Still hurting
January 17, 2012 3:28 PM   Subscribe

Tips for coping with day-to-day life and a herniated disc?

Hi y'all,

About 3 months ago, I injured myself by lifting improperly and was diagnosed by a GP with a "disc injury". I was sent to a wonderful physical therapist straightaway and began recovering very quickly. I kept up with the stretches, cut down on the heavy things I was carrying, and the sciatic pain, when it would pop back up, was always very manageable.
Unfortunately, last week, I bent over at just the wrong angle (honestly still unsure just what I did) and now my injury is much much worse. I spent most of the weekend lying flat on my back, barely hobbling around. I'm managing now to get around to perform basic things but the pain is pretty severe. The doctor thinks I most likely herniated a lower lumbar disc.
I am scheduled for an MRI, still seeing the physical therapists, and will probably progress to getting injections if the pain really doesn't improve, so my question isn't really about a course of treatment - a glance through other threads confirms that this really does vary per person and per injury.
I'm more interested to hear if any of y'all have any tips for getting through this thing, day by day. I'm trying to keep spirits up but am starting to feel depressed. My loving boyfriend and awesome roommate are the best and help with things, but I'm afraid I'm wearing thin on their patience. Painkillers don't really help - I take muscle relaxers to help me sleep but obviously can't take those during the day. I am about to begin another semester of grad school, which will be enjoyable but challenging, and the pain makes it hard to focus. (Plus all that sitting is like the worst thing for it.)
This has been a challenging year for me regardless, as I'm starting grad school in a new city that is great but still, well, new, so I already feel a little overwhelmed and sometimes isolated. This injury is really making things worse - I feel like crying or just hiding in my room and watching TV instead of seeing any friends or trying to get out, afraid that any little step I take might send me into debilitating pain/turn me into a crippled old lady/etc. I'm already prone to anxiety and depression anyway, and this does not bode well. I've got a heating pad, a rolling backpack, stretches I hope to be able to do again soon - but I'm starting to worry about my schoolwork and how I'm going to be able to manage day-to-day tasks if this doesn't get better, and my mood sours, and it's a vicious cycle.
If anyone has tips for getting through the emotional/mental aspects of this, assuming that I will eventually reach a point where the pain decreases, I would love to hear them.
Thank you, as always.
posted by bookgirl18 to Health & Fitness (14 answers total) 4 users marked this as a favorite
If you're sitting in lectures, get a note from your doctor over to disabled students offices-I had a slipped disc my last quarter of university [ended up with awesome healing surgery!], and got a note from my doc to disabled students to my professors that I had to stand up and walk around every 10 minutes bc sitting longer was BAD. I obviously changed my seat to the back of class to be as little of a disruption as possible.
posted by atomicstone at 3:34 PM on January 17, 2012

You poor dear. It's a horrible, horrible thing to be in pain. I was in your shoes a few months ago. The biggest thing that helped me emotionally/psychologically was, frankly, reducing the pain. I urge you to go back or be in contact with your doc and explain how much pain you're in.

When I hernited L4/L5, at my first appointment my doc put me on hydrocodone (for nighttime pain - yes, this is definitely not a daytime med) but also on skelaxin (sp?), specifically for daytime. And I have some serious daytime limitations: I'm a mom and I can't be out of it when a child's well-being is at risk. The skelaxin was strong enough to give me some relief but did not make me high/loopy/etc. You can also ask for a stronger dose of your nighttime pain reliever. Don't be afraid to ask for this. Yes, it's true, some docs are hesitant because there are people out there who abuse painkillers, but be persistent and stand up for yourself if necessary. Might be helpful to take boyfriend to the doc if you feel you're not strong enough right now (because of the pain) to be a great self-advocate.

But the big thing that helped take the edge off the pain for me was an immediate and big dose of prednisone. That's a steriod, and its purpose is to bring down the inflammation. When it comes to disks, it's that inflammation that's killing you -- and bringing it down, even a bit, might be just what you need to reduce your pain from levels that provoke insanity to levels that you can deal with. I had a high dose that tapered over the course of a week or 10 days. (Prednisone has side effects, I'm not a doctor, discuss this with a professional, etc etc.)

The other thing that helped me a lot at the beginning was sitting in a hot tub (I did this at a local gym) and movement in a pool. Not swimming per se, but a water aerobics class that did underwater movement which was not swimming. (Swimming was too difficult at first; you can see my follow-up comment on my question here. Also, I got a nifty zip-up-style swimsuit because I absolutely, positively could not contort my body to get into a regular suit at that time.)

Good luck. You WILL get better. You will.
posted by BlahLaLa at 3:45 PM on January 17, 2012

I found the exercises in a book called "Pain Free" incredibly helpful in getting my back working again and, much more critically, in preventing relapses. The stretches my PT friend gave me helped the initial pain but it didn't actually get better until I found the Pain Free book.

Also lie on an ice pack for blessed relief
posted by fshgrl at 4:03 PM on January 17, 2012

One more thing- those heated back pads worked well for me for immediate pain management.
posted by fshgrl at 4:06 PM on January 17, 2012

Again for heat. That's really the only thing that does much for me with acute pain and what they call "tenderness."

When you're better, and that will be sooner than you realize, try to work on developing muscles and habits that will protect your back.
posted by Lesser Shrew at 4:30 PM on January 17, 2012

My own book recommendation would be Treat Your Own Back, which follows the McKenzie method of stretching to reduce pain and regain mobility. My physio recommended it to me, and when I do have flare ups (twelve years after my second surgery, I still do, which is why I'd really, really suggest that you do as much as you can to avoid surgery), I still use the stretches and stabilization positions outlined in the book.

In a way, you really need to reevaluate what you can and can't do. Up until my disc issues, I was the strong guy who carried things for people, and I really can't be that guy anymore if I want to keep my back healthy. You need to try to change the things that you were used to, but are no longer healthy for you (sitting positions, sleeping positions, posture), and most importantly, work on building up you core (gut and lower back muscles) which helps take pressure off the discs.

That said, no, IANAD, IANAPT, but I have been living with disc issues for almost 15 years now.
posted by Ghidorah at 6:33 PM on January 17, 2012 [2 favorites]

Back pain sucks!
I have 7 herniated discs, three in my lower spine and four in my neck. I've had them for years, as I have the pain for as long as I can remember. Done the PT, still do stretches and (been slackin' lately) working out my core.
I manage the pain by doing the following:
Heatpad is your best friend.
I take nerve blocking medication daily for the numbing limbs, shooting nerve pain down my leg.
I take muscle relaxers multiple times a day.
I take opiate medication and you get use to the drowsy feeling after a while, narcotics generally don't disable me like they use to back in the day.
I take walks regularly, and can't really sit for long periods of time.
I smoke marijuana in the evening/weekends in order to distract me from the pain, It really helps me reduce my medication needs and be more productive in general. If you don't like smoking, you can always enjoy some good cannabutter and/or tinctures.

Take care of yourself, back injuries are no joke. I am just unfortunate enough to have arthritis in my spine, and I wouldn't wish this pain on anyone.
posted by handbanana at 6:59 PM on January 17, 2012

I've also did spinal injections, and steroids but found them relatively ineffective.
posted by handbanana at 7:00 PM on January 17, 2012

I don't know if you've tried ice baths, but they can be helpful for reducing inflammation. If your pain is mainly coming from spasming muscles due to the disc though they may not be a good idea.

Have you tried sleeping, reading, watching TV while lying on your back with your lower legs propped up, like knees at 90-degree angle and lower legs on pillows or a footrest or something? This helped me quite a bit by taking pressure off the lower back and helping the muscles to relax a little.
posted by schroedinger at 8:29 PM on January 17, 2012

Ugh. This happened to me two years ago. For several months I was in moderate pain that decreased for a little while, and then I suddenly started to experience some of the worst pain ever, which put me on my back for about three months.

I had injections, but I don't think they helped much. The weird thing was that the spine specialist was the one who insisted that physical therapy wouldn't do anything for me, but when my primary care physician's partner saw me to prescribe some stronger painkillers, he scheduled six weeks of therapy for me anyways. After three weeks of therapy, three times a week, I was walking upright again; six weeks later I was backpacking in the Manitou Islands in Lake Michigan and feeling no pain. So maybe you need to get back to the physical therapy, especially since it helped you before.

Sitting for any length of time was painful; I was at home lying on my back on the sofa doing work (I'm a technical editor). My little Asus Eee netbook was really helpful here, because it was light. A rolling, adjustable tiltable bookstand was also very useful.

Since I couldn't stand for more than a couple of minutes at a time, my dear husband got me a bath chair from the drugstore and put it in the bathtub for me. He also replaced the shower head with a hose sprayer. Sitting to bathe was still somewhat painful, but not as painful as standing.

To get around, I used the walking stick I normally use for hiking. It helped quite a bit.

It was awful. Believe me. I thought I would never be pain-free again, and I cried frequently from pain and frustration. But I'm here to tell you that it likely will pass. Hang in there.
posted by tully_monster at 11:30 PM on January 17, 2012 [1 favorite]

It's interesting to see all of the lie on your back advice, since that's roughly the worst position I can be in. The Mckenzie physio I saw made a big deal about finding the point where I felt a stretch, and not going any further when I was doing my exercises. He said that any position you are in which actively causes pain means you are actually inflaming the nerve more, an you should try to move to a non-pain position as quickly as possible.

In other words, if lying on your back hurts, move around until you find a position, however ridiculous, that doesn't hurt. For me, I need to sleep on my side with a pillow between my knees to keep my hips from shifting. For stabilization, I usually lie prone, and if I need to mark papers, propping myself up with a couple pillows under my chest help me function and stretch my lower back at the same time.
posted by Ghidorah at 11:40 PM on January 17, 2012 [2 favorites]

Don't be afraid. Herniated discs sound scary so you may think that something is very broken and that may, even if only subcounciously, make you afraid to move again, because you'll be afraid to "break" something again. Whether a disc is herniated or not has not much to do with how much pain you have. There are studies that show that quite a few people with no pain have herniated discs, and on the other hand, quite a few people with pain have perfectly normal discs. Movement is enourmously important, all current back pain specialists agree that it is important to keep as active as you can. Motion is lotion.

This is a good 15 min video about pain. It may help a bit to understand more about what pain is, to get your brain out of "must protect back at all costs" mode. This is a nice writeup about pain science.
posted by davar at 12:27 AM on January 18, 2012 [1 favorite]

I'm a little late to the party, but you may find some helpful information in the answers to my recent AskMe question about back pain.

You say that you can't take the muscle relaxers during the day, which I totally get, but could you function after taking half of one? I sometimes have days where the only thing that keeps the pain manageable is half a Vicodin at a time. The pain isn't totally gone, but I'm not a drooling idiot either. I still don't drive while on the meds though, even if it's just half a dose.

The mental aspect of it is hard, especially if you're already prone to depression and anxiety. Back pain is so nebulous, and what if you have to get shots and what if they don't work and then there's maybe surgery OMFGIMONLY28 WHYISTHISHAPPENINGTOME?!! I still deal with this on the really bad days.

I'm already being treated for depression and anxiety and was able to get my prescription adjusted on a temporary basis to help with all the angst I was carrying around because of the pain. If you're already being treated, talk with your doctor about how the pain is effecting your mood. If you're not being treated, it may be something to look into.

You mention seeing a physical therapist. How often are you going? Are you comfortable with the therapist? If you're not seeing results, you may want to investigate other offices in your area. I honestly thought physical therapy was going to do all of nothing for my back pain, but it's helped a ton. My PT guy was awesome and I was going two to three times a week until my insurance decided they didn't want to pay for any more visits. If you have insurance that will cover PT, use it for all it's worth. Even if you aren't going regularly, try to maintain a light exercise regimen using any stretches or exercises they taught you.

Another thing that's helped me is the support I've been getting from my boyfriend. He's the one that drives when we go places, buys me spaghetti oh's when I'm really grumpy, will bring me a heating pad, and switched sides of the bed and couch so I'm more comfortable. Do you have a friend or SO that could fill the same role for you? If not, try to think of little things you can do for yourself to keep your spirits up. Would peanut M&M's go great with whatever you're reading or watching on TV? How about a pedicure or a haircut?

When it comes to going out, I'm much more of a homebody now because of the pain. Sometimes I feel lame about it, but I just try and remember that forcing myself to go out for the sake of not being lame isn't worth the extra pain. When I do go out, I try to limit myself to spending time with people that I really enjoy and know about what's going on. That way, if I need to get up and walk around during dinner, they aren't offended or confused. If I need to bend over and touch my toes during a conversation, they just keep talking. We all crack jokes about how I'm getting old and falling apart before I'm 30.

I guess the tl:dr version looks like this - Eff you, back pain. There are still things that make me happy and you can't stop me from doing them all. I'm just going to be over here eating my spaghetti oh's, laughing about how the boyfriend called me 'mighty midget' when I couldn't stretch to reach a bowl in the cabinet. Did you see how I didn't fall off the exercise ball when I was doing my stretches? Take that - and here's some Tylenol 3 for good measure.
posted by youngergirl44 at 2:43 PM on January 19, 2012 [1 favorite]

Thanks, y'all. It's a really frustrating process - I start to feel a little bit better, and then I climbed a flight of stairs that was too difficult and now today I can't get out of bed. Not being able to go about my daily routine at all, not to mention try to stretch, is really really hard. I am trying to, as Ghidorah said, re-evaluate what I'm able to do, but I seem to be doing it the hard way. :(
My MRI is tomorrow, so hopefully that will open up a discussion for new avenues of treatment. And perhaps BlahLaLa is right and I should ask for harder pain meds.
Thanks again.
posted by bookgirl18 at 8:02 AM on January 26, 2012

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