physio will teach you how to do it for yourself in between visits. If your physio doesn't want to help you with that, and give you a really good explanation of the root causes - not just what's causing the immediate pain - keep going until you find one who does. Warning - it's the least fun part of the process. Also google kelly starrett - after decades of problems and many phsyios, osteos and chiropracters, the physio who finally helped me get to the root of my problems put me on to him. He has a book called "Becoming a supply leopard" which is mostly about improving athletic performance through soft tissue correction and optimisation, but chronic injuries are generally the end result of underperforming or unbalanced soft tissues so it's all relevant. He also has a bunch of youtube videos for free (and more stuff by subscription if you find him useful).

If your back's in spasm, you don't want to start stretching too soon or you'll make things worse. Ideally you want regular physio and gentle mobilisation - walking is good, and if you can do so gentle front crawl/backstroke swimming too (but no breaststroke unless you have the technique of an olympic swimmer). Use the back pain as a guide as to whether or not you're going overboard with the mobilisation - as soon as it starts to feel more achy than it did when you started back off.

You can start self myofacial release pretty early - basically you want to do as much of it as you can stand... it hurts like hell and you'll get nauseous and dizzy with the pain - that's a sign that you're working in the right place. The caveat to that is not to do anything that exacerbates or causes nerve pain, tingling or numbness anywhere other than the muscle you're working on - that would a sign that you're directly affecting the nerve which is never a good thing.

Good luck... it's a long road, but a worthwhile one!




 damowilk 24 Jul 2017
In reply to Ciro:

Just wanted to support the 2 good replies from Ciro and Y Gribin.
I think it's natural to want to know what's going on and a MRI may seem a no-brainer, but in a lot of cases it's either no help, or some evidence it can actually slow down recovery.
Of course if you have significant leg weakness, problems peeing or numbness of the "saddle" area, get thee to the Emergency Dept.

No ongoing pain is purely physical with no social and psychological elements, and psychological pain therapy in chronic pain is vastly underused and underfunded. In back pain as Ciro says active physio treatment is very important. It's maybe getting a bit dated now but Mackenzie exercises still worth looking at.

If you look at the Keele score for back pain, which shows the chance of slower or poor recovery, you'll see how important people's thoughts and anxiety about pain impacts on recovery: unfortunately it's easier to know this than to change it.
 Dave the Rave 24 Jul 2017
In reply to Ciro:

> Sciatic pain in both legs is unusual, but cauda equina is very rare, and generally indicated by bladder/bowel problems, severe muscle weaness in the legs, and/or loss of sensation around the buttocks, genitals and inner thigh.

> To the OP: if you experience any of those get straight to A&E, otherwise don't let dave the rave stress you out, and don't bullshit the doctors to try to jump up the queue ahead of people with a genuine need. That's an asshole move.

> Chronic back pain takes a lot of sorting out but your disks can regenerate up to around 60 years of age and surgery doesn't come without risk, so once emergency procedures are ruled out (and until you've reached the point where the pain is too much and you want to accept the risks of an operation), an MRI scan doesn't really do much.

> Poor posture and lifting technique causes the wrong muscles to do most of the work, and after years of this the resulting imbalances take a long time to fix... the six weeks since you started the physio exercises is an insignificant timescale so don't think this shows it wasn't working.

> You'll likely have a combination of three issues - muscles that are too tight, muscles that are too weak, and muscles that are chronically overworked. This means you need three different therapies - stretching, strength building, and myofacial release.

> A lot of physios think the myofacial release is their job, which is bullshit - for sure it's better to have someone else manipulating you but there's only so much that can be done in an hour a week, so unless you're wealthy enough to afford a daily massage, a good physio will teach you how to do it for yourself in between visits. If your physio doesn't want to help you with that, and give you a really good explanation of the root causes - not just what's causing the immediate pain - keep going until you find one who does. Warning - it's the least fun part of the process. Also google kelly starrett - after decades of problems and many phsyios, osteos and chiropracters, the physio who finally helped me get to the root of my problems put me on to him. He has a book called "Becoming a supply leopard"

No, CE is not that rare. I see possibly 1 a month.
Given his history of previous disc problems and bilateral symptoms, the OP possibly has a sequestrated disc. My wife had this with no bladder/bowel problems.
On MRI 90/c disc material in her spinal column which the consultant was amazed hadn't caused more damage.
So, don't piss about with the OPS health with your stretches and supply leopard.
If the disc material is out o the disc only diagnosis and surgery will remove it.

1
Rigid Raider 24 Jul 2017
In reply to GoneFishing111:

Your story is almost identical to my own and that of my climbing buddy who suffered chronic back pain after years of playing rugby. He even had a disc operation from within his chest cavity, they removed a rib and deflated his lung to gain access.

I took up mountain biking 28 years ago and then both of us took up road cycling about 10 years ago and neither of us now suffers back pain; road cycling helps you lose weight, gets you unbelievably fit and strengthens the muscles that support your spine. Having suffered chronic back pain from teenage years it's a real joy for me to be able to forget that particular problem. Now I sometimes notice mild back pain in winter when I'm cycling less and the muscles are losing tone but a couple of good rides sorts that out.
 Ciro 24 Jul 2017
In reply to Dave the Rave:

> If the disc material is out o the disc only diagnosis and surgery will remove it.

That's misinformation - the excess material can be absorbed back into the bloodstream. In my case it took around 18 months, which was a psychologically draining length of time to be in so much pain but saved me the potential consequences of the surgery.

I was lucky enough to get a surgeon who was a former Ironman triathlete, and so understood the importance of restoring full function as a keen sportsperson. He said he could guarantee to fix the problem, but there was a five to ten percent chance of permanent niggle from the surgical scarring. I was about nine months on from the incident when I saw him, and he felt there was a good chance the excess material had calcified and wouldn't reabsorb, but said that was by no means guaranteed yet and encouraged me to continue with the conservative treatment for as long as I was psychologically able.

I wouldn't want to go through that rehab process again, but having restored full function I'm glad I didn't listen to those who told me surgery was the only option.

 Ciro 24 Jul 2017
In reply to Dave the Rave:

> So, don't piss about with the OPS health with your stretches and supply leopard.

As for this, I'm not the one recommending lying to healthcare professionals, and thus potentially encouraging them to recommend unnecessary surgical intervention.

 nathan79 24 Jul 2017
In reply to GoneFishing111:

Can't offer much help but wish you the best of luck in getting it sorted.
Currently recovering from a bulging L5/S1 in my back, the worst pain I've ever known. Physio sorted enough to enjoy my eagerly-awaited annual week in the Alps a fortnight ago.
Still not 100% but in the absence of a physical job I can work around it.
 Shapeshifter 24 Jul 2017
In reply to GoneFishing111:
I had a prolapsed disk about 2 years ago and having never been very sympathetic previously of people who complained about back problems, I certainly wised up pretty quick.

My experience was that good physio was the way to go and you've had a lot of good posts already on that from others.
However, I found it took me several weeks in dire pain (taking a strong painkiller like Cocodamol with limited effect) before I could even start physio (which by the way I paid for myself, rather than wait for an NHS slot). At the first physio appointment the Physio suggested, maybe I should ask my GP about a muscle relaxant drug, to reduce the pain and help with starting physio.

In my case the GP prescribed Amytriptyline and for me this proved to be a wonder drug in terms of pain reduction / back movement to allow me to get into physio. The significant pain disappeared over night. There are a number of these muscle relaxants and some can have adverse side effects (e.g. Amitriptyline is an anti-depressant) and certainly should not be taken without consulting your GP, but all I'm saying is it might be worth seeing your GP to discuss that option, prior to and in conjunction with Physio.

Hope that the back clears up soon.
Post edited at 10:43
 Lord_ash2000 24 Jul 2017
In reply to John Kelly:

> Go climbing, seems to cure all my aches and pains, great for my back - forgot to add ' after consulting medical prof......blah blah blah blah'

Based purely on my own experiences I'd recommend the above too, any number of aches and pains, stiffness etc in muscles in my shoulders and back are normally sorted by a couple of light to medium climbing sessions. I guess it all just gets a good stretch out and the muscles actually used which seems to help a lot. Resting generally just makes it worse.

I'd be wary of chiropractors though, they are pretty much quacks, if you need professional help see a proper physiotherapist.
 Si_G 24 Jul 2017
In reply to GoneFishing111:

Given the herniated disc history, I'd be pushing for a scan, personally.
My wife had to have 2 ops as disc fragments were impinging her spinal cord and causing nerve damage. As a result she has lost some sensation and reflexes, and if she had just accepted the fobbing off, she'd be in a wheelchair by now.

I damaged my own back somehow a couple of years ago, and have struggled ever since.
You have my sympathies.

A good physio wringing me out and manipulating the vertibrae made a world of difference.
 Dave the Rave 24 Jul 2017
In reply to Ciro:

> That's misinformation - the excess material can be absorbed back into the bloodstream. In my case it took around 18 months, which was a psychologically draining length of time to be in so much pain but saved me the potential consequences of the surgery.

Glad you're OK.
But, you're just not getting the point.
Bilateral leg symptoms are not a good sign.
He is having an acute on chronic episode from what he's said and isn't showing pain behaviour as he still works in a manual job.
My wife's sequestrated disc could have left her with severe disability if the material wasn't removed. i. e long term nerve damage can be caused. Given the choice of that or have the material removed it's a no brainer.

GoneFishing111 24 Jul 2017
In reply to GoneFishing111:
Wow, thanks for all the replies!

I have been back at work today albeit hobbling around, light duties only. It does seem slightly better. Everytime i twinge it, probably on a weekly basis at the minute, it is worse every time.

The worse of the pain is in my groin, but really deep. My right leg has always had pain but now my left shin is sore too.

I also have numb hands a lot of time aswell, especially at night.

Interesting you have mentioned the CBT, i am well experienced in that department, i have seen many psychotherapists over the years for sleep issues (I'm pretty much fine in that department now) And in all honesty i cannot see how it would help, the pain is not coming from my thought patterns, I'm pretty sure i have damaged something physically. There may be a psychological/psychosomatic issue but i think it is minimal.

Completely forgot to ring the doctors!!

The physio said that the pain in my legs is deferred pain??

Anyone heard of Visceral-Somatic inhibition?
Post edited at 21:10
 Si_G 24 Jul 2017
In reply to GoneFishing111:

Referred pain. The nerve in you back is irritated. It's the nerve which comes from your leg. So your brain thinks your leg hurts.
Google dermatomes. You can work out which disc has the problem.
Groin pain is the sacral nerve. Physio tweaked mine and I woke up at midnight with bolts of lightning coming out of my arse and down my inner thighs. Made toothache seem like a picnic.
I've hurt one a bit higher up which runs down outer thighs and into some toes.
 Y Gribin 24 Jul 2017
In reply to GoneFishing111:


> I also have numb hands a lot of time aswell, especially at night.

This isn't a diagnosis (I'm not qualified to make one!) but I had a very similar symptom when I had my (similar) back issues. As the nerves in your hands come from your neck, the doc concluded it wasn't directly related but was due to the heavy painkillers I was on, causing me to sleep awkwardly (crinking my neck). This might have been made worse by general worrying/anxiety about my health.

I eased off the pills and the numbness went. Just a thought......

In reply to Si_G:

> Google dermatomes

I found bits of my face going numb after sitting staring at a computer for 25 years. I could map my numbness perfectly with a dermatome chart, and identify which nerve outlets were being compressed.

Adjusting the height of my monitor to force me to keep my head looking up fixed this problem in days. I do need to be careful about my head position now, though.
 Stichtplate 25 Jul 2017
In reply to captain paranoia:

> I found bits of my face going numb after sitting staring at a computer for 25 years.

Err, maybe give ukc a rest for a bit?

MarkM 25 Jul 2017
In reply to GoneFishing111:

> I may give one a try, any suggestions for a chiropractor in lancashire?

In reply to GoneFishing111:

If you're going down the chiropractor /osteopath route then I can highly recommend Charles Tisdall in Lancaster (Dacrelands clinic) -he has been looking at bad backs and necks for years and has helped numerous people I know (many who have been the down the GP/scan route).

He saw my wife last Friday and spend around 45 minutes assessing her before a combination of acupuncture and osteopathy over 2 sessions (Friday evening and Saturday) brought her from immobile (in agony at a trip from the bed to the bathroom) to tentative walking and a hope that we may even got away on a planned camping trip this weekend.

All the best in getting it sorted!
Mark

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