Sharp pain in mid-left back, and dull pain + occasional sharp pain in lower left back


Hi,

First, thank you for your time. Your opinion means a lot to me. I am an aid worker with a very low salary and no medical insurance (I live in a foreign country in Asia) and I try to avoid going to the doctor unless it is urgent.

I had a fall playing ice hockey two days ago and I slid into the boards with my back quite hard. I am now in severe pain, and most movements hurt a lot; I am just lying in bed because when I move, it hurts. I have very sharp shooting pains in my mid back (on the left side, near the spine; it feels like a muscle, and seems like a strain, from what I have read) and lower back (on the left side, from the spine to my side; this one I am much less sure about what it is) when I use some muscles.

I am afraid to move very much or use my core muscles for anything because it hurts a lot. If I am standing, moving to the right (away from the injury) is too painful for me to do, so as you said in your article, I walk like the Tower of Pisa, but leaning TOWARDS the injury, not away. Coughing and sneezing is VERY painful (but NOT when lying down), especially in my lower left back. Contracting my abdominal muscles (for example when trying to go to the bathroom) is painful, but again, is NOT painful when I am lying on my back. Rolling over from my back to my side is also painful. If I sit very straight and arch my back inward, I get some relief from the pain. I have no pain radiating down my legs, no numbness, no sciatica.

Please let me tell you about my previous back injuries: after playing basketball all day in 2011, I woke up the next day unable to bend over well, and with a kind of aching pain on one side of my back. Being young and stupid, I made it worse by playing sports on it twice more, before realizing that it was very bad. My back was inflamed, and ached in one spot- it didn't hurt during physical activity, but afterwards it became a lot worse. Over time, I discovered that running and jumping made it especially bad. I had back pain when bending over for a year or more, but eventually it faded to a reasonable level and I started sports again (but never anything involving running or jumping). I did a lot of research and I thought the pain corresponded best to a herniated disc or possibly spondylolisthesis. My back felt pretty good in 2013-14, but in March 2015, I injured it again at the gym, doing a deadlift. I stopped all physical activity immediately, and I had similar, but milder symptoms, to what I had in 2011 with the original injury. I rested for about a month, and then tried some easy skating, which was okay, so I continued playing ice hockey. I also continued to work out at the gym, but I avoided all exercises that put strain on my lower back.

Now with this trauma to my back, I fear that I have made my disc problem a lot worse, and that I also have a sprained back. I know that I should probably have an MRI, but this is unfortunately beyond my means. Does my theory about the sprained back AND disc problem seem plausible? If so, what course of action would you recommend?

Thank you very, very much for your kindness.

Hello DM,
It seems we have two injuries here.

The one in the midback is probably less serious, with a subuxated rib; it's not impossible that you've cracked it. Hence pain with breathing; it usually responds quickly to chiropractic treatment.

The lower back sounds more difficult, particularly if you have an antalgia, the sign of Pisa. It's often the prelude to a nasty sciatica.

Go to our "slipped disc rules" page and follow it faithfully for two weeks. If you are still antalgic, or have pain beginning in the leg, then you have to do something.

An MRI scan is very helpful, but often not necessary. We treat patients every day with similar problems with no scan. As you know, they are very expensive.

In particular do our lower back exercises faithfully every morning before getting out of bed.

I think you need professional help DM, but these conservative means a try for a couple weeks.

Good luck.

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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