Question
Dr. Ornstein,
Thank you for your time and help.   I had a back injury about 5 years ago.  I burst  L1 and L2.  It required extensive surgery and a long recovery.
Now I am working with preschoolers and it is very physically demanding.  My lower back hurts so bad, I'm struggling to walk.  Every time I take a few steps my back goes into spasm often causing me to collapse.  My legs ache a lot and I'm getting sharp pains in them.  My buttocks feels like a combo of numb and deep aching.  Mostly the pain goes down the sides of my thighs.  Tingling as well.
Do you have any ideas what might be going on?  I can't have an MRI, due to pacemaker.  I also have significant osteoporosis.  I'm 45.
Thank you so very much for your thoughts.
Christine

Answer
Hi Christine,

I'm sorry to hear about this. You do have a very demanding job and I'm not sure how you are doing it. With your condition, keeping stress off the back is a must. Standard x-rays will show any type of osteoporotic fracturing, which has to be suspect and ruled out. A CT scan should be done if the x-rays are negative.

So, I would not hesitate to take some time off and get diagnosed. Hopefully you are able to take medication and or supplements for the osteoporosis. Exercise - non weight bearing and within cardiovascular limits. I would have a good recliner. There are ones that are electrically controlled to help with proper angling easing stress of getting in and out. But these are symptoms that require attention. I know how much skill and dedication is involved in working with preschoolers. You must find a way to modify this. Your condition puts you at risk for vertebral fractures. We could go on about structures and related symptoms, but x-rays should be done asap and CT can give the best clues if needed.

You give so much, please take care of yourself.

Dr. Steve