At my wits’ end with back pain

[Orenoko]

Hi all,

This is my first post here, I’ve become really tearful today following a flare up in back pain. I’ll try and summarise as best I can. Prior to this happening I would say I was relatively active. I horse ride once a week and was attending the gym three or four times a week before lockdown. I also enjoy walking and yoga. My job is sedentary but I would always go for a walk at lunchtime and generally considered myself healthy and fit. Am 34 years old now, no children and no history of any trauma that could’ve caused the onset of this pain.

– 3 years ago I started getting lower back pain, it came on gradually and there was no trauma. The pain is always focused on the right side close to the SI joint.
– Went to NHS physio in Jan 2019 and was told I had a weak core. Did all the exercises they gave and attended their group classes. No improvement in symptoms.
– Went to private physio in April 2019 who said I have a right lateral pelvic tilt. She adjusted it a few times with mixed results, sometimes it would improve, other times it wouldn’t.
– Went to a personal trainer for three months last summer to continue trying to improve my core and strengthen my back. No improvement in symptoms(although I have continued exercising).
– Tried acupuncture in October 2019, if anything that made it worse.
– Pain began to worsen around Christmas time and included my right hip.
– Went to a different physio who suspected a problem with my hip and sent me for an MRI on the hip – all came back normal.
– Physio advised me to stop horse riding to see if that helped, so I stopped for a month but it made no difference to my symptoms.
– NHS sent me for an MRI on my back – all came back normal. NHS then told me I just have weak glute muscles. Started doing exercises to try and improve the strength in my glutes, no improvement in symptoms.
– When lockdown started I incorporated lots of stretching into my day, focusing on lower back and hips. Initially there was some improvement but then symptoms returned.
– In June I started seeing a chiropractor for adjustments and low level laser therapy, there was possibly a three week period of improvement but now symptoms are back to what they were. He also mentioned lateral pelvic tilt as the problem.

I have also tried wearing an SI joint belt on and off which sometimes helps. I have tried a back brace which relieves pain but I don’t want to rely on it so I try not to wear it. I’ve bought a new bed a year ago with a memory foam mattress, it hasn’t helped. I use a TENS machine which temporarily improves symptoms but doesn’t help long-term.

I’m now taking daily Paramol tablets to try and manage the pain. I have had some video appointments with my GP during lockdown but they just tell me to take ibuprofen, which does nothing. Unfortunately I can’t get an NHS physio appointment (have just checked again today) despite them wanting to see me as they aren’t allowed to, which I understand. My sleep is significantly disrupted and I feel like it doesn’t matter what I do, the pain always comes back just as bad eventually.

I have been religious about following any exercise, stretching and strengthening programmes I’ve been given since my initial physiotherapy back in January 2019, but I feel like it’s made no difference whatsoever. I woke up this morning in agony and just thought “what’s the point?” I am doing everything asked of me, I’ve spent a small fortune on private treatment, and nobody seems able to help. I’ve been given different diagnoses by every practitioner I’ve seen. I’m not the strongest person in the world but I wouldn’t say I have a weak core or glutes, prior to lockdown I was lifting heavy-ish weights and regularly attending the gym. I am just at my wits’ end. I’m not even sure why I’m writing this, I feel like I just need to vent. Every time I think I’m turning a corner my symptoms return just as bad and I don’t understand why.

[Orenoko]

Sorry I should also have said that I was keeping a pain diary for a few months at the start of the year to see if there was anything specific that made my pain flare up. Unfortunately there is no pattern to it. Sometimes an activity such as lifting weights would help, but then the next time I did it, it would aggravate things. There has never been anything consistent which has set the pain off, which has made it more difficult to get to the bottom of it.

[Lc]

Hi Orenoko, Welcome to this site, there is a lot of info at top of page in blue ,Pain relief and resources.worth a look. If your pain is to one side of your back and radiates around top of pelvis, and sometimes pain right through from buttock to groin area, then it probably SIJ problem(sacroiliac joint}. or if it is more central and sometimes straight across horizontal, or radiates straight up/down then probably lower back. both can cause nerve pain and irritation, in buttocks and down to feet, ie tingling, numbness to dull aches to sharp stabbing like pains. I know this because I have both, SIJoint pain/problems and nerve damage/pain after dislocation and fractured pelvis and two spinal ops. It is Good that you maintain physical exercise to strengthen core muscles slowly but if you over do these exercises it also can aggravate it all into a flare up, it is a fine balance of keep moving and resting, you need to learn to pace yourself, and establish your baselines .and not over do things.I wear a spinal belt and SIJ belt but only when I know I,m going to be busy, in your case when working out or walking long distances to help support those areas, when doing stuff , if its just pottering around then dont bother using the belts or while your at work, but make sure you have regular breaks from sitting to long and stand up and have a little pace about for a few mins before returning back to your work station.If it is your pelvic tilt then you need to try and address this problem through physio,but sometimes the damage is already done.you need to get your posture correct when at work especially if your sitting down a lot. Hope it all settles soon. take care and best wishes, Lee

[Orenoko]

Thanks for your reply, it definitely mimics SIJ pain, I have suspected that might be the case for a long time but I’ve been told it “shouldn’t” be that because it has come on gradually. I feel ignored sometimes by medical professionals, my gp just tells me to take painkillers and I get given the same exercises over and over. I try to wear the belt only when needed or, like you say, if I know I’ll be on my feet for a long time, but the physiotherapists tell me not to wear it at all, so I get completely mixed messages.

I have booked a telephone appointment with my gp for Friday and will definitely make use of the Resources page about making the most of medical appointments as sometimes I’m not as assertive as I should be. I’m not sure what more the gp can do but in the absence of being able to see a physio I feel I need to speak to someone.

I don’t know if there’s a specific type of physiotherapist I should be seeking out or if I’m really clutching at straws now. I’ve wanted to fix this ever since it became a real problem and am conscious that the longer it goes untreated the more chance of it becoming a long-term issue.

[Helen H]

Hi Orenko
And welcome to the forum. Some folk on here have pain because of operations or physical trauma, others like me ( and maybe you), suffer from persistent pain without a specific cause. I know firsthand how hard it feels to accept that there is no specific cause…and no specific treatment.I spent years trying to solve this.I too spent a lot of cash on private treatment, which didn’t help at all.

Gps also find it hard to make sense of the situation, which can feel really demoralizing when it is so dominant in your life. Of course keep pursuing your GP, and ask to be referred to a pain clinic. From my experience you have to hassle to get anything done, keep contacting them and telling them what you are unable to do,and how bad it is. Services have a huge backlog from lockdown, but keep pestering.

However well you pace your activities, flare ups will happen-could be the weather, could be getting upsetting news, or the gym being too hot, or aparticularly bad nights sleep. It’s not your fault and it’s awful when it happens, but if you ease off and rest more it will calm down more.( Is this nerve pain?)

I find heat pads very helpful and soothing, and keeping a pain diary is a good idea. I have found meditation also really helpful, and i would highly recommend the Breathworks online self-paced course For Pain and Illness. Breathworks is run by a woman in a wheelchair, who suffers from chronic backpain.

Take care
Helen.

[Orenoko]

Thanks Helen

I spent some time looking around at different treatments online last night and am going to ask my GP about them. Whether he can help or if it has to come from a physiotherapist I don’t know but worth a try.

I’m thinking of just backing off everything for a couple of weeks – no workouts or stretching, minimal walking, just enough to keep me ticking over- to see if that makes any difference. I don’t know if I’m aggravating things with my stretching and chiropractor appointments. Without knowing exactly what it is I’m fumbling around in the dark to an extent but perhaps it’s worth a try. In lockdown I thought it would be the perfect opportunity to stretch more and get things sorted but that hasn’t worked so perhaps temporarily trying the opposite might help.

I managed a better night’s sleep yesterday and the pain has lessened a bit, I feel slightly less emotional than yesterday but still thoroughly fed up of the entire situation. I feel like because it came on gradually I should be able to resolve it, and it’s probably not that serious, but the longer it goes on the more it impacts my quality of life.

• This reply was modified 3 years, 4 months ago by Orenoko.

[Lc]

Hi Orenoko, AS Helen says try and get your GP to refer you to a pain clinic, as you they will try and find out exactly what is wrong, also you will have more access to other areas of help you need, like physio and therapy by the pain team because in long term pain it is not just the pain ,it effects your mental well being and the way you deal and cope with things to. they can advise what you need better.GP’s do have a wide range of knowledge but not pin pointed to long term pain and just tend tp prescribed medication to help, constant pain is more than that, and can be complicated, and its’ more than just medication.also be careful of chiropractors as some, its just about the noise of crunching bones. and do more help than good, if your going to use them check them out fully, and that they are registered. Take care and best wishes, Lee

[Lc]

Hi, Sorry forgot to mention, within the pain clinic they would have referrals to chiropractors anyway, if they think it would be beneficial to you. and also there is a simple test to check if it is your SI Joint playing up. take care and best wishes, Lee

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