Advice for severe back pain?

[OnMyOwn]

My dh hurt his back very badly a couple of weeks ago delivering mulch with the Boy Scouts.  When he first injured himself, the pain was at the lowest point of his back, near his tail bone and also going down his thighs.  Now it alternates between being there and being in his hips.  He went to the chiropractor twice the first week and seemed much worse and came home in excruciating pain each time.  Then he went to his regular doctor, who put him on muscle relaxers 3 times a day as well as prednisone for two weeks.  He may have 5 days left on those prescriptions.

 

 When he wakes up in the morning, he isn't too bad.  By the end of the day, he is in horrible pain, even if he just spends most of the day sitting in his office here at home.  Thankfully, we have a leftover prescription for hydrocodone because the doctor would not prescribe him any pain medication and by evening, he is in agony.  He also gets some relief with a heating pad.

 

Today, he went to see a physical therapist for the first time.  They put some electrodes on his back, felt along his spine and put him in some different positions.  The physical therapist said it may be a disc, but it doesn't sound as if he knows.  Again, he came home in excruciating pain.

 

I'm not sure what to do.  I want him to go back to the general practitioner and see if he can get an x-ray, but the physical therapist discouraged him from that and said they won't normally do an x-ray unless he's tried 3 weeks of physical therapy.  If he doesn't go to get an x-ray, I'm thinking he should just lie in bed for a week and see if he's better after that.

 

Has anyone experienced anything like this?  

[Katy]

If he's in so much pain he needs painkillers, I would get the x-ray. I'm a little surprised the chiropractor didn't do one.

 

If the general MD refuses, I would seriously consider going to the ER for that severity of pain.

[MIch elle]

Take magnesium!

 

https://doctormurray.com/magnesium-for-chronic-low-back-pain/

[magnificent_baby]

If it's been this severe for a few weeks and no relief from PT, hydrocodone and muscle relaxants, he should really have an MRI. He has tried all of the conservative treatments. I"m sorry but it's also BS that they won't give him pain pills and I also do not believe what the physical therapist is saying about needing that many weeks of PT first. DH just went through this, he has a herniated disc and many areas of degenerative disk disease. It's finally better but has taken several weeks of heat, ice, pain pills. He has finally figured out how to use small pillows in just the perfect area of his back so he can sleep. Chances are time will help the inflammation, but in the meantime I'd ask for an MRI. 

[OnMyOwn]

Thanks.  I know he won't go to the ER, but I am going to try to get him back to the regular doctor tomorrow and see if he will do something more for him.  There are new guidelines for administering pain medication, so I suspect it will be difficult to get a prescription.  Plus, this doctor is no longer an independent practitioner, but now works for Inova, so he's got to follow whatever their guidelines are, I'm sure.  In the past, he treated my brother for back pain and had no problem prescribing him medication for the pain.

 

So, if we get an mri or an xray and it shows a herniated disc, does that mean he will just need to rest?  Because, of course, our insurance covers nothing and we are paying for every single thing out of pocket because our deductible is thousands of dollars this year.  If there is something they will be able to do for him, then, of course, we'll do it.  But if he's just going to get a diagnosis and then be told to rest, then I'm not sure we should.  So far, I haven't been able to get him to even try bed rest because he has so much pressure with his job.

Edited May 10, 2016 by OnMyOwn

[Starr]

In the old days we would put people in the hospital on bed rest with pain medicine and muscle relaxers. It is now recommended to walk. If he feels better in the morning the bed rest is letting those muscles relax. Walking , sitting in a kitchen chair up-straight (not for too long)  or lying down are his options. I also like to use an elastic wrap thing from the drug store. It wraps around the lower back and velcros in front. It really helps hold the abdominal muscles together and supports the back. They are also sold for support when doing heavy lifting. If he has to sit to work he should get up regularly and walk around a bit. Can he work at home, lying on his back with his knees bent? Is he taking an anti-inflammatory like ibuprofen or aleve? Ice? Look online for some gentle stretches. If he feels better in the mornings I would personally, I'm not a doctor, wait on the testing. Backs are usually treated with time before surgery is considered. Would he consider the doctor giving him a note for some time off?

 

I hope he feels better soon. I hate back pain. :(

[Carol in Cal.]

There are specific mild exercises and stretches for specific types of back pain, but they can be dangerous if other back conditions are present.  So it's really important for him to figure out what exactly he is dealing with, so he can develop a course of action.  That means, unfortunately, an MRI.

 

Also, if you happen to have one available, a Directional Non-Force Chiropractor is what finally helped my DH with his severe stenosis.  And they are pretty gentle. 

[kiana]

While you're investigating medical avenues, can he split up his time in the office? It sounds like he is not too bad in the morning but staying up all day is causing him to hurt a lot. Can he reorganize his day so that he can lie down for at least an hour and rest? It seems the lying down is helping his back. 

[Ali in OR]

When my dh had back pain with sciatica, he couldn't/wouldn't take even OTC pain relief because he thought they might be causing or contributing to his occasional vertigo. He found back relief using Robin McKenzie's exercises in Treat Your Back. Many PTs use the McKenzie method and his primary care doc confirmed that he usually recommended that book. The first exercise is just lying prone on the floor--the girls called it the dead-guy stretch. It took several weeks, but he saw slow but steady progress that encouraged him. When I threw out my back I also used the book and was back to normal in several weeks (it's not instant relief, but it does help). My improvement to dh's course of treatment was to add a gel ice-heat pack thing from the drugstore that helped during the day. I kept one in the freezer and I had another I could heat in the microwave. That felt good.

[Katy]

Thanks.  I know he won't go to the ER, but I am going to try to get him back to the regular doctor tomorrow and see if he will do something more for him.  There are new guidelines for administering pain medication, so I suspect it will be difficult to get a prescription.  Plus, this doctor is no longer an independent practitioner, but now works for Inova, so he's got to follow whatever their guidelines are, I'm sure.  In the past, he treated my brother for back pain and had no problem prescribing him medication for the pain.

 

So, if we get an mri or an xray and it shows a herniated disc, does that mean he will just need to rest?  Because, of course, our insurance covers nothing and we are paying for every single thing out of pocket because our deductible is thousands of dollars this year.  If there is something they will be able to do for him, then, of course, we'll do it.  But if he's just going to get a diagnosis and then be told to rest, then I'm not sure we should.  So far, I haven't been able to get him to even try bed rest because he has so much pressure with his job.

 

What they will do will depend a great deal on how much recovery your DH wants.  Things they might prescribe:

• a traction device (usually a counterweighted helmet that you hook on a door at home). He'll sit in a chair with it on, and it will gently pull up on his neck several times per day
• physical therapy
• walking
• TENS (electrical stimulation)
• surgery

 

I'm sure there's more, but I never worked in Orthopedics floors for long, and my sciatica is always cured by chiropractors and hip stretches.

[Harriet Vane]

It is completely ridiculous to treat with this level of pain, never having imaged the inside to see what is going on. 

 

I have had numerous back issues over many years, and never once have they treated without imaging first. Frankly, it is dangerous to treat when you don't know what the problem is.

 

Get the MRI. No question. Figure out what's going on in there. 

 

Edited to add:

 

Don't bother with the general practitioner. Go to an orthopedic doctor. You will so much appreciate the expertise a specialist brings to the table.

Edited May 10, 2016 by Harriet Vane

[Katy]

favorite hip stretch: 

[Katy]

2nd favorite stretch for low back pain is pictured halfway down, man stretching at kitchen sink.

 

http://www.julstro.com/joint-pain-lower-back-pain-2/

[ScoutTN]

If it's been this severe for a few weeks and no relief from PT, hydrocodone and muscle relaxants, he should really have an MRI. He has tried all of the conservative treatments. I"m sorry but it's also BS that they won't give him pain pills and I also do not believe what the physical therapist is saying about needing that many weeks of PT first. DH just went through this, he has a herniated disc and many areas of degenerative disk disease. It's finally better but has taken several weeks of heat, ice, pain pills. He has finally figured out how to use small pillows in just the perfect area of his back so he can sleep. Chances are time will help the inflammation, but in the meantime I'd ask for an MRI. 

 

 

:iagree:  :iagree:  :iagree:

[OnMyOwn]

Thanks, everyone, for all the great suggestions. He's going to take a couple of days off so he can just rest. I'll make an appointment for him with an orthopedic doctor. I never even thought of that and I know they can at least xray his back. My biggest concern is that he seems to be getting worse and that every time he's come back from the chiropractor or physical therapist, he is in so much pain.

 

We have a back brace, and I'm going to find it for him as soon as I get off of here. He's been taking aleve, but not regularly, so I'm going to help him get on a schedule with that. Sitting seems to make him worse, so maybe he can alternate with lying down and walking. We're going to try to set up his computer at the kitchen island so he can stand if he has to do something for work. He does work from home, but even sitting in the office is too much for him right now. I will also check out that mackenzie book. At least I feel like I have somewhat of a plan now. I've been sitting here feeling like I have no idea what else to do.

[ScoutTN]

I had much better help for my disc issues from a neuro doc than and ortho, fwiw.

 

Get the MRI. The imaging centers, as opposed to a hospital radiology dept, will often have a much lower cash price for this than what it would cost through your insurance. Still needs to be ordered by a doc. DH had a complete head and spine MRI with contrast  for $700 last summer. Would have cost us 2-3x that through insurance. 

 

Edited May 10, 2016 by ScoutTN

[magnificent_baby]

Thanks, everyone, for all the great suggestions. He's going to take a couple of days off so he can just rest. I'll make an appointment for him with an orthopedic doctor. I never even thought of that and I know they can at least xray his back. My biggest concern is that he seems to be getting worse and that every time he's come back from the chiropractor or physical therapist, he is in so much pain.

 

We have a back brace, and I'm going to find it for him as soon as I get off of here. He's been taking aleve, but not regularly, so I'm going to help him get on a schedule with that. Sitting seems to make him worse, so maybe he can alternate with lying down and walking. We're going to try to set up his computer at the kitchen island so he can stand if he has to do something for work. He does work from home, but even sitting in the office is too much for him right now. I will also check out that mackenzie book. At least I feel like I have somewhat of a plan now. I've been sitting here feeling like I have no idea what else to do.

 

 Great plan! Forgot to add that I made DH take the max amount of ibuprofen around the clock for week, I think that is what helped with the severe inflammation. Just be sure your DH takes Aleve or ibuprofen with food. Also, he saw a chiropractor who did the initial xray and also refused to touch his back without an MRI first, and thankfully he's the one who ordered the MRI. We asked for the results to be faxed to his family doc as well since he saw him as well. It takes a long time to get into ortho where I live, so you may want to ask whomever has seen him already to order the MRI while you are awaiting the specialist. DH had the same symptoms, could not sit down. It has been miserable, but much better now after all the conservative treatment.

 

Good luck!

[Snickerdoodle]

Try some of the escogue exercises.  They are super simple and can provide some relief while waiting for the MRI.    It's very much worth it to buy the book too, if you're prone to having oops moments, as the book has more exercises in it.

Edited May 10, 2016 by Snickerdoodle

[Epicurean]

See an orthopedist, not a general practitioner!

[OnMyOwn]

So, he stayed in bed most of the day, getting up to walk a bit. He is so much better than yesterday. He's going to go to the orthopedic doctor next week, but how long do you think he needs to rest like this? One week? Two? More? We are supposed to be taking a trip at the beginning of June and will be at the airport or on a plane most of the day and I'm starting to wonder if he'll be well enough to sit that long by then.

[purplejackmama]

When my dh had back pain with sciatica, he couldn't/wouldn't take even OTC pain relief because he thought they might be causing or contributing to his occasional vertigo. He found back relief using Robin McKenzie's exercises in Treat Your Back. Many PTs use the McKenzie method and his primary care doc confirmed that he usually recommended that book. The first exercise is just lying prone on the floor--the girls called it the dead-guy stretch. It took several weeks, but he saw slow but steady progress that encouraged him. When I threw out my back I also used the book and was back to normal in several weeks (it's not instant relief, but it does help). My improvement to dh's course of treatment was to add a gel ice-heat pack thing from the drugstore that helped during the day. I kept one in the freezer and I had another I could heat in the microwave. That felt good.

Thank you for this book recommendation. I just ordered it, hoping it can help me.

[jen3kids]

FYI....

 

You shouldn't mix Aleve with Ibuprofen - too much of them can cause liver damage. Use Aleve and Acetaminophen instead. One for inflammation, the other for pain relief.

 

I'm sorry to hear about your dh's back pain. it is the worst.

[kiana]

So, he stayed in bed most of the day, getting up to walk a bit. He is so much better than yesterday. He's going to go to the orthopedic doctor next week, but how long do you think he needs to rest like this? One week? Two? More? We are supposed to be taking a trip at the beginning of June and will be at the airport or on a plane most of the day and I'm starting to wonder if he'll be well enough to sit that long by then.

 

This is really something where you have to feel your way. When I used to throw my back out all they'd say (after they ruled out mechanical malfunction) was 'if it hurts, stop doing it'.

 

If he was up for an hour or so today, try two tomorrow (it's not an emergency or I wouldn't say this). If the pain increases, go back to one hour.

[Carol in Cal.]

FYI....

 

You shouldn't mix Aleve with Ibuprofen - too much of them can cause liver damage. Use Aleve and Acetaminophen instead. One for inflammation, the other for pain relief.

 

I'm sorry to hear about your dh's back pain. it is the worst.

I'm not sure this is right.  Acetaminophen is the one that causes liver damage.

[jen3kids]

FYI....

 

You shouldn't mix Aleve with Ibuprofen - too much of them can cause liver damage. Use Aleve and Acetaminophen instead. One for inflammation, the other for pain relief.

 

I'm sorry to hear about your dh's back pain. it is the worst.

 

 

I'm not sure this is right.  Acetaminophen is the one that causes liver damage.

 

Sorry, yes high does of  Acetaminophen can cause liver damage.

 

The combo of Aleve and Ibuprofen can cause gastro-intestinal problems.  I believe they are the same 'class' of drug. 

[SparklyUnicorn]

2nd favorite stretch for low back pain is pictured halfway down, man stretching at kitchen sink.

 

http://www.julstro.com/joint-pain-lower-back-pain-2/

 

This is very similar to the exercises I was taught when I had back pain. The only difference is this was done by doing essentially a modified push up.  You lay flat on the floor face down and push up and slightly arch the back (belly and legs remain flat).  This both helps with the back situation and strengthens your arms so you can take pressure off your back when lifting.  When my pain flares up I do these.  You do about 10 at a time, several times per day.  Works like a charm after a few days.  I taught it to my husband when he had back issues and it worked for him too. 

[Katy]

Too much Alieve & Ibuprofen can cause liver damage too.  You can call any pharmacist for information about how much is too much.

[SparklyUnicorn]

I was prescribed a very high dose of Ibuprofen with my back pain.  It was probably too much.  Now if I take even one Ibuprofen tablet I instantly vomit.  It's like my body says no way in hell...  It's weird.  (On another note it didn't really touch the pain.)

 

All of that stuff is very rough on the stomach.