Question
Hi Dr. Anzalone,

Thanks very much for fielding this question. If I can do anything for you regarding real estate title (my profession) or relationships (1 year on AllExperts.com and ready to create a web site) I'd be happy to help.

I'm 41, slender and fit. Picked up a nasty cold over the weekend and slept most of it away. When I woke up, went to the couch and was talking on the phone. Then got up to put a twist tie on a bag of garbage. Did not even lift the bag but when I stood up, a sharp, shooting pain went through my back, the lower left part of my back.

What happened?

For two days it hurt, off the spine, on just the lower left side of my back. Now three days later, it no longer hurts there. Instead, it is searing pain centered on my tailbone and on the upper part of my left buttock.

Crossing my legs, putting on socks, standing up, sitting down or stretching while in bed, getting into the car, well, extremely painful!

Surprisingly, I can walk fine, with only minimal wincing.

Will this heal itself or have I really hurt myself significantly?

Thanks very much. If I can offer anything in return to you, would be willing to do so.

Michael  

Answer
Michael,

Thanks for your question. While I can't provide you with diagnosis or a prognosis over the Internet, I can answer your question generally.

The mechanism of your injury and the symptoms you describe appear to be consistent with a lumbar disc herniation on the affected side of your body. Laying on the couch placed your spine in a disadvantageous position, and the forward bending movement that you assumed when tying the garbage bag were most likely the straws that broke the camel's back. Most likely, the herniated disc was already degenerative and probably herniated before your symptoms began, but became inflammed after laying on the couch and then bending forward.

As long as you you don't have neurological symptoms such as leg or foot weakness or bowel and bladder dysfunction, you should seek the services of a chiropractor or physical therapist. Treatment should most likely focus on passive modalities (spinal manipulation or mobilization) for pain reduction as well as specific active care such as rehabilitative exercises for a maximum outcome. Acupuncture may also be helpful in combination with either chiropractic or PT.

In most cases, patients improve within 12 treatments or so, but again, this is a ballpark estimate, and every patient responds differently to care.

If the pain is extreme and persistent, you might also see your primary care doctor for an anti-inflammatory prescription, if it is clinically indicated.

I would not advise you to simply wait and see if you improve on your own, as your condition could worsen significantly. In most cases, early intervention and treatment improves the outcome and shortens the treatment time rather than allowing the problem to worsen. Your condition needs to be evaluated by a competent musculoskeletal practitioner. Depending upon your physical examination findings and your response to care, you might need an MRI scan of the lumbar spine for further evaluation.

I hope that this answer is helpful to you.