advertisement


Lower back pain specialists...

If you get a Chiropractor who tells you that you’ve got one leg shorter than the other (who hasn’t) and tries to sell you shoe lifts, then walk, or limp, away
Chimes with my experience of chiropractors, but I did find the manipulation was good for short term relief from sciatica.
 
I've had two herniated lumbar discs as well. In both cases I saw a physio, the second travelling with the UK Athletics team as a mobility specialist at the time. The advice was the same. Read Robin McKenzie's book 'Treat your own back' and to do core strength exercises. Learn to engage the Transverses Abdominus. Or pelvic girdle exercises. Pilates will help. I've yet to find an instructor that has the same knowledge as my physios though.
 
Whenever I badly suffer from my back, a good afternoon dance and real pain killers (not paracetamol which has no effect, mainly placebo in many cases) will always be beneficial. Dancing usually fixes me very quickly!
Esoteric thingies probably also work, not for me because I don’t believe they do. Pilates is a trendy joke to me.
Resting is actually the worst remedy — a free piece of advice from my physiotherapist.
 
I myself have a monthly Osty session as an ongoing pain management system, if you go this route, try to find a good one as l have found not all Osteopaths are created equally if you do go this route, get him to show you some stretches/ exercises to do at home- Good luck.:)
 
An update on this.
I had an mri scan and then saw a spine surgeon recommended by a consultant I know.
He was fascinating, spent way over my time chatting and asking questions, and concluded by telling me that my spine is pretty worn out but there is nothing operable, but given what he'd found out about me he suggested that I speak to a therapist.
He said that 'pain is a powerful emotion' and that my emotional battery sounded pretty flat. Not what I expected at all.
I have found a therapist with one spare slot (obviously most are totally booked up) and after a few sessions I'm already able to sit better. Seems she thinks I should write a book given my family history and we've hardly started on my recent past..
 
An update on this.
I had an mri scan and then saw a spine surgeon recommended by a consultant I know.
He was fascinating, spent way over my time chatting and asking questions, and concluded by telling me that my spine is pretty worn out but there is nothing operable, but given what he'd found out about me he suggested that I speak to a therapist.
He said that 'pain is a powerful emotion' and that my emotional battery sounded pretty flat. Not what I expected at all.
I have found a therapist with one spare slot (obviously most are totally booked up) and after a few sessions I'm already able to sit better. Seems she thinks I should write a book given my family history and we've hardly started on my recent past..

Hi Steve.

As you will recall from when you dropped those massive Kefs round to me, I also suffer with back pain. Had I known you did too, I would have enlisted some assistance.

I am fortunate in that I have a specific diagnosis and am aware that surgery is a last resort for my condition and recently posted here eliciting first hand anecdotal experience of spinal fusion surgery as the failure rates are statistically significant.

However, as I aggregate advice, I am coming to a similar conclusion to your specialist, that developing psychological strategies for living with pain and managing it, as well as doing pilates to improve core strength for the (currently) significant periods that it is in remission, is probably the best way forward.

I do not do a physical job and my greatest concern is that it reduces my capacity for exercise and indirectly shortens my life as a consequence. As a 49 year old with very small children, this a source of some anxiety.

I really hope you achieve an outcome that works for you.

By coincidence, my wife is a counselling psychologist. However, it would be unethical for her to treat me in a professional capacity, which is a shame, as she is very, very good at what she does.
 
Last edited:
If you have access to a pool that is easy to get in and out of, and has a constant temperature of about 30°C. I would recommend using it for very gentle movement directed by a Physiotherapist.

I do not have lower back pain, but I am unable to do any exercise that involves impact. The warm water helps my movement a lot. The pool that I can access is just under a metre deep, but is deep enough to do non-weight bearing movement.
If there is a sauna/steam room available, I find they help as well. (although the pool I access has no hot room facility, I have used them before with good effect, albeit temporary in nature.)
 
Thanks for your replies and support - I do a physical job (when I can work, but that's another tale involving operations..) and also do a lot of exercise - cardio and gentle weights.
This back pain was unlike any other back pain I've known, more like the discomfort you get after sitting too long, but worse and it didn't go away in a hurry.
The recent past has included my wife's brother dying of cancer, and her other brother doesn't have more than a few months to go, my best friend dying of cancer, my mother injuring herself in a fall then loosing all lucid sense to confusion (although she is almost back to normal) and I had covid pretty badly and took several months to recover. The distant past is as full of incident too, so clearly there is a lot to sort out in my little head but it seems to be working so far, and it seems to be showing despite the 15 painkillers I'm on each day that make logical thought processes a trifle difficult at times!
 
I had lower back pain resulting from poping a disk when putting a suitcase into the boot of the car in 2000. Over the following 7 years I visited numerous practictioners of various trades. Eventually I was sent to a surgeon who speicialised in back and spinal malfunctions. I had a conventional MRI scan that only showed a slight defect, the surgeon mentioned that there were MRI scanners that enabled the patient to stand upright so that the spine was under load. However he did not know of one in the UK, thanks to comments in this forum and Google I discovered one had opened in London. The MRI scan showed the amount of distortion in the spine and the disc injury.

The surgeon operated and fused L4 and L5 together. It all worked well.
But
I had a fall while getting off a rib in the Galapagos Islands and that along with other issues meant that I visited the surgeon again and the upright MRI scanner again and the results shows that another disc had moved plus a screw was rubbing on a nerve so another op to fuse L5, L4, and L3.

The Upright MRI url is
https://www.uprightmri.co.uk/
it is located in London, they might be other sites available in the UK now.

The surgeon was so impressed with the upright MRI that he persuaded the funding group to approve the use of upright MRI scanner - even if it required the patient to travel to town for the scan

Note this post was started about 5:30pm so it is a bit out of sequence.
 
There are upright scanners around the uk but a lot of health providers will not pay for their use on the NHS.
There are specific conditions which are amenable to back surgery, but these are in the minority. As a general rule, I would try to avoid surgery at all costs, unless the surgeon was extremely confident of success. And even then I would probably get a second opinion in most cases.
 
THe cost of an upright MRI scan was not excessive and well worth it it if gives a better result than a lay flat scan which shows the spine at rest rather than in the "working" position.
 
I'm no expert.. in anything much.. But, what feels like lower back pain may or may not be spinal column related. I've had recurring issues with my right Sacro-Ileac joint..which can feel like back pain, or sciatica, or hip pain..or even Sacro -Ileac pain.

Proper diagnosis is key.
 
Is an MRI the only way that spinal disc damage, sciatica, etc, can be diagnosed or are there other, albeit perhaps less definitive diagnostic scans that can be used, such as X-ray and ultrasound? The reason I ask is...

At the end of July I noticed a very mild twinge sensation in my upper left buttock when I was sitting at a certain angle, a sensation I hadn't experienced before. I tried to correct the problem myself by improving my posture by sitting more upright with my back firmly tucked into the back of my chair, and sitting on a foam wedge to encourage my posture to tilt forward with my hips slightly higher than my knees (things a cerebral palsy physio recommended to me years ago but I never kept up with).

This did not help, the pain increased in intensity and spread a little more each day, and by the end of August I was in a lot of pain and struggling to find standing and sitting positions that minimised it.

I'm not good with anatomy but my pain is confined to below my hip line. I do not experience any pain higher up in my back.

The pain is difficult to describe, it's like a combination of a trapped nerve, feeling like someone is pinching your flesh very aggressively, and the kind of aching numbness you get in your buttocks and leg when you've been sat on a hard surface too long. Also, it doesn't always remain in the same place. What's a comfortable seating position one day may be excruciating the next, it can even vary from one hour to the next, and sometimes leaning forward or back just a degree or two can find a new sweetspot where the pain is much less.

I called my GP at the end of August, I didn't bother doing so before as the NHS website says that back issues like sciatica usually resolve within 4 to 6 weeks and recommends seeking help after this timeframe or if it's affecting your bladder and bowel control etc.

As expected, GP was useless. Prescribed amitriptyline hydrochloride and paracetamol** and instructed to take these for the next 6 to 8 weeks and arranged a home-visit from a physio subject to the usual waiting list. I haven't started either medication yet. I don't like the idea of taking a painkiller to mask pain unless it's absolutely unbearable and I certainly don't fancy subjecting my organs to 6 weeks of paracetamol. From the research I've done on amitriptyline, it doesn't appear to be a med that you can suddenly just stop taking. This is a concern for me because of my acid reflux which can flare up bad if a med doesn't agree with me.

Ideally I want a scan to determine the cause of the pain but my cerebral palsy and acid reflux complicates matters. My CP makes it impossible for me to hold my body still any longer than a few seconds, so any scans/tests that require staying still for longer periods would need to be done under general anaesthetic. However, due to my reflux, I am unable to lay flat (I haven't lay flat for the last 9 years or so, - I sleep on a 45-degree incline), and I am unable to undergo a GA unless I am simultaneously intubated to ensure there is no reflux into my respiratory system, so it's something I'd want to avoid unless absolutely necessary!

** GP initially wanted to prescribe either ibuprofen or co-codamol instead of paracetamol but I can't take the former due to my acid reflux and I declined the latter as the last time I took that for an excruciating rhomboid injury it barely touched the pain but made me feel properly weird.
 
Last edited:
Is an MRI the only way that spinal disc damage, sciatica, etc, can be diagnosed or are there other, albeit perhaps less definitive diagnostic scans that can be used, such as X-ray and ultrasound? The reason I ask is...

At the end of July I noticed a very mild twinge sensation in my upper left buttock when I was sitting at a certain angle, a sensation I hadn't experienced before. I tried to correct the problem myself by improving my posture by sitting more upright with my back firmly tucked into the back of my chair, and sitting on a foam wedge to encourage my posture to tilt forward with my hips slightly higher than my knees (things a cerebral palsy physio recommended to me years ago but I never kept up with).

This did not help, the pain increased in intensity and spread a little more each day, and by the end of August I was in a lot of pain and struggling to find standing and sitting positions that minimised it.

I'm not good with anatomy but my pain is confined to below my hip line. I do not experience any pain higher up in my back.

The pain is difficult to describe, it's like a combination of a trapped nerve, feeling like someone is pinching your flesh very aggressively, and the kind of aching numbness you get in your buttocks and leg when you've been sat on a hard surface too long. Also, it doesn't always remain in the same place. What's a comfortable seating position one day may be excruciating the next, it can even vary from one hour to the next, and sometimes leaning forward or back just a degree or two can find a new sweetspot where the pain is much less.

I called my GP at the end of August, I didn't bother doing so before as the NHS website says that back issues like sciatica usually resolve within 4 to 6 weeks and recommends seeking help after this timeframe or if it's affecting your bladder and bowel control etc.

As expected, GP was useless. Prescribed amitriptyline hydrochloride and paracetamol** and instructed to take these for the next 6 to 8 weeks and arranged a home-visit from a physio subject to the usual waiting list. I haven't started either medication yet. I don't like the idea of taking a painkiller to mask pain unless it's absolutely unbearable and I certainly don't fancy subjecting my organs to 6 weeks of paracetamol. From the research I've done on amitriptyline, it doesn't appear to be a med that you can suddenly just stop taking. This is a concern for me because of my acid reflux which can flare up bad if a med doesn't agree with me.

Ideally I want a scan to determine the cause of the pain but my cerebral palsy and acid reflux complicates matters. My CP makes it impossible for me to hold my body still any longer than a few seconds, so any scans/tests that require staying still for longer periods would need to be done under general anaesthetic. However, due to my reflux, I am unable to lay flat (I haven't lay flat for the last 9 years or so, - I sleep on a 45-degree incline), and I am unable to undergo a GA unless I am simultaneously intubated to ensure there is no reflux into my respiratory system, so it's something I'd want to avoid unless absolutely necessary!

** GP initially wanted to prescribe either ibuprofen or co-codamol instead of paracetamol but I can't take the former due to my acid reflux and I declined the latter as the last time I took that for an excruciating rhomboid injury it barely touched the pain but made me feel properly weird.

If you haven’t done it before, keeping a Pain Diary can be very useful when seeing a Doctor/Physio, Whoever. A pain diary can sometimes reveal patterns of incidence of pain that can help find the cause, and/or aid treatment.
The amitryptyline takes a few weeks to work for nerve pain, if it is going to work? It didn’t work for me.

The regular 4g. a day of paracetamol may help if taken regularly. If it reduces the pain then you may be able to move easier therefore (potentially) helping with the source of the pain.
I took it regularly for ages. It isn’t known to have a negative effect on the gut.

The codeine in co-codamol doesn’t suit everyone.
It is worth noting that not all opiod or synthetic opioid drugs affect people in the same way, especially the “feeling properly weird,” sensation that you experienced.
In most cases if the drug is having a positive effect on the pain, then any ‘weird’ sensations reduce within a week.
If the analgesia is doing sweet F.A. for your pain, but making your head spin, it is the wrong drug.
Codeine is good at slowing down unwanted diarrhoea - causing constipation.

I hope the Physiotherapist can help you without the need for medication.
Sounds horrible pain.







Obviously no one should take co-codamol and paracetamol together. :)
 
MRI more accurate than X ray from what I know

My similar pain in my right buttock, which also moved around a bit, after much faffing around was MRI scanned and found to be a synovial cyst on my lower spine, some distance from the pain site
Once I knew that I could work on it with exercise
Almost perfect now
 


advertisement


Back
Top