Back Again! Back Pain Support Thread

[PavlovtheCat]

Only right I start the new one seeing as I was responsible for the last one ending so abruptly !

This is a support thread for people with back pain (that does not even cover the description of hell that back pain causes). It's for all types of back pain, for long term posters with chronic pain (including those on the upwards journey to recover), short term advice through tough acute episodes and all the in betweens.

We moan, winge, share successes, guide each other and hand hold through the maize of a million medical routes and options, treatments, investigations. We internet shop as a form of pain relief, drink wine, take strong painkillers, eat cake and we go through lots of heat packs!

We don't always have the answers but we do have a lot to say about it all

Here are the links to our previous threads:

www.mumsnet.com/Talk/general_health/1871592-The-Back-Story
www.mumsnet.com/Talk/general_health/1992406-The-Back-Story-Continues
www.mumsnet.com/Talk/general_health/2023274-More-Terrible-Back-Stories

Hey just came across this thread.
Iv had mild bouts of upper and lower back pain for a few year now but nothing serious. However 10days ago something happened in my lower left back, I haven't got a clue as to what I done ,it just started hurting. It's not as bad as it was in the first few days but I actually ended up at the walk in centre where they found blood in my urine , this got tested at the hospital and came back ok so my back being related to my kidneys is not likely.
So I'm left doped up on a range of painkillers and nothing is helping .
I work full time as a support worker for adults with physical and learning disabilities, and there is a lot of moving and handling involved in my job I am due to do a 48 hour week and I an dreading it because there isn't really any light duties I could be doing.
Just going to have to grin and bear it

sorry to hear that Pav - yes the Cobra and lots of other yoga moves are very painful/wrong to do with certain back pain. Bottom line is listen to your instinct I think, rather than experts with a 'one size fits all' approach.

Zassabeans, be careful. If you do some heavy lifting and put yourself out for months you'll regret it . Everyone is allowed to be ill! If you feel any pain stop immediately. I wish I had heeded my own words a few months ago when I decided that trying to heave a mattress outside was a good idea - the next day I couldn't even lift a coffee mug.

I was off sick 1 day last week and can't really afford anymore sick days

Hello

I'm still reeling from a recent diagnosis and looking for others, perhaps even those further down the line who can offer reassurance, please!

My last baby was born feb 12 and I suffered with what I was told was PGP in both pregnancies. I felt reasonably ok between pregnancies, which was only 12 months, but after the second I've been in constant pain, constantly needing cocodamol and constantly trying pretty much everything to relieve it - GPs, NHS physio, Pilates in the physio department, private physios, osteopaths, acupuncture, massage....

When my private physio - women's specialist recommended by the Pelvic Partnership - went on leave I went back to the GP to hand myself and my care back into their hands. I hadn't improved much and at that point the spasms were crippling. Crying and desperate the GP was unsympathetic, claimed to have had the same problem post pregnancy and I don't need an MRI because I don't need surgery. I suggested the pain clinic as the last chance saloon, or rather giving up on a cure and accepting I would have to manage the pain and immobility instead.

I did have some surprising success with an osteopath and the spasms finally abated three months after starting.

Went to the pain clinic in tears - dreading being offered a pain management course. Instead I got some gabapentin, an MRI referral and a suspected diagnosis of a herniated disc. Not sure if anyone knows about the single leg raise test - this was positive for a lower back herniated disc and I'd pointed out this immobility on my right side to several physios so annoyed it wasn't diagnosed a year earlier. I don't have shooting pains as I know sciatica to be (had suspected herniation at 16 yr old diagnosed and fixed by physio), this is muscle tightness in the legs and back instead.

MRI confirmed a really large disc herniation, so bad the radiologist told me immediately instead of the usual rule of waiting for the follow up app. The pain dr re confirmed this and I'm awaiting an app with a neurosurgeon. Both made sure to warn me about the signs of cauda equina syndrome and the need to rush back if that happens. So far I'm ok and I'm trying to adapt to being more careful while a SAHM with a 4 and 2 yr old. I already have some bladder symptoms -retention- which I'd put down to having bad urine infections in the past and then before that to a tight pelvic floor. The NHS physio ignored this symptom and claimed I had a weak pelvic floor because that's what pregnancy does and I was just lazy and needed to do core strength and pelvic floor exercises.

So I'm waiting for the referral which is urgent, fighting the GP for pain relief and feeling very alone and scared about the prospect of surgery without much support nearby. I'm in west London with the GP in SW London sort of, and no clue where the referral will be sent.

If anyone has advice on good pain relief please send recommendations - GP app on Tuesday am and I thinking I'm having jaw pain from the gabapentin, cocodamol isn't effective anymore and tramadol did nothing so I'm withdrawing from that now and I stopped the amiltripiline because I couldn't get out of bed in the morning :S

Thanks!

I have AS and have been on sulfasalazine and hydroxychloroquine for the past 8 years.

It is really important that anyone who suspects that back pain could be caused by AS avoids any type of manipulation by an osteopath, chiropractor and massage until they have been diagnosed. The reason for this is that AS can make your spine more prone to fractures. I don't want to scare anyone or cause unnecessary alarm but some treatments and exercises cause more harm than good.

Hi all zazza is your pain about 2 or 3 inches to the side of your spine. I had this and I think it may be caused by an inflamed facet joint. I could actually feel a lump there when it was bad. Also I had sciatica, where it goes down the leg. like you I was reluctant to take time off work, but it really is worth it if you can avoid a worse problem. I ended up taking 6 weeks off after it got worse. So do all you can to avoid it worsening.

queenc sorry to hear what a terrible time you have had. About painkillers I think someone mentioned there is a different form of codeine you could try, dihydrocodeine if you are becoming resistant to the normal kind. Also have you tried naproxen, or diclofenac you can take these along with other drugs. Some people can get used to the side effects from amytriptaline and gabapentin, or you could try the new improved versions nortriptaline and pregablin that some people find better if you can get g.p or pain clinic to give you them. So hope that can give you something to try.

What is AS?

and would like to hear more about single leg raise test.

I'm home. Knackered but had a lovely time. Total agony each morning until the spasms subsided and huge drug doses kicked in.

Will read and comment a bit tomorrow.

Can I suggest very respectfully for newcomers to read back a bit as there is lots on medication etc up thread and even more on the previous threads.

And welcome to all. Stick around and we'll look out for you.

nancy ankylosing spondylosis.

Single leg raise, the angle at which pain starts ie 45 degrees indicative of the severity of the spinal cord compression. Basic neurological test.

Hth.

I have fucking foot ache. sorry for swearing. It's been a sweary kind of day. The ball of my foot, by my big toe is hurting. It's not nerve pain. It feels bruised, bit swollen, sore to touch, throbs. it hurts with any pressure, walking, standing, ( pressing, moving my big toe. )I am a right sight to see walking as I am limping from that as well as from my back pain! I've ignored it for a few days, but it's not going away. I guess it's how I have been walking, pressing on my feet differently or something.

For all the newcomers - out of all the possible things you should have in your medical armouries, the one thing you must must have is a HEAT PACK! in whatever form you prefer/have available. use them. all the time. whenever you are able - hot water bottles, stick on pads, gel packs, wheat bags, electric pads, they are work well. And sometimes ice does too.

Except, I am wondering how this will work in summer, as I almost cooked myself in bed the other day I had one on my shoulders due to some horrendous tension which is not going away there, and on my lumbar spine for the usual pain there. I proper heated up and felt a little unwell with it for a while! It took me some to realise what was going on

matilda glad you had a great time, looking forward to hearing more about it.

Foot ache be gone! How miserable. I always think any additional pain must be pretty bad if it is breaking through my barrage of drugs. Maybe it doesn't work like that, though. Does gently rolling your foot over a tennis ball help?

Echo the heat patches stc. When I was in Singapore my pain was definitely reduced. We all need to live on the Equator.. Heat patches in hot weather made me feel sicky so not so good then but in the British climate yes.

Also for newcomers remember the principles of combining meds to best advantage. For those unable to tolerate certain meds get your GP to prescribe the newer more expensive versions. There are also morphine patches available. I'm having some success with tramadol slow release plus cocodamol. The pity is that gps are so un proactive about all this and we have to work it out alone. That's really why this thread/ group of sufferers has been such a lifeline. Others who actually get it and have real experience.

Re sciatica, I was told I couldn't have a disc prolapse due to no shooting pains in leg. I did. I now also have quite severe sciatica which is not a shooting pain. So these very generic definitions can be extremely unhelpful. In fact no medics have really used the word sciatica, just leg and buttock pain. Anyway it's very distinct from back pain.

Hope you all had a good weekend. I had a lovely time despite the severe pain. Too much sitting and walking gave me terrible spasms each morning. I'm afraid I did feel very bitter about it all when I compared myself to how I used to be on a girly weekend. I'm like an old lady now and my darling friend has become like my carer. Have counselling tomorrow so some fodder there.

I'm going to potter and rest today. Old lady, you see?

Morning,

By some miracle I got sleep. Since coming off the amiltripiline it's been elusive. I even napped yesterday so thought I'd screwed my chances of a good night. I have stopped the gabapentin, I think it was causing pain in my jaw on the right side (feels better this morning), plus extra painful feet - probably nerve pain or muscle tightness from the nerve compression. It may have caused insomnia too. I've been naughty and I took a piriton tablet before bed, it may be a coincidence but it worked on Friday night too.

I've looked through a bit but it's hard not to read everything, getting sucked in, which would take forever. So far everything I'm already on or have tried is mentioned although the patches are of interest - I asked for them on Wednesday and was dismissed, trying again tomorrow. I thought they may reduce the constipation risk which is now a risk for cauda equina as straining may cause the disc herniation to increase! I have a bucket of lactulose on standby now.

I am trying ibuprofen again plus I found some voltarol but I think these drugs don't suit me, my tummy is cramping. This happened badly after taking naproxen even with a tummy protector, after two doses - recently a friend mentioned getting a tummy ulcer after taken naproxen, not worth it for me. I suspect the gels would be a waste of time. Heat is good and I should try harder to use it. I have a sacroiliac belt as I believed it was my pelvis causing the issue, I've no idea if that's worth using but it does help hold the heat pack against my lower back.

I'm not sure if I am now discharged from the pain clinic and it's about waiting for surgery and see how recovery goes. It's a shame to read how ineffective injections have been and I won't fight to try non surgical options if surgery is the suggested route. I hope it does the trick but I also suspect discectomy isn't the end of the story for me and a lot of people.

I'm lucky to be walking unaided if a bit stiff at times, I'm also at the gym on an exercise referral scheme (referred prior to diagnosis when it was believed it was laziness/unfitness and just muscular - I'm a healthy weight thankfully or I'd imagine they put me on a diet too). The disability being fairly invisible people can be pretty unsympathetic and that includes my husband, I'm lazy and demanding.

Have to go, still in bed with children running amok :(

matilda yes to the sciatic pain not being shooting pain. Mine is probably more shooting pain now, with some fuzzing and numbness. But, when my disc was actually prolapsed and trapping my nerve, I didn't have shooting pain. I had a hard, deep solid pain that went down through my hip into my legs and a tight grabbing pain around my foot and calf before it went numb. And also like you not many of my HCP actually call that pain sciatica. it's misleading like it's a condition when it's not, it's a symptom of something else going on. it gets referred to as radicular pain, nerve pain, radiation pain (my gp calls it this) neuropathic pain etc.

So annoyed for you that your love of weekends away has been dampened by pain. But great that you are able to rely on your friend to care for you. We have to find ways to accept that help, but it's hard isn't it? I felt terribly bad when my friend helped me with stuff to the beach and back to the car, like a burden even though she insisted it was not.

queen although I haven't benefitted much from injections they really help some people a lot. I have a very specific condition (caused by a careless discectomy) so my pain is very difficult to treat. I take enteric coated naproxen plus Omeprazole and have been fine. I'm naughty about eating with it but I am careful.

I would def be proactive about where you are referred. If you are london bases I recommend the National Hospital for Neurology in Queen Square. It's supposed to be world class. They tried to pick up the pieces after my disaster and I'm still under their pain clinic. You can call the surgery to ask.

Yes to buckets of lactulose. You sound as if you have been very proactive about your care, do consider injections even if to tide you over until surgery. And yes if full strength cocodamol in full doses isn't helping ask for dihydracodeine or morphine patches. Pregablin is apparently better than gabapentin but I haven't tried it. Combining is the way to go, though. I can't imagine managing young children so respect.

Oh and I did actually find my pain management course helpful. Not a cure but interesting because the psyche of pain is a big element of the whole thing and as you say, surgery may not be the single answer.

Sorry I forgot to mention that you didn't say what dose of amytriptiline you were taking? I never got past 20mgs and can just about get up now. It does come in syrup form so much smaller doses can be tried and built up very gradually. One poster here is now taking 5mgs this way and building up ml by ml. And sorry, don't know how long you took it but the side effects do improve.

Nortriptyline is apparently also better tolerated.

Hth

Omeprazole was what I took too, I just found the stomach cramps were far worse than the back pain and I'm scared of it happening again. Explaining what happened satisfies the GPs and I presume some of us have better tolerance than others. There is a family history of stomach ulcers too.

Nortriptyline sounds like a plan. I'm thinking of asking for baclofen too for the muscle tension - the muscles are so bad in the right leg that the leg is twisted according to the last physio I saw. I was taking 10mg then 20mg for most of the time. I was then told to up it for more relief to a max of 50mg so was taking 30/40mg by the end, it was too much but 20mg no longer helped and it seemed only to benefit sleep, not pain. I only asked about amiltripiline after seeing it in an article for pelvic pain.

I have been reading about hospitals, the National Hospital sounds good but getting into Central London not so much fun. Charring Cross seems to be closest, I didn't realise only a few hospitals perform this surgery. So far it's just going out to the surgeon with the soonest availability which may not be ideal. It sounds vital to find the right surgeon, I presume you sign a disclaimer accepting the risk of nerve damage before surgery. It's such a shame, it is so debilitating and getting financial help seems impossible.

I'm starting to feel a bit angry with the GP and physio, I knew I wanted to complain about the physio as soon as I was discharged against my wishes. Any one tried to complain or is it not worth the stress? It's so hard to assert myself against professionals who you think know better.

The kids are massively short changed, I struggle so much, we don't go out much and my moods are low. When they make a huge mess it's a disaster and I'm ranting and raving as I have to tidy it up. Thankfully the eldest has school nursery in the afternoon and youngest two days privately we fortunately can afford. I'm really praying surgery can wait so we can have our mini break to the new forrest in two weeks, or even until September when DD1 starts school. Friends have been suggesting nannies for the recovery but I'm hoping to work around it with family coming down to help.

pavlov random thought! could it be gout? I know that's bloody painful.

queen, I trained at Charing Cross* many years ago. You're right, it's the surgeon that counts. Very difficult to know, though. Yes, in an ideal world you are thoroughly consented and the surgeon does a meticulous job. Unfortunately not do much in my case but I know that there was no real alternative but to have the surgery. Sorry you don't get much support. That sucks. You will get it here even if it is virtual we know the grinding misery of back pain.

I'm lying on my bed with heat patch on as I type.

Two saying on this thread: Take it steady and rest, potter, rest. Both very true but difficult to achieve.

Hello again. When I last joined in on a previous thread (Christmas time)I had finally been referred for a physio appointment. Well today I went. Naturally I am actually doing quite well at present! I have been given some stretching exercises to do. I do most of them already, but possibly was not doing them properly. Confirmed my hips are hypermobile. I have to do cat stretch, side stretch, hip stretch, bottom stretch ( I don't know its proper name) child pose and thread the needle ( all things I do in pilates class but may have been getting them all slightly wrong. I am now rather achy.

I suppose I should say I feel a bit dismissed and not taken seriously. Can weak back and core muscles really cause sciatic pain and numbness? Any way I will see if the exercises every day makes a difference. I can but try. I am still seeing my chiropractor, but cannot continue for much longer (without robbing a bank anyway!)
Matilda hope your foot pain resolves - you have enough on your plate as it is. My chiropractor suggested using a chilled ball (keep it in the fridge) to do the exercises, (for planter fasciitis). I found a good set of instructions which I have been following but now cannot find them to show you. I think it was from the royal orthopaedic hospital - Stanmore,
Queen good luck. I think it is difficult not to become a bit ratty when you are in pain. I hope your DH understands better since the results of your MRI. I found my DH understood better ( for a lung condition) when I was got admitted to (HDU) hospital.
I am using a heat patch now too. I still have the front thigh pain ( different to sciatic pain) but it responds quite well to warmth.
Hoping everyone has a gentle night.

magso ime, weak muscles and poor core strength does not cause nerve pain of any kind. And, as you are already doing pilates you probably have good core already! physios can be so dismissive, especially, as I found, if they have no or little back pain experience. My own experiences of physio during my most acute phase when I could barely walk and could not use my leg at all was minimise, minimise, talk about core strength, until one day she went 'err, err, think I need to talk to my senior…' who promptly spoke to my GP about urgent referral to spinal team, where I then saw a spinal specialist physio, who made it all ten times worse. The reality is, I had good core strength, reasonably so, probably not fantastic, and I certainly don't know, but I did kayaking, running, bodyboarding etc, so my core was regularly used. I expect that sorting your core can strengthen the muscles and provide extra stability around any potential vertebral instability or disc protrusion, and certainly I think for my some of my pain know is due to poor muscles strength, but, I cannot see how reduced core strength can cause pressure on a nerve.

So, to say it quickly, which I am not good at doing, your physio is talking shit.

matilda off to google gout. But it can't be gout, that is what people who drink too much port and eat too much cheese and fancy meats and caviar get isn't it?

Hi magso, I don't think weak muscles can cause sciatic pain & numbness in themselves. I mean, they could contribute to conditions that could cause those symptoms - like disc problems - but not directly cause them themselves, if that makes sense.

Numbness particularly is something to keep an eye on as it suggests some kind of nerve compression, probably discogenic. What does your GP think about your symptoms? Has s/he done all the standard neurological tests?

Take it easy with the exercises, especially if any of them cause a sudden worsening in leg symptoms / nerve-type pain / increased numbness. If you feel any of them aren't helping, trust your instincts - it seems fairly common for physios. to push people with back / leg pain even when there hasn't been a proper diagnosis; & it can make things worse.

Have you had an MRI scan yet?

X-posted with pavlov. "Your physio is talking shit" is a lot more succinct than my post, too!

oh fucking fuck. Fucking Gout. It certainly fits. It says on Mr Wiki that acute attacks of gout resolve themselves within 5-7 days etc. I have had this type of pain before, and ignored it, as it's gone away and I always associated it with flat shoes or walking too long not in trainers or something, and it always went away. BUT. I swear because, it's not a huge thing, but the cause of it, some chemical thingy that increases in your blood can cause renal problems. And I have one, single, well functioning kidney, so don't really want to risk it becoming one single, not functioning kidney. I would usually just ignore this as it will go away soon enough I guess, yet another trip to the GP for him to say 'oh it IS lovely to see you Mrs P, how about some more painkillers?'

But, I don't fit the criteria - lifestyle increases risk of acute flare-ups such as meat and seafood (don't eat red meat and only eat fish, not bottom feeders etc), alcohol in particular not wine but spirits and beer (I am a wine girl, not spirits, and I drink far far less than i used to, hardly a thing these days), and that coffee reduces the risk of attack (My liquid properties are made up of half coffee/half blood), as does dairy, which I have a lot of, not eating meat or seafood.

Did I tell you what he said to me when I took DD in for a checkup as she had a rash over her body? We walked in, he commented on the million bears DD had taken in with her, something like 'you have the whole family today young lady!' and I said 'and it's not about me for a change!' he had opened the door for us, and as we walked back and I said this, he put his hand on my shoulder gently as he walked around me and said 'it's still always nice to see you though' and sort of chuckled. I felt very loved and just that little comment made me feel that when I do need to go and see him, I am not just wasting his time and even if he does roll his eyes when he sees my name on his list he does not show that, I don't feel like I am just a moaning patient with not much to be done with. Although I am actually that right now Arrr!

meant to say 'had this type of pain before, but not this bad'. It's not fucking off any time soon it seems. But swimming stretched it out nicely.

Talking of which, I did 20 lengths! I am so going to regret that. But swimming to 'No-one Knows' by Queens of the Stone Age and Recovery by Frank Turner meant I just kept going. Oh I love swimming to music! And in the jacuzzi which was hot for a change, and in the sauna. I hope heat is ok with my mp3 player.

I can feel it in my arms already Not fast lengths though, I plodded, and concentrated on upper strength/arms and not on legs (keep forgetting to get those floats for my legs matilda as I have some nerve pain now so could do with a little less leg movement). And, i did a lot of underwater swimming, push off, under water, and kick my legs until I run out of breath, that felt good.

Pavlov, have you googled metatarsalgia? Basically pain in that area - there can be causes other than gout. I've had pain there when my toe arthritis has been bad - that pain's right in the joint at base of toe, but can spread out a bit too.