Sciatica and lower back pain

Fionne

I'm 46. I had surgery 10 years ago on a ruptured bulging disc in my lower back. It started out bulging until I was told I wasn't bad enough for surgery and desperate for relief went to a physio who stuck her elbow right into the space I had the pain and hey presto! Ruptured disc. I've been terrified of anyone physically touching my back since.

The surgery was successful, the recovery was horrendous but I was walking lots and even climbed Galty Mór a year later. Then 18 months after the op, a friend asked me to go to Zumba classes. I loved it, the first exercise I'd ever enjoyed. Until, bam, I started getting the old familiar pain again.

It was bearable, I would get intense pressure if I walked too far so I just took Nurofen if I needed to and carried on. These last 6 months, I knew it was getting worse. I work in an office and was feeling very sore, pain down my leg by Day 4. I couldn't tolerate sitting at all when I got home so was having my meal and going straight to lying down.

Then, 3 weeks ago, I woke up on a Sunday morning unable to move at all without intense pain. I saw my GP on the Monday evening, he prescribed Difene and referred me for an MRI which is booked for 2weeks time now.

I got a standing desk at work as I can't sit which I'm struggling to get used to, I now add knee pain to my issues and one knee keeps almost giving way under me.

I have full on panic attacks most mornings as I wake up, generally in little pain although I did have a couple of difficult nights, but I'm so scared of how bad the pain will be when I move and stand up. I struggle with even sitting on the toilet, can't put on socks or tie my shoes, even reaching to turn on the tap is hurting. I live alone although I have a boyfriend so I have to muddle through.

I'm struggling. I keep feeling like I'm headed for a wheelchair (though I can't sit!) Or a nursing home. I'm overweight and have been trying to lose weight from before this latest pain began, I'm down 9.5lbs in 4 weeks but a long, long way to go. Nobody would be able to lift me up if I can't get myself up. I'm well aware that even if it's decided I do need surgery again, they may say they can't do it because of my weight.

I feel pretty hopeless. I'm 46 and feel like the things I wanted to do are out of my reach when I can't even properly dress myself, let alone travel or just live normally.

I don't know how much longer I will be able to cope with work if my knee is now giving out from the standing.

I went to a kinesiologist and while she was nice, I didn't get any help with my back. I'm inclined to wait for for MRI and the outcome of that before going for other treatments because of what happened with the physio 10years ago. I worry about being left paralysed. The outside of my left foot has remained numb since 2011. When I walk or sit currently, numbness extends from my right toes upwards.

I've been doing stretches in bed, lying with my legs on the wall. I love gardening and it's killing me watching weeds grow and I can't get near them.

I need hope.

MAULBROOK

You are describing 90% of what I went through 6 years ago. My advice is get the MRI and then work on a rehab plan with your GP.

I 100% understand your mindset as I did the same. Please keep strong and with time it WILL get better. I know my back is like a world war 2 bomb that could go off at any moment but with the lessons I learned I know I can overcome this.

This is a very slow long road but you will get back to near normal, you will not end up in a wheel chair.

If you want to PM me for a chat, that's no problem.

THIS WILL PASS and remember weeds are flowers in away.

Flinty997

What helped me was Pilates but one run by a physio and concentrating on the core. If I go a different Pilates I just don't do The exercises I think will be too much. If I stop going to classes the problems slowly come back.

But I got a MRI and talked to me doctor before doing anything, and I had an assessment with the physio before starting classes.

You're is a piece of equipment your need to maintain it. We don't do this if we spend years at a desk or just a bit if walking now and then.

apache

Sorry to hear FonE, I know what back pain feels like. I had a couple of discetomies which failed and then a spinal fusion which touch wood worked wonders for me.

I was in the kind of pain you described. And I always worry about it coming back.

Wait for the MRI results and have you got a referrel for a good consultant?

I hope you get relief for the terrible pain you are in. Should you be working?

Fionne

https://www.boards.ie/discussion/comment/117761282#Comment_117761282

I just have the MRI for now, I'm guessing the results of that will dictate whether I see a consultant, etc. as I know from 10 years ago, a bulging disk on an MRI plus excruciating pain doesn't guarantee any treatment, I was told that time that I'd have to learn to live with it until my GP put pressure on the consultant because of the numbness in my foot. I don't particularly fancy surgery again but I do need some kind of treatment to be able to function normally.

I have no choice but to work, I don't get paid if I don't go in.

apache

That's a very difficult situation to be in.

Will you get the results in a few days?

I hope things work out for you.

Edit - I'm out of work 6 weeks for an unrelated issue. I got a loan to cover the mortgage. Could that be a possibility?

horsey63

Obviously wait for the MRI results. I had a diskectomy in 09 and 13 and spinal fusion in 2015 (l4/5 level) and I am fantastic !! The key to this is getting a good consultant !

Now, what I have learnt over the years is that you may have to be proactive yourself in seeking out the 'right' person for you. See what happens with the GP, there are a number of very good Neurosurgeons out there that specialize in your problem. Also, not sure where you had your MRI done, but most places will release your scan report to you when you ask either 30 days after the scan or after you have been reviewed, sometimes it is very wise to get the report yourself !!

Fionne

https://www.boards.ie/discussion/comment/117762021#Comment_117762021

I have no idea when I will get the results, I'm having it done in the Mater Private in Cork - will have been waiting over a month by the time I get it and hoping I don't have to wait too long after to have some kind of plan of action in place.

I work in a small business so there is nobody to cover for me if I'm off and working from home is not an option (zero broadband area). Today is Day 3 of my working week and I'm really struggling with the pain. I might take my second Difene at lunchtime rather than waiting until I get home in the evening.

LaLa2004

https://www.boards.ie/discussion/comment/117756659#Comment_117756659

I second what Flinty997 says here. Following an MRI I was found to have significant wear and tear between 2 disks in my lower back. I had sciatica which flared up now and then. It was severe at times. The best thing was to keep moving and stretching gently. I went to a physio who gave me gentle exercises to do and the goal was to build up my core. I joined physio-lead Pilates and stuck at it. I walked out the door every Wednesday evening leaving kids and chaos behind me. We continued online during lockdown. Physio-lead Pilates is good because they won't be standing on their heads or anything! Pilates really worked for me. It is a life-long commitment however. You have the ability to help yourself.

kal7

It is very scary time, hang in there.

Regarding the worry about getting to wheelchair stage.

This is extremely unlikely, otherwise we would see far more people in wheelchairs.

Back pain and sciatica don't always get worse as we age, peak time for disc problem 35 to 55years of age.

Work with your specialist, gp and good physio or osteopath.

(no clicking or popping at the damaged area though)

I would say your frayed disc was on the way to going when physio dug in there, so although it may have aggravated it would most probably have gone anyway.

Good luck with it.

How would you rate your posture in general?

Lower back pain typically comes from underactive low back muscles (quell surprise) that connect from the hip to the rib cage.

Nice phat muscle called the Lumbar-Quads.

When this is underactive you lose the necessary curvature in your lower back which results in things like nerve impingement and disc herniation (bulging) etc.

It's most important to understand that essentially contracting this muscle is the natural counter measure to alleviating lower pain back, most often caused by spinal nerve impingement and disc herniation.

The mechanics of a healthy spine is actually incredibly straight forward but so often gets overlooked.

Quick example (finding an insightful example that's not somewhat obscene is extremely difficult because the nature of the posture):

So you can see the lower back muscle is contracted, you get that slight forward hip tilt, nice and strong spinal curvature, and it extends up the spine to good chest posture etc.

So as farcical as it may sound, those chicks you see at the gym in this posture, doing these exercises (they're doing it so their ass will look good) - they're approach is the IDEAL means to manage lower back pain and associated nerve and herniation issues.

gratefan35

A lot of what you are describing is similar to what I went through a few years ago, same diagnosis and downward spiral leading eventually to a fear of total immobility, pain like I’d never felt before.

Everyone seemed to have a magic bullet they said would work, but nothing did. Eventually I got lucky and came across Dr John Sarno and his work on back and body pain. Google 20/20 sarno and you can see a good introductory video from some years back. You’ve probably tried everything , like I had , and this might take a little adjustment in attitude to take on board, but I gotta say he pulled me out of a very dark place.

there’s more evidence around now to support his theories, particularly around the ‘normal abnormalities’ he mentions, it’s worth looking into when all else fails. All the best with it.

Fionne

I got my MRI results nearly a week ago - bulging and nerve impingement on L4/L5 and L5/S1 with spinal stenosis and slight touch of arthritis. Had to pay €40 to the GP just to get the results read over the phone. 😒 He said to give him a week and then ring again to see if he could find a neurosurgeon to see me - seems to think because I had surgery 10 years ago there may be a problem getting a consultation, let alone any talk of surgery.

My sister had an MRI a few days after mine, also done privately, she got an appointment date for a consultant already. I have not even got a chink of hope of getting an appointment yet.

I'm 46 - surely I can't be thrown on the scrap heap just yet? It's been around 6 weeks now with being unable to sit down. I don't know that I can live with that kind of pain indefinitely. To be honest, it's been a difficult week since getting the results, I was very upset thinking I may never be able to visit my brother in the USA and his family again, as well as all the other things I currently can't do, like drive (I'm barely managing the 5 min commute to work) go to the cinema, sit for a meal (having to eat lying in bed), etc. I have been trying to keep positive and I realise what I'm experiencing is but a fraction of many people's pain and things could be worse but.....I just want to know there's a plan to help me improve.

apache

What surgery did you have 10 years ago?

There's no reason why you can't get a consult with a Neurosurgeon. It might take some time unfortunately with covid.

I know how painful and frustrating it can be but try and stay positive. Wait and see until you get the consult.

I had a spinal fusion (can't remember when exactly but it must be nearly 10 years ago now) and if I have problems again I don't foresee an issue with getting a consult or further surgery.

Sounds like straight forward vertebral misalignment.

How many physio and/or osteo or chiropractors have you been to, and what did they do?

What exercise programs have you underwent?

Sounds like you're at a point where you'll need hands on work to mobilize you sufficiently to recommence an exercise program.

As a question of body mechanics, very treatable.

But taking into account lifestyle etc., some folk just prefer to have surgery.

apache

https://www.boards.ie/discussion/comment/117869663#Comment_117869663

You are talking shite!

Fionne

https://www.boards.ie/discussion/comment/117869222#Comment_117869222

I had a ruptured bulging disc L4/L5 repaired 10 years ago, it was pretty straight forward as far as I know (I can't remember if I was ever given full details) no fusing or inserting rods, etc

Fionne

https://www.boards.ie/discussion/comment/117869663#Comment_117869663

I haven't been to a physio or anyone else as I wanted to know for certain what I was dealing with first. I went to a physio 10 years ago who ruptured the bulging disc I had so I am reluctant to go near one again without proper guidance from a neurosurgeon first. To be honest, I'm unsure how a physio can repair a bulging disc, is that even possible?

https://www.boards.ie/discussion/comment/117869984#Comment_117869984

Okay...

Under what rationale do you base that opinion?

https://www.boards.ie/discussion/comment/117870038#Comment_117870038

I'm assuming it's posteriorly bulging (dorsally, to the back), as anteriorly bulging discs are extremely uncommon.

But your report should outline that.

This happens when the vertibrae are "flexed" or you have a "rounded" lower back, and then pressure is exerted through the spine causing the disc to protrude.

Counter measure = to "extend" (opposite of flexion) the lower back = eases the disc back into place, alleviates pressure on the nerves etc (as nerves project optimally via an "extended" spine; "flexion" causes the vertebrae to push down on the nerves natural angle of projection = nerve pain, numbness in body areas innervated by said nerve etc., in your case your foot).

.........

To attain this "flexion" of the lower back = you must tighten the muscles that attach to the vertebrae in that area = that will pull the skeletal posture back to where it should be.

Now the muscles are lax/underactive thus you have compromised spinal posture = bulging disc + nerve impingement.

.....

This is done by way of an exercise program, which a good physio may prescribe.

But you describe having so much pain you can't even sit down, so how you going to do exercises?

Thus, a physio will mobilize the area, alleviating your immediate pain = allows you to engage in an exercise program = long term rehabilitation.

....

Failing that and you just don't want the bother of exercising, surgery would be the next option.

Left = flexed or rounded lumbar spine = causes the disc to bulge or protrude posteriorly (what you have).

Right = Extended lumbar spine = optimal posture for exerting pressure through the back/spine.

....

You want to tighten or strengthen the lower back muscles to correct your spinal posture = eases the bulging disc back into place and alleviates vertebral pressure on the nerve projections which are causing numbness distally (far from the causal area, in your case your foot).

karlitob

You must be so confused OP.

Firstly - you need to read and listen to the experts in this area. Luckily one of the worlds lead in this area in from Ireland. https://www.rte.ie/brainstorm/2019/1108/1089517-back-pain/

And his paper for further reading.

https://watermark.silverchair.com/pzy022.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAsAwggK8BgkqhkiG9w0BBwagggKtMIICqQIBADCCAqIGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMh9amygxPURbmSOvVAgEQgIICc1wrG5UZOW6cgNZv4z47uejeb7IBe4IFOb6mknfCtAAx3ttEsdEPdAnN8qaAVBQdZLhuBu_ty6lfgvgbouYfiwUlwLD6jd8uRigVip5g-buU7drC2ta-cE9ImHFFHZDn3nVIzQlGJJHCiKyAbp6WBSKfGueTikyGjBj-Z0aXitq4RdEs7dd6k0iEz_4IUtR_Ie70-ptKYzMIxgjM5-2Y-jEJhtw5_80qmtl2jKP-BlEV4buTILBPaKkiW2hs43Z592LdmB_F9jug9btRelEcwGqayAPggC-g6ctDMY9qdlcD-fQzsCBDQTIg4seRpwTkdkwgca0SFCsUWuWh5Wi13xj4BptmVamSRzeITU63UP6iBQt0E4QXFmpnN3hZ4b2np5bqxk16l7yPQ9deb0ivoQ2lokUa790NKshGlmEo_JiPJ5qHlGnWJmZyVEnoQWQqHuzbv71D8B2k6q5NrTqjwcwu0YxxA5ZWJekeiWeS5K4sRiQyDpKBQxiNo2hNrPPKlfQtjt2Il_pIrNd7tSexCtKBi2bqjZX8d9-Rx6flfliJBuwjTvl_zk9hD8VSYo8FP2qJU0BMd5zALFTJlG7k1LyBl0MC7vP418SxvCVKFXv-P11dse_j8L4VJIt3Lp1XxCwpF4Jhf8HQwJK5ChxL86hug0wWqaOwfvXNWYYB85_64yro_S2P061oak2ucdLz23sjOpeqUU9voGL0UP--PDoahUzCpeaLYhlh19T7IbUSFh8JV2_5XwoUfbDev0AMz-V_3thZliAWQo01WchVe8gkyWofoCFtqXntWbre6WXpQWPB25fk9OOH5AOtYuwxCi9Cqw

Have a read/listen and come back with any queries.

I will say this though - the single most important thing you can do to reducei the pain in your back and increase your function is to lose weight. While increase weight undoubtedly has a bio mechanical effect (in the main affecting your posture and your ability to exercise etc) it also has a significant meta inflammatory effort on spine health.

Best of luck.

Fionne

https://www.boards.ie/discussion/comment/117870104#Comment_117870104

I don't know why you said "you just don't want the bother of exercising" as if I'm unwilling to try everything and anything to ease the pain I'm in. I've been through the surgery before, I swore I'd never go through it again, I definitely would avoid it if I can but if it offers the best chance of a good recovery, then I'll have to consider it. Right now, I would be happy just to get some proper guidance from a neurosurgeon, just to get in a room to have some questions answered. I know from last time, the doctors would tell me to stay away from physios, the physio said to ignore the doctor's advice, wouldn't it be great if they could all work together on a plan to help me?

https://www.boards.ie/discussion/comment/117871153#Comment_117871153

You had a discectomy 10 years ago?

Presumably that wasn't the L4/5 disc, the one now causing issue?

It sounds like your original physio just messed up.

Honestly with correct treatment the actual bio-mechanics of rehabilitation from this are straight forward.

It sounds like it may be complicated by a weight issue but a clued in physio should be able to manage that.

Unfortunately competencies can varying dramatically enough from one physio (or physical therapist, chiro/osteo) etc. and the next.

Can't do much more for you through an internet forum apart from saying it would be no harm to search around for a reputable physio/physical-therapist etc., do your homework, make some calls etc., whilst waiting for your neurosurgeon appointment.

There's several techniques used that can go a long way to pain alleviation, perhaps rehabilitation with a forward thinking care plan.

....

With extreme caution I'd mention anti-inflammatories are good, there's other pain killers available also - more powerful - but proceed with extreme caution as they're addictive, and would be fairly distinctly counter productive to weight loss (i.e. something containing opioids).

karlitob

https://www.boards.ie/discussion/comment/117871153#Comment_117871153

They are - just from their perspective.

Ive given you the latest up to date research in an easily accessible format.

I wouldn’t go to a gp with musculoskeletal disorder. They are general Practicioners - if the drugs don’t work at the first point of call then there’s nothing else they can do.

neurosurgeons chop - that’s their job - surgery. They’ll operate any chance they get. While they know about the spine - back pain, and prolonged back pain is not structurally in cause. As counterintuitive as it sounds, your MRI - for your age - is normal. A bulge - which is normal - it’s supposed to do that - can be reduced if you were sitting or in a different position.

physios - chartered physiotherapists…of which I am…..are like all professions. Some are good and some not so good. But none are bad as we are highly trained and need to maintain CPD and register. I won’t account for the other quacks out there - cracking your back does nothing

you also presume that our care is the reason why you’re not progressing. We call these yellow flags - look it up. https://youtu.be/Gwcumn9NggsAs I said above, the single most important thing you can do for your back pain is weight loss. A physio, Doc or surgeon can’t do that for. There’s no magic bullet.

when the weight is low and back is not as sore as a consequence then you need to understand how your body works, how your back is not broken and not inherently weak - it’s one of the strongest structures we have - and that you can live a healthy, pain free functional life. That’s cognitive functional therapy.

here is THE world expert of back pain. You won’t get better advice and understanding he’s got a lot of videos on YouTube

https://youtu.be/Gwcumn9Nggs

Fionne

https://www.boards.ie/discussion/comment/117872353#Comment_117872353

A bulging disc may be relatively "normal" as you say because I know a lot of people have it without any issue. The nerve impingement and stenosis surely isn't normal though. I was left with permanent numbness 10 years ago where the outside of my left foot never regained full sensation and my biggest fear is more of that happening. Back then, surgery was eventually put on the cards because I was told nerve damage could progress to the point of losing bladder control.

I know a GP can't help much but they are necessary for referring for the MRI for example as well as pain relief.

I have been asking people for recommendations on physios or chiros, it just seems a minefield. One person will recommend someone while another will tell me to avoid them at all costs. I guess I'm gonna have to take a leap of faith at some point which is quite scary as I can't afford to get much worse than I am. I'm also limited by not being able to drive far so will have to get someone as close by as I can.

I have lost 22lbs in the 6 weeks since I've had the bad pain so I am trying in that regard. I do realise it doesn't help being overweight as well as sitting at a desk for 8 hours a day the past 25 years.

I watched the YouTube video and definitely recognised myself in a lot of it, though I can't quite get my head around the "Feel the pain and do it anyway" logic but I will try.

apache

It comes to a point where Physio will do more harm than good. These people aren't qualified and don't know what they're talking about. If they were in the pain you were in they'd realise how ridiculous their suggestions are.

I hope you get a consult soon from a proper Neurosurgeon.

https://www.boards.ie/discussion/comment/117875366#Comment_117875366

"These people...."

....

To whom are you referring?

.....

I agree about the aforementioned "mine field" comment.

It really can be a shot in the dark sometimes.

A specialist in the area of musculoskeletal, what general area of the country are you in?

Fionne

I'm in North County Cork.

Fionne

I saw a surgeon/consultant yesterday and it went better than I anticipated - my biggest fear being that I would be sent home with a flat "No, we can't help you" which is what initially happened 11 years ago when I first saw the surgeon who eventually ended up operating.

I am booked in for an epidural next week, he says 70% of people get relief from that. It won't fix my issue though, there is a bone out of place in my back that is narrowing the nerve canal that runs through your spine so it's impinging on the nerves. An injection won't fix that but will hopefully reduce the pain.

It's great to have a possible solution for the pain but I also know that unless I eventually get the surgery, I won't be able to return to normal things that I currently can't do without pain - like sitting and driving. My immediate goal is to be able to drive the 10 miles to do my grocery shopping, after that my ultimate aim is to be able to sit for however many hours it takes to get to visit my brother and his family in America. Whether I will ever be able to sit for that long is a question I don't know the answer to yet. I did ask the consultant about how if I get rid of the pain via the epidural (which hopefully will work), and do the things that currently cause pain, am I doing nerve damage? His answer was Yes. So a standing desk is going to be a permanent fixture I think.

He said the surgery would be a fusion - has anyone had that type of surgery? I asked him if that was the surgery where you can't bend down but he said that shouldn't be the result of it.

Oranage2

Surgery will just kick the problem a few years down the road. You need to get to a healthy weight, strengthen your core muscles and maintain correct posture when sitting especially for prolonged periods of time.