2009 Author: Alan Gardner, FRCS

Question

 I would be very grateful if you could give me some further advice on my back problem, from which I have been suffering for nearly six years.

I hurt my back in October 2002 by lifting a car wheel out of a boot awkwardly. I had never previously had back trouble. This gave me (a couple of hours later) some pain in a small area of the lower right back, just above the buttocks, followed soon after by pain down the right buttock and thigh. I did not have, and have never had since, any problem with stiffness or lack of mobility.

Of all the treatments I have had, only two have had any significant effect and both made the problem much worse on a long-term basis (ie I am still suffering the effects now). The first was physiotherapy. The physiotherapist made me do bending-backwards exercises which were supposed to bring the pain back up my leg if it ever went as far down as the calf. This had the total opposite effect – it immediately made the pain worse and brought it all the way down my lower leg, where it has stayed ever since. This also resulted in muscle wasting on the outside and the back of my calf where the pain is.

The second significant treatment was 10 months after the injury when I saw a chiropractor for five treatments on the recommendation of an orthopaedic surgeon. After the last treatment, I started getting pain in the left leg too which gradually got worse over the next few months. This new ‘spreading’ (the only way I can describe it as it covers a large area) pain also spread to my right leg giving me two different types of pain in that leg. After a few months the new pain covered a lot of both legs, in particular the fronts of the thighs down to the knees.

In all I have had four scans and, while the first three showed disc bulging, the latest one (May 2006, in a positional scanner where images were taken standing, sitting and lying down) showed no real cause for the pain – only some degeneration in the L5/S1 disc (and early schmorl's node formation at L2/3). The second scan (October 2003) showed a ‘segmental anormality at the lumbosacral junction’ (partial sacralisation of L5 with the lowest disc space being L4/5). Although not considered important at the time, the osteopath who I saw in spring last year wondered whether that was why the chiropractor's treatment had caused so many problems. He also said he thought the original injury may have been a sacroiliac problem rather than a disc one (although the second scan covered this area, nothing was identified and his treatment did not help).

The other diagnostic tests I had were EMG and nerve conduction tests in September 2003. These showed that the right leg was not totally right but the differences were not significant.

The pain is made far worse by sitting at a desk for prolonged periods. When I am on holiday or out for a day’s walking, I hardly n...

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