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Persistent Lower Back Pain


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17 minutes ago, Atrecord said:

Thanks.

Another complication... is that I also have pain in my left knee. Was diagnosed with minor meniscus tear i think 6-7 yr ago, but doc said just manage and live with it, cos not worth the risk of surgery...

So i've been avoiding stairs wherever possible for some years now. still can jog though, but i've never tried going above 5 km for fear that the strain will cause damage to the knee.

Read up on barefoot or minimalist running. Start with low mileage under 5 km, three times a week and slowly increase 10% of your previous mileage per week.

Personally, I rotate between cushioning and minimalist shoes. Can't run minimalist all the way, injured my achilles tendon the last time.

Edited by Ender
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35 minutes ago, Atrecord said:

hmm...

according to my doc, our back are subject to these amt of strain:

- 20 newton when lying down

- 100 newton when standing

- 150 newton when sitting straight

- 250 newton when sitting and body bent forward

so he's asked me to avoid sitting down on prolonged basis going forward....

i better stand up now....

sounds like Dr Ruth...:P

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10 hours ago, Ender said:

Read up on barefoot or minimalist running. Start with low mileage under 5 km, three times a week and slowly increase 10% of your previous mileage per week.

Personally, I rotate between cushioning and minimalist shoes. Can't run minimalist all the way, injured my achilles tendon the last time.

you mean should jog with the ball - instead of the heel - of the feet touching the ground first? 

I've learnt this from that classmate of mine some years ago already, so should not be an issue. It was difficult and weird to change initially, having run with the heel touching the ground first all my life before that, but i've gotten used to the change now.

But i still worry about the knee leh 😅

or am i paranoid?

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9 hours ago, Etnt said:

It was contained inside, so lobbed the kidney away. Now dun have redundancy liao, lol

wah... ok. All the best to your health, man. If all goes well, should be no issue.

Reminds me of an ex-colleague, who shared that her son was born with only 1 kidney... Since his early days, this ex-colleague had joined NKF as member, saying that not sure if one day will need help from it... That was almost 30 yr ago liao. 

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12 minutes ago, Atrecord said:

you mean should jog with the ball - instead of the heel - of the feet touching the ground first? 

I've learnt this from that classmate of mine some years ago already, so should not be an issue. It was difficult and weird to change initially, having run with the heel touching the ground first all my life before that, but i've gotten used to the change now.

But i still worry about the knee leh 😅

or am i paranoid?

Yes, that way some of the load is absorbed by the calves muscle and tendon, lesser load for the knee. But just don't do like I did, suddenly run in minimalist all the way at my usual mileage, and that's how my achilles tendon got injured.

If you are still worry for you kne, just run lower than your usual, mileage   

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Twincharged
On 4/19/2021 at 12:42 PM, Atrecord said:

Thanks to all who gave the useful advices here. I really appreciate it.

The pain had gone quite bad at one stage, and was otherwise irritating at other times. It affected my work and life to some extent, and some days were worse than others.

While waiting for the MRI after seeing the ortho, the pain was so bad at one stage that I was seriously considering going to A&E, but in the end went to GP and was given arcoxia to relieve the pain. Managed to get MRI and follow-up appt with ortho brought forward a bit, and was diagnosed with slipped disc at L3/4 and L5... While doc was optismistic during the first consult, guessing that it might be just some tear that should heal in a few months, the MRI result was telling and he then suggested to have keyhole surgery to resolve it, explaining that some parts of the discs are damaged already and the fragments are pressing on my nerve, hence the pain i felt.

As there was risk of paralysis involved for such spine surgery (even though the doc stressed it very low - less than 1%), I was nervous and undecided and took a few days to think through it, and had spoken to family, friends and colleagues about it. Family was supportive of surgery, but a couple of friends were suggesting should try other ways - TCM (acupuncture), exercise, therapy, etc.

Even went for a second opinion with another specialist, and he also said surgery is the cleanest option, given (how bad) my situation (was), but also offered 2 other possibilities - steroid injection to relieve the pressure, or try therapy and painkillers to see if it will improve. Both the options are not guaranteed to work and the steroid injection also involved risks.

So I eventually opted for surgery, and it was carried out on Friday. The surgery went well, and i'm now back home recovering. Hopefully will go according to what the doc said: let the wound heal, then later will start physio and exercises to build up the core muscles maybe after 3 mth.

I asked what could be the likely cause, but was told it's difficult to tell. Degeneration due to age is a prime suspect, and excessive sitting is another likely reason. Sitting puts 50% more stress on the lower back, as compared to standing, apparently... So i'll need to change my habit of sitting down for long periods at work, or even at home...

Take care and have a speedy recovery.

remember to take care of the dressing.

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16 hours ago, Ender said:

Yes, that way some of the load is absorbed by the calves muscle and tendon, lesser load for the knee. But just don't do like I did, suddenly run in minimalist all the way at my usual mileage, and that's how my achilles tendon got injured.

If you are still worry for you kne, just run lower than your usual, mileage   

ok will do. Really hope to be able to start exercising to build up all the lost muscles again soon...

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16 hours ago, Credor said:

Take care and have a speedy recovery.

remember to take care of the dressing.

Thanks! Just went to GP clinic to change the dressing yest. 

and must say... the clinic nurse really not good at it, c.f. to hosp nurses... the changed dressing doesn't stick completely/well. now i shower also worry whether water will go in or not 😅

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On 4/19/2021 at 3:58 PM, Etnt said:

I did it early 40s and they put spacers to replace the disc rather spinal fusion.

Now looking back, I would say I wish that I'd done it earlier.

Btw, one year after my spinal surgery I was diagnosed with kidney cancer. The dr cannot conclusively say what caused it, but I would say the long term usage of painkillers probably played a part.

Painkiller played a part or any medication? Those people who need to take long term medication might also have risk to develop kidney cancer?

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Turbocharged

 

10 minutes ago, 13177 said:

Painkiller played a part or any medication? Those people who need to take long term medication might also have risk to develop kidney cancer?

I took nsaids for a long time, starting from simple things like ibuprofen till arcoxia; and they are not kidney friendly

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Turbocharged
9 minutes ago, Sporkypiggy said:

@Atrecord So what kind of key-hole surgery did you do?  Can elaborate a little bit more?

I think sometimes surgeon will also see actual condition in OT bah. Before going into OT, I was told keyhole; after woke up, open back.

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32 minutes ago, Etnt said:

 

I took nsaids for a long time, starting from simple things like ibuprofen till arcoxia; and they are not kidney friendly

Actually we are just taught that it may worsen kidney function. But never really thought about this RCC link.
But yes you are right.

Though i would be more worried about exacerbating renal failure rather than RCC since RCC incidence in general is not high.

https://emedicine.medscape.com/article/281340-overview#a4

Quote

A prospective evaluation by Cho et al concluded that longer duration of use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk for renal cell cancer. [

 

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@Etnt For Herniated Disc (cervical or lumbar), most public hospital tend to perform fusion surgery. Whereby they will removed the herniated disc, place a bone graft between the 2 vertebral segments to fuse them together. The surgeon will say that this is a minimally invasive surgery as the cut is about 5 to 6 cm.

Lumbar Fusion: https://www.spine-health.com/treatment/spinal-fusion/lumbar-spinal-fusion-surgery

Cervical Fusion: https://www.spine-health.com/treatment/back-surgery/cervical-spine-surgery

Some private Ortho doctor may perform a more minimally invasive or they claim key hole surgery to remove part of the herniated disc instead of removing the entire disc as in the Fusion technique.

The surgeon will usually run through the sequence with you in detail and have you sign the agreement form before proceeding with the surgery.

Do take note that it will take at least a year for the vertebral to fully fused together. So its a long journey to full recovery. The doctor will give you guidances on your daily activities.

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Turbocharged
40 minutes ago, Sporkypiggy said:

@Etnt For Herniated Disc (cervical or lumbar), most public hospital tend to perform fusion surgery. Whereby they will removed the herniated disc, place a bone graft between the 2 vertebral segments to fuse them together. The surgeon will say that this is a minimally invasive surgery as the cut is about 5 to 6 cm.

Lumbar Fusion: https://www.spine-health.com/treatment/spinal-fusion/lumbar-spinal-fusion-surgery

Cervical Fusion: https://www.spine-health.com/treatment/back-surgery/cervical-spine-surgery

Some private Ortho doctor may perform a more minimally invasive or they claim key hole surgery to remove part of the herniated disc instead of removing the entire disc as in the Fusion technique.

The surgeon will usually run through the sequence with you in detail and have you sign the agreement form before proceeding with the surgery.

Do take note that it will take at least a year for the vertebral to fully fused together. So its a long journey to full recovery. The doctor will give you guidances on your daily activities.

Mine was replaced by DIAM spacers, not fusion. Ortho said when it recur when I'm older, then fusion.

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