T Nation

Chronic Lower Back Pain

Injuries and Rehab
#1

Hey everyone,

This is my first post, so let me know if you need any additional information to help me out with my situation. Thank you in advance for any help! Here it is:

Last Feb. I maxed deadlifting and something in my lower right back shifted to the right. I could tell something was wrong when it happened (probably about 3/4 of the way through the lift). I stopped deadlifting and squatting since those aggravated it the most. I tried stretching but perhaps not religiously enough. I ended up going to the chiro 3x a week last spring, and nothing helped.

I still did not do any deadlifting or squatting this summer. I missed it a lot, and decided to get back into it this fall. I started off my deadlifts as just rack pulls, and my strength and power was still there. I tried squatting again today, starting light, and felt great for the first three sets.

Maybe I loaded up too fast, even though I was at 65% of my former 1RM of last winter, and as I tried to push up on my 8th rep of my 4th set, my lower right back shifted again. It felt kind of like a grinding when I tried to move it around after racking the weight. I tried to rack pull after that (probably a bad idea), and it tugged again once I went heavy enough. Now sitting hurts, and it’s a pretty sharp pain.

Last year, there would be small pains in the front of my right thigh to accompany the back pain. Now, there is none of that, but the new back “injury” only happened today.

If anyone has any idea of what happened, what I can/should do moving forward, and any other advice for me, I’d greatly appreciate it. I am a 20-year old male, 5’10", 175 lbs. Thank you!

-Tyler

#2

You absolutely need to see a doc and have an MRI done and go from there.I have had chronic lower back pain for over 9 yrs. and from the sound of the symptoms you have described it’s possible you may have herniated a disc and possibly have done even more damage.It also sounds like your sciatic nerve may be affected as well.You really should try to find out what exactly is wrong and then you can find ways to treat it and still be able workout around it.Good luck.

#3

Thank you for your concern. If I’m not pain-free soon, I will definitely see a doctor. The lower back pain is gone. The pain now, however, is in my right piriformis muscle region. When I do the piriformis stretch, I can really feel how tight it is. I’ve been trying to roll it out with a baseball and stretching it. The pain’s intensity comes and goes. Sometimes it feels great, but the last few hours the pain has been pretty significant.

Perhaps this could be the supporting muscles contracting to protect an injured region. Or perhaps it could be piriformis syndrome? Not sure. When I stretch it, I feel the muscle’s tightness, but when I stretch it AND put my chin to my chest, it’s a sharp pain. My guess is the sciatic nerve is being impinged.

Would rolling it out on the baseball and stretching cause this to go away? Any help/advice is very much appreciated, as always. Thank you!

#4

With lower back injuries it takes 6 weeks to 3 months for the pain to go away in most cases, so you are actually doing better than expected.

During this time, take it easy with the aggravating lifts and get back into it slowly once you are pain free. Going back, as you did, to 65% of prior trained 1 RM right after an extended period of not doing that lift is absolutely crazy, even for someone who doesn’t have a history of back injury. And then you didn’t stop but continued doing other aggravating lifts after you were hurt. You really were asking for it and it sounds as if you got off lightly so far, so take what happened as a lesson :wink:

It sounded as if the pain did go away eventually before you went back and aggravated it again, and it sounds as if it is going away again. That is not really what chronic back pain is. It sounds like two episodes of acute back pain.

An MRI is useless at this point. The treatment is going to be the same regardless, namely conservative treatment (light to moderate exercise - doesn’t really matter what, as long as it doesn’t aggravate it, but not major heavy lifting with the back) . If the pain should become chronic (i.e., if it lasts more than 3 months this time) you might then have an MRI, but even then its usefulness will be limited. MRIs very seldom clarify what is causing the pain, unless there is something major-major wrong - a majority of adults have all kinds of disc bulges and herniations that don’t cause them pain, so even if you have disc damage on MRI, you most likely will still not know if the pain actually comes from that disc or not.

#5

[quote]seekonk wrote:
With lower back injuries it takes 6 weeks to 3 months for the pain to go away in most cases, so you are actually doing better than expected.

During this time, take it easy with the aggravating lifts and get back into it slowly once you are pain free. Going back, as you did, to 65% of prior trained 1 RM right after an extended period of not doing that lift is absolutely crazy, even for someone who doesn’t have a history of back injury. And then you didn’t stop but continued doing other aggravating lifts after you were hurt. You really were asking for it and it sounds as if you got off lightly so far, so take what happened as a lesson :wink:

It sounded as if the pain did go away eventually before you went back and aggravated it again, and it sounds as if it is going away again. That is not really what chronic back pain is. It sounds like two episodes of acute back pain.

An MRI is useless at this point. The treatment is going to be the same regardless, namely conservative treatment (light to moderate exercise - doesn’t really matter what, as long as it doesn’t aggravate it, but not major heavy lifting with the back) . If the pain should become chronic (i.e., if it lasts more than 3 months this time) you might then have an MRI, but even then its usefulness will be limited. MRIs very seldom clarify what is causing the pain, unless there is something major-major wrong - a majority of adults have all kinds of disc bulges and herniations that don’t cause them pain, so even if you have disc damage on MRI, you most likely will still not know if the pain actually comes from that disc or not. [/quote]

Great response, thank you! What do you recommend I do for pain management in the meantime? Rolling it out with a baseball still? It doesn’t feel like muscular pain on the piriformis muscle, it’s a sharper, weirder kind of pain. Not sure how to describe it. I’m hoping it’s not nerve pain. Should I heat or ice? Ibuprofen? Just wait it out?

It hurts a little when I cough, bend over, and try to squeeze when I poop. Also when I do the piriformis stretch and look down (forehead to knee kind of thing) it makes it really hurt.