Help me help my girlfriend - lower back pain - possible herniated disc ?

[pumita]

I'm fascinated by physiotherapy in general, and I'd love some insight from more experienced people if possible:

So my girlfriend, about 5-8 years ago, had an accident. She sneezed while blow drying her hair - apparantly having your hands overhead and sneezing is a common recipe for blowing out your back. She was in debilitating pain for a few days. The doctor never had her go to see a physio/chiro, just gave her pain meds.

Now she has some pretty epic back issues.

I'll give you as much information as I can:

1. It's extremely painful when she bends over with her legs locked (back flexion). She barely has any range of motion. However she can bend over easily when her legs are bent at the knee.

2. Checking her individual legs - I had her lay down on her back, and lift her left and right leg (keeping her knees locked) to see how far she can go before she experiences pain. There doesn't appear to be bias between sides.

3. She can reach 90 degrees for both legs, but not more before feeling pain in her lower back. However her range of motion decreased significantly (~30 degrees) if her toes are pointed, in which case she experiences pain in the front of her shin (some sort of sciatica ? I thought it was supposed to be the opposite)

4. She also experiences a lot of pain (unsure if it's caused by tight joint capsule tissue or the actual lower back, I forgot to ask), when I apply pressure into the hip socket joint (ie, lying on her back, leg straight about 80 degrees, applying a slight pressure into the hip from the leg).

5. She has full range of motion with the test from #3 when her knees are bent (lying back, knees to chest type deal).

6. Sitting is painless

I told her to go see a physio or chiropractor, and she is going to go, but it will be in a while since she's extremely busy. I wonder if we can work together to get a head start.

Thanks a lot guys!

And if you have any tests you'd like me to run with her and report back - let me know!

Thank you
Pete

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[Yarok]

Hi

for me is disc herniated level between 4thand 5th lumbar verterbrea
take care
Y

[physio0907]

Hey Pete

It does sounds as if it is a disc herniation, and it sounds as if her sciatic nerve has become compromised, likely irritated, but it is hard to know as I would need to assess her in person. Looking at the info you gave above.. the reason why she has pain with knees locked and no pain when knees bent when she is bending over is because of the neural tension - the sciatic nerve tightens when you lock your knees when bending over, and the nerve slackens when the knees are bent..
You never mentioned where exactly the pain is - any symptoms down her legs / p&n / numbness / weakness in her legs??
The test you mentioned you did sounds like straight leg raise test, this confirms how much neural tension is evident, but you need to be careful with tests like this, as this can stir up her pain levels
Disc herniations can heal quite well with physiotherapy, the main problems that tend to occur after an initial acute disc problem is stiffened spinal segments and muscle spasms which flare up due to the inflammation occuring from the disc herniation. Then altered movement patterns start to occur, and that is when disc problems become chronic in nature. I wouldnt recommend you do any further testing yourself, as I said you can stir things up and make the pain worse, leave it to an experienced physio, best of luck to both of you!

[Elise470]

Just a thought, I have bilateral pars fractures. And what your gf is going through sound very similar to what I have. I hope she found relief. Ice, rest, stretching and building core strength is somewhat effective for me.