Discogenic Low Back Pain
As physical therapists, it is generally expected that we use proper body mechanics and lifting techniques all the time, right? Wrong!
On Saturday, February 1st, 2014, I was being a good big brother and helping my younger brother lift two snowmobiles off a trailer. Of course, I was in a tight spot. I used terrible lifting mechanics, engaging my low back instead of my legs. On the second to last “lift and pivot” I felt a slight twinge in my back. Two thoughts went through my head: 1) “if I do this one more time, I’m going to hurt” and 2) “only one more lift and pivot and this sled will be off the trailer.” I obeyed the second thought, and what I felt was unreal. An instant zing down my left leg into my foot, and immediate throbbing in my lower back. I bent forward trying to relieve the pain and tingling.
Naturally, my lifting was done for the morning, and I headed for my clinic to grab an electrical stimulation device to reduce my pain. The TENS unit greatly reduced the discomfort in my low back, and distracted me from the nagging radicular symptoms (tingling down my leg). That evening at home, with Ibupofen in my belly, I decided “I should probably do what I advise my patients to do…” So I proceeded with my first round of low back pain physical therapy exercises. These exercises include lumbar trunk rotations to loosen my low back, piriformis stretching to loosen my hips, pelvic tilts to decompresses the low back vertebrae and disc structures, and 90/90 heel digs to decompress the low back area and discs. As anticipated, I felt a bit better after completing these exercises. I wasn’t out of the woods yet, though.
By tuesday evening, my pain was pretty well controlled with ibuprofen, TENS unit, and my home exercise program. But a greater concern had surfaced. The tingling and numbness down my left leg was not only not going away, it was getting worse. I had three hours of interrupted sleep on wednesday night, and by thursday afternoon, I was having less success trying to change those symptoms with positioning or my home exercises. In fact, the pelvic tilts intended to reduce the compression in my lumbar spine area were actually increasing the tingling in my leg. Working with my manager, Steve Peterson, we identified that I likely had an issue with a disc in my low back, and that an extension based exercise program might be more beneficial. It helped. I also consulted with my favorite PA (Physicians Assistant) Jennifer Wiberg at Entira Inver Grove Heights, and it was determined I needed to go on a round of prednisone oral steroid to reduce the nerve root inflammation in my low back.
I’m now a couple weeks beyond my final day of prednisone, and I can comfortably tell you that I’m approaching 100% improvement. I haven’t been the best student of my home exercises, but they definitely do help. This experience really helped me put into perspective what my patients are feeling when they’re hurting. Overall, I learned that the physical therapy homework that I give to my patients actually does work if you do it, and that proper body mechanics are actually important. I’m not so sure I’ll jump into the next heavy lifting project my brother wants help with though…
If you’re having back pain you should definitely take advantage of our free phone consultation with a PT. Nothing makes you feel better than hearing it from the professionals.