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Difficulty walking + standing, maybe Lumber Stenosis?

hifinutt said:
Its a real shame the physio didnt pick up on this potentially life threatening condition . And it shows that telephone consulations can be dangerous in missing stuff .
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I'm afraid that my experience of both telephone and face to face physio on a self referal basis has been pretty poor. They do seem over reliant on excercise as the solution to everything.
When campaigning for my first knee replacement, I was given endless knee exercises until I finally ( but politely) 'lost it' with the physio and demanded an x-ray. "What for" "Because I had the cartilage out 40 years ago and I'm now convinced my knee joint is 'bone on bone'. She agreed to refer me for x-ray of right knee, so I said.. maybe left knee too, that is also extremely painful "No..you don't need the extra radiation.." So, I called my GP, who arranged left knee at the same time. It transpired that both knees had no joint space, or cartilage to speak of, plus bone spurs etc.. No amount of exercise was ever going to fix that.
By contrast, the physios at Wrightington Hospital, where I had my knee replacements.. are superb, and provide about 5 or 6 appointments plus exercise plans to aid rehab, and ongoing support if needed.
 
A second vote here for Wrightington. One of the few hospitals in which I have 100% confidence in no matter what they do.
 
This is a good article (with references) to the effects of bed rest on muscle mass - tl;dr is you lose a lot of muscle very fast when you aren’t using them, so use them or lose them.

www.nursingtimes.net

Effects of bedrest 5: the muscles, joints and mobility | Nursing Times

Abstract This article – the fifth in a series exploring the harmful consequences of bedrest on body and mind – describes how prolonged bedrest and
www.nursingtimes.net www.nursingtimes.net
 
AndyU said:
This is a good article (with references) to the effects of bed rest on muscle mass - tl;dr is you lose a lot of muscle very fast when you aren’t using them, so use them or lose them.

www.nursingtimes.net

Effects of bedrest 5: the muscles, joints and mobility | Nursing Times

Abstract This article – the fifth in a series exploring the harmful consequences of bedrest on body and mind – describes how prolonged bedrest and
www.nursingtimes.net www.nursingtimes.net
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Thanks for the link Andy, I'm enlightened now.
My daughter died last year, and I've become very inactive for the last 12 months. I've been active most of my life, walking, climbing, I was hardly at home! walked for miles!
Hardly been out for 12 months but now starting to get mobile again.

I thought my symptoms were just old age? Lack of exercise was the culprit.
 
Mullardman said:
I'm afraid that my experience of both telephone and face to face physio on a self referal basis has been pretty poor. They do seem over reliant on excercise as the solution to everything.
When campaigning for my first knee replacement, I was given endless knee exercises until I finally ( but politely) 'lost it' with the physio and demanded an x-ray. "What for" "Because I had the cartilage out 40 years ago and I'm now convinced my knee joint is 'bone on bone'. She agreed to refer me for x-ray of right knee, so I said.. maybe left knee too, that is also extremely painful "No..you don't need the extra radiation.." So, I called my GP, who arranged left knee at the same time. It transpired that both knees had no joint space, or cartilage to speak of, plus bone spurs etc.. No amount of exercise was ever going to fix that.
By contrast, the physios at Wrightington Hospital, where I had my knee replacements.. are superb, and provide about 5 or 6 appointments plus exercise plans to aid rehab, and ongoing support if needed.
Click to expand...
Until just under two years ago I was fine with walking and enjoyed the downs. Then my left knee suddenly went bad and in under a week was limping and in a lot of pain. Eventually I got to see our doctor who gave me cocodamol and I persuaded him to send me for an x-ray. My left knee was supposedly medium arthritis and right knee I was told only minor. By now I could hardly walk so I had an injection of Hydrocortisone and I could immediately walk pain free. A few weeks later my right knee went from being fine to crippling pain and was unable to walk down the garden. An Hydrocortisone injection made no difference so I was sent to the in-house physio. Even doped up with the max dose of cocodamol the exercises were impossible and was told that I couldn't see a consultant until I completed 6 months of physio! I went private and saw a consultant 3 days later who within 5 minutes examination told me that my right knee was like a balloon and required a full knee replacement.

I had the op 15 months ago and although still in some pain can now walk for an hour or so without pain killers before rest. Fortunately my left knee hasn't got any worse but I guess that one day it will also need replacing. I still do some of the post op physio exercises and I think that is building up muscle.

Strangely enough a short while after the op I had trouble with balance and can no longer ride my ebike. I have now been referred to a local falls clinic and believe it or not have had two home visits from them! I hadn't been able to see our doctor so the (paid for) consultant made the application. I hadn't heard of a fall clinic before then.
 
Mike Hughes said:
clivem2 said:
Once you damage a nerve it takes 6 weeks for it recover. Until it does you can’t do much to build your core strength…but I found physios ignored my pain which meant I was further damaging my nerves.
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Not been my experience at all. Indeed the very specific advice from both NHS physio and my private physio was that if I didn’t do the exercises they gave me to do in that period then the nerve damage would get worse precisely because my core strength continued to be lacking. NHS rehab. physio (the only sane part of the whole sorry process) narrowed that down to 2 specific exercises and they’ve stood me in good stead for a decade now albeit that I’ve had to move from as and when to daily in recent months allied to some new exercises to address related issues.
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As you mentioned elsewhere…common sense needs to prevail. In my case my sciatica was so bad I was struggling to walk and it was starting to hit both legs, which is getting to the point where they start thinking about an emergency op. My consultant/surgeon was emphatic, if my exercises result in or increase my sciatic pain I would end up on his table earlier than I’d otherwise need to. Yes build core strength but I mustn’t make my sciatica worse. The exercises I was given by the physio made my situation even worse. Fortunately she went on holiday so I changed physio, this new lady listened to what I had to say I. She found exercises for me that didn’t exacerbate the situation. When I get to the point where I have serious pain I find it doesn’t settle for 6 weeks and if I continue to crush that specific nerve it simply doesn’t improve. I have to select the correct exercises. I change the exercises according to twinges I experience. For a year now I’ve avoided what some call sciatic episodes. If I get a twinge I can work out how to ease this within minutes (usually). I walk 8 to 10 miles per day including walking our 50kg dog on a lead, I scramble up hills in the countryside and am pretty active. A year ago I needed a stick to walk.

Core strength is absolutely vital, I’m very into “listening to my body”, I’ve played a lot of sport in my life so I’ve developed an understanding about when something is good or bad for me. Sport won’t helped my body though…. I could rephrase what I said about exercising with nerve damage to “with continued nerve damage - exercising around it to do what you can to help build your core strength until you recover from the episode and can do a fuller set of exercises”.

Since the 2nd physio gave me a better set of exercises I also trawled the internet to find some more. These are not so much about core strength (already well covered), they are more about flexing my spine and opening up the gaps between the vertebrae to prevent my crushing nerves. There’s crushing the nerves between vertebrae and stenosis where there isn’t room for the nerve so it becomes crushed….then there are bone spurs and facet joint issues. Of course there’s also wear and tear on your discs along with a lack of lubrication as we age. Core strength is vital for holding everything in place, posture is critical too. I could write a book on this but it would only reflect my experience of my situation. What works for me won’t necessarily for others.

Some physios, osteopaths and chiropractors can use their experience to help people without seeing MRI scans but the more info they have can have will help them recommend the best way forward. Some doctors are very cautious about lower back exercise recommendations without having a good diagnosis of the causes, it’s too easy to make the situation worse when incorrect assumptions are made.

Apologies, I’m rambling now.
 
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Well, I went to my first of 6 weekly classes of lower back exercises. Two exercise coaches who were next to useless. Didn't know my condition and didn't ask any questions about it. No initial assessment. They only spoke when directly asked questions. Looked completely bored and disinterested. So it was basically just the use of an exercise room, plus an explanation of the exercises sent in an email. I'd rate it as 2/10 downhill with a following wind. Only 3 people turned up. One thing I discovered is that I'm extremely unfit, so feeling motivated to make some progress and do the exercises at home.
 
les24preludes said:
Well, I went to my first of 6 weekly classes of lower back exercises. Two exercise coaches who were next to useless. Didn't know my condition and didn't ask any questions about it. No initial assessment. They only spoke when directly asked questions. Looked completely bored and disinterested. So it was basically just the use of an exercise room, plus an explanation of the exercises sent in an email. I'd rate it as 2/10 downhill with a following wind. Only 3 people turned up. One thing I discovered is that I'm extremely unfit, so feeling motivated to make some progress and do the exercises at home.
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That all seems too familiar to me and mine were 1:1 sessions…

What happened to my fitness was I believe due to WFH during Covid, I wasn’t active enough even with 2 dog walks per day. I was WFH for decades before Covid but I was also travelling for work so more active. My core and especially my glutes became weak. Sitting in front of my screen all day was also bad.

Good luck with working out what works for you and managing your condition to the point where you aren’t in pain any more.
 
Mullardman said:
I cannot imagine how that must feel and you have my deepest sympathy.
In my experience, exercise, and especially walking, boost not only physical health, but also mental healt
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Mullardman said:
I cannot imagine how that must feel and you have my deepest sympathy.
In my experience, exercise, and especially walking, boost not only physical health, but also mental health and mood.
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Thank you, Mullardman.
 
Mike Hughes said:
I find this interesting. My D deficiency has never triggered back symptoms and when put to my GP and hospital specialists they both looked bewildered at the suggestion.
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Lower back only - every muscle and joint, both legs, from my lower back to my toes ached. Supposedly clasic symptom of vit. D deficiency is being unable to rise from a squatting position - I had to crawl to some furniture if none was near enough and even then struggled. I could only hoover if on my hands and knees as my back would not tolerate it.

After starting (mid Nov. 2023) to take vit D (6000IU/day), the aches disappeared within 2-3 weeks. However, I now struggle to walk because my legs are painful, but only when used (the aches were literally 24/7, uncomfortable, not painful).

Blood vit D two weeks ago was 130 nM/L.

Has 3 years (misdiagnosed) with very low vit. D caused some damage? I can find nothing absolutely categorical online.
 
Thanks @Vinny that’s genuinely interesting. I’m on Hux D3 20,000 unit capsules but my lower back pain etc. is totally associated with degeneration at L3 to L5 and I’ve not seen anyone online make that connection between D and back pain. I have pains elsewhere but consider them to be referred pain which usually indicates something bad is about to happen with my back (again) so I up my physio regime to avoid or minimise. This has been time consuming but also hugely successful.

Hard to imagine I had a D deficiency as I’ve walked 4 miles most days since lockdown but equally I cover up a lot because of my albinism. It occurred to me that may be related, which seems obvious, but the research in that area suggests not.
 
I retired a few months ago, but worked from home from April 2020.
I had sciatica in 2020 but walked a couple of miles every day, pretty much.
The sciatica cleared Christmas 2020 (no doubt the nerve "just" dropped back to where it should be - the same for both bouts of sciatica that I have had - I have been very fortunate), but left me with very mild aches, which were misdiagnosed and gradually worsened slightly. Unlike sciatica, the aches made walking extremely unattractive, so I didn't, and hence vit. D deficiency - vicious circle.
 
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