Question
QUESTION: Am a very athletic and in excellent shape senior citizen who runs every day, swims and lifts weights. Recently I've been bothered, shortly after I get up in the morning, with what I can only describe as excruciating debilitating low back pain. It comes on suddenly and is related to movement - even slight movement. The pain subsides rather quickly if I can get in a position to try and relax. I can still run, swim, etc., effectively without pain but I do think about it while exercising. I don't have pain or numbness in my legs so my pain, when it hits is localized in that one central spot in my lower back. I don't know if I can describe it as a cramp or pinch but it is excruciating when it hits.  By the way, after I get that one hit (pain) the rest of my day is quite normal althogh I'm cautious with my movements. I've tried ice, ibuprofen, heat etc., but it's still there..... Not every day but I never know when it will strike.  Seems like one wrong slight movement and it's there.  Any thoughts? Thanks

ANSWER: Hi Don,

The description you provided is quite common.  I probably see 6-10 people a week that show up complaining of the same symptoms, no injuries, good shape etc.  Many times it is just a simple misalignment (known by many as a pinched nerve).  If you have a chiropractor, great, see him/her and let them in on what's going on.  If you do not, and you have not seen a chiropractor recently, find one.  Look specifically for a Palmer Graduate.  Why you ask...  All I can tell you is that doctors from my alma matter treat differently than other schools.

Chiropractic treatment and adjustive skills are highly specialized.  Palmer docs just seem to do it better....  I don't know why, I'm not saying all are perfect or that the other schools do no produce good clinicians.  Just my own personal experience here in Las Vegas.  Just as an example, I travel back to northern California for my treatment due to frustration with local doctors that are not Palmer grads and don't "treat" me how I would treat someone in the same sense.  I guess I'm just picky.  It's not writing prescriptions where from one doctor to the next the antibiotic is the same, produced by the same manufacturer and dosed the same.

So, this sounds like simple mechanical lower back pain.  If you were in my office, I would have you put through a battery of movements and tests to further narrow it down.  What where you doing when you first noticed this?  Can you tell me whether bending forward or backward or side to side increases your discomfort?  Do any of these positions feel better?  Does it hurt to cough, sneeze or go to the bathroom?  Any history of surgeries, broken bones, compression fractures, car accidents or other injuries?

I am very glad to hear that you are a very active senior.  Keep it up!  I may be able to provide you some better guidance with those questions answered.  

I look forward to hearing from you.

Sincerely,

Dr. Kevin Kaldy
Chiropractic Physician
www.lasvegaschiro.com
[email protected]


**This post is for the purpose of providing medical information and is not a substitute for a face-to-face consultation with a doctor. This post is not intended to give or rule out a diagnosis, create a doctor-patient relationship or replace an existing one. I am not able to diagnose medical conditions online. Please consult with your doctor or a qualified healthcare provider for diagnosis and treatment options

---------- FOLLOW-UP ----------

QUESTION: Thanks for your timely response. Regarding your questions, this started abruptly when I bent over to pick something up. Since then (started 2 weeks ago) it only seems to hit me after getting up in the morning. I can just pour a coffee, gently sit down, and then it may or may not hit me with just the slightest of movement-example, attempting to tie my shoe. The pain itself, knd of like a spasm that is excruciating, only lasts until the cramp, spasm subsides. Usually a minute or less. After that there's no pain and usually doesn't happen again throughout the day. The more I move, the better I feel. I assume that laying down all night just tightens my back causing this to occur only in the morning. You agree? Thanks again

Answer
Hi Don,
Sorry for the delayed response.  Thanks for following up.  Regardless of how good of shape we are in, if we bend over wrong, and we are not warmed up or stretched out enough, we can cause some mechanical change in the lower back, even possibly herniating a disc.  From the sounds of it, after sleeping all night, the muscles tighten up and until you are adequately "loosened" up in the morning you will notice this discomfort.  
I would highly recommend you following up with a chiropractor as I stated earlier.  If it has been this long and you have noted very minimal to no relief of the symptoms daily, then it is beyond time to get it looked at.  Acute muscle spasms can be very painful and if there is a "mechanical" dysfunction in the spine, no amount of stretching you do will fix it.  There is an old saying, "I thought if I just left it alone it would go away."  I hear this everyday!  Unfortunately, this is not the case, if left uncorrected, this mechanical dysfunction can lead to further joint or disc injuries along with muscle problems.  So, sooner than later, make an appointment with a chiropractor and go visit.  If this is mechanical and not a disc injury, then it should only take a couple of visits to correct, however, the longer you wait, the more visits it will require to correct.  
If it is a disc injury, well, that can be a lot more involved, requiring other physicians to assist on your case, medications and imaging studies.  I am conservative, so my best educated guess from what you have described is that it is mechanical in nature and will be a quick fix.  Do not get sold on any long term treatment/cash deals.  If you experience any "used car salesman" tactics, get up and leave, they will not help you.
Best wishes!  Please let me know how it goes.

Sincerely,

Dr. Kevin Kaldy
Chiropractic Physician
www.lasvegaschiro.com
[email protected]


**This post is for the purpose of providing medical information and is not a substitute for a face-to-face consultation with a doctor. This post is not intended to give or rule out a diagnosis, create a doctor-patient relationship or replace an existing one. I am not able to diagnose medical conditions online. Please consult with your doctor or a qualified healthcare provider for diagnosis and treatment options