how to cope with long term back pain

[PavlovtheCat]

Over the last year i have 'put my back out' 4 times. I suspect it is disc related but not had it investigated due to a) lack of interest by gp and b) laziness in following it up - the first time it happened it was so so bad I had to call the out of hours gp unable to move at all for several days. Saw GP a few days later and was told poss disc, poss tendon damage, either way, no real treatment, get on with it type of thing oh and btw will take weeks to recover. thanks

So, next time it happened, over the weekend, i called ooh for painkiller/anti-imflammatories, and have done this each time. Been given a range of stuff, but what seems to work the best is codeine/paracetamol/diclofenac combination.

Anyway, two weeks ago or so, back went again during a coughing fit, improved after a few days with just co-codemol, then due to DH and DS bot being ill and us going on hols I had to do everything to get it all ready with DS on my hip and it went, again, fully, in the supermarket day before christmas eve.

Spent the last week in agony, emergency gp on boxing day gave me co-codemol and diclofenac, and it has slowly improved. However, it is not great, and every twist and turn and any lifting makes it feel that it will go again majorly at any moment. GP was going to give me some diazepam but I was reluctant as DH was away at footie so had kids on my own.

Sitting it the worst, cannot get into a comfortable position. This is not going to go away any time soon and I know I should see GP, will do that next week, but can't see they will do anything to help me sort it and I don't want to be on medication forever. It am also expecting this to now be re-occuring.

So, how do you manage your long term back problems? when it is at its worst and walking is impossible, do you use crutches? I was thinking this might help, as last week I just simple could not walk.

thanks everyone re tips and advice, there are some really good ones here and I will try as many of them as possible, including getting referral to MRI scan and oesteo if poss. I will also try hot/cold alternate, have heard that from several people so will give that a go for sure.

re pain relief - codeine is ok for me, as long as I eat first (or else I go sweaty and feel sick) but I am no good with tramodol. DH had some for tooth pain, which i took when pain first became unbearable and before talking to gp about pain releif. I only took one at a time as it is so strong and it makes me feel too out of it. I have to either look after the children or work where I have to be mentally alert so do not want something that wipes me out. But maybe it could be good to help sleeping at night. Do you get 'hungover' the next day? I am not the best at taking any drugs which changes how I function, would be nice to have the pain releif without the side effects!

I will do my best to not lift, but that is almost impossible with children! DS himself is quite clingy and enjoys a cuddle, he also likes jumping over me which can be quite painful.

Right now, I have taken diclofenac and co-codemol which has eased the pain and I can get around relatively easy but I am sooooo aware that it could change at any moment if I do something to put it out, like cough. And the house is a mess after our hols, DH is working til midnight and i really need to get on top of it. Had big plans for new year being nice and tidy and clean...

and sorry to hear of all you who experience this regularly (or ever) too, it really is truly horrible.

Re Tramadol. I suspect everybody reacts differently to it. I had to work whilst taking this drug and found that I could without it making me drowsy or 'out of it'. It enabled me to keep working - although when I had to travel I used a wheelchair. The alternative was such acute pain it made me even more out of it! And trying to stay working was really important in that it made me feel like there was light at the end of the tunnel. I did however lose my appetite whilst on this drug which wasn't good - although I didn't put on any weight despite being immobile which was a small bonus.

The alternating hot and cold works I think because it encourages tissue healing. Sitting in a hot bath can make things much worse for people as it adds to the inflammation. Anyhow - there is so much phoney science around I won't add to it by trying to explain why it works - but it did!
I also bought a new mattress as my old one was a bit saggy - and I bought a back roll to put in the curve of my back when I was seated. Although sitting was immensely painful I spent most of the time (when at home!) lyaing on the floor with my legs across a footrest. I religiously did the pilates exercises recommended by the osteopath.
PS Dont worry about the big plans for the house - tidiness and all that....just concentrate on getting better and keeping happy x

re work. I agree the need to keep this going. it is not a physically very demanding job. I have to get up and down from my chair a lot and walk between floors regularly, but we have a lift and I am sure if I needed to I could have my desk changed to one nearer the lift if that helped. I don't need to do any lifting of heavy stuff (other than paper for copier and I could easily get a colleague to do that for me). I do spend a lot of time sat in front of the computer, and have not had a risk assessment since I last did my back in, my own fault really as although they knew about it, the first time it happened i was already off sick due to having an operation on my nose so it all got hidden amongst that I think. I will talk them about reviewing this with H&S officer, can get a chair with support if required. If I did not work for any length of time I would go absolutely crazy!

Pavlov, please do not let the GP fob you off with 'back pain happens to some people'. Similar happened to me. My back would just 'go' every 3-4 months. I would be in agony.

In the end I saw another GP in the practice who suggested a MRI scan. Found out I had 3 slipped discs. Had physio which really helped, and have been ok back wise for about 11 months (fingers crossed).

Hoping you can get some answers soon. And you keep the pain under control.

Hi, can I please just echo the above? Particularly deemented, I too spent years being fobbed off and now have permanent sciatic nerve damage. For years and years, no exaggeration, I saw different consultants, had scans and was told I was too young for surgery.

I finally saw someone who I felt I could trust eighteen months ago and he said its too late for surgery, damage is too far gone, and I have to live with it.

So now I am waiting for the pain management people (and have been since I saw the last consultant!).

I am 35. Don't wait. Oh and find a good osteopath, I would marry mine if I could!

I had lower back pain for 15 years, it was McTimoney Chiropractic that cured it. I'd also second the advice regarding Pilates. Good luck, its vile when you are in so much pain, but there are loads of things to try.

hey all, back much much better today, I can move around relatively freely (but cautiously). Now there is a nagging dull pain at the base of my spine, feels much like mild contraction pain ifkwim but not as painful as full ones and is there constantly. I guess this is due to it recovering so I will just wait it out.

Should I continue taking diclofenac for the swelling now I can move about ok, i am just taking some paracetamol now for pain, but for the fact it is still painful to sit, should I continue with the anti-imf meds?

I was always told that you should keep on the anti-inflammatory drugs as it is clearly working....but as I'm not a doctor - am reluctant to say anything that would be best coming from a medic.
So glad you are having a better day though thats great.
Definitely get a scan - everyone on this post agrees with that!

I think you should, I find it really helps me with the swelling & infamation. Also using cold pack on the sciatic area, even a bag of frozen peas will do.
If you have trouble getting out of bed, try tying a rope or anything long, even scarves knotted together, on your bed foot board (if you have one) to pull yourself up with.
Sitting is usually bad for sciatica, the nerves are being pressed on if you sit, that can irritate them... better to lay down when you are able, and get up every once in a while to keep from stiffing up.

I am seeing go tomorrow. Do you think if I get no success with MRI scan referral on this appt that OH from a work would be able to add pressure for it? I am expecting a battle with gp and will need to go back lots before something is done to start looking at causes and treatment, if my employer thinks it is going to affect my work maybe they have some weight to push for investigation if they can demonstrate it is life affecting...

Oh dear. I've just done some googling and there really isn't any evidence in favour of MRI scans in lower back pain - it's mainly for reassurance, which doesn't cut much mustard these days. the fact is that most people when scanned will have bulging discs, degeneration etc, even when they don't have back pain - so there isn't much link to be found between level of back pain, what works in treatment, and what you find on an MRI. B*gger.

I think asking the GP to refer you to spinal orthopaedics is still well worth it, esp if they have specialist physios; also the work assessment would be a good idea. TBH the more walking and daily exercise dh does the better his back is, so getting some physio support on best exercises/pilates etc is going to be useful.

Sorry to contradict my earlier post.

i have done googling too...and i dont like it very much! it mostly says treatment is pain management, through exercises and posterial changes etc, rather than a 'cure'. so, it seems it may well be a complete lifestyle change, and as I put DS down in his cot to bed, i wondered how on earth that will be possible!

back pain almost gone, apart from numb/swollen feeling/pressure in the base of my spine (feels a bit like i need to go to the loo, if you get me) but sciatic pain is still there, although nowhere near as bad. It comes and goes in severity, worse if sitting, better if lying on back, but not on front (as I found out and struggled to get up as back seized!).

I have taken my meds today though. would be interesting to leave them off for a day and see if it hurts more. not that I am a sadist, but worth seeing if pain is manageable without drugs.

re MRI scan. I have read mixed reports about the level of success, there is one called an MRN scan which is less successful and seems to be when all else has been tried. We shall see what the gp says. I will let him have his say and once he has fobbed me off I shall direct him with where I want to go. But he might surprise me. He has done before when I was sick with hyperemesis with DS, i expected him to say 'drink and eat little and often, get on with it' and instead he wanted me to be admitted into hosp (i refused) and gave me a month of work! so he is not completely without understanding of how life can be affected by things (but, also his wife is a midwife, so he might have more of an idea about that kind of stuff).

I am looking into pilates. Have been talking to a friend who suffers from neck problems and her back specialist has given her exercises which seem very much like pilates, so we are going to go together. Should I wait til I have spoken to a specialist first before going? would there be exercises I should avoid in a class if say for example there is a disc issue? i would not want to make it worse!!!

"treatment is pain management, through exercises and posterial changes etc, rather than a 'cure'"

Yes that is what I found. Although a session of acupuncture got me through the very acute phase by relaxing the 'spasm' when I initially injured my back it was only many years later where the instructor at the gym I mentioned asked me to stand sideways and she took a look at my posture I really got it sorted. She said because of the back pain I had suffered in the past that I had subconciously been walking slightly hunched over and with my knees slightly bent and my hamstrings had become shortened. I was making my condition worse by subconciously trying to walk around bent over all day long.

To prove it, she told me to lay on my back on the floor and point the soles of my feet at the ceiling with my legs dead straight and at a 90 degree angle to my back.

Wow! Just Wow! I could actually feel the tension in my lower back around my pelvis and the back of my legs. I could not get my legs to a 90 degree angle at all. She then gave me a series of very gentle stretching and strengthening excercises which really worked and the back pain still comes on now and then but nothing like in the past.

I had tried pilates but it was too severe. The Pilates instructor there though had noticed I was physically unable to stand with my heels, bum and shoulder blades against a wall but she did not know why or what to recommend.

I said earlier on that posture is the key - it's all very well doing exercises, but it's a rare instructor who'll look properly at your form and tell you how it should be done - and especially how good posture should feel.

Hanging the head forward, letting the shoulders slump, swaying the back, thrusting out the pelvis, curling the lower back, bending from the waist instead of folding from the hip. I'll stop there, but you get the drift.

If I could go back 16 years to when this all started for me those are the things I'd tell myself to address. No scans or doctors can fix it for you.

Does anyone have anything specific on exercises? MoreBeta - are you able to let me know what those very gentle stretching and strengthening exercise are and how often you do them?

I've had three slipped discs, two in back, operated on, one in neck that I am "living with". Neck is the least problematic and I really really need to strengthen my core. I have taken professional advice but unfortunately every time I start the (very basic) exercises I am given, I end up barely able to walk. My muscles are just screwed and do not respond at all well to every very very gentle exercise. So I end up doing nothing at all, as I can cope (just) when I do nothing.

Which I know is ridiculous??!! Then I reach for the Voltarol.... vicious circle I really want to get out of.

Pilates is too much for me too, I really need to go back to the very very basics, but so far I've not found the right basics to get me on track for this.

TIA.

So, I have just been to the gp! that was an interesting conversation. He appeared reluctant to refer, but also guilty that he was reluctant to refer, gae me the impression he thought it was probably the best thing to do but was unable/unwilling for some reason - probably targets? !

Anyway, he said, along the lines of this

'it probably not as serious as something to do with herniated disc, because you have not lifted anything heavy enough/had an injury and that is the usual cause. Although you have lifted your 2yo son, he should not be heavy enough to herniate a disc. So it seems that you have ripped a ligament. Although it has happened 4 times now...that probably means you have a weakness there...but...you have sciatic pain. And sciatic pain usually means a herniated disc. So it could be a disc problem after all. But...i am cautious about referring to have a scan etc (I had not mentioned this so far), because I would like to see if it sorts itself out, which it will do if it is a ligament problem. But, it has happened 4 times, so that indicates that maybe I should refer. But...if I refer, and it shows a disc problem, there is not much that can be done, other than surgery, and I don't want you to go down that route just yet as it might heal itself. But...at least if you have a scan we can find out what is wrong, but will that help?

I will try to refer. they don't normally like direct referrals from a gp at the hospital, but I will give it a go. yes, that it what I will do. But I am not sure if they will accept it'

me: so how will they accept a referral if not from you?

'from the back pain clinic, who will also give you some better treatment like physio, acupuncture etc, i will refer to you them next week if no improvement, ok? but give it a week because I want to see if it heals on its own. it might not be a disc problem, so...call me on monday or tuesday if you are still suffering from back or sciatic pain, don't need to come all the way in, just telephone and I will refer to pain clinic. and here is a sick note for this week, if you need this extended, just call me and I will write it up for you'

gave me more painkillers/anti-imflamatories, told me most important thing was to manage the pain itself.

So the upshot is, he does seem to think it is a herniated disc, is reluctant to acknowledge this, as it means he has to refer for treatment he seems reluctant to let me access. He was so fobbing me off and not good at it.

As I left, he opened the door to me and said that I should make sure I called him next week if no improvement...?!

I just don't get why he won't refer now? it is going to be ages before I get n appt anyway, so the sooner it gets started the better eh?

and the funny thing is, all the possible treatment options he suggested were from him, not me asking, so it is not like I said 'can I have a scan?' and he said 'no because xyz' he came up with possible cause/treatment and then dismissed it!

He did however give me some very basic back pain information which he printed off the internet! I did not have the heart to tell him I already knew more about what could be causing it and what I could do about it that those 4 sheets had given me

Anonymous - I worked with someone else at the gym who had been properly trained in back injury and core strengthening.

I am reluctant to just say 'do what I did' as you have quite a serious injury. You need to find a person who can work with you to give you advice and motivation.

However, they key to everything I did/do is small gentle movements and allways laid down. One big thing I learned is to strengthen my abdominal/stomach muscles to stabilise my back. One simple and very gentle excercise I can do while watching TV is as follows.

Lay on my back with feet on the floor about 20 cm apart and my knees bent up so my heels are about 40 cm from my bum. Nice and relaxed.

Then I put the palms of my hands on my thighs and slowly slide them up my legs so they are on top of my knees and my shoulders are about 10 cm off the floor. Hold for 3 seconds and slowly slide back down again. Repeat 10 times. Relax for 30 seconds and then do another 10 repetitions.

It really excercises the stomach/abdomen but puts no strain on the lower back as it is always firmly pinned on the floor. Only my shoulders are rising and only 10 cm and only very slowly. It really gets the abs working though What it is not is an old fashioned sit-up which is just about the worst excercise you can do as it strains the small of the back.

mrsmibawber thanks for tip on pilates. I will give this a try once I am more mobile.

I am not convinced he will do the scan. He said he would but I think he said that to get me away from the place without moaning too much! He did not seem keen, even though he was the one who mentioned it! I would not want surgery on my spine unless it was absolutely the only and last option available. I intend to manage this conservatively if possible, whatever is going on, but agree we need to know what is actually going on. Doc seems to think it was best not to know as nothing can be done either way .

How awful that you have experienced such back problems yourself, but glad to hear pilates has helped.

He did ask how old DS was when my back first went like this, he was 10 months old and so he said 'your muscles should have recovered from pg by then' but thinking about it, I wonder if that might have been partly why it happened?

Also. I am worried that by the time I see the back pain specialist, the back pain will have subsided, as it always does eventually, for a period of time, and be told all is ok. I wish they could have seen it last week, done a scan last week - what if it is a disc and it pops back into place so the scan shows nothing.

Has anyone gone straight to A&E with severe back pain? If this happened this severely again, if I went straight to A&E would they just manage pain in the same way as gp did, or would they do MRI etc?

MoreBeta - thanks. I entirely agree that everyone needs their own "programme" as it were but I like the sound of your gentle lifts, that feels like the kind of thing I need to try.

Is there a good Pilates DVD out there does anyone know? I know there is nothing like a real person talking you through it and guiding you, but I am flat skint this month and cannot afford classes or instruction just yet and want to make a start somehow.....

And I am with MrsM, it requires no great trauma at all! I was putting on my shoe when I slipped my disc, first time around....

I DID have surgery, as I actually could not stand (no feeling in my right leg at all so I kept falling over and the pain was just unbelievable). The disc had prolapsed so far round the vertebrae there was, basically, no way back in order to regain feeling in my right leg. The MRI made me feel physically ill when I saw where the disc had gone.

However, having lived with a reasonably stable slipped disc in my neck for nearly 4 years, I can agree that surgery is not always the best option. Although it was very painful for some time, it gradually subsided. I have that under control and apart from a couple of times a year it when it has a bit of a fit on me, it causes me little problems now. Unfortunately, I cannot advise any particular regime that helped that one, it just seems to have stabilised and mostly stayed that way.

Its the damned back that is such a pain in the whatsit!

Pav, Do you want me to pop over and take a look? Tomorrow?