Help my back not hurt.
September 2, 2011 6:28 PM   Subscribe

If you had an L5 injury, and you were a runner, how would you treat it?

YANMD. YANAD at all, perhaps. You may not even be interested in the fact that I REALLY want a nice time at the Staten Island Half Marathon next month.

I’ve been dealing with an L5 displacement for the past few weeks. (I am apparently the most injury prone runner EVER, having now dealt with ITBS, shin splints, PF and a back injury in 17 months of running). Most of my injuries stem from the fact that i had serious birth injuries 31 years ago, and my body runs a little strangely.

Anyhow, my spine doctor has me on Ultracet (325 mg – two or three times a day) and Mobic (7.5 mg – once per day). I’ve been taking the pills faithfully for about two weeks now, and am running pain free, 25-30 mpw.

However, if I take even ONE day off the meds, I’m completely half limping, in sciatic pain, etc.

I have another appointment next weekend, and the doctor said if I wasn’t doing better on my own, that I could do an injection into my spine that would make me at least 80% better automatically.

I am REALLY frightened of doing this. Not because I’m afraid of needles. I have six tattoos. I’m just afraid of someone injecting things in my spine.

Should I seek out a different doctor/pain management regimen? My dad says I should use his chiro, but unfortunately, they don't take my husband's insurance.

I'm open to all kinds of weird therapies, medicines.
posted by roomthreeseventeen to Health & Fitness (15 answers total) 4 users marked this as a favorite
I'm open to all kinds of weird therapies, medicines.

This is not what you want to hear but how about skipping the marathon and taking it easy? If your injuries are related to running moderate-to-heavy mileage with bad kinesthetics, then you can either stop running, change your kinesthetics (earier said than done), or continue to cause self-injury and mask it with pain relievers. Running is great. I ran in college competitively. But I'm a strong believer that it's not for everybody. If your injuries were related to your new hobby of hitting yourself in the back with a 2-by-4, would you keep doing it?
posted by drpynchon at 6:55 PM on September 2, 2011 [3 favorites]

My dad says I should use his chiro, but unfortunately, they don't take my husband's insurance.

Chiropracty does not rest on a solid foundation of clinical evidence anyway, so consider yourself saved from an opportunity to waste time and money.

I’m just afraid of someone injecting things in my spine.

I would talk to your doctor more about this, find out what the procedure is called and what is injected, and try to find accounts from previous patients. Your doctor will disclose to you the associated risks of the procedure; if you don't feel comfortable with the thoroughness of his or her explanation, seek another physician in that specialty and get a second opinion and a further explanation. Perhaps if you explain your reluctance to undergo this particular procedure, your doctor can propose alternatives.

Also. there is substantial merit in drpynchon's advice. Sometimes you need a period of low-key physical activity or a change of exercise regimen to allow the ordinary healing mechanisms of your body to work effectively.
posted by Inspector.Gadget at 6:58 PM on September 2, 2011

seconding drpynchon - work with the doctors, figure out what's causing the problem, then fix it. the running's not important compared to the health of your spine.
posted by facetious at 7:03 PM on September 2, 2011

Chiropractory, especially where the lower back is concerned, is as effective as drug and rest based intervention, following the least charitable interpretation. There's a lot more information about when spinal manipulation is effective if people woud care to gather information before presenting preconceptions as facts.

It's particularly particularly effective on recent injuries. I am also a runner, though not a marathon runner, and displaced my L5 demolishing a dock a couple of months ago. It was pretty bad. Crippling, you might say. Since I'd prefer not to be pumped full of random drugs instead of being treated, I went to a chiro, who manipulated my back twice a week for four weeks and advised that I lay off weightlifting and jogging. Running, as in sprinting, or 800m pace was fine. Swimming was better. Also, ice. I did what he said, was human again shortly after the first manipulation, and came away with no permanent weaknesses.

Of course, this is anecdotal. Even so, I'd find a highly rated chiro that does take your insurance. This is precisely what chiropractory works well on.
posted by cmoj at 7:21 PM on September 2, 2011

I'd take some time off running.
posted by jacalata at 7:27 PM on September 2, 2011

I forgot to add that I took all of May off, and half of August. Time off doesn't do anything for my body, and running doesn't make it worse.
posted by roomthreeseventeen at 7:49 PM on September 2, 2011

Have you done PT yet?
posted by ch1x0r at 8:43 PM on September 2, 2011 [1 favorite]

I've had some success with an inversion table, but I would DEFINITELY consult your doctor before doings so. IAMNAD, etc.
posted by digitalprimate at 9:09 PM on September 2, 2011

Sigh. What does "better" mean according to your doctor? From your description, it seems like he views better as "requiring medicine indefinitely". What those pain pills are doing is NOT fixing you, it's temporarily covering up your symptoms. This is WRONG AND BAD. It means that you are doing ADDITIONAL DAMAGE to yourself because you do not feel when something you do causes further injury.

Please go see someone who will actually work on healing you rather than covering up the dysfunction in your spine. A massage therapist, a physical therapist, a (good) chiropractor, or all three.
posted by parrot_person at 9:12 PM on September 2, 2011 [2 favorites]

I've had an L5 injury and ran through it for a while. Then it got too tough to run because the sciatica was so bad I couldn't run, walk, or even stand for more than 5 minutes at a time without being in pain. I got 2 of the spinal injections you're talking about (also, I took mobic as well). The spinal injections didn't help me, but they might help you. But the main thing is, they're not that bad. They give you local anethesia so you don't feel them. The bottom line with me is that I needed a spinal laminectomy to fix where my L5 pressed on my sciatic nerve. Ever since then I've been fine, and I have even run distances greater than half marathons. Good luck.
posted by MoonOrb at 9:13 PM on September 2, 2011

Nix the marathon and get thee to a physical therapist, who will adjust you if needed and give you exercises targeted to strengthen the appropriate support muscles.

Rest isn't going to fix your problem, and I'd personally consider an injection only after PT had failed.

(And you might want to see a different doc.)
posted by moira at 9:45 PM on September 2, 2011

FYI, I'm not running a marathon. It's a half marathon, and I run 10-13 miles every weekend.
posted by roomthreeseventeen at 6:06 AM on September 3, 2011

get thee to a physical therapist, who will adjust you if needed

At least in the US, physical therapists are prevented by law from doing adjustments. It is out of their scope of practice and they could lose their license for doing so. See a chiropractor for adjustments.
posted by parrot_person at 6:05 PM on September 3, 2011

To clarify "adjustments," my own physical therapy doctors, who were very much working within the bounds of their licenses, did not do the extreme body twisting, pressing, and crunching that chiropractors do. (Yes, I went to a chiropractor repeatedly, and it did no lasting good.) They utilized specific, gentle methods to help realign my pelvic girdle, and gave me exercises to keep it that way. I also had gentle corrective adjustments and exercises for kyphosis, again very different from what my chiropractor had done. All of this was extremely effective.

These were (mainly) three therapists from two highly-regarded, medical practices in the U.S.
posted by moira at 2:06 PM on September 4, 2011

I'm a few days late here, but have spent a lot of time in the same boat you have. One question: do you think the running CAUSED the L5 displacement? Because if that's the case, there's something wrong with your form, and if you keep running (in the way that caused enough trauma to displace a disc), you're just going to keep re-inflaming it. L4/5 injuries are a special class of misery, and it's tough to take people at face value when they tell you to stay off of an injury, but until you get the injury under control (I'd listen to people who are telling you to see a physical therapist; it's the only thing that has helped me. Be warned that depending on the severity of the injury, you might be talking months and not days of therapy), high-impact physical activity that affects your back (basically any sort of running action that isn't on an elliptical machine) is going to cause further flareups. I notice you've said the running doesn't seem to make it worse, but I would submit that while you're spending your days on narcotic pain meds, you're probably not able to assess what is and isn't making the problem worse (especially since it can take a day or two to manifest).

I would also consider finding another doctor if this needs long-term management, because the absolute worst thing a doctor can do is give you weapons-grade pain medication and then tell you to be on your way without giving you a treatment regimen that's going to fix the problem...
posted by Mayor West at 4:33 AM on September 6, 2011

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