A&E needed

[givemeanother]

Please be kind as I'm feeling very tired and anxious.

Having seen the other thread about the falling off a horse and going to A&E, I have my own query.

2.5 weeks ago I woke in the middle of the night with extreme lower back pain that would not ease with painkillers. I thought I just needed to rest it but pain has not improved and stops me sleeping. 2 days before the pain started I was standing on top of a ladder lifting a heavy hedge trimmer over my head in a contorted position trying to trim tree branches that were providing resistance. As times gone on, I now wonder if that is the cause of all this.

I have since seen a GP who organised an xray which shows degeneration of lumbar facet joints, but I still get no relief from the pain in any position. Also saw a private physio who did some accupuncture that made it worse.

I'm feeling a bit lost as to whether there is a risk there is more damage not apparent on the xray and whether eg I should be in a brace or not. Kicking myself for not going to A&E when the pain first started.

Does anyone have any advice on where I should go for help. Could I go to A&E now and would they do a CT scan? The GP doesn't seem to know much about backs, eg has written for further advice on interpreting the xray and I'm terrified this is going to never improve or I'm risking worse damage.

Can you make an appointment with a chiropractor? If need be, privately. A chiropractor specifically deals with backs, so may better qualified.

DH was suffering badly with sciatica. He eventually saw a consultant privately who gave him an epidural plus 6 injections into his back.
He reckons the relief from pain was well worth the £600 it cost.

Previously he had a course of treatments from a chiropractor, which crippled him. Best avoid!

I'm not sure A and E would do a CT scan straight away. How much is it affecting your quality of life? Can you walk? Still work?

I would go back to your GP and explain that you are still in severe pain and ask to be referred to the hospital. Depending on the waiting time if you can afford it I would go private.

I can walk but am off work as I can't sit without being in pain, and can't think straight given lack of sleep/painkillers. Hurts to turn/bend etc so feeling very limited in what I can do and have kids/husband with his own health issues.

@TrickyD Did you'd husbands pain permanently improve or did the injections wear off?

Your lumbar joints have degenerated and the hedge trimming has probably set off an inflammatory reaction. It will likely pass but meanwhile the muscles are tensing and are becoming rigid and causing more pain.

I think you need a twice daily anti-inflammatory like naproxen, preferably taken with Omeprazole. Meanwhile find a good physio for massage and exercises to strengthen your core. You may need to consider long term management with regular pilates to keep the core strong.

I find the acute ohase lasts about 4 weeks and then begins to recede.

I am not medical in any way but have degenerated lower lumbar disks and two wedged vertebra arising from osteoporosis. Therefore have had to learn to manage my back. Luckily I do so with very little pain on a day to day basis but would not contemplate the activity you did recently.

I hope you feel better soon.

You have already been seen so I wouldn’t say it’s an A&E issue tbh. You do sound like you need to be seen again though as you are in too much pain to function. It should be go back to your GP but as it’s the weekend I would call 111 and get an out of hours appointment. That will probably be quicker than sitting in A&E on an uncomfortable chair

@givemeanother ps I wouldk suggest you find a really good physio, the ones who give four/six sessions on the NHS are, in my experience, ticking boxes. I learnt pilates with my physio's support. She runs classes that are mindful of individual injuries. I wouldn’t touch the pilates classes at the local leisure centre with a barge pole.

@SilkAndSparklesForParties thank you. It helps to have a positive story. Even knowing that it could be a few more weeks till pain starts to recede is something. Ibuprofen has done nothing, strong co-codamol slightly takes the edge off but I don't want to take that long term and not in the day.

Thanks also for the advice that this js probably a back to GP thing.

It took a few days to start to work, then I think whatever was injected sort of percolated gradually through to whatever was causing the pain. He keeps remarking on how different he feels since a year ago.
Obviously we hope the effect is permanent, but he would repeat if he felt it necessary and doc advised.

keeping moving is helpful, although difficult. I've relied on Youtube videos to do exercises that helped.

I did have a CT scan in A&E but had suspected cauda equina syndrome. I had 4 months of physiotherapy that started just under a week after my incident. I was in acute pain for 3 weeks, could only manage a few tiny steps. It was incredibly frightening. I walked up most of the Watkins path to Yr Wydda (Snowden) but the weather was too bad to get the top a few days ago. So recovery can happen but it takes work. I still do my exercises twice a day and it’s a year since my accident. I also took Pilates after my physio sessions ran out for about 3 months.

I spent a lot of time in a deep warm bath to help keep pressure off my back and did a lot of slow deep breathing. One possibly controversial thing I did was limit painkillers. I mean they are great but I wanted to truly feel what my body was capable of rather than push it if pain dulled too much. I did scoff them like candy for the first week.

Physio said to change position every 15 minutes. As soon as I could walk a bit more I did it.

I would see a good physio who specialises in backs. I have an ongoing back issue and have been given a set of exercises that I am supposed to do 3 x daily to strengthen the problem area. I forget when not in pain but as soon as I get a niggle I did then and it really helps.

This. Codine based painkillers won't help. You need major anti inflammatory relief. Ask GP for a short course of something like vimovo to get you moving. And then you need a decent physio to manage inflammation and build strength. And maybe also the injections.
I have similar issues and I do all of this to keep mobile.

@turkeyboots thank you. Do you get your injections via NHS or is it necessary to go private?

Ice pack for 15 minutes regularly was a game changer for me. Not sure if this will help you. Also if it's an option you could ask work for a standing desk. They're quite cheap these days and might help you return to work. Also you could pay private for an MRI if you want to know now what is going on.

Im not in the UK so my medical insurance covered it. But the treatment pathways should be similar, but slower and more painful with the NHS.