L3 or L4 DISC HERNIATION?!
Question: I have had a recocuring back pain that is so paralyzing, that I cant take the spasms anymore. I got hurt 2 and a half weeks ago, running for a backhand dropshot in tennis. I felt it go, dropped my racquet and did nothing for 10 days. It felt better by then, I stopped running, basketball, anything that involved pounding. I started doing the elliptical machine and love it. I am 5'11 183 pounds and in great shape, except for this. I was putting on a pair of jeans yesterday morning, simply bent forward and "bang" there it was again. I have gone twice for physical therapy, but he cant get the spasms to stop. I have gotten electric stim, heat, ice, and little manipulation etc. Nothing is working and I am totally bent looking. Should I go for an MRI, or something else? Please advise.
Answers: I have had a recocuring back pain that is so paralyzing, that I cant take the spasms anymore. I got hurt 2 and a half weeks ago, running for a backhand dropshot in tennis. I felt it go, dropped my racquet and did nothing for 10 days. It felt better by then, I stopped running, basketball, anything that involved pounding. I started doing the elliptical machine and love it. I am 5'11 183 pounds and in great shape, except for this. I was putting on a pair of jeans yesterday morning, simply bent forward and "bang" there it was again. I have gone twice for physical therapy, but he cant get the spasms to stop. I have gotten electric stim, heat, ice, and little manipulation etc. Nothing is working and I am totally bent looking. Should I go for an MRI, or something else? Please advise.
Unfortunately, electric stim, heat, and ice have viturally no effect on a disc herniation other than the same effects that "time" will get you.
Manipulation can have good effects, but only if you are getting the appropriate maneuvers to maintain what has been done after the manipulation. Due to the ability of the tissues to "creep" with movement and prolonged stresses, when healing there needs to be regular, specific movements done every two hour to maintain it and help it heal (see the link below for someone who can teach you these). If you were simply getting a manipualtion, the modalities and a few "stabilization or stretching exercises" to be done once or twice a day, this becomes inadequate for tissue healing.
Spasms are nothing more than a symptom, so to "treat" a spasm is ineffective, you need to really address the problem at hand...the herniation via the approach mentioned above.
If you are truely bend forward, this is known as an acute kyphotic deformity and requires particular care...and manipulation as this point could worsen the symptoms. I would highly suggest you see a physical therapist who is trained in mechanical diagnosis and therapy. You can find one at: http://www.mckenziemdt.org The focus of this treatment is showing you self management techniques to reduce the problem, reduce the chance of it returning and show you what to do if it should return...reducing your dependency on the clinician.
...As far as an MRI, your response to movements based on the examination by the PT trained in mechanical diagnosis and therapy is 90% as accurate as an MRI...I see no need for further expensive tests unless you get an emergent condition...sudden inability to urinate, unable to control your bowels, wide spread neurological deficits, or your response is inconsistent.
Best of luck to you...please, check out the site.
You should go see a neurologist as there are still a few more non-surgical treatment options available to you.
If you have insurance, you might want to see an orthopedic physician and see what they say.
If you don't have insurance, I would try rest for about 2 weeks if you can afford it.
I had back pain from repetitive movements of chopping wood and rested laying down for awhile, and thought it was getting better (after going to ER and they did NO tests but gave me muscle relaxants and pain meds)....then I bent over to pick up a cat and BANG it was back. I had to pretty much lay down and rest in bed for about 2 weeks, getting up to do very little. I laid on a gel ice pack under the lower part of my back (but they don't necessarily recommend constant ice ..supposed to be 20 mins on... 20 mins off I think..). After about 2 weeks it went away. I think I had sacro-iliac pain or sciatic. It was but pain and down the leg spikes sometimes.
You may have a different problem than I did though...but there is nothing worse than back pain.
Rest, rest, rest. You need about ten days with no stress on your back at all. Heat several times a day, muscle relaxants and pain meds for a couple of weeks. There is no "one treatment" cure.
A neurologist is certainly a good choice. It sounds, however, like you need continuity of treatment most of all.
Yes better to be safe than sorry see your Doc and ask for a MRI. At least that way you can rule in, or rule out disc problem. Good Luck
Give your therapist a chance to reduce the discomfort. Some gentle mobilizations may be in order, but if done too soon could cause even more discomfort.