Referred pain from back

[cmoc]

I have had fractures a couple of years ago at L1, L3 and L5 (as well as T10, T11, T12. Two years ago, when I got out of bed I had severe pain and then 2 years getting over that so I am assuming that was the L1, as that is the last one to fracture in the lumbar area.

At the time, the pain was mostly on the left sacro iliac joint but soon referred to the top of the left hip (like someone digging fingers into the top hip) and then also to the front under the left rib. I have been trying to work out what exactly is causing this as this pain keeps coming back, takes me a while resting and icing etc. for it to go, then it comes back again. It always starts with the lower back sacro iliac area (not even sure its to do with the L1 fracture). Has anyone had this, or got any ideas as to what is causing what here?

Thankyou

[Fruitandnutcase]

Have you thought of asking for a scan of your pelvis and hips? In particular as about your sacrum. I had a lot of pain in my lower back a couple of years ago then finished myself off by falling backwards from waist height onto my bottom. Need.ess to say it was agony and walking was extremely painful.

I asked my then doctor (I left that practice shortly after that) to be referred for an x-Ray and she refused point blank. Her reason being ‘the hospital is busy and at your age (I was 72) it’s probably a touch of osteoarthritis’. At that point I went to a fantastic physiotherapist who on my second visit said if I was prepared to pay for a private MRI scan he would refer me - so I did that. My first scan was in my lumbar spine and then I went back for a further two on my sacrum and hips. Not cheap but worth every penny to know exactly what was going on.

Turned out my ‘touch of osteoarthritis’ was a fractured sacrum! I very much doubt if it would have shown up on an MRI anyway.

So read up and see what you can find out about sacral insufficiency fractures - they are very often overlooked - and see if your pain could be that. I’ve had no treatment other than effective pain relief and very gentle exercise using my Nordic walking poles for support but I’m now back to pretty much how I used to be.

[cmoc in reply to Fruitandnutcase]

Hi, yes I sent a PETscan off for an opinion on the sacro and hips, it showed no fractures and just ostopenia in those areas (I have 5 x lumbar fractures) and severe osteoporosis of the spine. You went through a lot but great to get an answer, its so difficult to get that!

[Hidden in reply to Fruitandnutcase]

I’m currently in rehab for L1 and L4 fractures and two sacral fractures from fall on my bottom. More pain especially sacral, than fractures it seems to prior thoracic ones. Have been told 3 months healing time. Have you heard the same? Any thoughts and info would be so appreciated. Going home in two days. Ann in USA.

[Fruitandnutcase in reply to Hidden]

I was never really given a healing time and to be honest I would think complete recovery in three months is a bit optimistic. Having had no help from my doctor and still being in agony I was referred for my MRI scans by a very good physiotherapist.

He was absolutely adamant that I get good pain relief, but I ended up just taking acetaminophen because pain killers didn’t agree with me. I also bought a PEMF mat which made a huge difference - using that for 20minutes twice a day I was able to stop taking the acetaminophen but there are contraindications to using the mat, you also have to be able to lie on your back and it is expensive to buy but for me it has bern worth it.

So he wrote to my doctor and organised painkillers for me. He advised seeng a spinal consultant which I didn’t do in the end. Long story but basically I was still standing, I could walk - well just about - I definitely didn’t want anything invasive done and from what I could see recovery was just going to take time along with gentle exercise and painkillers. I had refused bisphosphonate treatment for my osteoporosis the year before so I didn’t want to have to argue my case with anyone.

Only my right sacral ala was involved although I’ve got a lot of lumbar spine problems going back quite a lot of years but no other fractures.

I used Nordic poles to help me walk, they take weight off your hips and knees and give you great support. For a very long time I only walked on flat paths and I couldn’t go very far without sitting down to rest. I was lucky that I could sit down because for some reason standing still was something that really caused me pain - nerve pain too which is horrible.

We have a lovely little nature reserve near us and that’s where I did most of my walking. To begin I could do hardly any distance - I’d get to the first bench and rest - gradually I was able to go a bit further until now I can easily get right round without stopping at all.

I have a Pilates teacher who is a physiotherapist and who has very good knowledge and experience of dealing with osteoporotic patients so I was able to keep doing Pilates - I’ve worked with her since about 2010. My group are all a bit ‘fragile’ in one way or another so basically we do osteoporosis friendly exercises, I do three one hour sessions a week, one in person and the other two on Zoom.

Since the first lockdowns in 2020 I was in the habit of walking for about an hour every day so I kept that up - I was very slow and needed to rest a lot.

I had said to the physio who referred me that I used to walk at least 10k steps every day and he said he was confident I’d be able to get back to that and sure enough I can. He also gave me some simple exercises that would be safe and help my recovery.

He said to be extremely careful in bad weather when there are wet leaves on the ground, mud and ice on the ground. Not to twist round on my hips so when I want something behind me I turn my feet and body, not to lean on one leg with my hip hitched up when I stand so I always stand evenly on both feet. He also said to hold onto work surfaces when I lifted things - I still don’t lift heavy things. I use a backpack because it keeps any weight balanced and leaves my hands free. I don’t climb up on furniture to reach things etc. basically I don’t do anything ‘stupid’ now,

I hold on to solid surfaces a lot more when I’ve been kneeling down to get into a cupboard or that sort of thing. My fracture was caused by getting up unaided from ground level - I pushed up with one leg and flew over backwards from about waist height onto my bottom! Ouch! Well you know what the pain from a sacral fracture is like.

My Pilates teacher often tells me how well I’ve done - and I can tell she means it - she says I’m ‘stoic’. I think she is right 😉

I would recommend taking things slow and steady, keeping moving but sensibly, not doing anything silly and finding a really good physical therapist with experience with people of your age and with your type of fractures that you feel you can work with and having some regular sessions.

Good luck with your recovery.

[Hidden in reply to Fruitandnutcase]

thank you for full reply. You’ve come a long way.

[Mavary]

Hi. It may be that something is touching a nerve. You maybe need to speak to your Dr or Cosultant. A scan may show something up.

[cmoc]

Hi, I keep having different scans and they just show up mild arthritis and osteopenia in those areas.