Back pain for 7 months

by Evonne Kok
(Grand Rapids, Michigan)

I've been suffering from back pain, sharp pains on the right side of the middle of my back, traveling into the hip and the right thigh (just a dull pain there). The pain is the worst in the back. I have tried three different physical therapists--stretching exercises, some manipulation, McKenzie. None has helped, and the McKenzie exercises actually made my pain worse. I used to have some better days, and now they are all bad days. I have also had injections in L4/L5, L1/L2, and L4/L5 facet joints. I have also had an MRI and a Bone Scan. They showed Advanced multilevel facet arthrosis, and advanced multilevel spondylosis of the lumbar spine. I am 67 years old and in constant pain. Please help.

Comments for Back pain for 7 months

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Nov 12, 2013
injections to facet joints
by: Sarah

Sight unseen, it's difficult for me to know whether you do indeed have facet joint arthropathy. However, it is fairly commonplace, I'm afraid to say, that injections to the facet joints are simply not accurate enough to give relief.
As for Mackenzie extension exercises, these will make inflamed facets more inflamed because it overloads them. Remember, that in the standing position the facet joints take only approximately 16% of load through the spinal segment. This is in the neutral midline position. Passively forcing the facet joints to take more load, especially if it is every two hours, will have a definite inflammatory effect, which could be thwarting the beneficial effect of the injections. You will find that passive hyperextension, lying on your back over a BackBlock is a very different exercise. It allows the spinal segments to separate while at the same time passively arching back, and this spares the facet joints.

Nov 09, 2013
further question from "back pain for 7 months"
by: Evonne Kok

Thank you, for your earlier reply. Here are a couple of follow-up questions: I have had an injection in both L4, L5, and L5, S1 facet joints. If it is the facets that are my problem, do you know why that injection would not have helped? Also, can you comment about why the McKenzie exercises, that I did every 2 hours during the day for 12 days actually made my pain much worse? Thank you.

Nov 05, 2013
mobilising the facet joint yourself to rid yourself of back pain
by: Sarah

Hello Eyvonne,
Multi-level inflammation of the facets (corroborated by MRI) is extremely difficult to quell if you cannot find someone to get their hands in there and mobilise them locally.
You can see on my iPhone app The Back App, me doing this to myself to demonstrate ~ but even so, it is quite awkward 'getting in' if you are not quite nimble.
Another alternative is to use something soft and spherical under the facets themselves and lying on it placed over the facet joint, gently manoeuvre your body around to get the desired mobilising pressures. I used to recommend a tennis ball, but in very many cases, it is too fierce and simply makes the inflamed joint(s) more sore. A much more suitable consistency is a pair of folded (thin) leather gloves. You lie on your back with your knees bent, lift your bottom and place the mound under the facet joint to be mobilised. Only you will know when you have found the 'sweet spot' when it elicits an agreeable sense of good pain, not quite 'sweet agony'. You should also read all about the regime of 'facet joint arthropathy in the self treatment section in Back Sufferers' Bible 'Chapter 3. Of course, you should also do your own spinal decompression to get better separation between the vertebrae which will unload the facet surfaces. You also need to do the 'floor twists' from Chapter 7 of BSB.
I hope this helps!

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