Help with my lower back pain issue

April 14, 2008 9:25 AM

Intense lower back pain on the left side. It's also painful down the side of my left leg. After being stiff and mostly inactive this winter I was doing some deep knee beds and intense hamstring stretches, now I'm in a huge amount of pain. My health insurance has a hefty deductible and am hoping to avoid the doctor's office. Any ideas on what to do to relieve the pain?
posted by huxley to health (19 comments total)

Advil (ibuprofen, not Tylenol) and a long soak in the tub. It won't make it go away, but it will help a little.
posted by ValkoSipuliSuola at 9:36 AM on April 14

Pain radiating down the leg is a sign you need to see a doctor. The money spent now will be well worth the money saved in the long run. Until you get in to see a doctor, try not to do too much physical activity. I am not a doctor, but I put off seeing a doctor for this exact problem. I thought that the pain would go away on its own if I did light exercise and stretching. Two years and several surgeries later, I am living with permanent nerve damage in my back. The sooner you see someone, the better.
posted by vincele at 9:43 AM on April 14

IANAD.

You should consider that back pain that radiates down the legs may or may not be indicative of a nervous problem rather than a muscular one. That's truly something a professional needs to determine and diagnose.

For the time being, to hold back inflammation (if there is any), load up on ibuprofen. Buy Motrin or any other ibuprofen in the highest dosage possible and eat 1.5x or 2x the suggested amount, preferably with food/hydration to avoid upset stomach. Stay consistent with it, as well. It may not have any discernible effect for a week or two, if at all. For serious inflammation, it's not uncommon to be prescribed 2.4g of Motrin a day - 3 of those 800mg almond-sized jawbreakers - for months at a time.

Really, though. It might be serious. Get checked out.
posted by crunch buttsteak at 9:50 AM on April 14

IANAD, this is not medical advice.

However, I do have a capricious back, and sometimes get pain/twinges running down the back of my left leg - welcome to the wonderful world of sciatica! (Well, probably. Could be something else, I suppose - did I mention IANAD?)

What works for me: anti-inflammatories (advil, aspirin) and alternating cold and hot packs. Hot packs help relax the muscles if they're in spasm, and cold packs will help reduce the swelling. Use one more frequently than the other if that one brings better results. Sleeping with pillows under my knees has helped when the pain is bad.

If it doesn't begin to resolve within a few days, see a doctor.
posted by rtha at 9:55 AM on April 14

From Mark Rippetoe at Starting Strength

Here is the tried-and-true injury rehab method for muscle-belly injuries we got from Starr and that has worked for years better than any other method I've ever used. It also works well on orthopeadic injuries in general, and should be tried before anything more elaborate is used. Wait 3-4 days until the pain starts to "blur",which indicates that the immediate process of healing has stopped the bleeding and has started to repair the tissue. Then use an exercise that directly works the injury, i.e. that makes it hurt, in this case the squat. Use the empty bar and do 3 sets of 25 with perfect form, allowing yourself NO favoring the injured side. If it's ready to rehab you will know by the pain: if the pain increases during the set, it's not ready, if it stays the same or feels a little better toward the end of the set, it is ready to work.

The NEXT DAY do it again, and add a small amount of weight, like 45 x 25 x 2 , 55 x 25. Next day, 45 x 25, 55 x 25, 65 x 25. Continue adding weight every day, increasing as much as you can tolerate each workout. It will hurt, and it's supposed to hurt, but you should be able to tell the difference between rehab pain and re-injury. If you can't, you will figure it out soon enough. This method works by flushing blood through the injury while forcing the tissue to reorganize in its normal pattern of contractile architecture.

After 10 days of 25s, go up in weight and down in reps to 15s, then to 10s, and finally to fives. During this time do NO OTHER HEAVY WORK, so that your resources can focus on the injury. You should be fixed in about 2 weeks, squatting more than you hurt yourself with.

This method has the advantage of preventing scar formation in the muscle belly, since the muscle is forced to heal in the context of work and normal contraction, using the movement pattern it normally uses. The important points are 1.) perfect form with 2.) light weights that can be handled for high reps, 3.) every day for two weeks, and 4.) no other heavy work that will interfere with the system-wide processes of healing the tear.

It is also very important through the whole process of healing the injury that ice be used, during the initial phase after the injury and after the workouts. Use it 20 on/20 off, many times a day at first and then tapering off to morning, after the workout, and before bed. Ice is your best friend in a muscle belly injury, holding down inflammation and fluid accumulation ("swelling") while at the same time increasing beneficial blood flow through the injury. But DO NOT USE ICE MORE THAN 20 MINUTES AT A TIME. More than that can cause more damage than it repairs.
posted by tiburon at 10:07 AM on April 14 [1 favorite]

My own personal experience:

When I suffered similar symptoms it was because I had herniated a disc in my lower back, which was then pinching on the main nerve running down my left leg. It eventually caused half of my left foot to go numb, and also caused me to lose the reflex in my Achilles tendon. What eventually eliminated the pain was a combination of physical therapy and chiropractic. That was nearly 20 years ago, and my back still goes out periodically because of that disc. For temporary relief, anti-inflammatories in combination with hot and cold packs do seem to help, at least for me. For long term relief, nothing but professional medical help is likely to work.

Best of luck to you, I feel your pain. Literally.
posted by Lokheed at 10:09 AM on April 14

IANAD either, but I've had a history of back problems, including a herniated disc at my L5.

Best case scenario, you "tweaked" your back. Take some ibruprofen or naproxen sodium (Alieve), but not both (naproxen sodium is a better muscle relaxant but dont take it with anything else or with alcohol) and rest up. Give it a couple days.

Worser case scenario - you have an injured back and you should go see a Doc. The pain in your leg is an ominous sign. Dont let it get worse by procrastinating. Trust me on this. I define my threshold of pain by how it compares to my herniated disc and you do NOT want to go there.

If it is a "tweaked" back and you recover quickly, remember that your back is supported by your stomach muscles and, well, your butt muscles. Try some simple exercises like crunches or leg lifts or pedaling while keeping your lower back forced to the floor. It's harder than it seems but it worked wonders for me when I was hurting. Hard to describe without graphics and I couldnt find any to link to. Perhaps you or others have better google-fu.

Good luck.
posted by elendil71 at 10:26 AM on April 14

Yeah, leg pain is from a nerve problem in your lower back, not a muscle problem. I had it a few years ago. When I tried to put on my socks and ended up crying I decided it was time to go to the doctor. Apparently, depending on which nerve you pinched, you can start to lose control of your bladder and bowels. Don't let this happend to you.
posted by Green Eyed Monster at 10:37 AM on April 14

You might have pinched your sciatic nerve. See a doctor as soon as you can.
posted by Koko at 10:42 AM on April 14

Do a handstand while saying the ABC's backwards four times. Then wink your left eye twice and meow like a cat. After four days repeat, then send a postcard to someone you went to high school with.

Seriously, I wouldn't put much stock in any of the advice offered here. Go. To. Doctor. Now.
posted by sero_venientibus_ossa at 10:52 AM on April 14

IANAD.

Advil until you can get to the doctor. Cold pack for 15 min only, perhaps every hour. I'm going to guess you have a herniated disc. The doctor may prescribe you some Cortico Steriods, which help alot with herniated discs.

btw - DO NOT WAIT ON THIS! It will suck more in the long run.
posted by Attackpanda at 11:08 AM on April 14

I have something similar going on with me right now, which I presumed was some kind of pinch of the sciatic nerve. My upper back hurts mildly when I'm in certain positions, my right arm hurts, my right shoulder hurts, my hip/butt does too, as well as the right side of my back under the shoulder blade. Basically the only area it doesn't hurt is my lower back. The pain is really very mild. However, when I squat or kneel for a bit, I get a horrible, throbbing, shooting pain along the outside of my right knee and down towards the ankle when I stand back up. It lasts ~30 seconds, throbs, stings, and brings me close to tears.

Believe it or not, I didn't think twice about it, except for figuring that it would pass as I get more in shape after a long, inactive winter. I've been overusing my right-side upper body, blah blah. However, I work with doctors, and happened to mention it in passing this morning at a meeting.

Then I saw this thread and began to wig a little at the very strong reactions. So I dropped by each of their offices and asked whether I should go see my doctor. They talked with me a bit more in detail, and I explained what I've just said above and then replicated the problem to make sure I was describing it well.

One's response was "Eh, get a massage" and the other's was "I'd take Tylenol round the clock for two-weeks."
posted by Stewriffic at 11:16 AM on April 14

Though your deductible is high, if you don't go to the doctor's now, you may end up paying even more in the future. Also, if you ever change insurances, you may not be covered for whatever this is, as it could be a "pre-existing condition".

Get yourself fixed, now.
posted by explosion at 11:30 AM on April 14

See a Dr or 2 or 3. there are too many bad things this could be (odds are nothing) so an ounce or prevention now...
(i see this regularly as I work in the chronic pain industry)
posted by doorsfan at 12:42 PM on April 14

When I got this last year it was because of a pinched sciatic nerve, and that happened because I used the psoas muscle in a way that isn't all that frequent. I am not saying you should not go to the doctor, but what you are feeling doesn't have to be symptomatic of a herniated disc. If you check yoga sites for stretching the psoas, you'll find a number of exercises which helped me and which might help you.

I took a lot of ibuprofen to stop the swelling at first, and even with that aboard it was painful enough that a couple of times my gf found me lying on the floor, chalk white and sweating like mad. These painful episodes would pass pretty quickly but they are extremely memorable.

This resolved with light but daily exercise to stretch the psoas.
posted by jet_silver at 12:43 PM on April 14 [1 favorite]

IANAD, "With backs nobody knows nothing" - The Sopranos, etc etc

I've had back problems off and on for years... happily I've been mostly pain free for a long time (though I still get twinges occasionally) but I've been 'oh jesus I can't move' times.

First you really do need to see a doctor, if only to discount it being something really nasty

The school of thought runs now that you are better off trying to be mildly active even if you if you are in pain, rather than let things lock up

Things that helped me in the long run:

Seeing a really good physiotherapist that got to the root cause of the problem and who gave me specific exercises to do. Since then I've had no really bad acute episode because if I feel stiffness or twinges coming on again I just start doing them again. (You might have to shop around because the first one I went to did nothing really)

The more general exercises in Treat Your Own Back by Robin A. McKenzie

Being very self-conscious about not slumping whenever I sat, and slowly increasing my general finest and flexibility.

For immediate pain relief I found Ibuprofen and heat-gell pack to be the best thing.
posted by fearfulsymmetry at 12:57 PM on April 14

I have chronic back issues. My advice: Avoid chiropractors. See a good doc. Don't stop moving altogether. That will only increase back pain. But give yourself a couple of days. As you start to feel better, start exercising, but with more caution. Don't try to go from couch potato to Olympic athlete in one afternoon. Forget the "No pain; no gain" slogan. For each new movement, try it once or twice and see how your body feels the next day. Then gradually do more. Yes, that makes getting back in shape take longer, but you're not 15 anymore.
posted by keith0718 at 1:35 PM on April 14

IANAD. It sounds like, among other things, you made your sciatic nerve unhappy.

It's not a quick fix, but there are fantastic exercises in this book:
Low Back Disorders: Evidence-based Prevention and Rehabilitation
by Stuart McGill

In this book, there are exercises for the transversus abdominus, the multifidi, and the rectus abdominus. There is also a technique for sciatic nerve "flossing" that frees up nerve impingement.

I have no idea what you did, but it's probably not that big of a deal, if you compensate for your desk job or whatever and counteract the weakening and shortening that takes place over years and years.

If you're gentle with your back for a few days or weeks, it'll probably go away. Again, IANAD!
posted by zeek321 at 1:45 PM on April 14

IANAD.

Find a good physical therapist that specializes in manual therapy. Before you make the appointment, ask if anyone in their office is an orthopedic certified specialist (look for OCS after their name), certified in McKenzie technique, or certified by the North American Institute of Orthopedic Manual Therapy. Make sure you are scheduled with that therapist. These are good indications that you have found a good PT -- there is a fairly wide range of expertise in physical therapists, and you need one that is very skilled in dealing with problems like yours. Find one that will spend a reasonable amount of time with you, and they should get their hands on you and see what's going on.

Radiating pain is something to get checked out -- it could be a number of things, and nobody online is going to be able to tell you what.

Also, the squats routine recommended above doesn't really make any sense -- there's no way to tell that what you have is a muscle belly injury, radiating pain in fact signals that it is not a muscle belly injury, and even if it were, that routine there could do you a world of hurt. Sorry, Tiburon.
posted by jennyjenny at 6:36 PM on April 14