Lower back pain

[myst]

Posted this as a reply to another thread, but probably better served as it's own.

I've been experiencing lower back issues for around a year now, and it's taking me ages to get on top of, with lacklustre results. I'm hoping some experienced people in here can offer some advice.

The pain I have is in the region of the multifidus

I can generally squat and deadlift small amounts of weight, but when the load gets heavier, say around 60kg or more, I get direct pressure right in that spot, which can radiate down into my glutes. This will inflame that muscle and cause soreness and loss of mobility for a few days afterwards.

I've tried a lot of trigger point therapy both myself and an Osteopath with dry point needling. My glutes had trigger points everywhere, and I've mostly gotten rid of all of those by rolling on a hockey ball. My upper and middle back also had a lot of trigger points which I believe I've mostly taken care of.

I've incorporated a lot of core work into my routine, but that hasn't made any difference to the pain.

I do sit down all day, and get very tight hamstrings and hip flexors. I try to stretch a lot before a workout, but nothing has seemed to work.

The pain is predominantly on the left, but sometimes goes to the right side, and on bad days it can be on both.

Thanks in advance.

 

[judgey]

Posted this as a reply to another thread, but probably better served as it's own.

I've been experiencing lower back issues for around a year now, and it's taking me ages to get on top of, with lacklustre results. I'm hoping some experienced people in here can offer some advice.

The pain I have is in the region of the multifidus

I can generally squat and deadlift small amounts of weight, but when the load gets heavier, say around 60kg or more, I get direct pressure right in that spot, which can radiate down into my glutes. This will inflame that muscle and cause soreness and loss of mobility for a few days afterwards.

I've tried a lot of trigger point therapy both myself and an Osteopath with dry point needling. My glutes had trigger points everywhere, and I've mostly gotten rid of all of those by rolling on a hockey ball. My upper and middle back also had a lot of trigger points which I believe I've mostly taken care of.

I've incorporated a lot of core work into my routine, but that hasn't made any difference to the pain.

I do sit down all day, and get very tight hamstrings and hip flexors. I try to stretch a lot before a workout, but nothing has seemed to work.

The pain is predominantly on the left, but sometimes goes to the right side, and on bad days it can be on both.

Thanks in advance.

Sorry I can't help out more than this - but don't stretch beforehand.

 

[Goosey]

Judgy is right, stretching before exercise is counter productive.

You need to strengthen this area, and you need to do some research in regards to finding an exercise that isolates the area to enable the muscle to be stimulated to grow.

An exercise that loads the muscle through full range without placing unnecessary load on the spine.

 

[Bazza20]

Trigger point stuff never did anything at all for me.

Deadlifts and back raises fixed my back. Might not help you but it worked for me.

 

[Mickydoo]

I live on Tiger Balm, my back is always giving me some sort of shit, I find too, after deadlifts and/or squats to do a couple of planks, I love the stretch in my back, same as swiss ball rolls, I do them now again for the back stretch, can almost feel my joints going ahhhh.

 

[Brick]

I get direct pressure right in that spot, which can radiate down into my glutes. This will inflame that muscle and cause soreness and loss of mobility for a few days afterwards.

Mate I'm not a doctor but radiating pain from a back injury is a bad sign, I'd consult a Dr if you haven't already.

 

[Goosey]

Mate I'm not a doctor but radiating pain from a back injury is a bad sign, I'd consult a Dr if you haven't already.

Yes!
I missed this, good pick-up.

Indicates ruptured IVD's

 

[March83]

Mate I'm not a doctor but radiating pain from a back injury is a bad sign, I'd consult a Dr if you haven't already.

exactly this. radiating pain means nerves are involved. I have had nerve issues in the past that were caused by muscle tightness (overuse from cycling) and were relieved by physio work, but it could also mean disk degeneration (such as a bulge).

I was in a similar position about 12 months and didn't handle it correctly, now i'm booked in for spinal surgery in 2 weeks. my suggestion would be to get to a physio (preferably a musco-skeletal specialist) and tell them where you are. they should know what to check for to see if it's nerve related. if it is, don't baulk at shelling out $3-400 for an MRI so you know where you stand.

out of interest, when you sit in a chair, can you raise the leg on the affected side to the horizontal? can you then point your foot and toes back towards your body? does that cause any pain in the lower back? alternatively, you could try this Straight leg raise - Wikipedia, the free encyclopedia as a means to self-diagnose...

 

[Brick]

exactly this. radiating pain means nerves are involved. I have had nerve issues in the past that were caused by muscle tightness (overuse from cycling) and were relieved by physio work, but it could also mean disk degeneration (such as a bulge).

I was in a similar position about 12 months and didn't handle it correctly, now i'm booked in for spinal surgery in 2 weeks. my suggestion would be to get to a physio (preferably a musco-skeletal specialist) and tell them where you are. they should know what to check for to see if it's nerve related. if it is, don't baulk at shelling out $3-400 for an MRI so you know where you stand.

out of interest, when you sit in a chair, can you raise the leg on the affected side to the horizontal? can you then point your foot and toes back towards your body? does that cause any pain in the lower back? alternatively, you could try this Straight leg raise - Wikipedia, the free encyclopedia as a means to self-diagnose...

I'd be getting an MRI, but i reckon anyone who's had a chronic back injury would say the same thing, fuck physios and all the other shit, just shell out the couple hundred bucks and know whats going on.

What surgery are you getting discectomy?

 

[miicah]

A CT scan will show any disc injuries as well; I had to have one when I had a herniated L4/5

 

[March83]

laminoscopy which is a key-hole laminotomy:
http://en.wikipedia.org/wiki/Laminotomy
tldr: drill through the vertabrae and scrape away bone from the S1 nerve root tunnel to relieve the pressure.

i have an 8.5mm bulge at L5-S1 and it's nailing the shit out of the s1 nerve root - direct hit so i'm a perfect candidate for a laminectomy. currently putting up with sciatica, pain, chills, a limp and some loss of strength and co-ordination in my left leg.

going under the knife 2 weeks from monday, should be back on my feet the same day and out of hospital by day 2. work has been awesome about it and they basically said "come back after easter and see how you feel" so i have a solid month to do my rehab properly and get it sorted. Haven't made my post-op physio appointments, but i have a particular musco-skeletal physio in mind to help me with an ongoing training plan to avoid/reduce further disc degeneration.

mine was not directly attributable to anything in particular, but at the time i was lifting, cycling, playing soccer, running and spending a lot of time at work sitting down :\ until the middle of last year, my squat form left a lot to be desired (i spent about a year squatting 100kg+ with pretty nasty butt-wink without realising it - fixed this prior to the injury) so if i had to put money on a lead contributor, that would be it, but there was never a specific incident that caused pain...

 

[Brick]

laminoscopy which is a key-hole laminectomy:
Laminectomy - Wikipedia, the free encyclopedia
tldr: drill through the vertabrae and scrape away bone from the S1 nerve root tunnel to relieve the pressure.

i have an 8.5mm bulge at L5-S1 and it's nailing the shit out of the s1 nerve root - direct hit so i'm a perfect candidate for a laminectomy. currently putting up with sciatica, pain, chills, a limp and some loss of strength and co-ordination in my left leg.

going under the knife 2 weeks from monday, should be back on my feet the same day and out of hospital by day 2. work has been awesome about it and they basically said "come back after easter and see how you feel" so i have a solid month to do my rehab properly and get it sorted. Haven't made my post-op physio appointments, but i have a particular musco-skeletal physio in mind to help me with an ongoing training plan to avoid/reduce further disc degeneration.

mine was not directly attributable to anything in particular, but at the time i was lifting, cycling, playing soccer, running and spending a lot of time at work sitting down :\ until the middle of last year, my squat form left a lot to be desired (i spent about a year squatting 100kg+ with pretty nasty butt-wink without realising it - fixed this prior to the injury) so if i had to put money on a lead contributor, that would be it, but there was never a specific incident that caused pain...

Good luck mate never heard of that procedure, sounds sweet. Nearly everyone I know who has had a discectomy has had them fail again down the track.

I'll get a fusion or prosthetic for my 4/5 & 5/s1 eventually just putting it off for as long as I can.

 

[March83]

laminotomy: since they're removing bone-mass from the vertebrae there is some loss of integrity, but it's supposed to be minimal and manageable. ongoing physio and maintenance work is unchanged - i have to do the same shit to prevent disc degeneration as i do to protect the compromised vertebrae, so whatever...

discectomy: yeah, understandable - there's been a lot of development in the last 5-10 years so the longer you wait, the better the technique should be.

a mate of mine had his 2nd discectomy about 2 years ago - this one has been fine, but the first one resulted in a full herniation within about 12 months.

how restricted are you, training and activity wise? at this point, if i'm able to get back to riding my bike and squatting moderately (~100kg) i'll be happy.

 

[Brick]

laminotomy: since they're removing bone-mass from the vertebrae there is some loss of integrity, but it's supposed to be minimal and manageable. ongoing physio and maintenance work is unchanged - i have to do the same shit to prevent disc degeneration as i do to protect the compromised vertebrae, so whatever...

discectomy: yeah, understandable - there's been a lot of development in the last 5-10 years so the longer you wait, the better the technique should be.

a mate of mine had his 2nd discectomy about 2 years ago - this one has been fine, but the first one resulted in a full herniation within about 12 months.

how restricted are you, training and activity wise? at this point, if i'm able to get back to riding my bike and squatting moderately (~100kg) i'll be happy.

Right now I'm fine but twist the wrong way or sneeze at the wrong time and BAM suddenly I'm laid up for a fortnight and fragile for months. I still lift heavy but there are times I can't deadlift and my squat form took ALOT of trial and error to get right for me.

I pretty much changed everything, gave up manual labour, lost a fair bit of weight all that shit. Took years to build up squat and dead but now I credit them for making my back heaps better.

 

[Hooroo]

I have a bulging disk l5-s1 and I recently discovered doing slow controlled seated good mornings really eased the pain before and after squats. I still can't pull through my glutes to lock out a deadlift but it reduced my pain.

Good luck mate

 

[myst]

Some excellent suggestions in here everyone, thanks!

My osteo gave me a referal for an MRI, cost has been the big factor unfortunately. If I avoid squatting and deadlifting then my back is generally fine, but being an ex powerlifter I would like to get into it again!

exactly this. radiating pain means nerves are involved. I have had nerve issues in the past that were caused by muscle tightness (overuse from cycling) and were relieved by physio work, but it could also mean disk degeneration (such as a bulge).

I was in a similar position about 12 months and didn't handle it correctly, now i'm booked in for spinal surgery in 2 weeks. my suggestion would be to get to a physio (preferably a musco-skeletal specialist) and tell them where you are. they should know what to check for to see if it's nerve related. if it is, don't baulk at shelling out $3-400 for an MRI so you know where you stand.

out of interest, when you sit in a chair, can you raise the leg on the affected side to the horizontal? can you then point your foot and toes back towards your body? does that cause any pain in the lower back? alternatively, you could try this Straight leg raise - Wikipedia, the free encyclopedia as a means to self-diagnose...

I can do both of those variations without any problems. Right now sitting here my lower back is just very stiff. I managed to do 3 x 8 x 100kg on deadlifts today after some lower back stretches and hamstring stretches.

But as everyone says, I need to just suck it up and get the MRI done and see what's really going on.

 

[trofius]

get it diagnosed properly, get it fixed, give up on heavy deadlifts or squats,

once its broke it cant be fixed, just managed, and pain releived.

i have learnt my lesson the hard way...

 

[bams_101]

I've incorporated a lot of core work into my routine, but that hasn't made any difference to the pain.

I do sit down all day, and get very tight hamstrings and hip flexors. I try to stretch a lot before a workout, but nothing has seemed to work.

Sorry for all the Q's in advance.

**Ok, while you're waiting to get your MRI could you explain what you've done specifically for core work?

**Also what are you stretching?

I ask because you generally won't have tight hamstrings AND hip flexors. Usually one will be tight and will be over stretched (depending on pelvic tilt). There are tests that can be done to determine which is which.

Pain radiating from the lower back does not necessarily indicate ruptured disc's. I've had a similar experiences and one was facet joint related. It also helps to know what movement/s cause pain...

**Lumbar Flexion - rounding of the lower back like a hitched deadlift?

**Lumbar Extension/Hyperextension - arching the lower back like the top of a back extension?

**Lateral Flexion - sideways bending of the spine?

**Compression/axial loading - When there is excess weight on your back causing pain?

If you can identify these things we can sort out what to stay away from.

 

[Bazza20]

Sorry for all the Q's in advance.

**Ok, while you're waiting to get your MRI could you explain what you've done specifically for core work?

**Also what are you stretching?

I ask because you generally won't have tight hamstrings AND hip flexors. Usually one will be tight and will be over stretched (depending on pelvic tilt). There are tests that can be done to determine which is which.

Pain radiating from the lower back does not necessarily indicate ruptured disc's. I've had a similar experiences and one was facet joint related. It also helps to know what movement/s cause pain...

**Lumbar Flexion - rounding of the lower back like a hitched deadlift?

**Lumbar Extension/Hyperextension - arching the lower back like the top of a back extension?

**Lateral Flexion - sideways bending of the spine?

**Compression/axial loading - When there is excess weight on your back causing pain?

If you can identify these things we can sort out what to stay away from.

All that sounds familiar. Been reading one of Mcgills back books??

 

[GUZZLA]

The longer you leave disc injuries resulting in nerve damage, the less chance you have of making a full recovery. The notion of putting up with it for as long as possible is stupid and doing you no favours at all.

Nerve pain, specifically sciatica pain, is a result of the sciatic nerve essentially being impinged, typically through spinal disc compression. Such impingements can also slow or stop blood supply through the nerve. Over time, without rectification, an impinged nerve begins to die from lack of blood flow, and with it, all the muscles in the leg begin to waste. For those that do seek treatment in time, the nerve typically regenerates at a rate of 25mm a month. If you don't seek treatment in time, the nerve may only partially recover or not at all, and then life becomes very fucked up and painful for you. As a guide, it was almost a year before I had my surgery and it took another 18months for all leg pain to disappear. Even in that short period of time, some aren't that lucky.

Remember, the sciatic nerves are the two nerves that branch off from the base of the spinal cord down each leg. It is the information highway to the lower body, supplying information about movements to the leg, and sends information about sensations back to the brain. If it's compromised in any way, everything else is affected. Numbness and tingling in the buttocks and leg are signs the nerve is severely impinged. Not being able to urinate means you require surgery ASAP. After a period of time, muscle wasting occurs since the impinged nerve is unable to send the required signals to the muscles to activate properly. Left long enough, the damage sustained can be beyond the realms of surgery and there are many who live a life of constant pain because they chose to not seek treatment soon enough.

Additionally, sitting puts significantly more load on the spine than standing does. Also, tight hamstrings is almost always associated with lower back pain. If your job entails large portions of sitting, I strongly suggest you implement a regular back and hamstring stretching and exercise program. You might laugh now but if you don't, there's a fair chance you won't be laughing later.

And as a word of caution, physical strength is no indication of back health. Yes, weight training has proven benefits for bone strength, but it is certainly no cure for those of us genetically disposed to degenerative diseases -something excessively heavy weight lifting expedites. Unfortunately, for most of us, such knowledge only follows an MRI report explaining why you can hardly stand up, or even take a piss.