WOW! Huge lumbar episode > 6 years out!

[mmglobal]

Most of you who watched me go through my ordeal know that I posted the good and the bad.... warts and all. I wanted everyone to see a realistic picture of my recovery.

During the first couple of years, I had many sudden episodes of low back pain that scared the crap out of me. I'd run to the doctors office and insist on xrays to make sure the discs were still in place. Normally, just a day later, I'd be laughing at myself for panicking as it all blew over in short order.

A week ago, I was playing with Zoey... lifting her and putting her down while moving fast, bent all the way forward, arms fully outstretched.... "flying" her into a pillow and watching her laugh.

Big mistake! While there was no pop or sudden pain, I knew just a few minutes later that I had done something. This was not just a little low back pain. I could not stand up straight. It was like my pre-op condition... pelvis is on crooked... shifted forward and down to the right. Pain is left sized fairly low.... iliac crest level. Pain is substantial even resting. Every once in a while, I'll get up and be straight, but for many days, I was crooked.

I had appointments with clients all Tuesday morning, but insisted on xrays Tuesday afternoon. Again... discs are good... same as always. Over the next couple days, things did not die down as they had in the past. I doubled my Voltaren and started taking low dose oxycodone. It helped, but on a very limited basis.

The rest of the week was a real eye opener. While I thought I remembered what this was like, and while I constantly see clients in this kind of pain and identify too strongly with it; I was really overwhelmed by how bad this really is. I'm now a week past the injury and really relaxed after the xrays. I knew this would blow over... maybe a couple of days, maybe more... but I knew it. Even so, I constantly thought, "I can't believe I used to live like this all day every day for years!" You cannot take enough meds to deal with that stabbing pain effectively. The meds help lower the pain during inactivity, but that stabbing pain that you get when you move wrong cannot be medicated. When moving wrong may mean the most innocuous movement... standing up... changing positions... your life is miserable. I missed a bunch of work and my boss is a reall ass about it. (I'm self employed.)

Things are much better know, but I'm not done for sure. I hope that this is a memory in a couple of days. I believe that I know what caused it as my last severe episode (4 years ago) was also caused by extreme flexion. I believe that with my configuration of the discs, there is disadvantage at L5-S1 for severe flexion. I believe that I subluxated or partially subluxated the facet causing major irritation. My hope is that this is an anomoly that I can avoid. My fear is that the condition of my posterior elements may be in play and that episodes will be come more frequent... more severe... last longer... etc. It's stupid to even think about this... one big episode on the last 4 years. I'll not worry too much except to be smarter about too much flexion and maybe increase core strengthening regimen.

My neck still bad too and I wonder if that is part of it. I returned home from Germany a few days before the injury and the lousy flight really set it off. After the 9 hour flight from Munich to Dulles and the 3 hour layover, we sat on the ramp for more than 2 hours before starting the 5 hour flight to LAX. I hate it when that happens!

In any case... I'm OK and expect to be OK and am not worried about the lumbar issue. I just want to keep it out there... warts and all. Hopefully others who experience similar issues will be helped by this.

Importantly... don't misunderstand my post and think that the message is that all will be OK. If you have the sudden onset of severe pain... see a doctor as I did! If you have hardware... get some xrays. You have to be sure.

All the best.

Mark

[ans]

I'm glad your x-ray was OK Mark. Did you ask for a CT to make sure (dunno if warranted). You certainly were in pain the last time I saw you. Wishing you well. - Allan

[mmglobal]

The doctor asked for thin sliced CT to review facet condition. I translated that into, "if things aren't good in a few weeks, I'll do the CT".

If this just blows over, I don't even want to know what my facets look like. Remember that this is the first episode of it's kind in 4 years. I (think I) know what I did to provoke it.

Mark

[Maria]

Mark,
A tired spine from all that you do with your business and then a little flight that you gave Zoey sounds just like perfect fodder for *an episode* arising from whatever interacting spinal parts.

Prolonged flexion or repeated flexion and or flexion with any sudden extreme movement seems to be a real shoe in for a rapid onset flare up for me (maybe not as rapid as prolonged sitting).

Be careful young man and thanks for updating us with the good, the bad,and the ugly.. then good again (at least lumbar wise). Here's hoping all's OK in there

[Firerescuefin]

Hey Mark,

I held my breath as I opened your post...probably nowhere near as much as you did as they presented you with the lumbar X-Rays. I am sure that it would be hard to quantify the relief that you experienced when you saw everything right where it should be. I read your posts a couple of times, and regarding the facets, wouldn't the pain associated with them be a gradual onset (unless there was a macro trauma that fractured them) and if this was the case, wouldn't that have been apparent in the X-ray. Our bodies are designed to maintain an environment of homeostasis. Is it posibble your body sensed a measure of instabilty (at ADR level or above) and put the lockdown on you to prevent further instability/injury?

Anyhow, a good post for me to read as we pack our bags. I spoke to someone who had a two level recovery similar to yours. I will never forget what he told me. "I no longer have lower back pain, but I think about my lower back every day"...Between my conversation with him, you, and the others I have read about it reminds me that although we may feel like Superman.....Lex Luther...or one of his demonic back pain superheroes may be right around the corner with the Kryptonite...Let's stay vigilent, and NO MORE THROWING ZOEY FROM THE FLEXED POSITION

[dshobbies]

Mark,

I hear you and I feel for you. Grandkids need us as much as we need them, our backs notwithstanding but due diligence at all times.

Just wondering, does the fear of repeating any major injury ever go away?

Take care, Dale

[mmglobal]

I don't know if this will be clear, but here goes....

The facet joints have corresponding sliding surfaces. I think that in my case, going into extreme flexion may push the facets to the point where there is so little surface area taking the load that pain and inflammation are caused by high pressure on a small portion of the joint. A step further would be to temporarily subluxate (or dislocate) the joint.

I took the pictures below of a Charite' model that I have. On the left would be a neutral position. On the right is the joint with the facets with the facets spread to the point where they barely overlap. This is my theory... I may be full of BS, but both of my episodes were brought on by extreme flexion... both were extremely painful for days. The first one blew over completely in about 4 or 5 days. I'm 7 into this one and it's much better now than a few days ago, but it still sucks. I'll bet that in a few days it will be gone.

All the best,

Mark

[sahuaro]

Ouch! Just your demonstration looks painful.
One of the problems of feeling good is that you do "stupid" things and then worry that you've messed up the ADR--as I've learned in the 8 months since my surgery (after spending an hour with the phone on my shoulder and my head tilted, concentrating on the conversation with a patient with no thought about my neck, my hand was totally numb).
I'm glad you've already had some improvement and hope this episode passes quickly.

[Cheryl]

Sorry to hear you are in so much pain. Hopefully your theory is accurate and you won't do it again. Neck and lumbar combined is really too much to take.

Thanks for updating us will be good to know for future reference.

[martyusa]

Mark, sorry to hear of the complications and I do hope all goes well. As we all know there is nothing worse than dealing with pain, especially when it is not expected.