First … thanks for the great forum. I’ve enjoyed it for a while, particularly Dr. Baraki’s reading lists. I’m a 51 year old physician, and this has been a great resource!
I’m having trouble with back pain and I would like to keep it from interfering with training.
The history goes something like this: I began developing non-radiating lower back pain, only while standing, about 2 years ago. That non-radiating, standing-only pain eventually lessened, until around October 2017 I began having right L5 radicular pain, again worse with standing, and it worsened until August 2018 when I had an MRI showing L5-S1 spondylolisthesis and a right L5-S1 Disc compressing the lateral recess.
I was told by a colleague that a transforaminal epidural shot would help, but in the time it took to set it up, the radicular pain sort of went away on its own, and so I never had that. I saw PT once, but never really followed their suggestions. Instead, I just kept up with CrossFit around 3-4x per week supplemented by some non-programmed squat/deadlift/press days. My strength improved, and I remain able to do about anything I like, and currently have 1RM deadlift at 375#, to give you an idea.
The problem: over the last month, the non-radiating lower back pain has returned. It presents only with prolonged standing (such as when I perform colonoscopies or teach medical students). It seems temporarily improved while exercising – either squats/deadlifts or CrossFit WODs. Sitting and sleeping seem to “help”, too.
The question: I’d like to ignore this and continue to train, letting regression to the mean occur. But the pain is really interfering with things that require prolonged standing. So – Assuming this pain is related to L5-S1 listhesis (I know – it’s an assumption) are there activities/lifts/movements that should either be avoided or, perhaps, encouraged?
For instance, I had a PT tell me to avoid “overhead” activities at CrossFit … Snatches, OH squats. I’m very happy to do that as I don’t really see the point of them, anyway. But is that evidence-based? Is there any evidence based advice for training with L5-S1 listhesis?