Stiff lower back every morning & a feeling like my lower back has gone with a sharp pain when I slump in a chair

by Jan
(Peterborough, UK)


Hello there and thank you very much for your time.

My problem first started at the end of January this year. I stood up quickly in the shower as I was cleaning it, twisted, and heard 3 loud cracks in my mid back and my legs gave way with each one.

I had some muscle guarding and pain but 12 weeks later I was on the mend, bit stiff first thing, but did some exercises to loosen my back off and I thought I was out of the woods!

I did go to see a chiro for this injury but she wanted to wait for my bone scan and MRI results to come through before seeing me again as I've had breast cancer.

Then came the daily 'argh that's my back' sharp nerve pains and jolts whenever I bent forward either on the edge of the bed, or the toilet. Sometimes I could get all the way downstairs and thinking 'yay, not getting one today' only to get a worse jolt when I sat (slight slump) down to eat my breakfast. Following these jolts I would have lower back pain, however I could move freely and bend and it was like I had nothing wrong with me, once the aching feeling had gone off. Then the following morning it all starts off again and I've had 3 months of this daily pattern.

Hospital in May did a bone scan as I had breast cancer 10 years ago. It was clear. Then followed an MRI in June. All fine except for some 'L5/S1 degeneration and minor bulging on right side but no focal protrusion and maintained exit foramina and central canal throughout.'
I haven't had a an X-Ray.

I am seeing a physio who has done 3 x deep tissue massages on me and says my muscles are very stiff and just they need assistance to switch off now. I decided to attend the physio as I was having muscle spasms in my neck, shoulder and back and couldn't even lift a kettle or pull open a heavyish door without getting a spasm. Scapula and pectoral stretching exercises have now sorted this out, (see below).

Every day my back is grinding and clicking but not little clicks/cracks, my whole lower spine feels very unstable and when I stand in the neutral spine position to help my lordosis (physio said I have it) it clonks.
My right shoulder is also clonking when I lift it laterally, then it inflames.

Two days ago after the 'argh that's my back sudden pain' I started getting a big clonk too. Today my mid-back is clonking every time I sit up straight.

I keep telling my doctor I think I have some facet joint trouble but she assures me this would've shown up in my MRI.

I work from home and I'm doing pelvic tilts, knee rolling, cat/cow, child's prayer and some scapular exercises with a green stretch band religiously, 3 times a day.

I'm just at a loss now what to do now. My doctor referred me back to my oncologist two days ago as all my blood tests for inflammatory diseases and Vitamin D deficiency are all negative. She has put me on Gabapentin 100mg 3 times a day so a low dose. This at least has deadened the nerve pain of the daily morning jolts and lower back pain.

I'm 54 and weigh 11 stone 9lbs. I have had a double mastectomy (2007) with a reconstruction (2010) on my left side using my left side latissimus dorsi muscle. I am also left handed.

I guess I am at a disadvantage from the offset as I am of balance.

May I please ask you what your opinion is?

Many, many thanks
Best wishes
Jan

Hello Jan,
Firstly a general comment; having had any form of cancer, even after ten years, it's vital to eat a clean and healthy diet; cut out the crap, or it will come back. In particular, do some reading on lignans; eat them daily.

I very much doubt any of this is cancer related. Clearly something is going on in your lower back. Advanced degenerative change would have been seen on the MRI, but all disease comes in mild and serious forms; a facet lock in a joint in the lower back would not draw attention on the MRI; but leave this and that facet will become arthritic. Or it could be in the SI joint, and you already know there are lumbo sacral disc problems developing.

If you sit in a normal kitchen chair, flex your head on your chest, and then hubby raises your leg parallel to the ground, first right and then left, is there pain or tightness? Repeat with a slumped back.

It's great that you are exercising; do them at least once in bed before arising.

Perhaps it's time to take your MRI back to your chiropractor who made the right decision initially; further tests were indicated.

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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