Managing Chronic Back Pain: Insights on Degenerative Spine Issues

Sharp pain and tingling in the left posterior mid-back?

Hello, Doctor: I am a working professional with a habit of slouching, which often leads to shoulder and neck pain.
I regularly receive chiropractic massages for relief, but I have been experiencing sharp and stabbing pain near the middle of my left back, close to the spine, for several years.
This pain does not occur frequently; it typically arises during long bus rides or when I am unable to move and can only sit.
I try stretching or using pain relief patches, but the symptoms persist.

On December 20, after a bus ride, the pain started again, and that night, while lying on my back, I began to feel sharp pain.
I had to lie on my side to alleviate it, but the pain returned when I switched back to lying on my back.
On December 21, I visited a hospital where the doctor diagnosed me with degenerative spondylitis and prescribed muscle relaxants, but they have not been effective.
On the nights of December 22 and 23, I took the prescribed medication, but I experienced pain whether lying on my back or side, making it difficult to sleep.
Ignoring the pain seems to cause it to radiate to the area below my ribs in the front.

I do not experience pain while standing, but in recent days, I have had pain while sitting at work, resting after work, and during sleep.
Could you please advise me on how to manage this? Should I consider consulting another specialist for further examination?

Miss Chen, 30~39 year old female. Ask Date: 2020/12/24

Dr. Lai Zhaokang reply Neurosurgery

Hello, it is suspected that there may be a spinal issue.
It is recommended to consult a neurosurgeon.
An X-ray or MRI assessment is advised.
Best wishes.
// Neurosurgeon Dr.
Lai Chao-Kang

Reply Date: 2020/12/24

More Info

Managing chronic back pain, particularly when related to degenerative spine issues, can be a complex and multifaceted challenge. Based on your description, it seems that you are experiencing significant discomfort that is exacerbated by prolonged sitting, which is common among office workers and individuals with poor posture. Here are some insights and recommendations based on your situation:

Understanding Your Condition
From your symptoms, it appears that you may be dealing with degenerative changes in your spine, possibly including conditions like degenerative disc disease or spondylosis. These conditions can lead to inflammation, nerve compression, and muscle tension, which may explain the pain you experience, particularly when sitting for extended periods or lying in certain positions.

Importance of Posture
Given your mention of habitual slouching, it’s crucial to address your posture. Poor posture can contribute significantly to back pain by placing undue stress on the spine and surrounding muscles. Here are some strategies to improve your posture:
1. Ergonomic Workspace: Ensure that your workstation is ergonomically designed. Your chair should support your lower back, and your computer screen should be at eye level to prevent slouching.

2. Frequent Breaks: Take regular breaks to stand, stretch, and walk around. This can help alleviate stiffness and improve circulation.

3. Posture Exercises: Incorporate exercises that strengthen your core and back muscles. Activities like yoga or Pilates can enhance flexibility and posture.

Pain Management Strategies
Since you have been prescribed muscle relaxants without significant relief, consider the following additional strategies:
1. Physical Therapy: A physical therapist can provide tailored exercises and treatments to strengthen your back and improve flexibility. They can also teach you proper body mechanics to avoid aggravating your condition.

2. Heat and Cold Therapy: Applying heat can help relax tense muscles, while cold packs can reduce inflammation. Alternating between the two may provide relief.

3. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and inflammation. However, consult your physician before starting any new medication.

4. Mind-Body Techniques: Practices such as mindfulness, meditation, or deep breathing can help manage pain perception and improve your overall well-being.

When to Seek Further Evaluation
If your symptoms persist despite these interventions, or if you experience new symptoms such as numbness, weakness, or bowel/bladder dysfunction, it’s essential to seek further evaluation. You may need imaging studies (like an MRI) or referrals to specialists such as a neurologist or orthopedic surgeon to assess for any underlying conditions that may require more aggressive treatment.

Conclusion
Chronic back pain can significantly impact your quality of life, but with the right approach, it can be managed effectively. Focus on improving your posture, incorporating physical therapy, and utilizing pain management strategies. If your symptoms do not improve, do not hesitate to seek further medical evaluation. Remember, early intervention can often lead to better outcomes and a return to normal activities.

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