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This same phenomenon has happened a couple of times previously.  Once in the summer of 2021 and more recently in April of 2022.  I woke up on Monday morning and my usual achy lower back was in horrendous splitting pain again.  It would be a 9 or 10 out 10 as far as the intensity of it.  Any little movement and I was wreathing.  That night I could barely sleep or get comfortable.  I don't remember injuring it in any way.  So, as I did previously, I went to the ER for a Toridol shot and I have been gobbling down 800mg of Ibuprofen 3X / day.  My back was WAY better on Wednesday and still feels better today (Thursday). 

Anyone out there experience this type of drastic back previously in your lower back or elsewhere?  I never seem to get a reason for it from doctors or elsewhere.

I lost my job coaching / managing a month ago and I have shifted my focus for now into officiating.  Obviously, my physical health is even more important now as this type of work is dependent on it!  I am still on my long-term codeine and I have been taking Simponi for months with no idea whether it is doing anything for my digestive tract inflammation issues. 

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Have you had any imaging studies to see what’s going on? You could start with your primary care doctor. In my case I struggled for a while with what turned out to be a ruptured disc. By the time I saw a neurosurgeon the problem was urgent, the MRI showed what was wrong, and prompt surgery fixed me up very nicely. But I didn’t experience relief after a few days like you did, so your problem is likely different.

Just an example of what I deal with...  According to my FitBit, I was asleep from 1:15am-9:15am last night.  I was awake 10% of that time (48m), had 20m of REM, slept lightly for 75% of the time (5h 54m), and slept deeply 11% of the time (54m).

I know that I used the bathroom for a bowel movement around 5:45am (and my FitBit accounts for it).  Upon waking up at 5:45am, my lower back was in absolute agony.  Just pressure pain/discomfort.  This has been ongoing for many many years.  I HAD to shift from sleeping on my back with a couple of pillows under my knees to my side.  I struggled miserably after waking up a couple more times before finally waking up at about 9:11am.  The pressure / pain in my lower back was so intense but would be relieved by changing my position or getting up.  After that, it was just a matter of dealing with the stiffness and that was nothing compared to the pressure pain while laying inthe same position in bed. 

Over 7 hours is a really good night's sleep for me.  That said, the longer I sleep, the more intense the pain becomes in my back due to the length of time I spemnd in one position.  So generally speaking, the longer I sleep the better I feel overall and the worse my back feels! 

Attached is a copy of my most recent MRI results.  Can anyone relate to my issues?  This is all part of my chronic lower back discomfort that I have dealt with since as long as I can remember (but after my j-pouch surgery). 

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  • MRI Photo

Capper,

It would seem that your pain generating issue is at L5-S1 where you have a herniation aka protrusion. I am not an MD, but a personal injury attorney, and I have read a lot of MRIs in my day. The MRI you posted is missing stuff, specifically it doesn't say what the MRI 2 years ago showed at the L3-4 and L5-S1 levels and it also doesn't provide a comparison in terms of the advancement or lack of advancement of whatever condition was identified at those 2 levels 2 years ago. It looks like someone forgot to finish the first sentence and perhaps the comparison section was left out.

The L5-S1 disc level being the pain generating source is consistent with your complaints and articulations of your pain issues.

Talk to a neurosurgeon specifically about medial branch blocks (MBB) and radio frequency ablations  (RFAs) which are procedures used to treat and inform further on these kinds of disc issues. The MBBs are diagnostic and will confirm the pain generating source and the RFA could provide relief. Read up on these procedures and disc with a neurosurgeon and/or an associated pain management specialist working with the neurosurgeon. Don't accept the pain you are in. Good luck and happy holidays.

Last edited by CTBarrister

Here's the report from my 2020 lower back MRI.  It is making reference to changes as I had one previously in 2014.


Jan 2020
CLINICAL INEORMATION: Chronic 1ow back pain
MRI LUMBAR SPINE:
Comparison 2014

L3-L4: There is a shallow left lateral and foraminal disc protrusion which is new since the prj-or study. As disc contaets the left L4 nerve roo! and the exiting left L3 with potential for irritation.

L4-L5i No abnormal-ity is seen.

L5-S1: Again there is a small left Iateral disc protrusion contacting the left S1 without compression

I get very bad pain in my lower back sometimes too.I thought it was sciatica but I think mine is caused by either standing still or sitting with pressure on one area for too long and a build up of fluids in that area.once I move or stretch and get the area moving the fluid seems to unblock.I use a magnetized heat waist belt at work that helps alot.It heats up with your body and has magnets inside.they are very cheap considering how I cant live without it.

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  • Adjustable-Tourmaline-Self-heating-Magnetic-Therapy-Waist-Belt-Lumbar-Support-Back-Waist-Support-Brace-Double-Banded_f10fa8ee-321f-470a-ad6f-922bf303db91
Last edited by Chook2
@capper posted:

Here's the report from my 2020 lower back MRI.  It is making reference to changes as I had one previously in 2014.


Jan 2020
CLINICAL INEORMATION: Chronic 1ow back pain
MRI LUMBAR SPINE:
Comparison 2014

L3-L4: There is a shallow left lateral and foraminal disc protrusion which is new since the prj-or study. As disc contaets the left L4 nerve roo! and the exiting left L3 with potential for irritation.

L4-L5i No abnormal-ity is seen.

L5-S1: Again there is a small left Iateral disc protrusion contacting the left S1 without compression

That's interesting because the 2022 study is calling the issue at L3-4 a bulge and not a protrusion, as the 2020 study did. A bulge is not equivalent to a herniation. However, the L3-4 level still could be the pain generating source as there is evidence of contacting of the nerve roots at that level in the 2020 study. As noted above seek out a neurosurgeon for an opinion on MBBs or RFAs, if you want to deal with this issue. Note that these procedures are not pain free themselves, but discuss that with the neurosurgeon or pain management specialist working with the surgeon who will likely do the procedures.

Last edited by CTBarrister

I am going to add a message to this post from back in December... I am dealing with exactly the same thing I posted about here.  Yesterday, for the 4th time since the summer of 2021, I did it again.  My chronic back pain turned acute.

In December I woke up one morning and was in agony.  The type of agony that when I move it's excruciating pain.  Sneezing, same thing.  All in the same area lower back area where my chronic pain has been.  This time I didn't just wake up not knwing what happened.  I was doing a workout yesterday afternoon and was near completion.  I decided to do some reasonably light dead lifts (with dumbbells) and I immediately felt a problem.  I got through yesterday fine - even went for a run after that - but today is way worse.

Here is an e-mail I sent to my GI back in December:

On Monday morning (Dec. 12) I woke up with my lower back in excruciating pain.  Any movement whatsoever and I was wincing in agony.  This lower back area is the same in which I have had long-term chronic pain (mostly night pain).  My MRIs have shown some problems with my Lumbar spine.
On Tuesday morning I went to the ER and got a Toridol shot.  I had done this in the past and it either worked or the pain mysteriously went away on its own.  By Wednesday, the pain had mostly disappeared.  Today is Thursday and I seem back to near normal.
I am not sure if this is related to my GI issues.  I know that I have heard other GI patients say that a pouch leakage caused for them the type of back pain I described.  I just thought I should reach out and let you know.  The roughly 48 hours that I suffered was intense and I think this was the third time in about 18 months that I've been through the same.
I have been taking the max doses of Ibuprofen to make sure the inflammation goes and stays down.  I am due for my next Simponi dose today (and will take tonight).  I have a prescription for oral Toridol if needed.  I am still stiff and the back feels a bit strange but 80-90% better than it was on Monday and Tuesday.
I don't remember injuring my back in anyway this time or previously.  I assume this is a systemic issue as opposed to a mechanical one.
Here's the response I got from my GI's office at the time:
Dr. XXX got your email and wanted me to let you know that she reviewed the MRI from earlier this year and she does not believe that the spine issues discussed on the report relate to your colitis. She suggests that you follow up with your GP regarding this back pain. She also mentioned that the Toradol medication can be bad for inflammatory bowel disease, but sometimes it needs to be considered if the back pain is quite significant.
The only difference this time is that I know I strained it, or at least caused my current condition.  It felt like I pulled a muscle right away.  The last times this happened I couldn't pinpoint what I had done exactly to cause the condition.
Why am I posting this here?   As my agony is at its worst right now (hopefully!), I am debating with myself whether to (a) go to the hospital to see a doctor and either get a Toridol shot or a Toridol prescription (or both), (b) take Ibuprophen or Tylenol at home on my own, or (c) suck it up and wait to see how it goes.
I am not certain whether the Toridol shots worked magic in the past or my symptoms just went away on their own.  Hard to know with my strange body.
I guess the other option is to wait at least a couple of days to see if the pain comes down on its own.
This has become a regular thing it seems...  In the meantime, I am suffering badly!  Not sure if I should be proactive and get it treated right away or wait and see if it goes away on its own...
Last edited by capper

Arnica & CBD icy hot spray or cream and a hot pad is what I might try.  Someone might say ice is good for something like this.  I'd do whatever feels better to you.  Maybe those treatments paired with some acetaminophen? Most people on this forum (and their doctors) seem to agree that NSAIDs can trigger bad responses from the pouch.

After the pain decreases, Iyengar yoga might help if you can find a good, experienced teacher.  I can't vouch for other types of yoga.

If the pain is too bad, the stress of that might irritate your guts, too, and/or cause you to tense up and make healing difficult.  What a conundrum!  I'd say go with your intuition about what to do next.  Our abbreviated, rearranged guts can still tell us a lot.

I seemed to catch a bug or virus of sorts that has caused the chills,  muscle aches, and a bad headache.  The headache is gone now but the others symptoms are still lingering some.  I have tried to rest and get as much sleep as possible over the last couple of days.  In order to help with that, I have taken some muscle relaxants that I had been prescribed previously.  It has a tendency to really knock me out.

Typically, the longer I sleep, the better I feel but the more difficulty I have with my back.  The longer I stay in bed, the more intense aching I suffer from.  Last night I went to bed early and stayed in bed for at least 9 hours - which is way more than normal for me.  I was able to sleep longer, or at least continue to fall back asleep with the help of the muscle relaxant I took the night before.  My back ache was excruciating in pain.  I couldn't stay in the same position for long as it was torture.  I am probably posting on the wrong forum but it is a scary thing to say the least.  The achiness was off the charts agony.  By afternoon, I could practically forget about what I went through in bed just a few hours prior.  This is typical for me.  But the pain was such an intense ache that it felt like my back was splitting in half (or on fire)! 

Any suggestions?  Do you think this longterm back issue is related to (a) my IBD condition, or (b) my total colectomy surgery I had 23 and a half years ago?

Lots of pain and so far no gain!

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