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


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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