That’s interesting because that position is absolutely agony to me. I have to sit reclined back or else I can’t sit for very long. The Adirondack chairs are the most comfortable thing in the world for my back.
My desk chair at home is pretty upright and set at the correct ergonomic height for my desk and monitors. I had all of that walked through for me by a specialist at work.
That’s why it is hard for anyone to help with back pain. Everyone’s situation is different and it changes over time, which is really annoying because when you think that you have something figured out, it changes! I find that I do best now if I only sit, stand or walk for short periods. But when I had slipped discs, I couldn’t sit at all.
I just read earlier this week on an Ehlers danlos forum that many people find relief from pregnancy pillows. I ordered one and it got here yesterday, and so far I am finding it really helpful. Its good to prop up on the couch with, and I slept more comfortably on my back. It also prevents from stomach sleeping which Im inclined to do and that really bothers my lower back waking up. The only thing I dont love is the thing is a monstrosity, but what can ya do?
YMMV!
It is crazy how everyone has different pain triggered by different things. I’m most painful standing - like in 2 min I’m shifting my weight and want to sit or lean on something. 2nd painful is laying down. I have one position I can sleep in and I tried a pillow between my legs but it just feels too bulky. I can’t sleep on my stomach that kills the lower back. I can’t sleep or even sit with my back super flat because I have costochondritis which is just ridiculous sternum pain that will knock my breath out if I happen to roll over while sleeping and end up on my back. If I sleep on my right side then my right shoulder hurts, it has some arthritis from overuse at a desk in the past with really bad ergonomics. Soooooo the left side it is lol. I did upgrade my mattress this past year when I literally couldn’t lay down to sleep without intense lower back pain. I had to lay on a million beds and finance the thing but if I have normal back pain I can sleep mostly through the night which is awesome. Least painful is sitting in a semi reclined seat. My hubby teases me when he gets in the car and I was driving it that my side piece rapper must have driven last.
Have you been assessed for anything connective tissue related past hypermobility? A lot of what you just described hits home with my EDS. I tell people I feel like a marionette puppet. Standing still is incredibly uncomfortable for me from the shoulders down to my feet; Im much better in motion. I am a leaner/sitter/squatter…you name it. I also deal with rib issues in that they like to dislocate from thing like coughing or moving the wrong way.
That’s really interesting because I have a rib out at least every few months that my chiro has to pop back in. I have not been assessed for anything like that. The hypermobility was diagnosed by the ortho Dr who looked at my shoulder. I’m constantly knocking stuff over trying to lean or just being awkward because standing is SO uncomfortable. What type of a Dr could do that assessment?
Really interesting I just googled symptoms and I bruise super easy even when I blood test as not anemic. My dentist also says that I bleed really easily even if my gums are in decent condition. I fit a few of the other symptoms too hmmm
My PCP diagnosed me and it was further confirmed by my rheumatologist. I think I knocked at least 2 things off the counter yesterday myself…proprioception is not my strong suit needless to say.
It sounds like it would be worth following up on, you have a lot of similarities to me! And it can cause a ruckus all over your body because you have connective tissue literally everywhere.
I have a similar issue (in the L5-S1 area, at least). I have tried MBB and Facet Injections and PT and a few other things. I haven’t found a solution. One of my doctors had me read a book called Back Sense about gaslighting yourself into believing that your back pain is muscular in nature, and that you just need to relax your muscles. This did not work for me either, but you might like the book. My doctor found value in it, at least.
Sorry, can’t wade through all the responses but your MRI is all degenerative unfortunately so conservative treatment options are typically:
Weight loss
Core strength
PT
ESIs (epidural steroid injections) as you have done- repeat as needed.
Muscle relaxants prn
NSAIDs prn- Diclofanec is a very strong one but can be hard in stomach
Gabapentin can help if nerve pain is involved
You could try Lyrica or a few other off label medications for pain or even an oral steroid Medrol dose pak for flare ups
Your ortho will go over more options for you and likely recommend PT. Stenosis typically can continue to deteriorate as you age so sometimes a decompression or fusion becomes necessary.
Stretching and lengthening the vertebrae can help the compression of them so yoga is sometimes helpful if you enjoy it.
Only know this stuff from 25 yrs handling work comp claims and both my hubby and me having bad backs too. Surgery often does not even resolve back pain and it is a difficult issue to resolve and typically does not go away completely but may improve somewhat.
I’ve been told that surgery is a 50/50 proposition. 50% that it may improve; 50% that it may get worse. Some people get that awful Failed Back Surgery Syndrome where there is scar tissue post-surgery that presses on the nerves. Most doctors around here don’t recommend surgery unless there are issues of incontinence or something like “drop foot” that interferes with mobility. (Unless it is minimally invasive surgery like trimming a protruding disc.)
Yes- we see failed back syndrome quite a bit and it’s usually after multiple surgeries and injections over the course of time. Surgery is definitely indicated for herniated discs with loss of bowel and bladder control. I will say that non-work related back surgeries have a higher success rate than work related surgeries do. That’s been studied quite a bit.
Now I’m looking for suggestions. I’ve been riding in a barefoot treeless English saddle that puts me in a really nice straight position and the seat is super comfortable. In a standard English jumping saddle I tend to pitch forward to protect my back. My tb also has high withers and can be tricky to fit. With this saddle the muscle around his withers really built up. This saddle was used and the billets totally tore off and it really doesn’t look repairable. Do I get the same saddle new? Get the upgraded one with a narrower position and adjustable location of stirrup bars? Do I go western since I’m going to be trail riding?
At my worst, I didn’t ride in a jump saddle but could still ride in my dressage saddle quite comfortably. I think it is going to be a matter of trying a lot of brands/models to find something that fits the both of you quite well. If you can, try all sorts of things, but based on what you’ve said I’d lean towards something you can have a longer stirrup and more straight position. Being able to have your pelvis neutral makes a huge difference on back pain.
Personally, I love my stubben aramis GP which has a great balance for me and my horse and lets me sit comfortably.
I trail ride so like having a little extra security of a western saddle but don’t want to feel completely disconnected. I have a McCall McLite Wade saddle that I love. It puts me in a perfect dressage type position and I still have plenty of “feel” of the horse despite it being a western saddle. I also have a Black Forest Treeless trail saddle so do like treeless, but now I much prefer my Wade.
https://marystack.com/mccall-mclite-wade-saddle-breast-collar/
Also some people are worried about getting a western saddle on their taller horse - there are some tips/tricks to do it easily. I don’t hold my saddle quite like he does, but I use a similar principle. 
Putting on a western saddle with ease
TL:DR
I have retrolisthesis of L5/S1. I have been classified Grade V for para, yay, a silver lining.
I swear by pilates, and riding in a WOW saddle.
Before you try dry needling, I highly recommend going to an acupuncturist. They have masters and doctorate degrees that are 2800+ hours of education. They can dry needle but that’s like only one breed of horse when there are hundreds. One tool in the toolbox. Pts only get 200 hours of training tops. Some less, and it’s not unusual for it to not only hurt but they can cause a nemothorax. If it hurts they’re doing it wrong.
LBP is probably the #1 issue acupuncturists treat. Probably chirps too count to think of it.
Very helpful suggestions. For right now really because of cost and because I know it works I ordered the saddle I was already riding except now it’ll be new. It’s treeless which he seems to like and it’s very padded and squishy for me. At the horse expo I went to on Sat I also bought a merino sheepskin seat cover to see if that helps add some squishyness too.
My chiro looked at the results confirmed pretty much what I had googled and we talked about long term options. He also supports PT/strengthening. He said the more chiro the better because it’ll keep me from getting locked up. Making sure my work seat and most places I sit are soft because hard will be more pressure on that disk. He did some slightly different adjustments that really actually helped. He said I should consider surgery as my last possible option.
I also met with the ortho Dr who is really kinda useless my friend is going to get me the name of the guy she went too who she really liked. He pulled up the images and talked me though it. There’s a clear bulge right in the center of that disc. It’s also basically black which shows no fluid but the disc height is good. He was pretty much like you can try another injection or do a nerve study and see a surgeon and see what they say. I had to bring up PT which he agreed too and wrote me an order for. I am going to do the injection just to see if knocking down the inflammation right before PT helps but this time I get pre-meds instead of doing it with absolutely nothing. I also know I have to take a few days off work. I asked about pain meds and he prescribed flexeril a muscle relaxer to help.
I’m going to do my best to try all other options before thinking about surgery. I’ve also done a nerve study before and this pain would have to be 2-3x as bad to get me to voluntarily walk into an office to do that test.
I’ll def look for an acupuncturist which I think I should be able to get some of covered by insurance. I’m not great with needles so starting with someone who is very trained should be my first step.
If you for a second think you may have a connective tissue disease, approach chiros with EXTREME caution and full transparency. My PT, even for properly connected people, recommends no neck adjustments if you are going to go.
Before I was diagnosed with EDS, I was seeing a chiro and it did no long term good for me, and occasionally hurt me pretty bad for days after.
Understood but I’ve been seeing this chiro for 10+ years and he’s literally the only reason I can walk around right now. Without him unlocking my hips and my back I am almost completely non-functional. I used to be able to just see him once a month. Right now it’s twice a month and honestly more often would be better but he’s $77 a pop, no insurance and 50 minutes from my house. It’s drop table adjustments not normal large huge adjustments.
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