Lower Back help needed

[AndyK5]

It is very nice to see a doctor that truly cares. I mean I know most doctors do care, but what you are doing right now is going above and beyond and I thank you for that.

[Jonathan Wylie]

This thread has SKETCHY wrote all over it!

[Jonathan Wylie]

Quick, a mod might want to throw up some kind of disclaimer here!

[DCdoctr]

This thread has SKETCHY wrote all over it!

I'm not following you. Please extrapolate. If it's my credentials you question I'd be happy to provide state licensure numbers, which by law I have to make observable in my clinic. Secondly, you can take these numbers and verify them on said state board websites. Thirdly, don't be so toxic. Surely you have better use of your time than to post glib replies to someone's thread who is seeking advice.

[DCdoctr]

It's no problem at all. I'll contact my Alma mater's clinic capstone this week and see who is in your area. I'm sure there are a lot to choose from in L.A. The trick is finding someone who knows there stuff and is willing to help. Also, if you end up not wanting to go this route then there are other options.

It is very nice to see a doctor that truly cares. I mean I know most doctors do care, but what you are doing right now is going above and beyond and I thank you for that.

[Pete Daly]

Well Andy I would take the doc's advice with a grain of salt. There's no way he can tell if there is a chronic injury from inferring such from long term back pain without a physical examination. He does not know your range or motion, and long term back pain =/= chronic muscle / joint problem necessarily (it could well be something to do with your vertibrae, spine, etc.). And no doctor in their right mind would prescribe any sort of heat treatment if he/she thinks a sprain or tear is involved. Ice is for swelling, and if you're constantly irritating your lower back, then it will almost definitely swell. NO HEAT! While you probably do have some sort of strain or pull, that does not necessarily make it severe. Louis Ho had a very bad problem, and it was clear from what he posted that it was indeed bad. It sure doesn't sound like you're prohibited from exorcise too much. In fact, it just sounds like a little tweak. If you have always had some back pain, then THAT is something a chiropractor can help with, but that is not necessarily related to your current injury (as this "doctor" seems to think). I happen to think that it is NOT a major injury, from what you've posted. I would start with rest ice and elevation. Ice as much as you can, lay down with an ice pack and a couple pillows under your back as often as you can. If that does not help after 3 or 4 days, go see a real doctor.

BTW I really am a registered nurse for the Mayo Clinic in Rochester, Minnesota.
http://www.mayoclinic.org/saintmaryshospital/ <-- Here is where I work.

[AJ Camacho]

Listen to Pete. I'm not qualified but my sarcasm alarm went off on DCdoctr and his 5 posts.

[DCdoctr]

Well Andy I would take the doc's advice with a grain of salt. There's no way he can tell if there is a chronic injury from inferring such from long term back pain without a physical examination. He does not know your range or motion, and long term back pain =/= chronic muscle / joint problem necessarily (it could well be something to do with your vertibrae, spine, etc.).

The most important step in diagnosis is the case history. It's obvious that this gentleman has a global range of motion issue/hypomobility. What do you think that a soft tissue injury doesn't affect the joint?

And no doctor in their right mind would prescribe any sort of heat treatment if he/she thinks a sprain or tear is involved. Ice is for swelling, and if you're constantly irritating your lower back, then it will almost definitely swell. NO HEAT!

Incorrect. Cryotherapy is only useful in the chief complete that is in its acute phase. Two weeks has passed. You really think he should utilize ice? If he was suffering from a tear the history would be different than his current presentation.

In fact, it just sounds like a little tweak.

Tweak? Ugh.

If you have always had some back pain, then THAT is something a chiropractor can help with, but that is not necessarily related to your current injury (as this "doctor" seems to think).

It most definitely could be related. Old injuries are usually the etiology for future injuries.

I happen to think that it is NOT a major injury, from what you've posted. I would start with rest ice and elevation. Ice as much as you can, lay down with an ice pack and a couple pillows under your back as often as you can. If that does not help after 3 or 4 days, go see a real doctor.

Not to be redundant but this is not how to properly treat a skeletal-muscular injury in this current non-acute state. The ice would've been great the day of the injury on in to the following week.

BTW I really am a registered nurse for the Mayo Clinic in Rochester, Minnesota.
http://www.mayoclinic.org/saintmaryshospital/ <-- Here is where I work.

I have the utmost respect for R.N.'s. My mother served under that title for over thirty years. However, her education was not comparable to the 4 years of biology: pre-med and an additional 4 years of college to receive my doctorate.

Please don't misconstrue my intentions here. I'm not looking to get into the proverbial pissing contest here. I see between 30-40 patients/day many with these same complaints. I'm not guessing or shooting in the dark, but am taking the data given and formulating a working diagnosis sans examination. I'm not trying to be Superman here, but rather help someone that can't afford to go and blow $1200 on imaging and another $1-$3000 receiving treatment.

[DCdoctr]

Listen to Pete. I'm not qualified but my sarcasm alarm went off on DCdoctr and his 5 posts.

I too was concerned about what that would look like. I'm a long time lurker and after reading this thread I felt compelled to finally sign-up. Like I said, I don't want to be thought of as a deceitful person here. Skepticism is normal and healthy when viewing outsiders, but if you guys believe me to be a fraud then I can hyperlink the 2 state board website that lists where I'm listed as a full-time and active practitioner. Also if that's not enough you can contact the state board of examiners and link my name, work address, and work number. After that you can call me and thus ease this state paranoia.

[Pete Daly]

The most important step in diagnosis is the case history. It's obvious that this gentleman has a global range of motion issue/hypomobility. What do you think that a soft tissue injury doesn't affect the joint?

How is that obvious? And of course soft tissue affects the joint, but there's no way you can know if it is indeed a soft tissue injury without physical examination. You need to feel "where the muscles insert into the bone they become tendons and thus where the sprain is." There's simply no way you can know that without physical examination. If you think this "If I sit and pull my knees to my chest a thin flat horizontal strech of area that is about 12 inches higher than my butt crack hurts." will suffice as positive identification to injury location, you are completely lost.

Incorrect. Cryotherapy is only useful in the chief complete that is in its acute phase. Two weeks has passed. You really think he should utilize ice? If he was suffering from a tear the history would be different than his current presentation.

That's not even true. Ice helps swelling regardless of phase, so yes, I think he should continue to ice and elevate his back.

If you don't know what you're talking about, then you should NOT be giving someone advice