T Nation

Lower Back Pain Correlated to TRT Use?

59 year old male. Been taking 200mg test cypionate a week for 4 years. Was a life changer for me. Id hate to know Id have to stop it. Labs have always been in the “normal” range.

Started developing terrible lower back pains about 3 years ago, especially in the a.m. when getting out of bed. No injuries or lifestyle changes to cause it. Just came on “out of the blue”. Hard to even straighten up in the mornings the past 3 years.
Was recently out of town for 3 weeks. Forgot to bring along my Test injections.
During these 3 weeks, lower back pain has subsided to the point it is almost gone. Havent taken my test shot yet.

Had another occasion not long ago where I didnt have a injection for 2 weeks and noticed the pain subsiding.

Ive done some online research, and did find a 1-10% incidence of musculoskeletal issues (back pain) in some.

Any thoughts or similar experience?

You made it 1 year of TRT with no pain and then 3 years with pain? What happened after that first year? I don’t know if lab work would help in your situation but it might be helpful just to see if anything is off.

It may have been gradually getting bad, cant remember. It didnt get “unbearable” overnight. It was gradual.

Have had several labs over those years. No issues other than elevated creatinine and slightly low red blood cell count…

What is your iron status?

The skipping the TRT doses along with lack of back pain is coincidental in my opinion.

I too have back pain. It comes and goes depending on my training.

Do you do weight training?

I would try lowering your dose.

The fact that your symptoms wax and wane throughout the day point away from TRT as a cause. Back pain is common, especially for those 59. You are describing symptoms consistent with degenerative arthritis, disc degeneration, or spondylosis. You feel better with movement, worse with inactivity, such as sitting or lying down for extended periods. As we age, the morning is often the worst time of the day. We get up, move around, get a shower, we start to feel better, which is why it is important to stay active and move as we age.

Gradual onset is consistent with degenerative arthritis.

Pain which seems worse with particular positions also leads away from testosterone as a cause. You have the same testosterone in you when you bend forward as when you bend backwards. Why would it hurt more extending? That points to a biomechanical cause. Difficulty with extension also leads towards degenerative conditions as a cause.

Of course, this is all speculation. A physical exam and x-rays would help.

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Op stated he missed injection and pain essentially went away. Very simple non invasive trial. Lower dose to 150 mg (from 200) and see how you feel after a few weeks. Or since no injections for a few weeks - start back up at 100 mg a week split it 2.

“Was recently out of town for 3 weeks. Forgot to bring along my Test injections.
During these 3 weeks, lower back pain has subsided to the point it is almost gone. Havent taken my test shot yet.”

IMO coincidence.

Agreed. The most significant factor is your age of 59. I’d imagine that since you are on TRT, you are fairly active. Aches and pains accumulate over the years, especially if you’re living a full life.

Another correlation is the mattress. Different mattress, no low back pain. Old mattress=back pain.

I get the association, but then the same testosterone in his body causing pain when he gets up in the morning and extends his spine must be gone by early afternoon when he flexes his spine.

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Update. Dropped from 200mg a week to 100 last 4 weeks. Lower back pain has all but subsided, more energy, and libido has increased! I actually feel better overall. Also having less tendon issues.

Valuable lesson learned here for me is, it’s not just the numbers, its the overall feeling.

Coincidence? I dont know but I do know I feel great!!

Your levels aren’t at a steady state yet, so more time may be needed to gauge this new protocol.

So, less back and tendon pain, lower BP, more energy and higher libido are all coincidental in the past 4 weeks?

It’s real man. Good that you lowered. Only in this forum you have ppl pushing 150-200.

How you determine least amount needed if you start at 150 or 200.

BTW you do IM? Frequency?

Sounds like your dose was too high for you. Stay at that dose and if pain returns, TRT aint it. Not everyone needs higher doses.