Lower back pain

by Robert
(Lexington, SC)

Hi. I have had lower back pain for at least 5 years now. The first time I really noticed it was a night after I had been breaking limbs for the fireplace by leaning them against a tree and stepping on them hard with my right leg to break them. I suspect that was the initial culprit. The pain has never really gone away even for a second, but it doesn't always hurt a lot. Most of the time it just feels like a headache but in the back and only gets bad after doing work all day or standing on a hard floor all day.

The thing that makes the pain unbearable (and even hard to stand back up straight) is if I do some activity where leaning forward for a long time is required (cleaning fish, putting down flooring, even washing dishes at times). The pain is in my lower back almost where it meets my backside.

It's mostly pain slightly to the left of the spine, but sometimes all the way across. Leaning to the right is much worse than leaning to the left. Sitting doesn't usually result in pain, unless I don't use good posture. Laying down never hurts unless the mattress doesn't support my back at all. Standing doesn't even hurt as long as it's not on a hard floor for a long time.

However, bending is sometimes impossible, especially as far as to tie my shoes. There hasn't really ever been any pain running down my leg as described with sciatica pain, but my calves do hurt every day. But that has been an ongoing problem throughout my life.

I've never been to have my back checked, because I'm afraid an MRI would cost thousands (and that it not even help as it sounds like many times doctors only work to relieve pain and not the problem). It hasn't been bad enough yet to not be able to deal with. I was just wondering if you may have any idea based on the symptoms as to what I may be dealing with. Thanks for any information you can give.

Hello Robert,
What's good is that it doesn't go down your leg; what's not so fine is that you've had pain for five years. You've lived with this for a long time; too long.

Some lack of understanding has been part of the problem. It's rare that anyone would order an MRI if you have no leg pain. But some xrays are certainly indicated.

It's unlikely to be something serious like cancer, but serious enough to cause you all this pain and disability for five years. That's a long time.

Start asking family and friends, and your doctor, for the name of a local chiropractor who comes highly recommended. This sounds very treatable.

What you will have to accept is that Rome wasn't built in a day, and with five years of pain, daily exercises will be necessary and an occasional, regular treatment. I'm afraid it's unlikely that anyone, chiropractor or otherwise, is going to cure this; fix it so that the pain goes away for ever. Maintenance care and exercises are going to be your lot.

Do it, because it's going to go down your leg in time. You have a fixated joint somewhere in your lower back or pelvis and immobilisation arthritis will set in and eventually affect the sciatic nerve.

You'll find some basic exercises at Chiropractic Help. Start doing them every morning before getting out of bed, and ask your chiropractor which are most pertinent to your case.

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

I hope this has contributed.

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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