Ill preface this by saying its the best shots ill give not having evaluated you, and basing this entirely out of imaging, what as a PT we try NOT to do.

1) Yes and no. Skilled ortho PTs will be better equipped to handle low back pain than an average general-path but moreso the importance will be on a) quality of the clinic and b) specialty con-ed of the therapist. IMO search around, see if you can find any OCS', preferably with ongoing edu in pain science and neurodynamics (my interest)

2) evidence suggests average time someone should be on moderate to high dose oxy is 3 days. Id recommend staying far away from opiods as they have a de-sensitizing effect on your pain reception as a whole, and are incredibly addicting. Which is why i recommended actual illegal interventions over opiods from a practical/friend perspective and not a medical one. In conversations like this I like to go with the "what would I do in your situation" perspective.

3) I doubt the amount of fish oil you are taking is enough to make any negligible difference, the studies that show any sort of efficacy are very high doses. IMO invest in a very concentrated EPA/DHA pill and take the upwards dose of around 2000 mg per day. Wont be night and day but over time it may have some beneficial effect.

4) The best and upcoming evidence now is actually in the pain science world for management, and not heavy dose medicine. The cornerstone is trying to rid the mind of thoughts that involve threatening effects of movement--exactly the ones you are putting forth "better to sit" "damage my spine" "swimming could do x y z" "yadayadayada about theoretical mechanisms of muscle interplay, posture--basically arbitrary and hypervigilence/focus on your condition. Avoid these thoughts at all costs, because subconsciously to you, they will upregulate the pain pathways from your condition. It sounds far fetched but the research is becoming clear on this, especially with chronic back pain.

5) Yes in the meantime I would focus on light, diversified, deloaded movement that is tolerable. Swimming, walking, gentle stretches that avoid end range flexion and extension. Core strengthening cant hurt. You can try XYZ protocol that worked for 12 peoples best friend or cousin and give it a whirl--sometimes they do help. Sometimes they dont. Depends on the condition but my bet is a cookie cutter "postural program" isnt gonna cure you no matter what the snakeoil salesman and kool aide drinkers would say. The risk is the false hope youd get by people selling you an assured cure when likely, it wont be.

Id also start looking into second and third opinions. Whoevee the idiot is that I quoted above, is right in terms of surgeons being 1) knife happy and 2) likely to recommend the surgery type that they know and are familiar with. A person with a hammer--everyone is looked at as a nail.

Theres several options that may or may not be indicated for you, but at the level this is affecting you, again in your position, id be looked at by at least two spine orthos and maybe an op pain doc. If they think mostly disc related, possible microdisects are easy now. If joint related, ive seen good results with diagnostic and surgical ablations; spine stimulators for pain that cannot be narrowed down to the aforementioned causes, etc.

Feel free to shoot me a PM. I dont have a horse in the race. None of my money is ever made rec surgery so its comical thats even suggested, if anything Im incentivized not to recommend surgery and more PT.

I have similar issues. Stretching is the fix. You need to elongate your muscles. It's very time consuming because you need to hold each muscle in a stretched state for a total of at least 3 minutes per day.

You're very welcome! Would do anything, within reason, to help someone get over their BS pain. That stuff can ruin a life.

Well, I only do it a couple hours before bed, so I'm not on it when I'm out doing things. I could do that, but I just chose not to because I'd rather enjoy the relief at my house. People do it all the time, though. Hurting myself while it's working hasn't happened yet, but I'll look out for that, just in case.

You don't get to buy it, your health insurance does. Sadly, they're very expensive, as are pretty much all health related, surgical things, but you get to go over the many options with your pain doctor. I went with the pump made by Prometra (https://www.cardiva.com/products/pro...-pump/?lang=en), and the company that sent their representative over was Flowonix. Any time I need an adjustment, I meet with the Flowonix rep, after discussing the changes with the pain doc, and he applies those changes. I have great health insurance, so I didn't have to pay anything for it. I also pay nothing for the refills, which I imagine are also expensive, but I've never inquired how much those cost. I'll do so at my next visit.

Tens machine is kind of similar. I've also had one of those in the late 2000s, but it was for my back pain, which didn't do much. There's a huge difference between them, in that the neurostimulator is surgically implanted and the electric lead rests against the spinal cord instead of against the skin. It worked very well for quite a well. They both use electricity to help with pain, though.

I definitely stack pain meds, but only because I have to to get relief, although I'm not currently given crazy combinations that've been known to kill people anymore. At one point I was on benzos for sleep, ******** for the constant pain, instant release roxicodone for the breakthrough pain, and ****s for relaxation, since I was always in discomfort. I was a zombie for 5 years, and that's when I started abusing the stuff. I took more than needed because that was the only way to be close to pain free, but when you start doing that, you have to keep doing it to get the same effect, obviously. You then resort to making excuses and lying to the doctor to get higher doses just so you don't get considered abusing them. It really is, IMHO, best to stay away from pain meds, but we both know that stuff can get to the point where it severely affects your quality of life, and that's when I would say pain meds are warranted. As you've been dealing with the extreme pain, I'm sure you've dealt with depression, which can and does make the pain even worse. It really is a vicious cycle and is why you have to be really damn careful with pain meds.

Have an apt as in appointments? I see my pain doc once a month to get my refills, although he trusts me enough to give me multiple months worth of my prescriptions (the hardcopy RXs that you give the pharmacy). I could only see him every couple months, but my pain is so intense that I chose to see him every month so we can discuss new options. I see him again on Friday, and we'll be discussing the reflex sympathetic dystrophy and a steroid injection into the hip that'll see if the pain is from the sciatic nerve.

I've definitely rested for a long time before, tried healing naturally, used natural chemicals, etc. None of it worked, because my issues aren't "normal." I'm a, for lack of better words, special case. Without surgery, my spine would've gotten much worse, causing the pain to skyrocket. I had unnatural bends in the spine, multiple discs wasting away, and have something called heterotopic ossification (HO), which is bone growing ridiculously fast in areas that it shouldn't, like soft tissues of the body. HO has no known cause, but it happens in people with traumatic brain & spinal cord injuries (TBIs/SCIs) and I had both in '06.

Pain doctors are just specialists that deal with pain management. These days, to become one, you have to trained as an anesthesiologist, I think. So they're very knowledgeable about which meds will do what, drug interactions, etc, but they also know about and perform a huge variety of procedures (invasive and noninvasive) and can refer you to other specialists that can perform specialized surgeries or non-surgical, non-medication related therapy. It all depends on what you tell them. You can tell them that you don't want meds and they'll go the route of treating your issues without them. Mine had to refer me to my neurosurgeon and he is excellent.

Maaaaan, we've been trying to find the cause for years now with no luck, so we can only treat the symptoms. I'm also going to ask for another CT scan of my hip on Friday, since it's been so long since I've gotten one. Would love an MRI, but I can't have those since I have so much metal in my back. Like you, it's a waiting game and it definitely sucks lol. I can look for the most recent images of my hip and back and post them if you're interested.

Sorry for another novel lmao

1) stop all spinal loading movements, this will be any dumbbell/barbell back movement, unless you have a FULL chest support like a seal row or using an incline bench.

2) learn proper movement patterns. You have been riding the ego train and youtube videos/googling how to lift for too long now. Time to actually do some research and learn how muscle fibers are oriented and start reading some N1 education(coach kassem), Paul Carter, Dr Mike Israetel, Joe sullivan, Ben Pollack, guys who are actually teaching proper movement patterns.

3) drop the ego completely on all lifting, stop chaisng numbers 100% and start chasing proper execution

4) listen to episode 213 of the grow or die podcast on lifting, you will find a LOT of answers to your questions if you listen.


The more your back muscles gain strength the more your spine will heal and the less it will hurt and the inflammation will start to go away.

Also learn to brace with your glutes adductors and hamstrings. You need to find out how to REALLY acticate your leg muscles to brace, most males with back problems dont activate their leg muscles for **** and use their spinal erectors for almost every lifting movement.

also OP you can find some good information from certified doctors over on reddit on r/medical_advice

I take doctor's advice with a grain of salt now. I went to a specialized sports ortho with all the glowing reccomendations of professional athletes in the area. He has like 15 years in sports orthopedics. He tried to fix my knee with tear and lots of holes in my patellar tendon. Gave me prp, prescribed a pt, cortisone, multiple other treatments. Finally when I just decided to learn to move better, stabilize better, and strengthen my quads better and drop my ego I made a 100% recovery FAST

I then did the same thing to treat 2 other nagging injuries and sure enough, boom, gone like magic never to come back again.

Just my experience. Overall I have made most of my health improvements learning things outside of what the doctor's have recommended(which is mostly drugs, specialists, other doctors, surgery, expensive PT that doesnt work, injections, etc.)

Why do u recommend this?

So how did that happen to u? Was that as a result of lifting? I've asked around at the gym (some are in the medical field and can scan at will). This 1 guy was lifting all slow and stuff, said he had herniated discs but is asymptomatic. Crazy that he is still conscious of it.

Chiropractors are pretty expensive, went before and they suckdd. Just fiddling with my back.

Inversion table sounds cool, saw that in a movie do u have one of those? Surely it's just the same as flipping upside down on a pull up bar/door frame?

Subbed.

My brother thinks this too (genetic), especially since this all happened during my growing ages. Sadly his body works fine :/

The reverse curve thing is confusing me a lot. Even if I keep my head neutral/stacked, I still feel a huge weight on the back of my neck. (Ie, my stacked posture is the same as a regular guy poking his head out to lick a vag. My cervical spine must be beyond perpendicular to the ground when I jut it forward, ****kkkkk!!)

Have u ever seen those pictures that show the force on the neck for every inch forwards? Like an extra 10lbs per inch or something? I do wear a scarf basically everyday so I don't tax my spine :/

Saw a rheumatologist, she made all the referrals. Same ones I'm waiting for now.

Mayo clinic?

Psych approach, very cool. May try a version of that, break out the wii and do some meditating.

You could also just look up the doctors and see if they'll take new patients without referrals. That's how I got my pain doctor. If you do that, you should get your medical history from whomever and bring it with you, if they take you without a referral, which happens all the time.

At a minimum, bring the report posted in the OP with you.

Yeah, good advice. I just worry that I'll do more damage. Piece of crap spine is meant to last a lifetime.

Since u started gym, have u been more aware of ur movements, in a bad way? Prior to gym, everything was so fluid/natural, now it's all rigid/awkward aside from the pains. E.g, brushing my teeth is the most awkward thing ever. Just feel like a pained up robot.

Since most people drive to sit at work, how do u stay mobile? I used to play tag or live at the beach, now I'm confused.

Okay cool thanks for letting me know about that

As for u, do you tackle all ur pains with medicine? Have u ever ventured out and fixed anything?

Sounds like you need to give up weightlifting, maybe do body weight workouts after you fix yourself up but for the love of god just stop weightlifting. I’ve been doing body weight for years and I’m happy with my results (pretty much just maintenance of what I had at the start) but big muscles is not my main priority these days and I don’t think it should be yours at this point either

I never used a belt but I think it shows. Honestly I always had good form (except hinging, there was some kind of mental block with that for some reason).

Did you guys fix him yet or wat

This is not the **** I want to see. I have to go see a neuro next month for numbness and tingling from my neck all the way down my left arm and leg. Thought was either the boozin caught up with me and caused nerve damage or my neck pain and lower back issues that I've had forever finally started doing some damage. Thankfully getting better but man it sucks staying out of the gym.

Thanks for ur epic response. I'll answer numbered too.

1. Okay cool, will check that out. I always wanted to find a physio who was a lifter, I think most physios go by the book and it really shows. Where would you find a good one? I am in UK.

2. Hmmm, so when are opioids used and why do I hear that it is amazing for pain? (Most celebrities like Lady Gaga or Chandler off Friends have been on them) Aside from them, lol, lots of people with chronic pains hop on it.

3. I have read that before, when you read a lifters diet, it says like 8 cod liver oil capsules. I will increase it thanks, I'll double it and see if I notice a difference?

4. Interesting, will keep that in mind from now on.

5. Okay awesome, I'll try to move around more without overthinking it. So why can't I stretch to end range flexion/extension? I don't get that. I read that gymnasts stretch for 2+ minutes aggressively, look how flexible they are. (Surely the same principles can be applied to a dysfunctional muscle right?) It confuses me when I read that 20-30 seconds of gentle stretches will suffice in fixing a tight muscle. Apparantly it works, sooooo, I don't know lol.


Thanks for explaining all of these things, appreciate it. So, as far as a game plan in order of what I should be doing right now/in the next few weeks, what would you recommend? I think I should move around without calculating each step and whatever.


Thanks.

do planks daily boyo

not sure, just noticed pain gradually coming in. I've had extremely bad and extremely uncomfortable sciatic nerve pain running down my right leg. It's backed off somewhat, but it's still there.
yes I have the inversion table. I was told not to do a full 90 degrees though.

I had bad herniated l5s1 with terrible sciatica, and had success with the McKenzie method of treating low back. I know there are McKenzie PTs who do the neck, although I have no idea if it's appropriate for your specific condition. It might be worth asking your doctor if they think it could benefit you and see if they know a McKenzie PT who could evaluate you. Good luck bro.

McKenzie method isn't chiropractic manipulation. It's like stretching multiple times a day and frequent evaluation to see if they recommend continuing or else bailing out for more aggressive and invasive medical intervention.

3 minutes per day total? So 3 sets of 30 seconds per leg/bodypart twice a day would suffice?

So what stretching protocol worked for u?

I tried doing psoas/rectus femoris stretches before. 3 sets of 2ish minutes 3x a day everyday. Well over an hour a day stretching. Giant waste of time, over the span of 2 months aswell. So mad just thinking about it.

Thanks, I have been looking up the things you're saying here. Interesting stuff.

Probably a dumb question, but is that weed from dodgy morons under bridges or is it from a pharmacy? I am clueless, furthest I've gone is paracetamols lol, just typing weed and stuff is weird for me haha.

Okay I see, what country are u in now? If ur in USA as it says, not sure if laws/medical interventions are different where you are. I'll have to ask about pain pump.

Yeah haha, just thought I'd bring up the tens/ems thingy because they both use electrical impulses as u said. Wow, I'm surprised on the things you've tried to fix your pains, very invasive methods you're describing here. Do you think you're getting close to figuring it all out?

Some hardcore stuff! I've heard of ********, crazy that you're allowed to have that. Did u get that kind of stuff from the doctor? I remember I worded it to my Doctor, "just give me the most insane/hardcore pain killer out there that I could keep my hand on a stove/fire without pain, the stuff you keep army guys with blown off legs." Etc etc, so many examples. Doctor was not impressed and cast me aside.

Nah, in my case, I never get depressed. I'm just pretty damn mad that my body is malfunctioning. Sitting on the sidelines watching all the drug addict morons out there coming home at 6am, thinking, wow, their health is probably much better than mine. Well, atleast they feel better, not spazzing out over something as simple as their gait.

No, I meant apt as in anterior pelvic tilt. I'm sure you're aware, just a common postural deviation. Many people are unaware that they have it because how would they know unless they researched it. You could have it, I have it. I owe a part of that to my lumbar spine being all smashed up.

Wow that is crazy, when you said unnatural bends in the spine, is that like a weird scoliosis?

Okay I understand, thanks for explaining about the pain doctor thingy. Will let u know what happens when I speak with them.


So, do you know the first day you started having chronic pains?

Thanks.

Thanks for ur insight on this.

1. Yeah sounds about right. May try rowing like that.

2. True will look into that. I used to look at Yo Elliott videos for lift execution.

3. I haven't lifted heavy in a while, haven't benched in over a year. I'm not sure if I should hop back into a balanced routine.

4. Okay will do, I don't know how to use podcasts but I'll try and find it. Is that like a Ted talk or something?


So how should my back be strong? I thought a mixture of pull ups, rows, lower trap exercises and rotator cuff exercises would suffice but apparantly not.

I'm still thinking about that massage stuff. Maybe my body is still holding a lot of waste that'll never be corrected with solid lifting?

Actually, I have newly started tensing my adductors as I've been experimenting with wide squats. But that was subconsciously, makes sense because the ROM is wide so the adductors have 0 choice.

So do u use lift mechanics in day to day life? A non lifters wouldn't but I'm unsure if they're slowly/unknowingly damaging their bodies.

Thanks.

Thanks, I have been on there but they don't seem to be clued up on gym interventions.

Very true, I have basically stopped all heaving lifting. Still trying to keep active.

Why do u thinkni shouldn't be lifting? Cause further damage?

Wow, how do u handle the pains now? How long has this been going on for?

What do u think ur neurologist will say?

What people perceive as back strength is often glute, hip, erector, and hamstring strength. Most peoples actual backs are weak AF. Thats why you need to get on machines with a chest support and drive your chest forward on concentrics. That is what makes you use your back and not your hips. Then when you get that down maybe move to a smith machine and work on rows while driving your chest into the bar and not pulling back.

Then after that you can move back to dumbbells and learn to completely brace so your hips dont move A CENTIMETER and your shoulders dont twist AT ALL and your elbow is driven back first then up

Hmmm, interesting! Didn't think of it like that but it makes sense. Will try chest supported rows, thanks. I did try batwings, basically a chest supported row, but an isometric for rhomboids/mid traps.

Okay, keeping in with this thread, this is my last post.

https://forum.obnoxiousbrutes.com/showt...hp?t=181341663


Thanks for all the help and advice over the years, will hopefully figure this all out.