Chronic Lower Back Pain: Seeking Solutions After 18 Months of Discomfort

Q: Chronic Lower Back Pain: Seeking Solutions After 18 Months of Discomfort

Hello： Scoliosis, combined with the fact that humans spend most of their time either sitting or standing, increases the likelihood of degenerative changes in the spinal joints. <br>If the symptoms you described are indeed that severe, it is advisable to visit a hospital for furth

Lumbar pain lasting for one and a half years?

Dear Dr.
Wang,
I apologize for the lengthy message, but I believe that clearly describing my symptoms will help you understand my situation better.
I have had scoliosis since high school, with a curvature of about 15 degrees.
After giving birth to two children, I have been experiencing persistent lower back pain.
I have seen doctors and tried various traditional therapies, but I have not fully recovered, although my condition has not worsened significantly either.
In January of last year, during an office renovation, I packed and moved heavy items, but I felt fine afterward.
However, in March, I had to take the train for about three hours without a seat on two or three occasions, and afterward, I began to experience frequent lower back pain.
If I stand (whether cooking, working, or even just waiting for someone), I start to feel pain after about half an hour, accompanied by stiffness in my lumbar spine, making it difficult to bend down (I have to bend slowly, bit by bit).
If I bend over (for example, searching for something in a drawer), I experience excruciating pain in my lumbar spine in less than five minutes, and I have to straighten up slowly.
I also cannot perform backward bending movements due to pain, and even standing up straight causes discomfort.
When sitting in a chair, I can only do so for a short time unless there is back support; lying down in bed is the only position that alleviates the pain.
I have previously seen a doctor who diagnosed me with muscle inflammation causing lower back pain, but medication and exercise have not improved my condition.
It has now been over a year and a half of pain.
I have carefully assessed my situation and believe that the pain is originating from my spine (lumbar region), rather than from muscle pain.
This month, I have been in pain almost continuously from the moment I wake up until I go to bed, which severely affects my daily life.
(Currently, my work is light, requiring only computer use and stamping; my children are now in college, and household chores are not demanding, consisting mainly of cooking and doing laundry.
Therefore, my lower back pain should not be related to physical labor.)
I would like to ask you, should I continue to patiently perform rehabilitation exercises for my lower back pain, or should I seek further examination to check for other issues? Thank you for taking the time to read my message and for answering my questions!

Xiao Luo, 30~39 year old female. Ask Date: 2015/08/26

Dr. Wang Shouji reply Orthopedics

Hello: Scoliosis, combined with the fact that humans spend most of their time either sitting or standing, increases the likelihood of degenerative changes in the spinal joints.
If the symptoms you described are indeed that severe, it is advisable to visit a hospital for further evaluation to determine the underlying cause.
Thank you!

Reply Date: 2015/08/26

More Info

Chronic lower back pain can be a debilitating condition that significantly affects one’s quality of life. Based on your description, it seems that you have been dealing with this issue for over 18 months, which is quite concerning. Given your history of scoliosis and the physical demands placed on your back, it is essential to approach this situation with a comprehensive understanding of potential underlying causes and treatment options.

Firstly, it is important to consider that chronic lower back pain can arise from various factors, including muscular, skeletal, and neurological issues. Your history of scoliosis, which you mentioned is around 15 degrees, could contribute to uneven stress on your spine and surrounding muscles, leading to pain and discomfort. Additionally, the physical strain from lifting heavy objects and prolonged periods of standing or bending can exacerbate existing conditions.

You mentioned that you have already sought medical advice and received a diagnosis of muscle inflammation. While this is a common cause of lower back pain, it is crucial to ensure that there are no other underlying issues, such as degenerative disc disease, herniated discs, or spinal stenosis. Given that your pain has persisted for over a year and has not improved with conservative treatments, it may be beneficial to undergo further diagnostic imaging, such as an MRI. This can provide a clearer picture of the structures in your lower back and help identify any abnormalities that may require specific treatment.

In terms of management, continuing with rehabilitation exercises is essential. Physical therapy can help strengthen the muscles supporting your spine, improve flexibility, and promote better posture. A physical therapist can tailor a program specifically for your needs, focusing on core strengthening, stretching, and techniques to alleviate pain during daily activities. It is also important to incorporate ergonomic adjustments in your workspace to minimize strain on your back while using the computer.

Additionally, consider exploring other treatment modalities. For instance, modalities such as acupuncture, chiropractic care, or massage therapy may provide relief for some individuals. If conservative measures fail to yield improvement, discussing options such as corticosteroid injections or other pain management strategies with your healthcare provider may be warranted.

Moreover, lifestyle modifications can play a significant role in managing chronic pain. Maintaining a healthy weight, engaging in regular low-impact exercise (like swimming or walking), and practicing good sleep hygiene can all contribute to reducing pain levels. Mindfulness practices, such as yoga or meditation, may also help in managing pain perception and improving overall well-being.

Lastly, it is crucial to maintain open communication with your healthcare provider. If your symptoms worsen or new symptoms arise, do not hesitate to seek further evaluation. Chronic pain can sometimes lead to psychological distress, so consider discussing your emotional well-being with a mental health professional if you find that your pain is affecting your mood or daily functioning.

In summary, while it is important to continue with rehabilitation exercises, further evaluation through imaging may be necessary to rule out any serious underlying conditions. A multidisciplinary approach that includes physical therapy, lifestyle modifications, and possibly alternative therapies may provide the best chance for relief from your chronic lower back pain.

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