Sudden agonizing, crippling, lower back pain. What to do?

[NZRob]

@James I hope your back comes right quickly mate, it's really shit what you're going through....lots of us fellow back pain sufferers wincing in sympathy and feeling your pain

 

[Brad J]

@James , hope you are getting better , have had similar problems in past , It may take some time for it to calm down.

 

[Primoz]

Seems to have calmed down for now. I walked a little. Any experiences coping with this type of spasm?

If it's really just back pain, then you can't do much except (painfully) wait. Best option is to get to doctor so you get shot of hmm... no idea what's right word for that in English. It's basically pain killers on steroids and it make your muscles real soft and relaxed. It's not gonna heal anything and certainly won't heal reasons for this, but it relaxes your muscles and with extreme back pain that's only thing that helps.

 

[fatbob]

Last time I had debilitating back pain I summoned up the guts to drive the half mile into town, begged unsuccesfully at the docs for a an emergency limp in appointment (Saturday am) and was then begging at the pharmacists for the strongest OTC stuff they had ( the pain was so bad I was struggling to get words out logically) when it started easing a bit. I'd have gone to hospital but literally couldn't face the 15 min drive or taxi & I thought ambulance was possibly overkill.

Pinched nerve.

 

[James]

Thanks for the well wishes!
It's getting better. Can walk carefully. Bending over more, but not picking something up off ground. Sneezing or coughing is still painful but not nearly as bad. Still can't lift both legs at once lying down.

Ibuprofen. Diazepam. Methocarbamol. Whiskey. Active rest.

Low and behold this is what I was prescribed minus the whiskey. Plus tylenol staggered with the ibuprofen.

I expect you have some damage/degeneration to your lumbar spine and you need to develop a long term therapy and stretching routine based on a solid diagnosis.

I would agree. I've had right side IT band tightness for years.
Season before last I did a lot of indoor rock climbing which I think helped in general. Plus rock climbing is a good incentive to lose weight as you fight gravity all the time.

I was going to go to Abasin in 2 1/2 weeks. Prob not a good idea.

 

[Sibhusky]

In general though, going to the er there's a huge difference where you are. Some small regional hospitals no have doctors in the er. PA's to stabilize then you're shipped out for advanced care.

To those who think that Whitefish has no "real" hospital (looking at you, @Pat AKA mustski ) I want to go on record saying there are real doctors in the emergency room here. All three in our family have been there on multiple occasions and seen an orthopedic surgeon immediately. I'm stunned that James here has such a situation going on.

 

[Dakine]

Swimming is a great exercise for back ills.
It is the only way to exercise without the influence of gravity.

 

[Steve]

Yes. Swimming also gave my shoulder the ability to do things the Docs said it never would. (Rotator cuff tear -> sugery -> re-tear in overagressive PT.)

At first all I could do was elementary backstroke and very weak breast stroke. You don't need to do the crawl or the butterfly to get benefits from swimming.

 

[Doug Briggs]

I got a twinge in my lower back last week and have been applying heat 2 -3 times a day, Valium (saved from my mt bike accident) at night and not skiing for a week.

Yesterday I tried a demonstration of a BEMER system (www.bemeramerica.com) which is a PEFT system (Pulsed Electromagnetic Field Therapy). You can read more about it here: https://www.ncbi.nlm.nih.gov/pubmed/?term=bemer+microcirculation

You are supposed to have multiple treatements, I just had the one demo at a ski race, but I definitely felt better after the treatment. I had more ROM with less discomfort. Placebo effect? I don't know. I was doing lots of different things yesterday including pulling and rolling B-net, wearing a back brace (like a lifter's belt) and being very careful not to strain anything (I know B-net doesn't really fit into that regimen) but maybe the activity after a week of inactivity helped.

 

[Steve]

Motion is lotion.

 

[Wendy]

To those who think that Whitefish has no "real" hospital (looking at you, @Pat AKA mustski ) I want to go on record saying there are real doctors in the emergency room here. All three in our family have been there on multiple occasions and seen an orthopedic surgeon immediately. I'm stunned that James here has such a situation going on.

I've been to the Springfield "Hospital" that James is referring to. It reminded me of a refurbished elementary school. I don't remember (this was like 13 or 14 years ago) if there was a doctor there, or just nurses and PA's (and this is not a jab at nurses and PA's...they are skilled professionals). But I was stunned at how small it was. If you're in rural VT, you've got to drive to get to a good hospital.

@James glad you've got some meds to ease the discomfort. Yep, the Tylenol/ibuprofen combo works great...my doctor calls that "poor man's codeine."

As far as the lifting both legs off the ground when on your back.....there are some people in my boxing class that have difficulty with this.

 

[Tahoma]

Hi James--Glad to hear that your back is (hopefully) getting a bit better. As an MD and someone with a history of low back issues myself, I can empathize. Several years ago, I had sciatica so bad that I abandoned the usual MD denial defense mechanism and went to see a spine surgeon. Long story short, some lumbar stenosis and pinched nerve root. I was lucky, and a selective steroid nerve root block knocked the pain down and facilitated recovery and rehab. It also woke me up to the need for keeping my back and core conditioned, which I've been religious about since, and IMO has helped me avoid a lot of the low back strains that I used to get.

I don't generally try to engage in curbside consults, since one rarely has enough info to make more than some educated guesses. On the plus side, if you haven't noticed signs and symptoms of nerve root compression (pain running down into a leg, numbness in the area supplied by that nerve root, foot drop or other focal weakness), then it's likely (but not guaranteed) a nonsurgical problem, as opposed to something like a ruptured/"slipped" disc compressing spinal nerve roots, or something more insidious (like an abscess or bleed or tumor). That said, and as others have noted, the causes of back pain are many. And in my personal as well as professional experience, stuff like SI joint pain, IT band issues, and leg or hip issues can be causes of back pain. Remember, the legs and pelvic girdle are attached to our back.

The natural history of acute low back pain is that most cases get better with what you're doing + gentle, progressive PT in six weeks or so. That sucks for your plans for A-Basin, but at least most folks don't need surgery. However, I'd encourage you to talk with a doc about possible underlying causes that could re-trigger it, and absolutely get thee to an ER at once if you note any focal weakness or numbness in one or both legs, or problems with your bladder or bowels!!

 

[Goran M.]

After few weeks of having similar symptoms (pain tolerance is different to each individual) I did visit a spine surgeon and after some X-Rays and MRI - today I was diagnosed with Lumbar Spinal Stenosis.

Prescribed 6 weeks of PT, advised to stop running and "slow" down (basically stop) with tennis playing. Biking and swimming is OK. No triathlons for me this year.

Conservative approach to treating symptoms for now. Focus on core strengthening and posture.

It is suggested ALEVE over Ibuprofen (taking ALEVE every 12 hrs. vs. Ibuprofen every 4 hours). I am not a big believer/fan of NSAID.

Set off the process of obtaining Medical Cannabis Registry Card.

Seek medical counsel ASAP and you will be glad down the road that you've done that.

 

[James]

I've been to the Springfield "Hospital" that James is referring to. It reminded me of a refurbished elementary school. I don't remember (this was like 13 or 14 years ago) if there was a doctor there, or just nurses and PA's (and this is not a jab at nurses and PA's...they are skilled professionals). But I was stunned at how small it was. If you're in rural VT, you've got to drive to get to a good hospital.

Well VT only has 600,000 people. Fact is, if you've got anything serious, you'll be sent to Dartmouth-Hitchcock after the PA's have done what's necessary, presumably with consult. I believe there is one doc floating in the hosp during the day. I just learned about the er situation last year.
You'll go by helicopter if there's no ambulance with paramedic available or it's time critical. That's 14-16k$. The only other choices in VT are Burlington way up Northwest, or Albany, NY if southwest. Bennington, (sw VT), Hospital is more sophisticated than Springfield but I don't think up to major crises.

Back when you're talking things might have been different. In 2000/1, I ended up going to Springfield ER for a tiny splinter in a pinky that went from nothing on Thurs to I had to wear mittens on Sat because gloves wouldn't fit. By Sun after skiing the finger was really swollen and shiny and red lines were going up the hand. I was told over the phone to go to the er immediately.

Pretty sure there was a doc, he ended up doing a little exploratory surgery of the nickel size pinky bump after an x ray. While I was on the IV antibiotic, I talked to the nurse. Besides all the stories of ski instructors and their horrible toes, she told me about her two teenage boys, then making enormous money, one of them $200k+, snowboarding. That was the time of big money, long gone now. They all had Biblical names, Abraham, Elijah, iirc, and a younger girl Hannah. Several years later, Hannah Teeter was in the Olympics at Torino, 2006. She went on to win a gold medal in the half pipe, and later a silver at Vancouver in 2010.

 

[Wilhelmson]

On the bright side it happened in April. Do some breathing exercises once it's not so painful. Hope you feel better.

 

[Tahoma]

After few weeks of having similar symptoms (pain tolerance is different to each individual) I did visit a spine surgeon and after some X-Rays and MRI - today I was diagnosed with Lumbar Spinal Stenosis.

Prescribed 6 weeks of PT, advised to stop running and "slow" down (basically stop) with tennis playing. Biking and swimming is OK. No triathlons for me this year.

Conservative approach to treating symptoms for now. Focus on core strengthening and posture.

It is suggested ALEVE over Ibuprofen (taking ALEVE every 12 hrs. vs. Ibuprofen every 4 hours). I am not a big believer/fan of NSAID.

Set off the process of obtaining Medical Cannabis Registry Card.

Seek medical counsel ASAP and you will be glad down the road that you've done that.

Agree 100% with the advice you got for core strengthening and PT. Even though one may argue that stuff like spinal stenosis is an anatomical problem that only surgery will correct, I've seen way too many folks pull the surgery trigger before giving conservative treatment an honest go, and live to regret it. It's just my opinion, but a lot of people walk around with varying degrees of back/core deconditioning, and that just sets us up for more problems down the road.

Knowing what I know about back surgery, I'm doing everything to stave it off for as long as possible. But then, a lot of MDs tend to look at stuff from a glass-half-empty point of view! ;^)

 

[James]

I've had IT band tightness on the right side for years. Also, not sure if it's the same thing, but if when standing I move my pelvis horizontally to the right, at some point there's a sudden shift in I guess the hip joint. Also at times chronic low level ache in the right hip joint.
Many years ago I went to an Osteopath who pretty much took away that pain in the right hip after one visit.

What is this SI issue people talk about?

 

[LiquidFeet]

 

[James]

So I gather that when say driving for extended periods, one would want to rotate the pelvis forward somewhat and push the coccyx into the seat back? Instead of the usual default slouch that's easy to get into.

 

[Wendy]

Many years ago I went to an Osteopath who pretty much took away that pain in the right hip after one visit.

My grandfather was an osteopath. He always could find trigger points, or use massage and manipulation to ease pain. At his funeral, dozens of elderly people went through the visitation line and told me, one after another, how my grandpa made their lives so much better by easing their pains. I have several quilts that women made him as payment for his treatments during the depression, when there was no money to pay. (I just needed to share that).