Back Pain and Thigh Issues After Sports Injury: A Guide

Back pain

Hello, doctor.
I previously had scoliosis but did not pay much attention to it as there were no special issues.
However, two weeks ago, on Saturday, after playing basketball, I started experiencing severe pain in the lower part of my spine the day after, which has continued until now.
Additionally, starting this Monday, I have had some issues with my thigh; it feels like something is pressing inside, similar to a cramp, but without the tightness typically associated with muscle cramps.
The most distressing part is that I cannot sit down; as soon as I do, the symptoms I mentioned above occur.
I can only stand or lie down.
I saw a doctor yesterday, who prescribed anti-inflammatory and pain relief medications along with a topical ointment.
After taking the medication and applying the ointment, my condition has improved (I can sit now).

Duration: 2 weeks.

Additional notes: I would like to ask: 1.
Currently, I am working in Australia, so I consulted a local doctor.
During the examination, they used a reflex hammer to test my knee sensation, and I did not experience any numbness or loss of bowel/bladder control, so the doctor confirmed that there is no nerve damage.
However, they could not explain the cause of my thigh issue, stating it might just happen sometimes, and they are unsure.
Currently, it seems to be cramps and inflammation! Therefore, I would like to ask if, based on my description, you could help me understand the current condition of my thigh? 2.
When I played basketball, I did not perform any cool-down exercises; could this be the underlying cause of my back and thigh issues? 3.
Are there any other recovery or treatment options available to me (the Australian doctor only mentioned medication and massage)?
Postscript: From August 27 until now, several days have passed, and my lower back pain has gradually improved.
However, if I sit for about 10 minutes, my back becomes sore, and I have to get up and move around or lie down intermittently to feel more comfortable.
Additionally, regarding my thigh, whenever I get up or assume certain positions that require effort from my lower back, I can distinctly feel a tearing sensation or something akin to a cramp.
What exactly is going on? Since I cannot return to Taiwan in the short term, if I do not seek timely medical attention now, could it lead to irreversible damage? Is there a way to manage my current condition? I will be able to return to Taiwan in about a month.
Thank you for your response.

Rui, 30~39 year old female. Ask Date: 2015/09/01

Dr. Lai Zhaokang reply Neurosurgery

Based on your description, my personal judgment is that the most common issue is likely a herniated lumbar disc compressing the nerves.
The lumbar disc is initially injured, causing back pain, but if the disc gradually bulges out due to pressure, it may compress nearby nerves, leading to thigh cramps and pain.
For diagnosis, in addition to a medical history and neurological examination by an Australian physician, further imaging such as lumbar X-rays or even an MRI can confirm the lesion.

In terms of treatment, as managed by the Australian physician, the first step is to allow the lumbar spine to rest, take anti-inflammatory pain relievers, muscle relaxants, and vitamin B complex, and wear a lumbar support brace.
It's important to avoid bending and other poor postures, refrain from heavy lifting, and possibly undergo rehabilitation (commonly lumbar traction, colloquially known as "spinal stretching").
Self-rehabilitation methods such as swimming, lumbar stretching, and hanging from a pull-up bar can help relieve pressure on the lumbar disc.
Generally, about 70% of patients will improve within two weeks (if you have already shown improvement).
However, if pain persists without improvement, it is advisable to seek further medical attention, potentially considering invasive treatments such as surgery.

If symptoms are severe, such as intolerable pain, incontinence, or lower limb weakness, immediate medical attention is necessary, and emergency surgery may be required.
Based on your description, there does not appear to be an immediate danger, and there is a chance for further improvement.
Please return to the clinic for evaluation when you are back in Taiwan.
Wishing you safety and good health.

Reply Date: 2015/09/01

More Info

It sounds like you are experiencing significant discomfort and pain in your lower back and thigh after playing basketball, which is understandably concerning. Based on your description, there are several factors to consider regarding your symptoms and potential treatment options.

1. Understanding Your Symptoms: The pain in your lower back and thigh could be attributed to a few different issues. Given your history of scoliosis, it is possible that the physical demands of playing basketball exacerbated any underlying issues related to your spine. The acute onset of pain following physical activity suggests that there may be muscle strain or ligamentous injury involved. The sensation of tightness or cramping in your thigh could indicate muscle spasms or even a strain in the muscles of the thigh, particularly if you were not warmed up properly before engaging in the sport.

2. Role of Warm-Up and Cool-Down: Not performing warm-up exercises before playing basketball can indeed contribute to injuries. Warm-ups help prepare your muscles and joints for the physical activity ahead, increasing blood flow and flexibility. Similarly, cool-down exercises help in gradually reducing heart rate and preventing stiffness. The absence of these practices may have led to the strain you are experiencing.

3. Potential Treatment Options: Since you have already consulted a physician and received anti-inflammatory medication and topical treatments, it is crucial to continue following their advice. In addition to medication, consider incorporating physical therapy into your recovery plan. A physical therapist can provide tailored exercises to strengthen the muscles around your spine and thigh, improve flexibility, and promote proper posture. This can help alleviate pain and prevent future injuries.

4. Monitoring Your Condition: It is essential to monitor your symptoms closely. If you notice any worsening of pain, numbness, tingling, or loss of bladder/bowel control, you should seek immediate medical attention, as these could indicate a more serious condition. Given that you are currently in Australia and may not be able to return to Taiwan soon, it is advisable to find a local healthcare provider who can continue to monitor your condition and provide appropriate care.

5. Self-Care Strategies: In the meantime, consider implementing self-care strategies such as applying ice to the affected areas to reduce inflammation, practicing gentle stretching exercises, and maintaining good posture while sitting or standing. Avoid activities that exacerbate your pain, and try to incorporate rest periods throughout your day.

6. Long-Term Considerations: If your symptoms do not improve or if you continue to experience significant discomfort, it may be necessary to undergo further diagnostic imaging, such as an MRI or X-ray, to rule out any serious injuries to your spine or surrounding structures.
7. Mental Health and Coping: It is also important to address the emotional aspect of dealing with pain and injury. Anxiety about your condition can exacerbate your symptoms. Consider mindfulness techniques, such as meditation or deep-breathing exercises, to help manage stress and improve your overall well-being.

In conclusion, while your symptoms are concerning, with appropriate care and management, there is a good chance for recovery. It is vital to stay proactive about your health, seek further medical advice if necessary, and engage in rehabilitation exercises to facilitate your recovery. If you can maintain a consistent routine of self-care and follow-up with healthcare providers, you should be able to manage your condition effectively until you can return to Taiwan.

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