Low Back/QL Pain

by Beth C
(Upstate NY, USA)

Hello,

I am in my early 40s, and I am currently experiencing my second incidence of low back pain. The first occurred about 18 months ago without a clear trigger. (I assumed that I might have caused a strain while exercising--I exercise daily as well as engage in yoga 3-5 times per week.) I was able to recover on my own through yoga and other therapeutic exercises; I also saw a massage therapist for one visit.

My current episode began just after Christmas, and again, there was no clear precipitant. As before, I engaged in gentle yoga & stretching activities, and by the end of the first week, I was seeing some improvement. At the start of the second week, however, I must have re-aggravated something, because I then got worse again.

Now, my condition seems to have plateaued, and my continued exercising doesn't seem to be helping. The problem also seems different from before: I now have a constant, dull ache right in the area of my left QL that will not go away (I've tried self-massage with a foam roller and therapy balls, but this does not help for more than a few minutes). The low back pain is fine when I am sitting or lying, but if I am standing for more than a few minutes, I begin to feel painful pressure in my low back and need to sit down. Although the discomfort in my left QL extends a bit into my left hip, I don't feel any pain extending down into my buttocks and/or my legs.

Any thoughts on this? I read about Maignes Syndrome on your web site--could that be what is going on with me? Do you have any suggestions for how I should proceed? My doctor referred me to PT, but I'm not sure I would get any exercises there that I am not already doing. I was also considering returning to my massage therapist.

Thank you in advance for any help you can provide!
Beth

Good morning Beth,
What a pleasure to have a letter written in decent grammar with the problem so succintly set out.

Pain with standing, but not sitting or lying, immediately makes me think of a short leg. In that case, brisk walking is often good, but dawdling also painful, as in windowshopping. Ask someone to stand behind you, place their hands firmly on the iliac crests, and compare the heights of the hips.

Let me know what bending forwards, backwards, and to the side does.

It's a good sign that it's not radiating to the legs, but be careful, one slip on the snow... a heatwave here in sunny South Africa!



Dr B

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Jan 12, 2012
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by: Beth C

Thank you so much for your quick reply!

RE a short leg: wouldn't that have bothered me before now (age 43)? Or is that something that can develop over time/with age? Age I mentioned in my first letter, I do exercise daily (not just yoga but weights & cardio as well), so I believe that I am maintaining good strength/muscle tone for my age.

None of the things you mentioned aggravates the pain I am having. In fact, NO movement at all seems to make it feel worse--movement (through exercise, etc.) generally feels good, whereas just standing seems to hurt.

My own theory (after doing further research yesterday) is that I may be experiencing a spasm in my QL. Therefore, I attempted more prolonged self-massage work in that area, and I THINK it may have helped, as it is feeling a little better today. Time will tell, but I certainly would still be interested if you have any further thoughts.

Thank you again!

Hello again, Beth,
When movement doesn't aggravate the pain, be aware it could be systemic. Kidneys, bladder, ovaries... good health otherwise?

The Leg length inequality is a strange bird. Sometimes it may start to be a factor, but yes, I would have expected it to bother you before. Get a friend to look at the height of your pelvic crests.

Like all conditions, if after a period you know it's not improving, then see someone for advice, diagnosis and treatment.

Try the Maignes syndrome exercises ... type it intot he search this site function at C-h.

Let me know in a month how you are getting on.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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