Lower back / Hip pain - probable cause ??

2

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  • josehernandez
    josehernandez Posts: 243
    Having had a chronic long term condition for the past 10 years mrwibble I completely agree with you that the NHS is "treatment by numbers". I have a great deal of respect for NHS staff but the organisation itself is enormous, antiquated and often ineffective.
    I will inquire into seeing an osteopath or chiropractor as you suggest.
  • mrwibble
    mrwibble Posts: 980
    See first if you have a sports massage practitioner, tell him your symptoms and get all that muscle tension lessoned before getting the big boys in. where are you based out of interest?
  • josehernandez
    josehernandez Posts: 243
    mrwibble wrote:
    where are you based out of interest?

    I'm in Dumfries.

    I had one session with a local sports therapist a few weeks back and was a little concerned at how little they asked about my injury and how rough they were in action. The session was very painful however I did feel a bit better afterwards.
    I'm never sure whether I should be going to loads of different experts at the same time or if it would be better to see them one after the other.
  • mrwibble
    mrwibble Posts: 980
    In my opinion the deeper the injury the more it will hurt treating it, if it doesn't the sports massage is not deep enough. Did you talk to therapist give them feedback? If you are not happy with him, is there anyone else local? You probably need someone who can do a few range of movement exercises as well as massage, you would need a good hour of treatment.
  • top_bhoy
    top_bhoy Posts: 1,424
    Here's my input form someone who has had problems recently with a bad back.

    I think you need to get a scan done...a CT or MRI. This will identify the exact problem, from which the preferred course of action can be determined. It will also give a confirmed baseline from which all the professional health people can reference from. Until then, professional opinions are more speculative than based on hard, clear evidence.

    I wouldn't be aware of the costs but in my opinion, it would be worth biting the bullet and paying for the scan if the NHS wait is going to be too long. The sooner the problem is diagnosed correctly, the sooner the corrective action can be implemented.

    The scan I undertook recently on my back had the result back a few days later. The news wasn't the best (nor worst) but at least the problem can now be managed better and monitored for deterioration. To sum up, use a good sports physio for remedial advice and the doctor for painkillers and for organising any additional health support which may be required.

    Good luck.
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  • josehernandez
    josehernandez Posts: 243
    Pain and discomfort in the daytime almost bearable but at night time I am still experiencing intermittent dull ache in my right hip and down the length of my leg to the foot. Some nights sleep is impossible.
    Had my 2nd visit to GP yesterday. He has now put me on Codeine which doesn't seem to have made a lot of difference from the Co-codamol. Doc has referred me for MRI.

    2nd visit to Physio tomorrow.
  • mrwibble
    mrwibble Posts: 980
    how old are you if you don't mind me asking? If I was in your position while waiting for NHS, I would have a sports massage that contained this, glutes, piriformis, hamstrings, IT Band and vastus lateralis. So, rear of legs above the knees and a legs at the sides, try and loosen everything attaching to them hips. Try and do stretching after and everyday. Throwing lots of NHS drugs at it turns you into a junky!!!!
  • StillGoing
    StillGoing Posts: 5,211
    I too have had small of the back problems that I thought stemmed from a motorcycle crash in 2004. A few years ago I noticed the left hip was continually aching like hell and also the left knee. A trip to the Physio who is extremely good, checked for the usual tight abductors. An MRI scan confirmed there was nothing wrong with the knee and that the pain in that was from whatever was wrong with the hip. The Physio diagnosed a rotated pelvis and sent me to see Dr. Roger Oldham who specialises in Prolotherapy. The treatment involved a course of 3 injections of dextrose and glycerine into the joints of the right ankle to build it back up. A before and after scan was done to confirm the regenerative process in building the cartilage back up. The recovery process will take around 12 months to restrain the muscles in the correct posture after years of walking, sitting etc with a crossed up pelvis. He's treated professionals from the world of football, rugby, cycling, golf, athletics etc.

    http://www.spirehealthcare.com/leiceste ... -r-oldham/

    http://www.nuffieldhealth.com/consultants/oldham-roger
    I ride a bike. Doesn't make me green or a tree hugger. I drive a car too.
  • pcb24
    pcb24 Posts: 98
    edited November 2013
    Some cold, hard facts:

    1) Your pain is in NO way being caused by tight muscles and do not need releasing!! Since when have tight muscles kept you up all night and had you reaching for pain killers because you can't take the pain??

    2) You are receiving the right treatment, take the meds reguarly to ease the pain and follow the physio's advice

    3) Easing pain and restoring function takes time. Be patient!

    4) The treatment you receive in NHS and private physio is EXACTLY the same. You may get seen twice a week privately as opposed to once a week but the treatment is not by numbers!

    5) An MRI will not show you exactly what is wrong. Some patients with NO back pain can have the most horrendous MRI results when they have been screened to check.

    6) Sports masseurs are not qualified in diagnosing musculoskeletal ailments and so often treat blindly unless guided by a Dr or physiotherapist

    This is information coming from a highly experienced health care professional who has worked with weekend warriors all the way up to elite level athletes, both privately and in the NHS.
    Cervelo S2
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  • josehernandez
    josehernandez Posts: 243
    mrwibble wrote:
    how old are you if you don't mind me asking? If I was in your position while waiting for NHS, I would have a sports massage that contained this, glutes, piriformis, hamstrings, IT Band and vastus lateralis. So, rear of legs above the knees and a legs at the sides, try and loosen everything attaching to them hips. Try and do stretching after and everyday. Throwing lots of NHS drugs at it turns you into a junky!!!!

    I'm 43.
    Enquired with Chiropractor and Osteopath today who suggested I check with Physio before starting with them.
  • mrwibble
    mrwibble Posts: 980
    edited November 2013
    you need someone professionally to give you the definitive answer and manage your injury from there. Ignore us on here, too many answers to the same thing. I always recommend some yoga classes...
  • pcb24
    pcb24 Posts: 98
    kingrollo wrote:
    mrwibble wrote:
    Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg. Quote from Wiki...

    My understanding is that a shortened Piriformis muscle (bulging in a contracted state) brushes the sciatic nerve, prolonged sitting, lack of flexibility can cause this so if you say it's not true, you must be correct.

    Gotta say thats my understanding - not just from wikki - from numerous web sources

    Please can you provide your web sources?
    Cervelo S2
    Langster for the winter
  • pcb24
    pcb24 Posts: 98
    JoseHernandez wrote:
    mrwibble wrote:
    how old are you if you don't mind me asking? If I was in your position while waiting for NHS, I would have a sports massage that contained this, glutes, piriformis, hamstrings, IT Band and vastus lateralis. So, rear of legs above the knees and a legs at the sides, try and loosen everything attaching to them hips. Try and do stretching after and everyday. Throwing lots of NHS drugs at it turns you into a junky!!!!

    I'm 43.
    Enquired with Chiropractor and Osteopath today who suggested I check with Physio before starting with them.

    See point 6 in my previous post
    Cervelo S2
    Langster for the winter
  • mrwibble
    mrwibble Posts: 980
    edited November 2013
    why don't you give the man a consultation?
  • pcb24
    pcb24 Posts: 98
    mrwibble wrote:
    why do you give the man a consultation?

    Do you mean why don't I give the man a consultation? If so, he lives around 200 miles away from me.
    Cervelo S2
    Langster for the winter
  • mrwibble
    mrwibble Posts: 980
    I have altered my spelling error, exchange numbers, talk to him.
  • pcb24
    pcb24 Posts: 98
    He is already seeing a health care professional and it is not possible to diagnose and assess without seeing the individual face to face. As I said in my previous post, the OP is receiving the best treatment as he is in the hands of the professionals. Be patient and follow their advice. My purpose for posting was to make sure he wasn't discouraged from this as there is a lot of unhelpful (but some good when they have suggested seeing a professional) advice on here.
    Cervelo S2
    Langster for the winter
  • josehernandez
    josehernandez Posts: 243
    Painful 2nd session with Physio today who reckons even though it may not feel like it I have made progress.

    I have a pronounced stoop and my spine has become slightly banana shaped so I was given an exercise specifically to sort that out - lying face down on bed with pillows underneath my abdomen, my waist slightly offset then press ups lifting my head up as far as I feel comfortable.

    Understandably she is not keen for me to see an Osteopath or Chiropractor until our sessions are completed.
  • josehernandez
    josehernandez Posts: 243
    Another nightmare night with barely a wink of sleep. GP has put me on Tramadol, early days but seems to be quite a step up from Co-codamol. Pain is now manageable as long as I don't have to walk far.
  • StillGoing
    StillGoing Posts: 5,211
    JoseHernandez wrote:
    Another nightmare night with barely a wink of sleep. GP has put me on Tramadol, early days but seems to be quite a step up from Co-codamol. Pain is now manageable as long as I don't have to walk far.

    Tramadol is serious crap. I was put on it after shoulder surgery but had to stop taking it after it caused hallucinations at night.
    I ride a bike. Doesn't make me green or a tree hugger. I drive a car too.
  • top_bhoy
    top_bhoy Posts: 1,424
    philthy3 wrote:
    JoseHernandez wrote:
    Another nightmare night with barely a wink of sleep. GP has put me on Tramadol, early days but seems to be quite a step up from Co-codamol. Pain is now manageable as long as I don't have to walk far.

    Tramadol is serious crap. I was put on it after shoulder surgery but had to stop taking it after it caused hallucinations at night.
    Similar experience. I had back pain and Dr prescribed it for me...initially it was the 100mg tablet but then she changed it up to the 200mg. Next morning, the back pain was debilitating and so I popped a tablet to try and get to work. I went dizzy and into another planet within a few minutes. and never took another one after that.
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  • josehernandez
    josehernandez Posts: 243
    Glad I'm on the lowest dose of 50mg then. Had the best nights sleep for weeks.
    Feeling quite spaced out this morning but small price to pay for the pain relief.
    I wouldn't want to be driving or doing any complicated work though.
  • slowandsteady
    slowandsteady Posts: 339
    JoseHernandez wrote:
    Glad I'm on the lowest dose of 50mg then. Had the best nights sleep for weeks.
    Feeling quite spaced out this morning but small price to pay for the pain relief.
    I wouldn't want to be driving or doing any complicated work though.

    Glad you're making progress but you still sound like you're a bit off a return bud.

    Keep me posted on how you get on.

    mp.
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  • josehernandez
    josehernandez Posts: 243
    Will do Mark.
    Cheers.
  • kevdewell
    kevdewell Posts: 13
    Wow reading this thread is scary! I'm a physiotherapist, I work in the NHS and manage a private practice. PCB24 is correct is everything they have said. Just continue with the physiotherapy treatment you are receiving, if you see no improvement after 4 sessions ask to see another physio in the department. Most NHS services still have a tier 1 and tier 2 service. More experienced and specialist physios working in tier 2.
    Don't hold too much hope for your MRI scan, fortunately pain doesn't equal damage and damage doesn't equal pain. Any1 that tries to tell you what is wrong with you without seeing you and assessing your posture, range of movement, strength, myotomes, dermatomes, reflexes and a range of special tests is wasting their time and yours!
  • josehernandez
    josehernandez Posts: 243
    Appointment with Orthopaedic consultant yesterday. He thinks all symptoms are consistent with sciatica - lower back L4/5 issue.
    X-rays showed all clear for joint/bone issues.

    Next stop Physio on 3rd Dec and thereafter MRI.

    Consultant was optimistic that I would be able to return to cycling in due course and that usually the 1st episode of severe back pain is the worst. Just have to be diligent, do stretches and excercises religiously and listen to my body.
  • ilovegrace
    ilovegrace Posts: 677
    I have to jump in here , i am the prolapsed disc king "par excellence" .
    I will not bore you with all the details , i will only say that in my experience treatment phsyio etc for what appears to be a herniated/prolapsed/bulging disc is more or less a waste of time.
    You have to do what you can and work through the pain with pain killers etc.
    To quote Sarah Keys "the disc will heal in its own stately manner".
    Where a disk has bulged this means that the Nucleus within the disc has penetrated the discs walls and you guessed it , caused a bulge which presses on the nerves surrounding it,this causes excruciating pain.
    Trying to "treat " this problem is like trying to put toothpaste back in the tube, it wont happen.
    I know you will not like to hear this but "time" is the healer with this one. There is no quick fix.
    But , things DO get better each day, the pain reduces and normal service is resumed.
    I am cycling 150 plus and running 8 miles per week , but this does not come without 100 % attention to posture and specific exercises.
    While you are laid up read "Treat your own back "
    Take it from me you WILL be back on the bike and you WILL be pain free . I know it is hard to believe this when stood at the bottom of the stairs getting to the top looks like scaling Everest and even turning over in bed need about 5 mins serious contemplation but it will get better.
    With a little more thinking time on your hands, use this time to plan ,once you have recovered how will you manage this problem in the future?
    regards
    ILG
  • josehernandez
    josehernandez Posts: 243
    Your advice is very encouraging ilovegrace, many thanks for your input.
  • mrwibble
    mrwibble Posts: 980
    lovegrace is right about things will settle down, just a footnote to my similar injury which was a bulging disc, I paid for a bike fit to help my posture on the bike. Worth every penny in my book.
  • ilovegrace
    ilovegrace Posts: 677
    mrwibble wrote:
    lovegrace is right about things will settle down, just a footnote to my similar injury which was a bulging disc, I paid for a bike fit to help my posture on the bike. Worth every penny in my book.
    Mr wibble, I still have problems with my back when on the bike.
    I would be interested to know what the bike fit advised you to do and how at is helped you ?
    regards
    ILG

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