firecaseyParticipantNovember 25, 2011 at 7:34 amPost count: 6
First off – Happy Thanksgiving! I am very excited to have found your forum where you provide advice… thank you. I am not looking for a diagnosis by any means, just some expert advice. I will try and provide you a detailed history, please forgive me if I am long winded.
27 / M. Active lifestyle, full time structural firefighter for 9 years. I am a tall individual, 6’8 but in good physical shape.
When I was a senior in High School (approx 10 years ago) I suffered a weight lifting accident doing power clean lifts (280lbs). I felt immediate pop in my lower back. I never seeked treatment as the serious pain subsided after a couple of weeks. Over the past 10 years, I have had CONSTANT lower back pain and discomfort from this incident (the pain is everyday, literally).
I lived on and “just dealt” with it as the pain would come and go, sometimes lasting a few weeks and then okay for a week or two. But it has always been constant. The pain radiates mostly in what I believe to be my left SI joint, and middle of lower back (just above butt crack) with pain mainly radiating in my left butt cheek and lower back. It is a constant ache. Over the past 10 years I have been able to easily ‘adjust’ my left SI joint about 10-15 times a day. I cannot avoid doing it, it just happens and ‘pops’ very easily.
I have been living with this for the last 10 years…it is every day but really flares up when I sit (driving) or in a chair, and in the morning and night time. I toss and turn constantly having to adjust my sitting position. Being I am in a very physically (firefighter) demanding profession, some days are better than worst.
——Fast forward to now——
About 5 months ago I was working a house fire and was doing alot of heavy lifting. My back was sore and I was dealing with the pain as I always had done. After a couple of hours I went home and literally had to drag myself out of my car. I was bed ridden to two days and nearly called an ambulance due to the pain and inability to stand or walk. I called my doc (workers comp due to the pain associated with the fire) and was evaluated. I could not raise my left leg out without pain, and I could not bend to right side (right hand touch right side of knee) without pain. I had an MRI and the findings are as follows, from the
Radiologist report findings:
– Broad based disc buldges at L2/L3, L3/L4, L5/S1.
– High signal annular tear at L3/L4
– Moderate Disc Degeneration at L2/L3, L3/L4, L5/S1.
– No nerve root impingement (I somewhat dispute this after obtaining copies of the MRI CD…I am not Doctor by any stretch but it appears evident that I have it at my L5/S1).
– SI Joints appear normal (Again, ?)
My follow up Occ Health appointment was with a Physicans Assistant, and he basically said “Looks like you got some Arthritis, but you’ll be fine”. That was the end of it, and the workers comp accepted the claim as strained back.
My pain from this instance has pretty much subsided completely and am back to work, however, I am still having the Chronic Pain and discomfort that I have always had since my high school incident (Pain in left SI Joint, muscle spasms, low back pain, etc).
My concern is about the MRI report. For being young, I am surprised that I have the Degenerative Disc Disease. I am worried that if I am living in constant pain as it is right now, how will I be when I am 60 years old? Should I try and schedule an appointment with a Spine MD, since I have a feeling the PA who told me I just had arthritis may not have been accurate. I am also concerned about how loose my left SI joint is, since it literally pops 10-15 times a day. This has been ongoing since my High School incident.
Again, thank you and I apologize for the long winded-ness of this posting. Respectfully, CaseyfirecaseyParticipantNovember 25, 2011 at 7:53 amPost count: 6
Also, I forgot to mention. For the last year and a half I have been having discomfort in my left lower abdomen. I consulted with my Dr who sent me to a Surgeon for eval. I had a CT scan done which showed nothing wrong. The pain is like a sore muscle, in the area of where my colon is. The surgeon said that the muscle is fatigued and essentially just sore.
I was happy to hear that it wasn’t something to be concerned about. Is is possible that it could be attributed to my back issues? Can it affect an abdominal muscle like that?
Please also don’t think I am a cry baby, I have literally only been to the doctor a handful of times in my life! Its just this chronic low back issue is really starting to irritate me.
Thanks againDonald Corenman, MD, DCModeratorNovember 26, 2011 at 3:24 amPost count: 8506
Happy belated Thanksgiving!
Now to your questions.
Degenerative disc disease which appears to be causing the pain is related to both occupation, advocation and genetics. I believe that genetics plays a large role.
The pain in the central back most likely is related to the degenerative disc disease in the lowest portion of the lower back- most likely at L5-S1 but the symptoms could even originate from L4-5. Sacroiliac pain almost always is not from the sacroiliac joint but from the disc itself or from mild irritation to the adjacent nerve root.
These disc will not heal and the treatment is core strengthening and medications. Non-steroidal anti-inflammatories (Aleve) can be very effective in some patients to relieve pain. Epidural steroid injections can also be very effective. A consult to a spine surgeon or a physical medicine doctor may be very helpful.
The good new is that even though the symptoms are painful, they are not dangerous. That doesn’t help you when the pain can be incapacitating but at least you know that you are really not doing any more significant damage.
There is occasionally surgery for your symptoms, but you would need a good surgical work-up and you may not be a candidate for surgery depending upon the results.
Dr. CorenmanfirecaseyParticipantNovember 26, 2011 at 3:46 amPost count: 6
Thank you Dr. Corenman for this reply! It is so nice to be able to speak to an actual Doctor, not to mention an expert in this specific field, via an online forum. Please know that the service you provide is very much appreciated.
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