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Herniated and degenerated disct at l4-l5 with persistent back pain for 6+ months

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  • Herniated and degenerated disct at l4-l5 with persistent back pain for 6+ months

    Hello Doctors,

    I came across your page a few days ago. I was surprised and relieved with so much information regarding low back pain, and it gave me hope. I will share my experience with low back pain for the past year:

    I first started strength training at the gym (mostly with machines) back in January 2020. Due to the pandemic, I was stuck at home since March with access to very little equipment. I began with bodyweight routines (squats, planks, split squats) and then began routines with dumbbells. My exercises consisted of isolations for biceps and triceps, bench and overhead press, goblet squats, crunches, and hip thrusts. I also did bodyweight and band exercises for my glutes like donkey kicks and side clams. All of my exercises were performed with dumbbells only and 10-pound dumbbells were the biggest weight I had.

    Since April, I started waking up with a sore low back and tightness most mornings. At that time, I assumed it was only the effect of a bad night’s sleep. One day during June I woke up with excruciating low back pain that went all the way to my hips, my glutes, my pelvis, and down my left leg. My body was leaning to the left, I couldn't get back to a straight position without feeling pain and I was getting sudden pinches in the areas I previously mentioned. I had to keep my butt tucked in because the pain was unbearable if I just tried to stand or walk normally. I refer to this time as my first “episode”. Since we were quarantined and I didn't want to make a physical visit to a Dr's office, I only got medical help through call. With my symptoms, I was diagnosed with "lumbosciatica" and was prescribed some rest, pain killers, and muscle relaxants. It took about one week for my body to go back to its normal position, and about two weeks for the “bad” pain to go completely away. However, there was still lingering pain around the same low back area, sometimes the leg or pelvis, and glutes.

    I began training again, with persistent pain, which was bearable to me and shrugged it off. However, I got another big “episode” like the first one once again in August. This time my orthopedist told me to get an x-ray. The findings on this x-ray, according to my doctor, were the following:

    - Sacroiliitis, predominant especially on the right side (where my pain was stronger).
    - Grade I or II retrolisthesis at L5-S1

    I was told to stop lifting (not until the pain went away, but forever). I was told I couldn’t run or jump anymore; I was prescribed more painkillers; I was told to get an MRI.

    At that time, I didn’t know as much as I do today, but I was still skeptical about the fact that I was being forbidden of these things forever. I set on to look for a second opinion and visited a physician. This time I did go for a physical evaluation. Several mobility tests were performed on me. She explained to me that both of my SI joints were inflamed. I asked her if “lifting” was the culprit behind all of this. She explained to me that it wasn’t lifting but my scoliosis instead. Apparently, my imbalance was causing me to hold weight more on one body side than the other causing my muscles to contract which then caused my joints to become that way.

    I was prescribed yet more medicine, and 10 sessions of therapy. At this time, I felt relieved and convinced that my therapy would get me back to normal and make the pain go away and that I would be training again once this was over. At home, I kept only walking to keep myself active. I began my therapy sessions which began with ultrasound therapy on my lower back, TENS on my lower back, and manipulation of my back by the PT. This went on for the first 6 sessions. I felt better only for the 20 minutes after my therapy had finished. However, the pain persisted, and I was still getting “episodes” (excruciating pain on low back, sciatica mostly on my right leg or both, pelvic pain, and my body leaning to the left). I told this to my PT, and I was prescribed another 10 sessions. Before ending the first 10, I was also doing some guided rehab exercises at the clinic (bird dog, cat camel, cardio bike, standing on a power plate, one-legged squat on a power plate, lifting my legs with ankle weights, and stuff of that sort).

    During my pain journey, my biggest concern was that I would never be able to lift again and that I had just started with all this when this happened. This made me start my research of what was happening to me to understand everything better. I came across backfit pro, watched a lot of Dr.McGill videos, bought back mechanic, read back mechanic, followed back mechanic to make my spine hygiene better. Every time I found more and more about people with similar conditions who were lifting and that made everything better. I was becoming more and more frustrated because nothing of what I saw on the internet, which were sources I trusted, was similar to the rehab processes offered by my doctors. I knew I just HAD to strength train, but I was also afraid to “disobey” the doctor.

    20+ therapy sessions passed, and I was not feeling better. The pain on my back was always there, sometimes faint but sometimes very active. I finally decided to visit another orthopedist in December. He made some physical exams again and told me to get an MRI and so I did. My MRI showed a herniated and completely dehydrated disc at L4-L5. He told me the pain from this would eventually go away with proper medication, or that I could opt for an ESI. If it didn’t get better after this then I could opt for surgery or just live with the pain until it eventually went away. He told me he was also surprised to see my disc completely degenerated because of my young age. I asked what the cause of this had been, and I didn’t get a concrete answer. He told me it was probably the effect of heavy lifting and repetition of movement which caused so much pressure on that disc until it eventually became herniated. I didn’t understand how the little weight I was lifting could have caused this.

    I decided that I would visit another doctor since I was recommended that for the ESI I should have a neurosurgeon do it. I went and visited the best neurosurgeon in town. She confirmed my diagnosis once again, told me my SI joints were still inflamed and prescribed another treatment for this to finally go away. She asked about my daily activities and I told her it was mostly housework, sitting to work, and walking a lot since this was the only way to keep myself active. She told me to stop walking as much since this still caused a micro impact on my discs, and to avoid bending or lifting stuff for a while until the treatment kicked in. I was sent to bed rest for 21 days which was the duration of my treatment which consisted of Etoricoxib, Thiocolchicoside, Lysine clonixinate, glucosamine. She also told me I should use a lumbar brace when sitting and walking, which I did. I think this was the hardest time for me since I believed I was fragile. I was scared of twisting or bending, or even moving at all since everything was going to make my pain worse. I knew there were people out there with conditions similar to mine, but I came to believe my case was “another thing” and that I couldn’t just strength train on my own to get me back on track. However, in my country, there was no single doctor who would recommend strength training to me. I was also told to avoid this.

    It took about two weeks for the treatment to kick in. I was pain-free for about 3 days after my treatment was done and then I was feeling the constant pain again. The one thing that did get better after this was my regular sciatica. Ever since I’ve only felt it like 3 times. I went back for another visit because I was frustrated that after doing almost NOTHING it was still getting worse. My doctor told me there was nothing else to do but wait. She explained to me how our spine is dynamic so everything I did would be causing an impact to that disc, making the recovery process slower. She told me that surgery wasn’t necessary but that I could opt for it to end the chronic pain. It was depressing to hear this because I just couldn’t let myself lie down all day not to feel pain. Life was still going on, there was stuff I had to do, and I just knew all this “not doing anything” was making it worse.

    I decided I was not going to listen to this medical advice anymore and kept on with my research. This is when I found BarbellMedicine (about two weeks ago), and everything changed for me. I knew I was not condemned and after reading a lot decided I would get back on the bench. I cautiously tried doing some exercises to see if I felt any pain. Absolutely NOTHING hurt or felt bad on my back during my training sessions. I was able to perform bodyweight squats, bench press, incline rows, hip thrust, lunges, and extensions. This is what I have tried so far and will be trying to progress following what I know from you guys.

    My constant back pain still lingers, extending my back sometimes feels like a burn, and sometimes I sense little sciatica coming my way, but I am no longer scared of it. I don’t feel fragile anymore and I am hopeful that the barbell will be THE medicine to cure this once and for all. However, I’m still new in my rehab and would truly appreciate some feedback to feel more confident about what I am doing and that my symptoms are nothing to worry about. I would really like your opinion or advice on my case to feel I am doing things right.

    P.D: I have uploaded pictures of my xRay and MRI.

  • #2
    Hey Elenafg - thanks for sharing your story. Sorry to hear about your journey to finding us. Sounds like a lot of not great advice was provided to you along the way. Fortunately it sounds like you are starting to move forward away from those narratives. Ultimately we need an individual consult with you to work through this process and provide recommendations. We do offer remote consultations. If you are interested, please complete our intake paperwork HERE. We also offer remote programming to help guide this process.

    With that said, based on the info you've provided here, I think you have the right mindset about returning to desired activities to tolerance. You will likely notice some symptoms along the way and that's ok and normative. Ideally you are remaining active to your tolerance level (which is likely to change day to day and week to week, which is also ok). Check out our podcast on low back pain HERE and review our general recommendations in these scenarios HERE.

    Hang in there. Happy to help.