[Closed] STW: BadBackTrackworld

Two lots of anti inflammatories? I'm no Dr, but that seems a bit strange to me.

Fire some heat on it.

Get down the doctors and ask for some high strength diclofenac. I went from crawling around the house to running up and down the stairs in 72 hours with that stuff. Quite literally a miracle cure. I was quite panicked when I ran out.

Long suffering back problems here, currently flares up every year or two so quite lucky. But, when it is bad, I really know about it.

Be careful about pushing medical route too much, lots of evidence that getting scans can quickly lead to surgery without necessarily better outcomes. Most recent research on this was in BMJ, will hunt out a link later.

Good quality physio works for me. The longer you leave it, the more damage that can be done through loss of flexibility, compensatory movement etc. therefore well worth getting yourself to a quality physio sooner rather than later, even if that means paying. If I had done so at the point of injury 15 years ago, I probably wouldn't still have the problems I have now. My physio is a sports specialist working with international rugby players, he is very much into making you sweat for your recovery rather than tiptoeing around with gentle massage. Intensive stretching (fOr me, mainly hamstrings) and deep massage really works.

If you are struggling to sleep try sleeping on your side with a pillow between you legs, it can straighten everything up and really helped me

Backs are funny things, but you quickly compensate and move around the injury , making longer term recovery difficult. Ask around, get a recommendation and get to physio.

Taking two lots of NSAIDS at the same time is a really bad idea, unless you like puking up blood.

Get down the doctors and ask for some high strength diclofenac

He's on Naproxen.

Agree with dazh. Amazing drug. i also turned to quality whisky which really made life better.

Stretching exercises work really well on preventing it flaring up but once inflamed get a cold pack on it.

get on youtube and search for sciatica exercises. As has been said stretching really works.

My back once 'went' whilst out for dinner in a posh resturant. I stood up to stretch it and couldn't move. Was hunched over with my head near the table candle. I burnt my cheek as I couldn't move quick enough and figured it would be less painful than moving my back.

get on youtube and search for sciatica exercises. As has been said stretching really works.

This ^

Mrs J had it so bad, sshe claimed the pain was worse than childbirth 😯
No amount of meds seemed to help long term - the GP recommended a book http://www.amazon.co.uk/Treat-Your-Back-Robin-McKenzie/dp/0958269203 which basically recommends the exercises shown in the video.

She's now qualified as a pilates instructor and recommends this to many of her clients.

I hurt my back terribly once in Austrailia. The farmer I was working for found me still holding on to the genny I'd tried to lift. I was in unbelievable agony and unable to stand. He lifted me in to the back of the ute and took me to the nearest town to see the (Aussie rules) footy team's physio. A thoroughbred alcoholic she looked more like Lily Savage than Lily ever did complete with leopard print minidress. She practiced the Bowen technigue (subtle manipulation for me interspersed with fag and red wine breaks for her) within an hour I was able to stand within 2 hours we were all in the pub. I recommend it thoroughly

Go to docs, see what the MRI results say and work out with the doc what happens next.

In my case the scan showed a prolapsed disc and luckily physio work (core stability) sorted it. That was seven years ago and it still flares up if I'm stoopid with lifting stuff.

NSAIDS? Not at the same time. About 1600mg of Brufen and 500mg of Naproxen plus 300mg of Gabapentin overnight. Knocks the edge off but that's about it.

I had a session with a Physio. Concentrated on hamstrings as they were tight... Well HELLO... I was doing over 250 miles per week and have cycled reasonably long distances all my adult life so they will be tight. I can pinpoint the cause and it isn't hamstrings.

Anybody had a jab of steroids? Doesn't sound like a bundle of fun... :-/

Not at the same time. About 1600mg of Brufen and 500mg of Naproxen plus 300mg of Gabapentin overnight.

😯

Is that bad?

Next door neighbour has had the steroid injections. Last session before Christmas had her unable to walk for 2 weeks. Previous sessions were trouble free.

Yes.

Recommended max dose of Ibuprofen alone a day, not overnight, is 1200mg.

Here read this and that's just for Ibuprofen.

http://www.patient.co.uk/medicine/ibuprofen-for-pain-and-inflammation

I wouldnt be taking that lot no matter how much pain I was in. You are taking two pills that effectively do the same thing - why would you do such a thing?

I had a session with a Physio. Concentrated on hamstrings as they were tight... Well HELLO... I was doing over 250 miles per week and have cycled reasonably long distances all my adult life so they will be tight. I can pinpoint the cause and it isn't hamstrings.

A tight muscle is a weak muscle..... Your problem will be due to an anteriorly titled pelvis due shite muscle strength in ths usual places.

I understood you can take 2400mg of Brufen per 24hrs with food? I wanted to stay well within that and the Naproxen is supposed to be kinder to the stomach?

****ylung, what 'usual places' please?

Speaking from experience.

Sciatica. Something is pressing on the sciatic nerve, either an inflamed muscle, or worse, a bulging or herniated disc. This causes pain down one or both legs. The location and severity of the pressure will show as to how far down your leg the pain manifests. The worse the pressure, the further down it goes.

Naproxen is the better anti-inflammatory out of ibuprofen or declfenac. What dosage and frequency are you taking the Naproxen? You can combine with paracetamol every four hours, or better still, P, 2 hours, N, 2 hours, P, 2 hours, N, 2 hours, etc.

If it's really bad diazepam in low dosage, can help relax the muscles. I have recently started taking Amitriptyline. It used to be used as an anti-depressant, but in lower doses it can work as a nerve feedback blocker. It's helping me, but the side effects are pretty horrible, but worth it to be free of the leg pain.

I'm off work ATM, 3 weeks now and just been signed for another 6. I've had it on and off for 8 years, lots of treatment and big improvements over that time, but also some big relapses. Caudal epidurals, facet joint injections and nerve root blocks. I'm seeing my consultant on Friday for pre-op and X-ray, then op in the next couple of weeks. Partial flexible fusion with discectomy and decompression.

Hip flexors, lower back, belly, and hamstrings.

I understood you can take 2400mg of Brufen per 24hrs with food?

What were you prescribed by your GP?

1000mg Naproxen p/d. It hardly touches it.

Go and speak to a pharmacist before taking any more brufen. Then go and see you GP for some more pain relief.

Don't **** about with NSAIDS.

Bigblackshed that sounds utter shite. :-/ Bloke at work had the option of surgery. Consultant told him 50% chance of improvement, 50% chance of deterioration inc possibility of 100% fercked... He chose the cortisone epidural.

<edit> @drac fair enough. Back in Thursday so I'll sort it then.

Have you tried heat? Or a tens machine?

Don't do the McKenzie stretches until you've seen your MRI scans. If the disc is bulging it can trap the disc and nerve and worsen it. It can work but it depends.

A more gentle and progressive exercise is the cat stretch. On all fours, gently arch your back up and head down, hold, then arch your back down and head up. All whilst "zipping up" your pelvic floor muscles. YouTube will have it some where, but my google-fu is failing ATM.

Heat, yes as in hot bath. Lying flat on the floor helps (not at the same time....). Didn't really do much of the hamstring stretches as a lot of the twisting stuff is a non starter. It's better first thing after laying overnight but over the day it gets progressively worse.

When Cycling I get a really sore knee and hip. Never had this before, ever.

I found naproxen didnt really work very well for my lower back pain. A combination of ibuprofen and paracetamol was much more effective.

I also find that ham string stretches,hip flexor streches and using a foam roller to massage the various hip muscles helps.

NSAIDS are anti-inflamortories, that's Naproxen and Ibuprofen they will reduce the inflammation arguably to promote healing and to give some ease on the discomfort. Gabapentin is a nerve suppressant so helps reduces the irritation to the spinal nerves. A pain killer such as codeine may help give some pain relief but for all those speak to your GP or visit a Pharmacist for advice and over the counter equivalents until you can see a GP.

Anyway that's enough advice from me before I get into trouble but watch those NSAIDS you've been taking.

dazh - Member

Get down the doctors and ask for some high strength diclofenac

Have to agree with this, industrial strength pain relief - always hits the spot!

I've had all of the injections possible. Hasn't worked for me.

My L3/4, L4/5, discs are properly herniated into the sciatic nerve. L4/5 is causing hip and hamstring pain, imagine the worst cramp you've ever had x10. L3/4 is causing ankle and foot pain, imagine a sprained ankle and electric shocks through your toes and sole of your foot. Plus L3/4 is herniated into the spinal cord, causing muscle spasms from shoulders down to buttocks. Add in lack of sensation in the toilet parts.

I'm surprise dim as chipper as I am TBH. I'm actually looking forward to surgery, the possible chance of reducing this pain to something bearable is the goal.

Oh, and to be able to ride a bike again.

OK, ta. I don't take codeine or cocodamol. The side effects would be particularly unwelcome when trying to strain with a buggered lower back 🙂

Ooo just found some Tramadol and Diclofenac in the cupboard from previous misbehaviour... Don't worry Drac, they're going in the bin.

Cat stretch video.

Sounds bad Boblo.

The only thing that helps me when my back misaligns is physiotherapy.

I've got three prolapsed discs. I suffered for years on pain killers with lots of spasms and sciatica. Sciatica so bad I had no sensation in my feet. The consultant tried to induce a reflex reaction in my knees with no success.

I went for a final consultation before surgery. The consultant grabbed my leg to see how much articulation I had, with no sympathy he moved it and I fainted outright in pain.

At my worst I was prescribed Zydol. I had no idea how potent a drug it was until some had been stolen from a pharmacy and the local radio station put out a warning should anyone find it.

My GP was opposed to surgery, I trusted him.

Eventually I found a very good physiotherapist who could realign my spine and release the spasm. I still get a twinge now and then, but I have to recognise and react to the warning signs.

The Lick Lake Pass descent in Idaho was the last episode.

OK, ta. I don't take codeine or cocodamol. The side effects would be particularly unwelcome when trying to strain with a buggered lower back

😆

Diclophenac has recently been shown to cause heart failure in people with an underlying condition, and as the Dr won't know if that's you, Naproxen is now being given as standard instead. If you've been on it before chances are you're safe but always worth checking before getting anymore...

Piriformis syndrome (muscles in the hip going a bit wonky) can cause sciatica, it's a debated topic but seems to be common in cyclists/runners. All spinal causes need to be ruled out first, but if they are and there's not an obvious cause, looking at bike set up can help. This may be why your physio was looking at what's going on in your legs overall, might be worth asking? I recently bought a new saddle and within 3 rides I got the familiar stinging sciatic tingle starting down my left leg a few hours after riding. Swapped back to my old one and no problem since! Most of my sciatic episodes (bar a flare up from a rear DNS shunt) have been caused by muscle imbalance in my hips and were alleviated by stretching/binning the new saddle

Eventually I found a very good physiotherapist who could realign my spine and release the spasm.

I suspect that your definition of a "very good physiotherapist" and my definition are diamterically opposed.

Boblo - if you dont get on with codeine, maybe try nefopam. That's what I've got for my knee just now and it knocks me out (apparently i'm one of the lucky ones).

Diclophenac has recently been shown to cause heart failure in people with an underlying condition

That's pretty much all NSAIDS including Naproxen.

Well I'm not sure what a good physio or a bad physio looks like... The one I saw seemed to be going through the motions and decided hamstrings were the culprit. I lifted a 200kg motor bike and my back immediately reacted. For me, that's the issue not hamstrings that have been shortened by years of cycling abuse.

Naproxen has no increased risk of vascular events, whereas Diclophenac raises risk by a third:

http://www.nhs.uk/news/2013/05May/Pages/high-dose-nsaid-painkiller-heart-risk-small-significant.aspx

Oooh ta!

Ah sorry, didn't realise you could pin it to a specific event. If the physio didnt pick up on the pain being directly related to a specific event then I'd probably not go back to them, been to one or two good ones and it's been quite obvious from the off when they are vs the poor ones I've seen. If you get the feeling they were just 'going through the motions' with you it's possibly not a good sign

Good/bad physios? My last one put the newest tear in L4/5 disc. I'd put that down in the bad column. Apparently he's the "best" in his field.

PS in terms of pain relief for spinal nerves Amittriptyline even beats morphine (well, for me it did!), did make me a tad zombified though...

anniison - Member
PS in terms of pain relief for spinal nerves Amittriptyline even beats morphine (well, for me it did!), did make me a tad zombified though...

It does that to me. Taken last thing at night and I get 10-12 hours uninterrupted coma. When it was used as an anti-depressant it was normally twice the dosage!

The Gabapentin works fine overnight as it knocks me out. There's very little back pain now unless I move so the laying down bit seems to help.

I have a physio appointment in half an hour which I think I'll give a miss now. I went to see an Osteopath a couple of weeks ago and he wouldn't go near it once he knew I had an MRI scheduled so sounds like good on him from the experience above.

Thanks everyone.

Update: MRI showed herniated disc at L3 so off to the spine man I go. I asked to be referred to the local BUPA mob so no long Soviet era style queues...

Quack suggested more Paracetamol/less Brufen. So I'm on 400mg Brufen/1000mg Paracetamol twice a day plus 1000mg Paracetamol two more times then happy pills overnight.I refused codeine or morphine based stuff as above. It seems to be helping.

Choice thereafter seems to be Cortisone epidural, microdisctomy or fusion. Hmmmmm, shit sandwich or another shit sandwich? We'll see next week hopefully.

Have you tried a lot of stretching? Mine grumbled on for 6 months - not as bad as yours but I was apparently a bit shit to live with over this time - and I was on the verge of going for surgery but then it resolved itself quite rapidly when I found the right stretches to relieve it. The Mackenzie stuff really works, for quite a lot of people at least. That was over a decade ago, haven't given it any thought for years.

I've had issues with degenerating disks / arthritis@ l3/4/5 and bulging disk @ 3/4 4 was causing foot numbness

Recently had a spinal stabilisation op on 2 levels l4-5 and decompression / diskectomy at L4 S1
Plenty different types of stabilisation out there but I had dynesis done

Best advice I can give is Pilates, use the physio , keep walking lots and naproxen pre op with the stuff that protects your stomach / gut

My surgery went really well and the NHS really came through for me , long road to getting fixed but it'll be worth it

My feeling on injections is that it's a very short term fix , if Pilates physio can't improve it , then surgery to remove the issue , injections get just you short term relief , then you need another & another

Well the prognosis is; 2 degenerative discs and 2 herniated discs. The only surgical option being fusing and Mecano. The chances of success vs much worse aren't good enough to go for that.

I've opted for a few jabs of cortisone to see how we get on. Least invasive, quickest acting but temporary. Quack thinks there's a good chance of the herniated discs repairing themselves within 12 months which will be fine if it happens.

He was quite jolly about the jabs saying how the didn't hurt. But they wouldn't if you're wielding the needle would they? 2 weeks rest post jabs then back to it (apparently) 🙂

Trick with Amma is to take note of the 12hr cycle it has.
I was on massive dosages of it for back/nerve damage with a 9pm spec for the Amma.
Complete Zombie the following morning right up to lunch sometimes.
Switched to taking it around 5-6pm meant I was in bed asleep by 10pm but able to wake and be bright 7-8am.
Diclofenac is useless though - over the counter or prescription - all it did for me was damage my stomach to the point of having to remove a number of foods from my diet because of them causing pain.
Naproxen work better with none of the side effects.

I would suggest Mezolar Matrix but that stuff is born of Satan's loins.... in 25+yrs of meds incluing IV Morphine - that stuff is the only one to make me physically sick. A tiny little 24hr patch that even high dose Cyclazine couldn't master. Once you got past that though - NOTHING hurt 😆

Be prepared to watch a live x-ray of a straight needle coming out looking like a corkscrew!

Have a read of this.....
30Min Yoga session.
[url= http://www.yoga15.com/blog/2015/2/12/a-short-yoga-routine-to-fix-lower-back-pain-in-bikers ]MTB back pain yoga[/url]

This is designed to stretch out all of the lower back, hips and legs and bring them back into a more balanced alignment.

Deffinately work a try, although from your symptoms you'd probably get much more benefit from going to actually see someone about it to get a tailored program of exercises.

Scar

I did some of them stretches during my last bad bout of sciatica that had me floored with pain that nothing would touch....I bit the bullet and picked up a dual channel tens machine as a last ditch hope before resorting to having to go to the docs and risk someone cutting me open etc........three days using the tens machine and stretches pain all gone however I did end up with a dead/ numb biggest two toes and top of my right foot for six weeks!
I know myself where my back is unstable and since the last bout have switched to a Wingnut Hyper and it's helped no end ( my necks buggered and a section of my back just below shoulder blades).
Seriously try a tens machine, it's a bit odd/ painful in the first few seconds but with the massage function too it's really pleasant and eliminates the pain.

I posted this in a previous thread.

Look up Foundation Training and Stuart McGill. I have tried just about everything going and these two are the one's which have worked in helping me recover.

McGill is possibly the number one back specialist in the world.

I have a herniated disk, a years worth of sciatica and was due to have surgery at the beginning of this year.

While it's not perfect, it's getting better and I have avoided having my disc butchered.

http://breakingmuscle.com/mobility-recovery/foundation-training-relieve-pain-and-improve-performance

Well I had the delights of 4 cortisone jabs in the back this afternoon. I was crestfallen to discover, it's not an instant fix. Bastards! I thought the anesthetic would kick in then pain would go and it would be all betterer in a couple of weeks. Apparently not so. Bolleaux.

Good luck dude, sounds bloody awful.

Ahhh glad you popped along. Back shite notwithstanding, int it time we planned a little adventure?

@boblo - yeah had those and yeah thats about right. feels good when it comes together though...

tell you what though, last bout of bad back/sciatica, i'd just come off a summer of 60k weekday rides with 5k lunchtime runs everyday and usually a big ride at the weekend---then boom
so....
every medical advice under the sun - something is to short, something is not strong enough, you do this wrong, you do that wrong, you need to do yoga/pilates/stretch/heat/ice/change your lifestyle/stop riding/slow riding/no running/running/swim/MORE core...... yada yada yada
in the end nothing worked,
so i just stopped everything for a week, rubbed on voltorangel thingy and its all turned out fine.

@kudos100 - have you tried prootherapy? i had the same as you 8 years ago, had 6 treatments of prolotherapy and was fine, search for BIMM prolotherapy to find a local person - if not try The Wharfedale clinic in leeds - he sorted me out.

Ahhh glad you popped along. Back shite notwithstanding, int it time we planned a little adventure?

I'm a tad busy, you going to Ton's touring weekend in April?

May might be good for me. See how you back heals first.

Here we are a month later and mebbies a little improvement. I think more to do with industrial quantities of Tramadol/Gabapentin and doing very little rather than real recovery.

I'm scheduled for a percutaneous microdiscectomy on Monday. They stick a big hollow needle into the offending discs then drill a few holes in it, hoover the gunk out and send you on your way. All done under local, 30 mins tops. Apparently 85% chance of success and back cycling within a week or so.

Bring it on... :-/

Well here I am a couple of hours after the procedure and it was a doddle. The most painful bit was the cannula being stuck in. They filled me full of some mind expanding stuff and then I didn't feel a thing though I was awake the whole time. I heard the buzzing of the drill thing and that's the only way I knew the surgeon was busy.

They said it could be a few days before the full effects are felt though already there is zero pain in the knee and hip. This could be down to the local he stuck in my back so I'll give it a few hours before I get too carried away.

The message is; I'd go for this over cortisone any day of the week. It's less painful and the success rate is higher but it carries more risk of infection. For me the upside far outweighs the risk (assuming I don't get MRSA 🙂 ).

The other good news, they say I can get back out biking within a couple of days. Hooray!