Good Ol Back Pain - updated imaging 5/23/24

[stargzng386]

I’m mainly posting this just to try and hold myself accountable. I’ve had chronic back pain since I had a bad fall off a horse about 20ish years ago. It’s been mostly maintained by regular chiro work and something I can work around. I was finally getting back into the swing of riding regularly a few years ago and for some reason the past year my back pain has just been uncontrollable. It’s 100% all of the time, I can’t sleep, I can’t really ride at any speed above a walk and I’m struggling with daily home farm tasks as well. My mental health has suffered from it too. I tried an epidural inection last summer which only lasted 3 months and I’m hesitant to do that again. I needed to wait for a switch in health insurance and finally got an MRI done last night and already have the results. I’ll have to meet with my Dr in a few weeks to go over options and with the new health insurance have significantly more coverage and can pursue more avenues of treatment.

I did a lot of googling last night. I’m guessing he’s going to try and push another injection, I’m also thinking hitting PT hard might help. At this point I’d need chiro weekly for any sort of relief from that. I already decided to move my horse where I can trail ride more and honestly that’s probably going to be my riding career moving forward. Cantering is fine if I’m in a little half seat. Trotting in any way shape or form is excruciating and the days of pain after isn’t worth it.

Anyone else have similar results/problems? Any suggestions on what might help?

[Eclectic_Horseman]

Gabapentin (neurontin) is a medication that helps quite a bit for nerve pain. If epidural injections help, there is really no downside to doing them on a regular basis.

If you need to lose weight, do it. If your core muscles are not as strong as they can be, then fix that.

Gravity is not your friend. So anything that you can do to keep some of your weight off your spine helps.

It is my understanding that there is no “fix” for spinal arthritis and stenosis. But you can manage the pain.

[cayuse]

I have moderate to severe facet arthritis in all my lumbar spine. Trigger point injections help with associated muscle spasms and I’ve had SI steroid injections. Right now I’m going through testing to have nerve ablation. Like Eclectic Horseman said, there is no “fix” just management. I’m sorry you are facing this, I can relate. It sucks.
ETA: I take Tizanidine for the pain. it’s a muscle relaxant that also works on nerve pain. It helps some and the side effects are minimal.

[cayuse]

If you can, find a good Pain Management Doctor and get a consult. It’s good to get established with one so that you can be seen if you have an acute flare up.

[stargzng386]

My ortho is supposed to be a non surgical pain management Dr but I’m not getting anything from there or talking about pain meds etc. He also just doesn’t want to talk and jets out after 5 min. I’m definitely going to look for a new Dr I just went back to get the imaging without needing multiple more appointments. It’s hard because I have a high tolerance for pain and appear totally normal and can talk about it all very rationally. What they don’t get to see are the tears when I lay down to sleep and can’t because it hurts so bad. Or the total meltdown because I did something small/stupid that tweaked it bad.

Even my chiro was just going along like normal and I went in one time midday because I couldn’t take it and burst into tears and just couldn’t stop crying. He took me much more seriously then and has been helping a lot more but do I have to cry to prove it hurts? Because if I’m crying I can bet the average person would be on the floor. I’ve broken bones without shedding a tear.

What causes the absolute most pain is anything in a twisting motion. like if I could just wear a brace keeping me from twisting ever again I’d be fine just fine

[stargzng386]

I still haven’t quite figured out quoting text.

I 100% need to lose weight - emotional eating because I hurt is not helping
I 100% have a very weak core right now, again pain got so bad I wasn’t pushing through it. I’m not great at doing exercises on my own. I’m thinking PT first and then transferring to a gym and personal training.

I also have hypermobile joints so yoga is out, pilates most likely too. I have to be very careful about how I build my muscle without over flexing my joints.

[stargzng386]

I passed out during the epidural injection, granted I had zero pre-medication. I also got pretty much all of the steroid side effects and couldn’t work or do anything for a few days. If it worked for 6months+ I’d consider it again but at only 3 months and then coming back more painful after I’m just hesitant.

[Eclectic_Horseman]

@stargzng386

I have to be very careful about how I build my muscle without over flexing my joints.

A good PT should be able to help you with that!

ETA: To quote text, open a reply window by clicking reply, then go back up to the text that you want to quote, use your cursor to highlight (or “select,” if you use that terminology) and a little icon will appear that says “quote.” If you click that icon, the selected text will magically appear in your reply window.
At least that’s how I do it. I figured it out by trial and error, so it may not be the “correct” way!

[Eclectic_Horseman]

@stargzng386

I passed out during the epidural injection, granted I had zero pre-medication. I also got pretty much all of the steroid side effects and couldn’t work or do anything for a few days. If it worked for 6months+ I’d consider it again but at only 3 months and then coming back more painful after I’m just hesitant.

I hear you. But you really have to weigh the more long term pain relief against the short term discomfort. Only you know if it is worth it. When my back is at its worst I will do anything that might help. But everyone is different, and maybe you can find enough relief in other ways.

[stargzng386]

Yea it didn’t really take the pain away enough where I felt it was worth it. I still had massive mid and upper back pain. It felt like it really only helped the pain 25%. We’ll see I may change my mind. Or if they have some meds to make it less miserable that might help.

[Eclectic_Horseman]

@stargzng386

Or if they have some meds to make it less miserable that might help.

Yes. Ask them about gabapentin!

[FjordBCRF]

@stargzng386

I 100% need to lose weight - emotional eating because I hurt is not helping
I 100% have a very weak core right now, again pain got so bad I wasn’t pushing through it. I’m not great at doing exercises on my own. I’m thinking PT first and then transferring to a gym and personal training.

I also have hypermobile joints so yoga is out, pilates most likely too. I have to be very careful about how I build my muscle without over flexing my joints.

Among other things, I have hypermobile Ehlers Danlos Syndrome and multilevel disc degeneration disease in my cervical/thoracic spine. HARD no on the Chiro for me. BIG yes on PT. The number 1 best thing you can do for hypermobiilty is weight training and pilates is great for building up the core while protecting the back. I also do restorative yoga almost daily. If something doesn’t seem like a good move or doesn’t feel right, I modify with something else. I thought Id have to give up yoga…that was actually the catalyst that got me diagnosed with the EDS, but I just had to approach it a little differently.

Staying at your ideal weight also can make a huge difference in any kind of joint pain if you’re hyper mobile as well.

I would absolutely recommend seeing a PT very familiar with hyper mobility and going from there.

Editing to add, I just did this pilates workout this morning…you may have to have the subscription for this one thought https://fwfg.com/programs/flexion-free-core I’m def going to see this one in regular rotation, very similar to what my PT recommends to do regularly.

[stargzng386]

Thanks for the suggestions!

I can’t do standard regular chiro at all but I can do chiro using a drop table. Sections of the table drop just a few inches and they do hundreds of little adjustments versus one big adjustment. That was really life changing when I first found it about 10 years ago.

[FjordBCRF]

One of the big issues I have with Chiro in general for people and horses, is that if you also aren’t doing PT type work, you at best maybe get some short term relief. It doesn’t always address the underlying issues and if that is something like muscle weakness, you have to spend the time strengthening the muscles too. I spent a lot of time with a chiro before I was diagnosed and it didnt do anything to help in the long term. Anecdotal of course.

[cayuse]

I have and am walking in your shoes. I could write everything you have written. I don’t want to be negative, but getting pain medicine is going to be a very difficult thing. I’m not saying this to be a downer, I’m saying it so you know it is NOT you, it is the system and they way they are dealing with the opioid crisis, and it is not fair to chronic pain sufferers. You are going to have to have everything documented with tests and persevere. My rheumatologist told me she does not take patients on opioids and if I get to that point she will “fire me”. Her words, no negotiating.
Keep looking for a pain specialist and hang in there. Keep posting of your progress. We need a chronic pain thread here, lot’s of us have it and throwing horses into the mix is something most people don’t “get”. Horses are our solace but not our bodies friend.

[stargzng386]

I wonder if my regular Dr would be willing to look into any pain options. Mainly because she’s been my Dr for 15 years and has record of my back pain going that far back. I also don’t want to take any opiods but something that could help my nerve pain or a once in awhile muscle relaxer would be nice.

[stargzng386]

I definitely think the horse aspect is a really rough one mentally. I had 3 horses not hold up with soundness issues. During those years I wasn’t riding super regularly think more rehab riding 3-4x a week mostly w/t nothing strenuous with long breaks of no riding. I retired my youngster a few years ago and with my limited funds bought and OTTB. Walking he’s fantastic, trails he’s fantastic. Even if he throws a major spook or bolt it’s super easy to sit and stay on and he stops 3 seconds later like omg so sorry. His trot is like a washing machine, his canter is very smooth but once he has trotted or cantered game over that’s all he wants to do. We worked past it with 6x a week riding in the beginning. He does also want to lean into the bit which of course is agony on my back.

I’ve been mostly walking the past few months and recently decided to move him no matter what the results showed to be somewhere less expensive, with trails. But now going through my head is is this the right horse for me? Do I even want to keep riding? Is the expense worth it? idk just a lot of conflicting thoughts. I spent thousand and thousands of dollars into broken horses and finally have a sound one…that I can’t freaking ride. I also 5 years ago purchased the dream farmette property. We have a pony and goats and a huge garden. And all of the maintenance kills my back. So again wtf. Work my entire life to have my dream and it goes up in poof smoke because physically it’s killing me.

[FjordBCRF]

Have you tried marijuana in any capacity? In addition to it relieving my chronic fatigue, I have also found certain strains/terps to help with pain. I was dealing with some pretty severe GI issues last week and the THC/CBN combo really helped with that. As someone who is in some degree of pain every day, I find that it generally makes things more bearable while I am still able to fully function.

[FjordBCRF]

@stargzng386

But now going through my head is is this the right horse for me? Do I even want to keep riding? Is the expense worth it? idk just a lot of conflicting thoughts. I spent thousand and thousands of dollars into broken horses and finally have a sound one…that I can’t freaking ride.

On horses specifically, if they are something that gets you up and moving every day…don’t walk away from that easily as it will only cause you to be more sedentary. I truly believe that a good part of the bond I have with my guy is BECAUSE I’m a health mess. Some days I can’t ride. Sometimes those days turn to weeks or more. When I can’t ride, I do groundwork if I can. If I can’t do groundwork, I groom and give him extra “spa time” and/or I set a stool in his stall and hang out. If Im out for more than a week, I have a young friend that is always thankful for more saddle time so she keeps him going for me. Even on those days that Im bummed I can’t ride, I still feel better leaving the barn than when I got there. If I can muster getting on, I have gotten a really long ways with work at the walk/lateral movements/neck rope riding. There is no question to me about the therapeutic nature of our equine friends.

[stargzng386]

I haven’t and I’m totally open to try. Do you have any recommendations?