Lower back pain

[leagle81]

I had a l5 s1 laminectomy/disectomy almost a year ago in august. I had relief right after i had the surgery but as the days went on the pain started to come back. I was being treated for si joint dysfunction and recieved si joint injections for the longest time and once i started seeing my rhuemetoid doctor he did an xray of the si joints and it turned out that there was nothing wrong with them at all. So now i am back to square one in trying to find out what is causing the pain. I am going to dry needling as well and it helps until i over do it. I still can not stand or walk for long periods of time and they told me that i was still having pain in the lumbar region and the periformis muscle. I dont think taht the pain management wants to help me anymore as they think that i should be better by now..

Any help would be greatly appreciated.

Thank you

[Boozybird]

Hi L,

Sorry to hear about your troubles. If you've read Sarah Key 'back sufferer's bible' you might come to the conclusion that your L5 facet joints are complaining big time following the discectomy at that level. She describes how a discectomy is like letting the air out of the tyre so the facet joints are obliged to take over the job of support rather than movement. Not surprised that you thought it was SI but the facet joints are nestled snugly in that corner and are highly wired for pain unlike SI joints which are robust.. Have you tried diagnostic injections by good pain/orthopod in hospital? Anti inflammatory medication. In her book, she describes many stretches for this type of pain, probs a copy in the library. Mobilising the joint will bring relief but can also irritate things further. It's a subtle problem and swollen facet capsules can keep on keeping on... A good manual therapist should be able to feel if the capsule is swollen but L5 is tricky coz its buried in the corner with the SI.... You can use tennis balls in the buttock and a squash ball for the joint but gentle rocking knees to chest targeting low low back at L5 level may bring better relief for the underlying cause...

I'm not an expert. This is just my experience. Best wishes 😜

[Ariadne1925]

I have an almost exact story except it was a L4/5 discectomy. Had surgery in August, rested and came off all the medication save occasional codeine. Then I was back to normal (school runs and childcare) and bang I could hardly walk. It did ease but the back pain is intolerable, the muscles are tight but weak and the piriformis is super tight and sore. I have pain in my hips and SI joint. I haven't explored SI joint treatment save for some osteopathy - one side seems looser and is causing the muscle tightness I'm told. Another suggestion is tight facet joints and I've been offered injections there but there is only a 40% success rate according to my GP and success can be for a few weeks rather than the months they suggest, plus the risk of it flaring up.

I haven't started yet but my plan is physio and getting fit. The osteopath recommended exercise, cardio etc as well as stretches. I've read the Sarah Keys book too but I'm wary of starting physio work without supervision. However it is an expensive plan as NHS physio isn't enough, they don't do enough hands on work and the appointments are too short. I'm also convinced that sufficient pain relief is essential to relax the muscles but both GPs and pain clinic aren't interested in offering proper pain relief, I'm astonished when I see what other people are taking for similar issues. Hopefully you can get this support so keep pushing.

[victoria1000]

Hello Le

Back pain is usually caused by infection trapped in the lower spine. It can be viral or Bacterial. Taking a good probiotic and vitamin C 2000 grams daily. ( I take Citrate Magnesiun 400mg and vitamin B12 1000)

Eating loads of green vegetables will heal body and help you to obsorb vitamins & minerals.Try gentle exercises 4 times a day

If the pain is too much try a Tens Machine

Warm regards

[maggi999]

Hi Leagle81,

So sorry to hear about your pain, I too had an L5 S1 discectomy 10 years ago and I can remember how painful an irritated sciatic nerve is!

When I attended the pain clinic about my fibro pain, the physio explained the fibro pain response to me as follows:

A fibro sufferer's brain remembers a long standing, repetitive pain much in the same way as the brain remembers a song that you hear repeatedly, by which I mean that a the words of that song come back to us as soon as we hear the music.

So the fibro brain 'remembers' the pain and registers it straight away, at full power. The wonderful brain also saves energy by remembering the repeated pain and shortens the pathway through the brain so that the pain is registered more quickly. Because the pain receptors in the fibro brain have a greatly reduce amount of the chemicals that help to filter pain (ie seratonin and dopamine), again pain is received at full blast by the brain.

The reason for this explanation is to hopefully reassure that the site of your discectomy (as confirmed by the x-rays by your rheumatologist) has not degenerated further - you are suffering fibro pain!

Before I was diagnosed, my GP suspected I had psoriatic arthritis or rheumatoid arthritis, both of which could eventually lead me to needing a wheelchair. So it was a bit of a relief to know that my pain was neuropathic rather than degenerative (sorry to all those who have RA or PA xx).

One of my worst fibro pains mimics sciatic pain, from my buttocks right the way down to the heel of my right foot. To relieve this I carry out the 'sciatic nerve stretches' that I did 10 years ago - it doesn't eliminate the pain but it does take the edge off. Can I suggest that you do the stretches and exercises you did previously (and the excellent ones suggested by boozybird) to help reduce your pain.

I hope this helps you to relax you back and reduce your worry and stress xxx