Two Months of Treatment for Lower Back Pain: Seeking Answers and Solutions

Lumbar sports injury has not improved after two months of treatment?

Dear Doctor,
I experienced core training at home on September 21st, and possibly due to poor posture or prolonged support time during the "plank exercise," I felt discomfort and pain in my lower back in the evening.
The next day, I visited a clinic and received medication and injections about six times over the course of a month without improvement.
During this time, I frequently felt discomfort in my lower back.
I am currently seeing an orthopedic specialist at a major hospital.
After an X-ray, the doctor prescribed a month’s worth of anti-inflammatory and pain relief medication and advised me to wear a back brace and avoid exercise (except swimming).
I have completed a week of medication without improvement.
In total, I have been undergoing treatment for two months with no significant improvement.
I would like to ask the doctor:
Q1.
What could be the reason for the thigh pain in addition to the lower back pain?
Q2.
How long does it typically take for medication treatment to show effects?
Q3.
Given the duration of my condition, is it possible that it has developed into chronic lower back pain?
Q4.
Is there a possibility of injury to the lumbar nerve, and how should I respond to this?
Q5.
After swimming (breaststroke), I felt slight discomfort in my lower back.
Can I continue swimming as a rehabilitation exercise?
Since my puppy was just born, my lower back has been injured for a long time, preventing me from fulfilling my responsibilities as a father (unable to carry my child), which has left me feeling depressed.
I would greatly appreciate it if you could take the time to answer my questions and guide me in the right direction.
Thank you very much!

Xinshou Baba, 40~49 year old female. Ask Date: 2021/11/22

Dr. Chen Yongxue reply Orthopedics

Q1.
What could be the reasons for experiencing thigh pain in addition to lower back pain? There are many potential causes, ranging from a one-time injury to overuse in daily activities.

Q2.
How long does it take to see results from medication treatment? Medication can only address the symptoms temporarily; once the effects wear off, the pain may return.
It is essential to identify and address the underlying cause.
Q3.
Could the prolonged pain have developed into chronic lower back pain? It is possible.
Q4.
Is there a chance that the lumbar nerve is injured, and how should one respond? A clinical examination is necessary to determine this.
Q5.
After swimming (breaststroke), I feel slight discomfort in my lower back.
Can I continue swimming as a rehabilitation exercise? Yes, you can.

Reply Date: 2021/11/22

More Info

It sounds like you are dealing with a challenging situation regarding your lower back pain, and I appreciate your detailed description of your symptoms and treatment history. Let's address your questions one by one, while also providing some context and additional information that may help you understand your condition better.

Q1: Why is my thigh also feeling sore in addition to my lower back pain?
The soreness in your thigh could be related to several factors. One possibility is that the pain in your lower back is causing referred pain to the thigh, which is common in cases of lumbar spine issues. When the lower back is injured or inflamed, it can affect the nerves that innervate the thigh, leading to discomfort. Additionally, if you have altered your movement patterns due to back pain, this could lead to overuse of certain muscles in your thigh, resulting in soreness. It's essential to have a thorough evaluation to determine the exact cause.

Q2: How long does it typically take for medication to show effects?
The duration for medication to show effects can vary significantly based on the type of medication and the underlying condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) usually provide relief within a few hours, but they primarily address inflammation and pain rather than the root cause of the problem. If you are not experiencing relief after a week of medication, it may indicate that the underlying issue is not being adequately addressed. It's crucial to communicate with your healthcare provider about your lack of improvement, as they may need to adjust your treatment plan.

Q3: Is it possible that my condition has become chronic lower back pain?
Yes, if your pain persists for more than three months, it can be classified as chronic lower back pain. Chronic pain often requires a multifaceted approach to treatment, including physical therapy, lifestyle modifications, and possibly more advanced interventions. Early intervention is key to preventing acute pain from becoming chronic, so it's essential to stay proactive in seeking treatment.

Q4: Have I potentially injured my lumbar spine nerves, and how should I respond?
Injuries to the lumbar spine can indeed affect the nerves, leading to symptoms such as pain, numbness, or weakness in the legs. If you are experiencing significant changes in sensation or strength, it is crucial to seek further evaluation, possibly including imaging studies like an MRI, which can provide more detailed information about the condition of your spine and any potential nerve involvement. If nerve injury is suspected, early intervention is critical to prevent long-term damage.

Q5: Is swimming a suitable rehabilitation exercise if I experience discomfort after doing the frog stroke?
Swimming can be an excellent low-impact exercise for rehabilitation, as it helps strengthen muscles without putting excessive strain on the spine. However, if you experience discomfort after swimming, especially with specific strokes like the frog stroke, it may be wise to modify your technique or try different strokes that place less strain on your back. Freestyle or backstroke might be more comfortable options. Always listen to your body and consult with your healthcare provider or a physical therapist for personalized advice on exercises that are safe and effective for your condition.

Additional Recommendations
Given your situation, I would recommend considering a comprehensive approach to your rehabilitation. This may include:
1. Physical Therapy: A physical therapist can provide tailored exercises to strengthen your core and back muscles, improve flexibility, and correct any postural issues that may be contributing to your pain.

2. Pain Management: If medications are not providing relief, discuss alternative pain management strategies with your doctor, such as physical modalities (heat, ice, ultrasound), acupuncture, or even cognitive behavioral therapy for pain management.

3. Lifestyle Modifications: Incorporate gentle stretching and strengthening exercises into your daily routine, and consider ergonomic adjustments to your workspace and daily activities to reduce strain on your back.

4. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your progress and make necessary adjustments to your treatment plan.

5. Emotional Support: Given the emotional toll of chronic pain, consider seeking support from friends, family, or a mental health professional to help cope with the psychological aspects of your condition.

I hope this information helps you navigate your recovery process. Remember, persistence and communication with your healthcare team are key to finding the right solutions for your pain.

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