My pain in the ass, I mean lower back
May 8, 2013 5:57 PM   Subscribe

Three days ago I was negotiating my XXL body around one of the smaller spaces in my XXS apartment when I got a sudden sharp pain in my lower back, left side, just above the hip, causing my left leg to buckle. I caught myself before hitting the floor and the pain went away (except for a barely detectable ache), but since then, it recurs if I move my back in 'the wrong way' - a category that is expanding daily. Standing up straight, sitting up straight, walking very straight and laying down is painless (except I'm starting to notice amild ache in my usual sleeping position, laying on my left side). The only pain medication I have access to, Ibuprofen, is minimally helpful. YAallNMD, but with three days of worsening, is it time to get my ass to a doctor while I can still move my ass, or should I give it just get comfortable and relaxed, and not move for X hours first?
posted by oneswellfoop to Health & Fitness (15 answers total) 4 users marked this as a favorite
If you have the resources to see a doctor, this sounds like something you should see a doctor for.
posted by The Underpants Monster at 6:07 PM on May 8, 2013

I don't understand why you wouldn't go to the doctor. It seems to be worsening and you can't get comfortable in any position - why would you have any reasonable expectation that it will magically go away?

If you explain your reluctance to seek help, maybe people can recommend some alternatives to try first. If you're just trying to be tough - why? Life is too short to be in pain.
posted by desjardins at 6:07 PM on May 8, 2013

Hi. This was me a couple of years ago. Yes, go to the doctor now. You need a stronger pain pill, a stronger anti-inflammatory, and a prescription for physical therapy. Please do this now, because you will solve your problem while it is at a "beginning" stage, rather than waiting till the "now it's an emergency and I can no longer sit, stand, lie down or drive" stage. Um, as I did.

My doc gave me Vicodin (which I could only tolerate at night, but that was good because it helped me finally sleep), and Prednisone (not my favorite medicine, but it does its job, namely to reduce that inflammation), and six weeks-worth of physical therapy, which he later extended another six weeks. I had a huge reduction in pain right away -- within the first few days -- and about ten days after the doctor's visit I started PT, which I used to gradually strengthen the muscles in my back, my abs (turns out, this is verrrry important for your back), and the associated small muscles which assist in all of my daily movements. I got better. I do have some lingering issues two years later; I attribute part of that to the fact that I waited until I had reached the emergency stage.

Interim solution for tonight while you wait for your appointment tomorrow: those stick-on Salon-Pas style pads. Have a friend run out to the drugstore and buy the largest size. There are different brands - you want any one of those Tiger Balm/IcyHot/Ben-Gay style things, stuck on your back 24/7 until you see the doc. MeMail me if you like.
posted by BlahLaLa at 6:18 PM on May 8, 2013

Go to the doctor if you're worried, but don't expect a miracle cure. Google "lower back pain", there is tons of advice, most of it self-consistent & pretty much what my doctor told me, 30 years ago, when I first did this to myself. As has been said above, the corrective treatment is likely exercise and stretches.
posted by mr vino at 6:29 PM on May 8, 2013

Bump it up to naproxen (brand name: Aleve), take two or three at a time, twice a day. The label will tell you that 2 is the max, but you can take more. Warning: a side effect of naproxen can be loose stools or diarrhea. You probably won't experience that with 2-3 pills a day, but it should be noted.

Okay, after that, I ruptured a disk (L5S1) about 15 years ago which nearly ruined my life. Horrible sciatic pain, a burning sensation which would originate in my very-low back and then would radiate down my right leg all the way to my big toe. I could barely walk or move for a long time, and routinely used a cane or walking stick to get around for several years.

I'm not like that anymore, but not because of any medical intervention.

The two factors which solved my problem were 1) finding the right way to sleep, and 2) strengthening my core and the muscles surrounding the injury and learning how to move.

Learning how to move was the first step. There are certain things which make it worse, other things which don't. These are likely different from person to person. For me, it was to perform as little "twist at the waist" movement as possible (I turn with my feet) and to rethink how I carry loads and lift things. This was all learned through trial and error. At this point I'm pretty confident with how I move, and can do most if not more things than i did originally.

The second thing was learning about sleeping. I went through several mattresses, sleeping on the floor, all kinds of things... And then I discovered my couch. It's long enough for me to lie down on (rare for my 6'1" frame), but it let me lay at an angle between "on my side" and "on my back" which put most of my weight on my good (left) side while letting me settle the rest of my body against the cushions on the back of the couch. I slept on my couch for about 5 years. I don't sleep there anymore.

This is largely because learning how to move and finding the right sleeping position let me begin to live some days without pain and so I was able to function, and as I functioned I was building up the parts of my body which supported everything surrounding my injury. The more days I could function, the stronger I got, and the more days without pain I had.

At this point I'm nearly pain free, but still quite afraid of aggravating my injury and regressing. I no longer walk with a stick, I now sleep in my regular bed (granted, it's memory foam which helps a LOT), I hardly ever take even naproxen for my back, and I work at an extremely active warehouse job which has me on my feet picking things up and putting them down again all day.

Now... All that said....

You should certainly get to a doctor. But just know, my experience shows that recommended surgery or other medical interventions are not always needed. Sometimes it's just a combination of self-study and habit adjustment and the passage of time which can provide the eventual relief you need. It's just getting through all the crap in between which can be difficult.
posted by hippybear at 7:16 PM on May 8, 2013

Seconding BlahLaLa. When back pain starts to interfere with your daily life it's time to see a doctor.

I ended up with chronic back pain because I didn't see a doctor after a back injury. The sooner you see a doctor the more likely it is you can begin treatment that is right for you. It might take several doctors and several treatments before you figure out what is right for you. It is probably a combination of exercise and anti-inflammatory mecidine.

I am not a doctor. Take this advice at your own risk. If you tolerate ibuprofen well and can get your hands on tylenol take them together. You can take up to 1000mg of ibuprofen at a time. It will be hard on your stomach so eat something. That's more than the recommended dose, but that's what my rehab medicine physician and neurologist have instructed me to do for short periods in the past. Do not take more than the recommended dose of tylenol. It's worth it to go out and get the tylenol because these two medicines together will give you more relief than just the tylenol on its own.

Use heat or ice on your back. It doesn't matter which, use what gives you relief.

Don't do any stretches or exercises until you see a doctor. You could worsen your problem.

It's probably nothing. It'll probably go away on its own in a few days or after a course of steroids. But it's better to be safe than sorry. Trust me, seven years and counting of neverending pain.
posted by vincele at 7:18 PM on May 8, 2013

I am not yet to the point where I would normally call the doctor, but at the rate it has gotten worse, I'd hit that point by Friday, which is a bad time to call my doc. Again, it's not constant pain, so it's harder to tell what relieves it, but the fear of the big twinge is stressful and makes me 'tighten up' in ways I shouldn't.

I have since chatted with a neighbor who reminded me I had just gotten over a bad cold that put me mostly in bed and non-mobile for over a week, so I was obviously vulnerable to straining and MAYBE being MORE active would help. Well, I was so angry, I lunged at him (not really, but I did do some walking/trotting around outside which is not the obstacle course my apartment is) and came back inside feeling a little better.

So, I then tried the simple exercises in the video MoonOrb had previously linked (in my pre-posting search, I overlooked the 'Competitive Powerlifter' AskMe because that was SO not me). The first time I did each I got a little twinge, by the last rep, nothing. I'm impressed.

Will acquire other OTC main meds (Aleve, Tylenol, Salon Pas) and try them out JUDICIOUSLY, do the exercises, increase my activity JUDICIOUSLY, and if it's not down to nearly nothing by the end of the weekend, I'm clearing my next week for medical consults.
posted by oneswellfoop at 7:40 PM on May 8, 2013

I am a doctor and I have never prescribed a patient more than 800mg of ibuprofen per dose. I particularly wouldn't recommend it over the internet to a stranger. There are risks even with my usual RX dose, although for a healthy person and short term use the risk level is not high. Also, Aleve and ibuprofen are both NSAIDs so I would not recommend combining them - if you're not getting relief with the maximum dose of ibuprofen it would indeed make more sense to try alternating it with Tylenol. The Salonpas patches have an active ingredient similar to aspirin (i.e. also an NSAID).

Glad you're getting relief with the stretches.
posted by treehorn+bunny at 7:58 PM on May 8, 2013 [1 favorite]

MoonOrb, that video is amazing. Thanks for sharing it.

oneswellfoop, I may have something similar to your bum hip. Lumbar support belts, sacral wedges, and pilates have been a big help. Rolfing too, even though I am skeptical.

Also I think moving around regularly but in a non-strenuous fashion helps. If you have a day job or any hobbies that keep you at your desk for hours at a time, get up every 25 minutes so your lower back/pelvis won't get more hinky from being stuck in one position for an eternity.
posted by spamandkimchi at 8:25 PM on May 8, 2013

Here's a MobilityWOD video expanding on that pelvic fault treatment.

Generally the best practice for surviving the initial week or so of inflammatory agony is to encourage as much blood & lymphatic flow through the lumbar-pelvic muscles as is practical - walking is usually a very good way of doing this, and when you can manage them without debilitating discomfort, basic back stretches and stability drills.
posted by Kandarp Von Bontee at 8:43 PM on May 8, 2013

I realized it happened while you were moving around, but in my direct experience something that's actually diagnosed by a doctor as a muscle issue can still turn out to be a kidney/ureter stone. Or two. :| So yeah, go to a doctor and if what s/he suggests doesn't help soon, get back in contact right away.
posted by wintersweet at 8:52 PM on May 8, 2013

Seconding wintersweet - when I had my kidney stone, I was sure I'd just "pulled a muscle." First, find out what's wrong with you, then figure out how to treat it. Even if it's your back or muscles in your back, some things are best exercised but others are best rested. Diagnosis first.
posted by aryma at 10:53 PM on May 8, 2013 [1 favorite]

Seconding Blahlahlah. I had pain, and I ignored it, or thought I could just deal with it. By the time I got to the 'agony, no position offers any relief' stage, surgery was pretty much the only option.

The thing is, as you've just seen from the YouTube stretching video, if you catch this stuff early, you can pretty much take care of it with stretching and adjusting your posture. I would still go see a doctor/ physical therapist. It's one thing to watch a video online, it's another to have a professional guide you through the exercises, and to give you a personalized regimen.

Just a food for thought thing: I didn't do any of what I'm recommending. I'm saying all of this because right now, twelve years removed from my •second• surgery, I'm going through yet another period of feeling a bright circle of pain around my right ankle, combined with searing muscle cramps from flexing in whatever my horribly abused nerves decide is the wrong way at the current time.
posted by Ghidorah at 2:14 AM on May 9, 2013

I had a lumbar disc removed surgically in 2006, and at the time my surgeon told me that it looked like I had another disc that was prime to give out at some time in the future. I experience lower back/ sciatic problems a few times a year now, but it hasn't come to the point where I'm ready to go back under the knife. As a matter of fact, my back started acting up this last Sunday when I bent over to put a coat of spray paint on a project.

What helps me in these times is to stay on a low dose of Ibuprofen around the clock. I take two every 4-6 hours all day. There are also a few stretches I have learned are particularly helpful for me:

Piriformis Stretch (and there are a lot of ways to do this, you can search around and try others if you think it might help)

Cat / Cow yoga poses This one helps me a lot. I usually do this a few times and then do Child Pose and really try to stretch my arms out as far as I can.

Usually, a few days of this puts me back in pretty good shape. I'm about to go into an empty office and go through these right now, as a matter of fact. YMMV, but this stuff helps me.

But you also know your body better than anyone else. If you need to go to the doctor, then go. Once I saw the MRI of my herniated disc, I knew there was no way PT or anything could help me. It was bad enough that my surgeon's reaction on seeing the image was "How are you able to walk?" So, sometimes medical science is the only way to go.
posted by Shohn at 6:09 AM on May 9, 2013

Everyone else has offered really good advice with the stretches, and like the others I'd suggest seeing a doctor. Other conditions can present as back pain including kidney stones, and in my case gall stones so better safe than sorry.

I have found ice can be wonderful for pain relief, it usually is used when the injury first occurs but I've had good results using it for pain management even days after an injury if the pain was caused by inflamation. Also a heat pad can be really useful and I know some people prefer the heat. This link has a lot of useful info.

Keep up the ibuprofen on a regular cycle 4-6 hour cycle (making sure not to overdose), don't wait until you hurt to take it. If you are in a lot of pain you can take Ibuprofen and Acetaminophen (paracetamol) at the same time as they work differently in the body, but again being careful not to take more than the recommended does of either.
posted by wwax at 9:02 AM on May 9, 2013

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