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Lower Back Pain - 19-year-old

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Posted 2/9/2015 6:55 PM (GMT 0)
Hi, I am fairly new to this site, so please be kind

I am 19-years-old, and I have been suffering from lower back pain for over a year. I hurt it when I was at track practice, we were doing multilevel box jumps, and I was tired and one was too high. I barely made my feet on the box, but as soon as I did, I felt a twinge and knew something was horribly wrong. I think I have a pretty high tolerance for pain, and this was the worst pain I had ever felt in my entire life. I could not bend even the slightest bit forward without serious pain, and felt pain in my butt and legs daily. Like a moron I am, I though that this would pass, and it was nothing serious, so I never went to a doctor.

Now, a year later, I still feel pain in my back, though not as painful as it once was. I have good days, and bad days, as everyone does. The pain is the worst when I stand for prolonged periods of time, like this past weekend, I went shopping with my mom and I was in a great deal of pain, only better when I could sit down or lean against a wall. I also feel a bit of relief when I bend forward, almost like I need to crack my back. I also have pain when I lay down flat on my back, or flat on my stomach, sides are usually comfortable. And still, I feel the pain in my butt and legs, no numbness though.

I'm sorry if this seems like a rant, I am just frustrated that I am 19, and already having chronic back pain. It worries me that standing for long periods of time is almost unbearable because I am currently in school for Nursing, and I know that nurses are prone to back injuries.

I have an appointment for a regular physical this week, and I am considering mentioning it so I can get a referral to an orthopedist.

Thank you for hearing me out, and enjoy your (snowy, if you're in New England) day! :)
Posted 2/9/2015 7:04 PM (GMT 0)
I would mention it to your doctor. Any pain that last more than a few weeks should be followed up on. You could of done something back there that PT might help with or something.

I have lots of low back pain, mine started at 17 and PT and injections help with that.
Posted 2/9/2015 8:26 PM (GMT 0)
Hi, SyXx, thank you for your response, I think I will bring it up at my appointment. Sorry to hear about your back pain.


meganec17
Posted 2/9/2015 8:39 PM (GMT 0)
its good to get it looked at, there could be something minor wrong or something a little more serious. After a year i would definately bring it up, an MRI will not hurt anything.
Posted 2/10/2015 12:31 AM (GMT 0)
Hi Meganec17,
Well first of all, welcome to the Chronic Pain Forum. Let me tell you as a new member myself, there is a wealth of information and advice here from people of all ages and all illnesses. If you don't mind reading, there is much to be learned.
I am sorry to hear that you are in pain, but remember, pain takes prisoners of all ages. I understand that you are young, but realistically that's when we are prone to injury ourselves - young and lively! Anyway, I definitely think that you should make mention to your dr. about what happened a year ago, how it has been for you since then, and how you feel now. Be specific on where your pain is, what makes it worse and what makes it better. Ultimately depending on his exam, your motor skills and reflexes with your history, he will decide if an MRI is warranted. In the meantime I wouldn't do anything too strenuous until you get checked out.
The best advice I can give you, take care of your back because everything you do revolves around it. You have many years of life ahead to enjoy!
Take care and be well!
Pam
Posted 2/10/2015 9:05 AM (GMT 0)
Welcome Megence and sorry for you having a reason to seek us out. Did you have any medical care when this happened? Its important to see the right kind of Dr and get the right kind of tests as young as you are treating whatever's causing your issues now will prevent further problems later in life. As a retired nurse with 30+ years I can say that the risks show we have a higher than normal chance of having spinal problems and they naturally come with all the lifting,bending and long hours on your feet generally on tile floors. You certainly don't want to go into a new career with a existing issue. Hopefully once you alert your primary Dr he will refer you for a more thorough look at what's going on.
Posted 2/10/2015 7:59 PM (GMT 0)
Hi all, thank you for the kind responses.

SisterPam, my appointment is tomorrow, and I am definitely going to bring it up and she what she thinks. I know she is no expert, but if she believes it warrants the consultation of an orthopedist, I will for sure schedule an appointment. I totally understand what you mean about being injured when young. I was at the height of my high school sports career, and too nervous, and preoccupied to worry about (another!!) injury. I figured it was a tweak, and it would pass, unfortunately it did not. Thanks again for your response.

nvrthesame98, no, I did not seek medical help when it first happened, which I deeply regret now. I was in the middle of a sports season, and didn't want to risk having to take a break, so I carried on and assumed that the pain would fade in a few weeks. I am very nervous that this may affect my future career, as nursing is the only thing I have ever wanted to do. Thanks for your response, I appreciate it!


meganec17
Posted 2/10/2015 9:53 PM (GMT 0)
Sorry you are dealing with this! You definitely need to see an orthopedic sports medicine doctor. There is a common back injury in young athletes called a pars defect or spondylolysis.

An MRI should be done and can tell you if you have this or a damaged disc. My son had this and he is doing great now after rest and physical therapy. He has been back playing lacrosse for a year now and hasn't had any further problems.

Good luck and please let us know how your appointment goes.
Posted 2/10/2015 11:26 PM (GMT 0)
Hi upbeat, thank you for taking the time to respond! I have been looking into different things that could be causing my pain, which is never good!! But I came across spondylolysis and I thought it fit well. I also came across sponylolystesis(sp?), which also seemed possible. I will for sure mention these to my doctor! I will update when I have been to the doctor.

meganec17
Posted 2/10/2015 11:31 PM (GMT 0)
ahhh, just realized a dumb mistake. Pars defect and spondololystesis are the same thing, correct?
Posted 2/11/2015 12:52 AM (GMT 0)
They are, pars defect is a more common name - much easier to say too! :)
Those box jumps are tough on the back. My son had been doing them too, but his back got bad after he was practicing his lacrosse shot one day. We thought he had just pulled a muscle.
Posted 2/11/2015 12:54 AM (GMT 0)
Yes, Pars defect and spondylolysis are the same. I am glad to hear you are going to the doctors and get it checked out. Don't assume the worse Meganec17, lets hope it is something that can be taken care of with minimal intervention. You are young and have a strong body so there is much on your side.
Your aspirations to become a nurse will be an inspiration to all your future patients!
Please let us know how it goes with your appointment.

Take care and be well!
Pam
Posted 2/11/2015 10:51 AM (GMT 0)
They are not always the same,pars defect is a precursor of spondo but it doesn't always occur after a pars defect. In other words you can have one without the other occurring. Think of how a single vertebral body looks with two like sides with the bony prominence riding the middle,a pars is a fracture in between the two sides generally and spondo occurs when the vertebrates slip forward and away from the adjoining vertebrae due to the pars defect. For years they thought pars defects were a congenital issue but have since found that its an occurrence from injury usually with little to no symptoms other than feeling a pull or strain thought to be muscular in nature. Rarely is it caught at the moment of injury and common to have Drs diagnose muscular issues. In other areas of bone with such hairline fractures very little problems occur and the bone will fuse somewhat on its own given time,unfortunately this fusion doesn't happen to vertebrae and continued wear allows the fracture to become larger allowing the vertebrae to rock so to speak on the spinal column and that's when spondo eventually happens. It will rock to far one way shifting and catch nerve roots under or behind and then slip away from its natural order. Surgical fusions are the only unnatural fix but rarely prevent reoccurring and doesn't fix the pars but can fix the spondo by re-anchoring the vertebrae to the above and below vertebrae or sacrum if in the lower lumbar area.
Posted 2/11/2015 9:12 PM (GMT 0)
Hi guys, I just got back from my physical with my primary care doctor. She seemed very concerned with my back, and referred me (as expected) to an orthopedist. I called to make an appointment with the orthopedist, and they said that I would be better off seeing a neurosurgeon, thoughts?

meganec17
Posted 2/11/2015 10:29 PM (GMT 0)
Also, I just now heard back from a sports medicine orthopedist who is willing to take a look at me. My appointment is on Tuesday, so I will for sure let you guys know how it goes! I know for sure that I am getting X-rays.

meganec17
Posted 2/11/2015 10:55 PM (GMT 0)
That is great you can get in so quickly!

My son started with a sports orthopedic who diagnosed him correctly, but we did end up seeing an orthopedic spine specialist when his back went into spasms again a few months later.

The orthopedic practices in our area have special physical therapy centers for athletes. These PT's really seemed to understand the problem and how best to get him playing again, which was all he cared about at the time :)

Good luck!
Posted 2/13/2015 2:33 AM (GMT 0)
Hey that's great that you got the appointment with the sports orthopedist. Make sure you explain what happened before and how your back is affecting you now.
I hope it is a simple fix for you and then you can continue to focus on becoming a much needed nurse.

Will watch for your update. Good Luck!

Pam
Posted 2/13/2015 10:48 PM (GMT 0)
Hi all,

I was able to get into an earlier appointment today with the sports orthopedist. Unfortunately, it was confirmed that I have sponylolisthesis on my L5 vertebrae, but did not tell me which grade it was. I was not impressed with my doctor, and found that he did not give me much information. I have another appointment with another doctor for Wednesday. Will update after my second visit. Thanks all.

meganec17
Posted 2/14/2015 12:40 AM (GMT 0)
Definitely find a Dr your comfortable with an preferably one who takes the time to explain what's happening and why. If a Dr doesn't do this on your first appointment look at others since this is a appointment that should be greater in length,a time when he gets a good history and gets a feeling for you and what kinds of issues your having with the problem. Subsequent and follow-up appointment not so important,initial appointment very much so.
Posted 2/14/2015 12:57 PM (GMT 0)
Sorry the doctor didn't give you more information! How did he make the diagnosis? X-ray? I don't know if doctors use the terms interchangeably, but spondylolisthesis usually means the vertebrae have moved and spondylolysis just means there is a stress fracture.

I would make a list of questions for the doctor you see next week. Sometimes they rush you out so fast you think of ten things to ask by the time you get to the car! (At least i do tongue )

I would ask treatment plan - brace, physical therapy, rest? Do you need an MRI to determine grade? (If there is slippage already maybe the X-Ray is enough to tell)

A lot of times your body has compensated for the injury by tightening the hamstrings and hip flexors. This is protecting the back, so don't try to stretch these areas yourself. Wait until you are in physical therapy and they can tell when your back can handle it.

Good luck on Wednesday!
Posted 2/14/2015 5:22 PM (GMT 0)
Hi!

I think that I saw the doctor for maybe 5 minutes. I took X-rays, which determined that I had slippage of the L5 vertebrae. I had to ask my doctor for the specific name, as he never mentioned it but when I asked he said it was spondylolisthesis. I had X-rays, and he said that there was slippage, but he said 'they are too blurry to see a fracture', umm, why don't you retake them then? UGH! He also said you have a choice "you can watch it, go to PT, or get an MRI, what do you want to do?" I had no idea, as he never told me which was best, or what caused it, or what to avoid to make it worse so I said I wanted to check with my parents. The only information I received from the doctor was the initial diagnosis. I will be seeing another doctor on Wednesday, so I will hope for a better appointment.

meganec17

Post Edited (meganec17) : 2/14/2015 10:49:08 AM (GMT-7)

Posted 2/16/2015 7:44 AM (GMT 0)
Hi Mega,

Welcome to HW. I am sorry to hear that you are already in pain at such a young age. Unfortunately, I can totally relate. My chronic pain issues also started very young -- at 15. But my biggest problem began when I was 18. And I am just a few days shy of 27 now.

I was a competitive swimmer on the senior national circuit before I destroyed my shoulders (the start of my chronic pain journey, although I have much worse problems now), and boy did I ever hate box jumps! They used to scare me, actually. I was always afraid of slipping (we usually did them on a wet pool deck) or coming short of the platform and falling. Between the concussive force of the landing, and the power required at take off to reach the highest boxes, I can totally see how you could have gotten hurt doing them. Because of the immense stress put on your body, all it would take is a slight deviation in form for things to go terribly wrong. And unfortunately, being an athlete, instead of being taught that pain is the warning sign of a (potentially serious) injury, we're taught to ignore, or push through the pain; "no pain, no gain." I know that's how I personally got into serious trouble with my shoulders. I pushed on when I should have stopped and listened to my body, and sadly, I paid the price -- 3 surgeries, the end of my swimming career, and I'm forever left with 2 bad shoulders.

Anyways, I am glad that you finally got your back checked out. If I were you, I would have the MRI done. As you probably know from your nursing studies, x-rays are pretty good about telling us about bone, but they are rather lousy when it comes to providing information about the soft tissues. So the MRI will give you a better idea of "the whole picture" of what you are dealing with in regards to your back. As it will tell your doctor about the soft tissue component, and be able to provide additional information about the boney component, as well.

PT is a good idea, too. And it is likely something that you will end up doing either way (unless you opt to continue to "wait and see," although at this point, you've already done that for a year). But if it were me, I would want to have as much information as possible about what was wrong with my back, before I let anyone touch it. As great as PT can be, it can also make things worse if the PT doesn't know exactly what they are dealing with.

I'm glad that you are getting a second opinion, though, since you weren't very happy with the first doctor. There is no reason why you have to stick with the first doctor, if you don't feel comfortable with him. It's your back, and you only get one. And you have many, many years to go yet. So it is important that you take care of yourself now!

Hang in there. Hope the second appointment goes well.

Skeye

Post Edited (skeye) : 2/16/2015 12:53:38 AM (GMT-7)

Posted 2/16/2015 2:40 PM (GMT 0)
Hi there!

I had a huge post about this but I lost it! Stupid iPhone! My suggestion was to google McKenzie exercises, specifically the back bend while laying down. Also when in this position, if you find the pain is on one particular side of your lumbar, butt cheek or leg, raise that particular leg, for fifteen to thirty seconds at a time. You're isolating that particular vertebrae and 'popping' it back into place. I was told that if I was diligent about my exercises that it could take about a week for the collagen to fill back in around the disc so that it stayed in place. It took about six months -- it's hard to remember to stop what you're doing every waking hour and do the back bends, but I was finally successful. I now do the same exercise when I start to get sciatica and it works almost instantly. A McKenzie PT practitioner was my lifesaver!

Physical therapists are incredibly good at finding the cause of pain when regular western physicians/machines can't, and are worth their weight in gold. Likewise, they find easy ways to avoid surgery -- if they're good at what they do. I highly recommend McKenzie practices ( I worked with two and their therapists were all really good), but make sure you check them out thoroughly -- go through their association lists for your area and then google their ratings (Yelp is great for this).

And don't feel back for not taking care of it sooner. A lot of us do that, I did! And my back pain is now manageable with a few PT exercises.
Posted 2/16/2015 2:43 PM (GMT 0)
Oh, and agreed about the MRI -- you need to know exactly what's up, and make sure to share this info (the actual films/images, not the report from the MRI tech) with the PT so they don't blindly go in there. We want to avoid further injury! :)
Posted 2/16/2015 9:23 PM (GMT 0)
Megan,

I had to comment on that doctor that u saw. Anytime a doctor spends that little quality time with a new patient is a total red flag for me. I have seen so many of the same in that it is cause to just never go back for his care. When a doctor isn't concerned with spending any time both providing input for your condition and also giving you the opportunity to ask questions and get answers, they just don't care! You are a patient record number, he gets his money and is not concerned with any of your future care. He should not be asking you "whether you want an MRI" or not, if he feels there is sufficient clinical evidence to order to it, then it should.
I could rant and rave about this because it just infuriates me when these doctors just care about themselves and not their patients. UGHHHH!!
It's like what happened to that oath they took?
Good luck with your upcoming appointment, I hope it goes much better for you!
Pam
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