general concerns, back and ligaments

[jchoffman]

hi there

i'm not sure how to formulate anything nor the right terminology but i'd like to get some sort of guidence before paying heaps of cash in going to a doc only to find out i'm at the wrong place or have to land up paying huge amounts of money for the wrong tests.

a few things about myself you may need to know: i'm a 28 yr old female, no history of heart ailments or diabetes etc. used to be a provincial swimmer but quit while i concentrated on my final year of school and just never went back. i have since tried going back but my sport-induced asthma and lower back complaints prevented me from persuing it. I have tried gymming but have found this to be rather boring, even with a personal trainer or gym partner. yoga and pilates give more pain than i benefit from. i have since started pole dancing, of all things, despite my better judgment. my occupation is helpdesk coordinator in the IT industry so i am predominantly in front of my pc most of the day.

i have the following concerns:
1. i've had lower back complaints since i can remember. the pain is located in the small arch of my back. x-rays, the last being in 2006, showed the very beginning stages of arthritis (ragged edges around the vertibrae). i have had a few times when i've been thrown into bed literally by sever back spasms that i could not lift my legs or sit in a car. x-rays at the time revealed that the natural arch that there should be in the back was rather straight, and this was caused by the spasms pulling the vertibrae together. i have quite a bit of stiffness in the lower back when sitting for too long, but doesn't feel like a muscular pain at all. trying to move the area to increase mobility is rather a challenging task. a yoga move that i have tremendous difficulty with is stretching the tummy muscles by arching the back while being on the tummy and pushing upwards using the arms. the only way i can stretch these muscles is lying on the back and bringing the legs over the head to roll the back rather. this i have little to no issue with. i am trying to fight all the pain by trying to build up enough strength in the core muscles that hopefully will decrease this pain. just most back exercises do cause more pain literally dead centre in the back. would a chiropractor be the best person to go and see for this?

2. doing leg curls hurts because it feels like i have a little bone or tendon or something that "pops" over the bone but behind the knee. not entirely behind the knee cap, but behind the side of the joint - not sure if that makes sense. i have the same sensation when doing tummy strengthing exercises by lifting the legs from the floor upwards, when this sensation is on the side of the hip / pelvis. to the point where i can lift my legs again for fear that it may just get worse apart from it being very painful too.

3. i have somehow injured my wrist too but i think this is purely due to lack of strength. when i flex my wrist, the pain is situated on top of the wrist in the area where all the little muscles run through to the rest of the hand. this pain also arises now when i gently press down on my hand to lift myself up from out my chair at the office too.

any thoughts / comments would be greatly appreciated, but my concern about my back is the biggest issue at the moment.

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[gcoe]

You may be prone to joint pain - some people are.

1. i've had lower back complaints since i can remember. the pain is located in the small arch of my back. x-rays, the last being in 2006, showed the very beginning stages of arthritis (ragged edges around the vertibrae). i have had a few times when i've been thrown into bed literally by sever back spasms that i could not lift my legs or sit in a car. x-rays at the time revealed that the natural arch that there should be in the back was rather straight, and this was caused by the spasms pulling the vertibrae together. i have quite a bit of stiffness in the lower back when sitting for too long, but doesn't feel like a muscular pain at all. trying to move the area to increase mobility is rather a challenging task. a yoga move that i have tremendous difficulty with is stretching the tummy muscles by arching the back while being on the tummy and pushing upwards using the arms. the only way i can stretch these muscles is lying on the back and bringing the legs over the head to roll the back rather. this i have little to no issue with. i am trying to fight all the pain by trying to build up enough strength in the core muscles that hopefully will decrease this pain. just most back exercises do cause more pain literally dead centre in the back. would a chiropractor be the best person to go and see for this?

AS this is a chronic problem I think you would be wasting your money going to someone such as a chiropractor for manipulation. There is absolutely no evidence that manipulation helps in the long term - may be for short term episodes - even then it depends on the person.

It sounds like you have lost mobility in the arching movement of your back and possibly too much movement in bending movements. However that is just based on what you describe and this could well be wrong.

Thinking about strengthening may in theory be a good idea but you may have problems with muscle imbalance - that is one group of muscles are too weak or too flexible and the opposing group is too strong or too shortened. These sorts of muscle imbalances promote abnormal wear on your joints tendons and ligaments. Yoga, pole dancing and Pilates can in theory be good but sometimes these can actually be detrimental if the wrong muscles are getting strengthened or stretched.

I would suggest you get some help from a physio who takes a "Movement Impairment Syndrome" approach - Shirley Sahrmann is the lady who invented this approach and many physios around the world may practice this approach. It involves a detailed assessment of your posture and movement, diagonosing imbalances and faulty movement patterns and prescribing specific exercises. This is approach addresses things in the long term so you don't always get immediate relief - however usually start to feel better after a few weeks of diligent exercise.

Alternatively you could consider trying a somatic education approach. Both the Feldenkrais method or the Alexander Method may help with the latter showing evidence for helping chronic low back pain. these methods are gentle, and subtle but are more educative than therapeutic. They teach you how to use your body better through specific types of improvement in body awareness.

I would definitely get some help rather than soldiering on with these different types of exercise regimes, particularly as you aren't really feeling better form practising them
Additional Comment I forgot:
You may be prone to joint pain - some people are.

1. i've had lower back complaints since i can remember. the pain is located in the small arch of my back. x-rays, the last being in 2006, showed the very beginning stages of arthritis (ragged edges around the vertibrae). i have had a few times when i've been thrown into bed literally by sever back spasms that i could not lift my legs or sit in a car. x-rays at the time revealed that the natural arch that there should be in the back was rather straight, and this was caused by the spasms pulling the vertibrae together. i have quite a bit of stiffness in the lower back when sitting for too long, but doesn't feel like a muscular pain at all. trying to move the area to increase mobility is rather a challenging task. a yoga move that i have tremendous difficulty with is stretching the tummy muscles by arching the back while being on the tummy and pushing upwards using the arms. the only way i can stretch these muscles is lying on the back and bringing the legs over the head to roll the back rather. this i have little to no issue with. i am trying to fight all the pain by trying to build up enough strength in the core muscles that hopefully will decrease this pain. just most back exercises do cause more pain literally dead centre in the back. would a chiropractor be the best person to go and see for this?

AS this is a chronic problem I think you would be wasting your money going to someone such as a chiropractor for manipulation. There is absolutely no evidence that manipulation helps in the long term - may be for short term episodes - even then it depends on the person.

It sounds like you have lost mobility in the arching movement of your back and possibly too much movement in bending movements. However that is just based on what you describe and this could well be wrong.

Thinking about strengthening may in theory be a good idea but you may have to problems with muscle imbalance - that is one group of muscles are too weak or too flexible and the opposing group is too strong or too shortened. These sorts of muscle imbalances promote abnormal wear on your joints tendons and ligaments. Yoga, pole dancing and Pilates can in theory be good but sometimes these can actually be detrimental if the wrong muscles are getting strengthened or stretched.

I would suggest you get some help from a physio who takes a "Movement Impairment Syndrome" - Shirley Sahrmann is the lady who invented this approach and many physios around the world may practice this approach. It involves a detailed assessment of your posture and movement, diagonosing imbalances and faulty movement patterns and prescribing specific exercises. This is approach addresses things in the long term so you don't always get immediate relief - however usually start to feel better after a few weeks of diligent exercise.

Alternatively you could consider trying are somatic education approach. Both the Feldenkrais method or the Alexander Method may help with the latter showing evidence for helping chronic low back pain. these methods are gentle, and subtle but are more educative than therapeutic. They teach you how to use your body better through specific types of improvement in body awareness.

I would definitely get some help rather than soldiering on with these different types of exercise regimes, particularly as you aren't really feeling better form practising them. All three approaches I have suggested are wholistic in nature so may look at all the problems you are having.

[physiofixme]

Just a quick follow up regarding your comments about early arthritic changes on xray. Your xray was taken four years ago?? At the age of 24 that's very young to be showing arthritic changes in your spine. Did you ever have blood tests taken?? You didn't mention it so thought I would ask as a couple of conditions spring to mind - ankylosing spondylitis being one of them....do you know if your Dr has ruled this out?? The sorts of blood tests that are usual for this sort of thing are HLA B27 and rheumatoid factor. Might pay to have these things tested for before embarking on anything else as it may have an impact on your management.

[jchoffman]

Just a quick follow up regarding your comments about early arthritic changes on xray. Your xray was taken four years ago?? At the age of 24 that's very young to be showing arthritic changes in your spine. Did you ever have blood tests taken?? You didn't mention it so thought I would ask as a couple of conditions spring to mind - ankylosing spondylitis being one of them....do you know if your Dr has ruled this out?? The sorts of blood tests that are usual for this sort of thing are HLA B27 and rheumatoid factor. Might pay to have these things tested for before embarking on anything else as it may have an impact on your management.

hi there.

thanks for this. blood tests weren't taken at the time as they said i should just be aware of it but continue as normal. the dr at the time didn't see it necessary for blood tests at the time but said i should speak to my doctor after i've had follow up x rays done. i never realised that blood tests would be used to further confirm arthritis. i know arthritis does run through the family, as my cousin, daughter to my dad's sister so maybe not such a strong gene, has chronic arthritis. she's just a few years younger than me and has it in every single joint in her body. she can't walk up too many stairs, stay stationary for too long, etc. when i felt her back, it felt solid with just a few bumps here or there. i'm not sure if its rhematoid arthritis but its not oesteoarthritis (spelling???) as far as i know.

[jchoffman]

You may be prone to joint pain - some people are.



AS this is a chronic problem I think you would be wasting your money going to someone such as a chiropractor for manipulation. There is absolutely no evidence that manipulation helps in the long term - may be for short term episodes - even then it depends on the person.

It sounds like you have lost mobility in the arching movement of your back and possibly too much movement in bending movements. However that is just based on what you describe and this could well be wrong.

Thinking about strengthening may in theory be a good idea but you may have problems with muscle imbalance - that is one group of muscles are too weak or too flexible and the opposing group is too strong or too shortened. These sorts of muscle imbalances promote abnormal wear on your joints tendons and ligaments. Yoga, pole dancing and Pilates can in theory be good but sometimes these can actually be detrimental if the wrong muscles are getting strengthened or stretched.

I would suggest you get some help from a physio who takes a "Movement Impairment Syndrome" approach - Shirley Sahrmann is the lady who invented this approach and many physios around the world may practice this approach. It involves a detailed assessment of your posture and movement, diagonosing imbalances and faulty movement patterns and prescribing specific exercises. This is approach addresses things in the long term so you don't always get immediate relief - however usually start to feel better after a few weeks of diligent exercise.

Alternatively you could consider trying a somatic education approach. Both the Feldenkrais method or the Alexander Method may help with the latter showing evidence for helping chronic low back pain. these methods are gentle, and subtle but are more educative than therapeutic. They teach you how to use your body better through specific types of improvement in body awareness.

I would definitely get some help rather than soldiering on with these different types of exercise regimes, particularly as you aren't really feeling better form practising them
Additional Comment I forgot:
You may be prone to joint pain - some people are.



AS this is a chronic problem I think you would be wasting your money going to someone such as a chiropractor for manipulation. There is absolutely no evidence that manipulation helps in the long term - may be for short term episodes - even then it depends on the person.

It sounds like you have lost mobility in the arching movement of your back and possibly too much movement in bending movements. However that is just based on what you describe and this could well be wrong.

Thinking about strengthening may in theory be a good idea but you may have to problems with muscle imbalance - that is one group of muscles are too weak or too flexible and the opposing group is too strong or too shortened. These sorts of muscle imbalances promote abnormal wear on your joints tendons and ligaments. Yoga, pole dancing and Pilates can in theory be good but sometimes these can actually be detrimental if the wrong muscles are getting strengthened or stretched.

I would suggest you get some help from a physio who takes a "Movement Impairment Syndrome" - Shirley Sahrmann is the lady who invented this approach and many physios around the world may practice this approach. It involves a detailed assessment of your posture and movement, diagonosing imbalances and faulty movement patterns and prescribing specific exercises. This is approach addresses things in the long term so you don't always get immediate relief - however usually start to feel better after a few weeks of diligent exercise.

Alternatively you could consider trying are somatic education approach. Both the Feldenkrais method or the Alexander Method may help with the latter showing evidence for helping chronic low back pain. these methods are gentle, and subtle but are more educative than therapeutic. They teach you how to use your body better through specific types of improvement in body awareness.

I would definitely get some help rather than soldiering on with these different types of exercise regimes, particularly as you aren't really feeling better form practising them. All three approaches I have suggested are wholistic in nature so may look at all the problems you are having.

hi there

thanks for your response. and you have really given me a lot to think about.

i will first of all mention that i do not perform any movements / exercises that do result in that much pain. i would then ask for an alternative exercise that would have a similar result. i am aware of the damage it may cause in the long run, so i generally stay away from the excessive back stretches / exercises.

another factor that may affect all this is an injury i had when i was just starting school. i was on a see-saw with a much older child, this child decided to get off while i'm in mid-air. i was leaning slightly backwards at the time and i came crashing to the ground and landed straight on my coccyx. however, xrays don't reveal any fractures there at all.

movements in specific that i have trememdous difficulty with is stretching my hamstrings. whether my legs are in front of me and closed or stretched open and i lean forward, this causes pain more in my lower back and in the tendons, i think it is, behind my knees and to the inside of the leg (pretty much in the hollow part of the knee), and more so in my left leg than the right, which is the same leg that had the torn ligament, than anywhere else. i can't seem to get to the point where it stretches my hamstrings significantly enough. when i then try and get up, i literally need to do in stages. this is when my vertibrae feel "dry" in my lower back and this is when mobility is rather low around any kind of back movements for at least 5min or so. co-incidentally, it was coming up from positions like that, for example picking up a shoe from the ground, that i often had shoots of pain running along my spine, which one day became a week long spasm.

i've not had blood tests done for anything, but have been told to just stay away from any movements that cause pain. and that's all i've really done since childhood (mostly since my parents couldn't afford any extensive therapy at the time).

research i have done till now, has given me the inclination to believe that the ligament injury i had in my ankle (torn the major ligament in my ankle while climbing off a merry-go-round and stepping skew while it was still moving) shouldn't cause any signifant damage to any muscles higher up the leg. however, i am just a member of the general public so there may be bits that i am not aware of.

with regards to treatments i've had thus far, i've had physio for quite some time while i was still swimming. here the physio concentrated mostly on keeping the lower back as mobile as possible concentrating on the vertibrae themselves by gently pressing on each one then massaging the muscles afterwards. i have also had accupunture done, when i was suffering from the said spasms, and this worked wonders, at the time, but i fear that the spasms may be returning soon as the muscles are feel rather stiff lately.

thanks again for all the comments i have received so far. and for the most poart, it seems that physio is the way to again...

[jchoffman]

You may be prone to joint pain - some people are.



AS this is a chronic problem I think you would be wasting your money going to someone such as a chiropractor for manipulation. There is absolutely no evidence that manipulation helps in the long term - may be for short term episodes - even then it depends on the person.

It sounds like you have lost mobility in the arching movement of your back and possibly too much movement in bending movements. However that is just based on what you describe and this could well be wrong.

Thinking about strengthening may in theory be a good idea but you may have problems with muscle imbalance - that is one group of muscles are too weak or too flexible and the opposing group is too strong or too shortened. These sorts of muscle imbalances promote abnormal wear on your joints tendons and ligaments. Yoga, pole dancing and Pilates can in theory be good but sometimes these can actually be detrimental if the wrong muscles are getting strengthened or stretched.

I would suggest you get some help from a physio who takes a "Movement Impairment Syndrome" approach - Shirley Sahrmann is the lady who invented this approach and many physios around the world may practice this approach. It involves a detailed assessment of your posture and movement, diagonosing imbalances and faulty movement patterns and prescribing specific exercises. This is approach addresses things in the long term so you don't always get immediate relief - however usually start to feel better after a few weeks of diligent exercise.

Alternatively you could consider trying a somatic education approach. Both the Feldenkrais method or the Alexander Method may help with the latter showing evidence for helping chronic low back pain. these methods are gentle, and subtle but are more educative than therapeutic. They teach you how to use your body better through specific types of improvement in body awareness.

I would definitely get some help rather than soldiering on with these different types of exercise regimes, particularly as you aren't really feeling better form practising them
Additional Comment I forgot:
You may be prone to joint pain - some people are.



AS this is a chronic problem I think you would be wasting your money going to someone such as a chiropractor for manipulation. There is absolutely no evidence that manipulation helps in the long term - may be for short term episodes - even then it depends on the person.

It sounds like you have lost mobility in the arching movement of your back and possibly too much movement in bending movements. However that is just based on what you describe and this could well be wrong.

Thinking about strengthening may in theory be a good idea but you may have to problems with muscle imbalance - that is one group of muscles are too weak or too flexible and the opposing group is too strong or too shortened. These sorts of muscle imbalances promote abnormal wear on your joints tendons and ligaments. Yoga, pole dancing and Pilates can in theory be good but sometimes these can actually be detrimental if the wrong muscles are getting strengthened or stretched.

I would suggest you get some help from a physio who takes a "Movement Impairment Syndrome" - Shirley Sahrmann is the lady who invented this approach and many physios around the world may practice this approach. It involves a detailed assessment of your posture and movement, diagonosing imbalances and faulty movement patterns and prescribing specific exercises. This is approach addresses things in the long term so you don't always get immediate relief - however usually start to feel better after a few weeks of diligent exercise.

Alternatively you could consider trying are somatic education approach. Both the Feldenkrais method or the Alexander Method may help with the latter showing evidence for helping chronic low back pain. these methods are gentle, and subtle but are more educative than therapeutic. They teach you how to use your body better through specific types of improvement in body awareness.

I would definitely get some help rather than soldiering on with these different types of exercise regimes, particularly as you aren't really feeling better form practising them. All three approaches I have suggested are wholistic in nature so may look at all the problems you are having.

oh, i also forgot to mention that i do have joint pain more often than not the times that i do realise that there is pain... (sounds strange but if you get used to a certain amount of pain every day, i only tend to notice it when it beyond what i'm normally used to)

another factor that may come into question is hereditory issues. my younger cousin has arthritis in and on every single bone / joint in her body and she's one or two years younger than me. hands, knees, back, etc. even her jaw. her back feels like a solid piece of bone just with a few bumps on here or there. i'm not sure what type of arthritis she has but i know its not osteoarthritis. research i've done has also not indicated to me that arthritis is genetic but also not too sure of this fact either.

[gcoe]

Hi jchoffman

Sounds like a lot of things might be going on. What I suggested was more treatment oriented for indistinct musculoskeletal problems. However Physiofixme is absolutely right in suggesting having another look at an adequate diagnosis. History of arthritis in sibblings/parents is an important. So how about this:

if you can organise it get a good diagnostic workup. May be best to get a referral to see a rheumatologist or at least get your general practitioner thinking along those lines.Get things like rheumatological disease ruled out. Another possibility to check if you have developed a chronic pain syndrome if no other clear organic disease is present. this could lead you down a pathway of pain management that can be helpful.

However at the end of the day if nothing is showing up diagnostically then you are just one of the masses of people with non specific musculoskeletal pain. And that may be where you could take on board some of the suggestions for management I have made