Referred pain and cramping down leg after back tweak

[Bassist_phil]

Hi docs,

I posted a quick post on the general FB group and was rightfully pointed to seek out a consultation with one of you.

However, before i pull the trigger here I thought it worth asking on the forums - not for free advice, but whether you would recommend me seeking local (UK) advice and possible screening before heading down the route of a consult.

Three weeks ago, I tweaked my back midway through a set of tempo squats. For a few weeks prior to this I had been dealing with a little bit of tolerable hip pain, usually during RDLs. I’ve been carrying on with a bastardised BBM powerbuilding 1 template (just doing slightly higher rep sets to encourage some hypertrophy) and modifying when necessary. However, the pain and symptoms are becoming unbearable…

Symptoms:

For a few days after the tweak, mild lower back pain
pain down the back of my right leg, specifically the top half of my hamstrings and calf muscles.
moderate to severe cramping, especially during sleep, in my right hamstrings and calf muscles. This feels like I am about to tear a muscle.
right hip pain at the front, side and back during loading (squatting, picking things up off the floor).

I’m not suffering from parethesia.

This is a recurring problem, which seems to happen around this time of year and has done for 3 years now. I’m not running a particular program around this time. Last year, I had the same issue which resulted in weakness and parethesia (but no cramping) and I sought professional advice. I received an MRI which showed a para central disc extrusion L4-L5. By the time I saw a neurosurgeon(~9 months later) I had self-managed it and had recovered. Another interesting incident saw me tear an adductor during this period simply by standing around at a concert (there was no head banging involved - they were crap!).

This time around I would have just well-managed, and maybe considered the lower-back pain rehab template, however whilst my lower back feels fatigued, I am not suffering any symptoms there. Instead, it’s the severe cramping, or more appropriately, the feeling that my hamstrings and calf muscles are about to tear during certain movements that has me concerned. This sensation is new this time round, despite actually tearing a muscle the previous time. The sensations and pain are worse first thing in the morning, and stay the same for 3 - 5 hours before dissipating. I may have a few symptoms during the day, and after specific movements (at the end of a squat set, for example) but otherwise tolerable in the evening. Sleep is painful and I regularly wake due to cramping.

These movements are:

Hamstring-dominant movements (deadlifts, rdls, stiff-leggd deadlifts, hamstring curls [these are horrendous!], at the bottom of both high-bar and low-bar squats sitting onthe toilet [again, horrendous].

I’m getting pain symptoms in my hip from almost anything that may load it, but this is more than tolerable at the moment.

I am fairly well-informed with your approach to medicine using the biopsychosocial model, and would simply alter my program to suit, however the cramping is beginning to worry me.

Should I seek screening and diagnosis in this case? Its affecting my daily life and I’m currently prescribed 30mg/500mg co-codamol (which, whilst fun, is making me a bit sleepy).

Thanks in advance, and apologies for the ramble.

[Bassist_phil]

I should add (I forgot about this!):

I had been experiencing nightly cramps in my right calf only for a few weeks BEFORE the back tweak. These would occur at least once per night. I am fully aware that this is probably not related, however I believe it important enough to at least mention it.

I would also like to add that for the best part, I can still squat and deadlift as long as I let the pain guide me, and this, in general, is increasing in weight. For example, I got up to a single set of 120kg for 8 today (I’d say I would usually get 155kg - 160kg x 6 @ 9.) The pain was tolerable today. Ths only exercise I simply cannot do due to severe cramping is hamstring curls. It’d be interesting to see if any other hamstring-dominant exercises trigger the same response. The cramping comes post-session and always overnight and for up to 5 hours after waking.

[Michael_Ray]

@Bassist_phil

Hi docs,

I posted a quick post on the general FB group and was rightfully pointed to seek out a consultation with one of you.

However, before i pull the trigger here I thought it worth asking on the forums - not for free advice, but whether you would recommend me seeking local (UK) advice and possible screening before heading down the route of a consult.

Three weeks ago, I tweaked my back midway through a set of tempo squats. For a few weeks prior to this I had been dealing with a little bit of tolerable hip pain, usually during RDLs. I’ve been carrying on with a bastardised BBM powerbuilding 1 template (just doing slightly higher rep sets to encourage some hypertrophy) and modifying when necessary. However, the pain and symptoms are becoming unbearable…

Symptoms:

For a few days after the tweak, mild lower back pain
pain down the back of my right leg, specifically the top half of my hamstrings and calf muscles.
moderate to severe cramping, especially during sleep, in my right hamstrings and calf muscles. This feels like I am about to tear a muscle.
right hip pain at the front, side and back during loading (squatting, picking things up off the floor).

I’m not suffering from parethesia.

This is a recurring problem, which seems to happen around this time of year and has done for 3 years now. I’m not running a particular program around this time. Last year, I had the same issue which resulted in weakness and parethesia (but no cramping) and I sought professional advice. I received an MRI which showed a para central disc extrusion L4-L5. By the time I saw a neurosurgeon(~9 months later) I had self-managed it and had recovered. Another interesting incident saw me tear an adductor during this period simply by standing around at a concert (there was no head banging involved - they were crap!).

This time around I would have just well-managed, and maybe considered the lower-back pain rehab template, however whilst my lower back feels fatigued, I am not suffering any symptoms there. Instead, it’s the severe cramping, or more appropriately, the feeling that my hamstrings and calf muscles are about to tear during certain movements that has me concerned. This sensation is new this time round, despite actually tearing a muscle the previous time. The sensations and pain are worse first thing in the morning, and stay the same for 3 - 5 hours before dissipating. I may have a few symptoms during the day, and after specific movements (at the end of a squat set, for example) but otherwise tolerable in the evening. Sleep is painful and I regularly wake due to cramping.

These movements are:

Hamstring-dominant movements (deadlifts, rdls, stiff-leggd deadlifts, hamstring curls [these are horrendous!], at the bottom of both high-bar and low-bar squats sitting onthe toilet [again, horrendous].

I’m getting pain symptoms in my hip from almost anything that may load it, but this is more than tolerable at the moment.

I am fairly well-informed with your approach to medicine using the biopsychosocial model, and would simply alter my program to suit, however the cramping is beginning to worry me.

Should I seek screening and diagnosis in this case? Its affecting my daily life and I’m currently prescribed 30mg/500mg co-codamol (which, whilst fun, is making me a bit sleepy).

Thanks in advance, and apologies for the ramble.

Hey @Bassist_phil sorry to hear about these symptoms. We would need a consultation to discuss all of this and provide guidance on moving forward. Nothing you’ve said thus far gives me pause that we couldn’t help remotely. Sounds like you are doing a pretty good job at self-managing already, based on your last comment.