Back Pain, Again

I mentioned a little while ago that I had some severe back pain (here and here). Taking the advice of many family, friends, coworkers, and acquaintances, I pushed for an MRI before starting physical therapy. The issue, many of them explained to me, was that physio is great as long as you are being treated for the right cause. In many cases, however, they started physio right away and nothing worked or their back trouble got worse, because you do different physio based on the root cause of the problem.

The MRI was last week and I got the results today. Turns out that I have disc herniation in the L4-5/S1 area of my back, presenting on the right side. Which is exactly where all of my pain and discomfort came from. Even down to my right leg not wanting to make a full arc when walking due to the discomfort I still feel in it.

The herniation is NOT pressing on the nerve, which is great news, but the fact everything is swollen and not in line still causes a lot of pain and discomfort.

Now that I have a cause, I can go get the right physio for my situation. And my doctor is setting up a referral to a back specialist to review the case and make sure that nothing more is needed, like surgery or specialized treatment.

Hopefully, in a few weeks or months, I can post how my back pain is gone and my therapy worked. Now that we know the root cause of the problem.

Oh, and to the ass hat of an urgent care doctor that didn't want to listen, didn't want to know, and acted put out that I insisted on an x-ray, gave me bad pain medication, and refused to pay attention to my medical history -- I was right and you were wrong. Idiot. I don't know where he graduated in his class, but I can guess he failed the parts about "bedside manner."

Fall Out

I saw my GP today. Or, rather, I saw the doctor he had filling in for him while he's on vacation or otherwise away from the office. She had me run through a series of tests to determine what may be going on with my back and, in the end, agreed that I am "MRI worthy." However, she also said that regardless of the MRI results, the immediate therapy will be the same and will probably do what is needed: stop the pain and strengthen the back.

As I said I would, I argued for the MRI anyway, saying that it can't hurt, it gives us new and better information, and, on the off chance that something serious happened, it will catch it and we can change course at that time. She agreed and wrote me the script. Now, the bad part: MRI availability is such that I probably won't be seen for three to six months. The joys of being in the Atlantic Provinces!

She was confused that the UC doctor gave me a script for Percocet for two reasons: 1. it doesn't treat potential (and most likely) nerve pain and 2. it is filtered through the liver, and I have a chronic liver condition. So she wrote me a script for both an anti-inflammatory and something to help with the nerve pain, which I will start taking tonight.

Her in-office tests showed that I don't appear to have any nerve damage. I'm to watch for incontinence and loss of muscle function and get to the ER immediately if either happens. That means the nerve has been damaged or pinched again, and the signals are not getting through to where they need to go. It also sort of confirms what was going on during the worst pain from a week ago, as I needed to use the bathroom much more often than I usually do (with large volume each time -- seemingly more than I had actually taken in) and I got to the point where my right leg would not support my weight at all. My nerve must have been under some serious stress at that time, so I'm glad my wife took me to the UC the next day.

I made yet another follow up appointment for November. Hopefully by then I will be back on my feet (literally and figuratively) and my normal doctor can suggest therapies and other regimens along with what I plan to ease back into doing (walking, riding my stationary bike, etc.). In the meantime, I need to avoid lifting and twisting, even after my back feels "fine," as I could re-injure it. I also need to be better about having assistance when I need to move something and not doing it on my own. I already have helpers/doers lined up for our upcoming heavy lifting needs, so that should work out.

Back Pain a Week Later

It is now September 11th, an auspicious day, and I am finally able to walk without too much effort and assistance. As long as I don't move around too much, lift anything heavy, or over-exert myself, my pain is minimal. However, I walk with a shuffle, as the pain is still there and my right leg doesn't want to take my weight as well as my left leg. At night, when I roll over, I am waking up and rolling slowly and carefully, due to the stabs of pain that still exist. Sitting in my work chair in the office is uncomfortable and I have to take frequent pauses to stretch and move so my back doesn't lock up and hurt worse when I finally do move.

All told, I hurt my back in the late afternoon of September 1st (around 4 pm) and I am only just starting to feel like I am getting back to normal on September 11th. That's 10 full days, plus a half of a day on the 1st itself. And that includes having the Percocet to take daily and being given 4 days of full rest from the doctor, during which I did next to nothing except sit or lie down and try not to move.

While I know spasming is occurring, and it is difficult for me to keep my back relaxed and loose throughout the day, I find it hard to believe that there is not some sort of underlying cause to this pain. Nearly every person who has had a similar situation happen to them has mentioned that they wound up having either a pinched nerve or some sort of back or disc trouble that needed further attention. In one case, it led to back surgery after years of trying to force her doctor to do the necessary tests to find out what the problem was. In most cases, it required at minimum physical therapy, massage, acupuncture, and/or chiropractic manipulation. In some cases, it has required changes to lifestyle, including one friend who had to get a standing desk at work and is still doing therapy over a year later.

I go to my family doctor tomorrow. Although I am obviously improving, I am going to press for an MRI so that we can definitively rule out or confirm disc issues and proceed with the proper course of action based on that conclusion. I still find it hard to believe that the urgent care doctor wouldn't have insisted on that being done at the time of my visit to rule out anything more severe. Maybe it is nothing -- maybe the MRI will show no damage and it truly is nothing more than severe spasms. Or maybe it will show the simplest form of damage, either a pinched nerve or a bulging disc, which typically require exercises and massage therapies to alleviate. Either way, I want to know.

This situation has driven home the point that I need to work on my weight and my core strength more consistently. I was to the point where I was using my stationary bicycle regularly, and was starting to see some results, when our basement flooded. That resulted in our workout equipment being put into a bin for over six weeks. I did continue to do walks, but walking is not very comfortable for me (rheumatoid arthritis), which is why I got the low-impact bicycle. Just as the situation started to turn around and we started moving our items back into the basement, I strained my back. So it has been since mid-June that I've used my bike. Once my back is to a point where I can walk and ride, I plan on pushing myself to improve my effort and get my endurance back up to a reasonable level (I still generally have my strength, what I lack is any endurance). This should help improve my weight, which will also help my back (as I carry nearly all of my extra weight on my belly).

What is frustrating me the most is that we are in the prime "John needs to do stuff" period of the year. There is wood that needs to be split. There is wood that needs to be ranked/stacked for winter. There is maintenance on the front porch needed. I need to take the AC out of the office window and store it. Even simple things have been affected: I haven't been able to stand well enough or long enough to help with dinner (usually one of my main tasks). We have new flooring coming soon, and I may not be able to move the furniture out of the way or back for when that is happening.

So, basically, during what is usually one of my busiest times around the house, I have been useless. My wife has had to do a lot more and she's got a lot of pressure on her from other sources (work, family, etc.) not to need my poor health and inability to help out adding more to her plate.

I am hopeful that my GP can help. Hopefully he will agree to the MRI. I assume he'll also provide me with some sort of therapy to help strengthen my back to resist this from happening in the future. For my part, I have firm plans to work out more regularly to build up my endurance, continue the plans to eat better to help lose weight (which should help my back as well), and move toward strengthening my core as I am able to do more. I have contacted friends who have offered to help with the wood, furniture moving, and a few other "John-tasks" around the house. And I hope to be able to start taking back some of my responsibilities around the house, like making dinner, soon, so I can relieve some of the pressure on my wife.