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Suggest Treatment For Severe Lower Back Pain
Question: I'm 29 and have been a distance runner. The first time my lower back pain was rather excruciating when it hit me was this January 2015; and it was not while running; but it was after I was riding my motorcycle. The Standard Chartered full marathon was due on 20th Jan; two weeks later. I then took painkillers and much needed rest and it got slightly better and ran the marathon comfortably with a little pain hitting me only post the 35 kms mark; but I ran through it not running at normal pace though. The pain disappeared in a couple of days. I then started riding again after a few days; but the pain resumed again every time I went riding. I also resumed running a month later; I could comfortably run 2-4 kms but after that pain would resume and make it uncomfortable. Also my lower back would pain a lot when I was seated for long working hrs or after a hard days work; while riding a motorcycle it would be bearable but still quite annoying. The pain was of the inflammable kind. I didn't visit a doc until very recently when I had a rather minor fall at my local rly station. I fell on my buttocks not very seriously. The pain continued as normal and kept playing on my mind. Fearing that the fall wouldn't have done damage I went to an orthopedic with my xrays.
The doc diagnosed a small compression fracture on the d12/t 12 zone but said its very minor and pain didn't subside. The pain however is just over my tail bone and not where the fracture is shown. He asked me to come back after a week with vitamin d3 and b12 tests. D3 read 23m/g and B12 read 267. Hence he found deficiency; and has prescribed a vitamin d dosage of 60000 iu per week and another tablet with calcium 250 mg and 100 iu of d3 once everyday for 4 months.
The doc mentions only if pain continues after a couple of months should I get a MRI scan done.
Question: 1. I just started a cafe a couple of months ago which is 28 kms away from home with lot of hectic work everyday and the train remains the only mean to travel . The pain would get excruciating every night I reach home. Should I take rest to let it heal up and build on vitamin d3 for a few months or to continue work with this pain. Note that the cafe needs my services dearly although my partner thankfully manages it for me.
Question 2: should I get an MRI scan done right away to know more or wait like the doc suggested. Do u think the pain is only due to the lack of vitamin d3. I also hear a creeking sound just over the tailbone on my lower back right where the pain is when I kind of stretch it a little.
Your advice will be helpful
Cheers!!!
The doc diagnosed a small compression fracture on the d12/t 12 zone but said its very minor and pain didn't subside. The pain however is just over my tail bone and not where the fracture is shown. He asked me to come back after a week with vitamin d3 and b12 tests. D3 read 23m/g and B12 read 267. Hence he found deficiency; and has prescribed a vitamin d dosage of 60000 iu per week and another tablet with calcium 250 mg and 100 iu of d3 once everyday for 4 months.
The doc mentions only if pain continues after a couple of months should I get a MRI scan done.
Question: 1. I just started a cafe a couple of months ago which is 28 kms away from home with lot of hectic work everyday and the train remains the only mean to travel . The pain would get excruciating every night I reach home. Should I take rest to let it heal up and build on vitamin d3 for a few months or to continue work with this pain. Note that the cafe needs my services dearly although my partner thankfully manages it for me.
Question 2: should I get an MRI scan done right away to know more or wait like the doc suggested. Do u think the pain is only due to the lack of vitamin d3. I also hear a creeking sound just over the tailbone on my lower back right where the pain is when I kind of stretch it a little.
Your advice will be helpful
Cheers!!!
Brief Answer:
Pain is due to coccydynia.
Detailed Answer:
Hello,
Thanks for posting your query.
The pain in your tailbone is not related to the fracture of T12. These symptoms are suggestive of coccydynia caused by inflammation of the coccyx bone. The symptoms are generally worse when sitting for prolonged periods of time, or with direct pressure to the tailbone area.
Follow these measures for relief from the symptoms:
1) Avoid sitting down for long periods of time. When seated, do not sit on hard surfaces and do alternate sitting on each side of the buttocks. Also, lean forward and direct your weight away from the tailbone.
2) Take adequate rest and apply cold compresses, avoid re-injury to the affected area and take some antiinflammatory and pain medications like ibuprofen(motrin) or diclofenac. Some severe cases with persistent coccydynia are treated with local cortisone injection and surgical resection of the coccyx.
3) You can also use a "doughnut" cushion or pillow to sit on. This cushion has a hole in the middle of it to prevent the tailbone from contacting the flat surface.
4) Also eat a high fiber diet foods to soften stools and avoid constipation.
If the pain is unbearable even after taking the pain killers then it is better to take a week off your work to have adequate rest.
Regarding MRI scan- In case the pain is mild and bearable rthen you can avoid an MRI scan for now. Let the fracture heal in 4-6 weeks and then get an MRI done in case the pain is persistent.
Low levels of Vitamin D3 will delay the healing. So, continue with the supplements as suggested by your doctor.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Pain is due to coccydynia.
Detailed Answer:
Hello,
Thanks for posting your query.
The pain in your tailbone is not related to the fracture of T12. These symptoms are suggestive of coccydynia caused by inflammation of the coccyx bone. The symptoms are generally worse when sitting for prolonged periods of time, or with direct pressure to the tailbone area.
Follow these measures for relief from the symptoms:
1) Avoid sitting down for long periods of time. When seated, do not sit on hard surfaces and do alternate sitting on each side of the buttocks. Also, lean forward and direct your weight away from the tailbone.
2) Take adequate rest and apply cold compresses, avoid re-injury to the affected area and take some antiinflammatory and pain medications like ibuprofen(motrin) or diclofenac. Some severe cases with persistent coccydynia are treated with local cortisone injection and surgical resection of the coccyx.
3) You can also use a "doughnut" cushion or pillow to sit on. This cushion has a hole in the middle of it to prevent the tailbone from contacting the flat surface.
4) Also eat a high fiber diet foods to soften stools and avoid constipation.
If the pain is unbearable even after taking the pain killers then it is better to take a week off your work to have adequate rest.
Regarding MRI scan- In case the pain is mild and bearable rthen you can avoid an MRI scan for now. Let the fracture heal in 4-6 weeks and then get an MRI done in case the pain is persistent.
Low levels of Vitamin D3 will delay the healing. So, continue with the supplements as suggested by your doctor.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you doctor glad you could diagnose the reason of the pain. Is this a cause of concern since I always had these symptoms in the past 5-6 months sometimes while running or while riding a motorcycle and it hasn't healed; but came to light after the fall. Even now after the fall its been 3 weeks and have been only resting but no signs of improvement; pain is usually constant in most positions. While working it pains a lot due to long hours of standing at my cafe and constant bends forward. Should I avoid such work and take rest until it heals. Also what's the best position to be in during the recovery standing or lying down.
Your advice will be appreciated.
Regards
XXXX
Your advice will be appreciated.
Regards
XXXX
Brief Answer:
Rest can heal the inflammation.
Detailed Answer:
Hello.
Thanks for writing again.
Rest of 1-2 weeks in resting/ lying down position will help in healing. In case the pain is still persistent then local steroid injections under the guidance of an orthopedician can help. Do take oral anti inflammatory medicines till then.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Rest can heal the inflammation.
Detailed Answer:
Hello.
Thanks for writing again.
Rest of 1-2 weeks in resting/ lying down position will help in healing. In case the pain is still persistent then local steroid injections under the guidance of an orthopedician can help. Do take oral anti inflammatory medicines till then.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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