Monday, December 13, 2010

My back injury

I'm not really sure I should refer to my current condition as an injury. There was no incident of injury, but it hurts really badly, and it's different from any previous back pain I've suffered through. Usually when my back hurts it's because I strained it somehow, and the muscles in the lower back are in spasm. A lot of rest usually has me all fixed up, but this has been entirely different. The pain is localized primarily in the back of my hip around my sacroiliac joint, and it occasionally shoots down my leg. I've decided to document my experience here in the event that knowing something of my experience may be of some help to someone else.

Week 1: A sharp pain around my sacroiliac joint had been pestering me on and off for a few weeks. It bothered me mostly when I was running laps at the start of my taekwondo classes. It was only occasionally annoying, so I just ignored it, hoping it would go away. By 10/14/2010, I decided that it wasn't going to go away without help. Assuming that I had pulled a muscle, I asked my taekwondo instructor for a stretch that might help. I took a week off taekwondo.

Week 2: A week of rest didn't help, so I made an appointment to see my primary care physician on 10/19/2010. She prescribed some anti-inflammatory medication, some muscle relaxants and an x-ray.

Week 3: The x-ray came back inconclusive, so my primary care physician ordered an MRI. The anti-inflammatory medication worked great, but the prescribed dosage diminished each day, and the pain came back, so my physician refilled it. I actually competed in a tournament 10/30/2010. I took first in sparring.

Week 4: The MRI was a horrible experience. I had to stay very still in a very uncomfortable position for what seemed like a very long time. I guess it was loud and crowded, too, but I didn't notice. The results came back for a bulging disc, so my physician referred me to a specialist. The specialist turned out to be a surgeon, and he couldn't see me for three weeks, so I went back to my physician. She refilled my prescription for anti-inflammatory mediation and she referred me for some physical therapy.

Week 5: I had my first physical therapy session 11/08/2010. It was pretty intense. The therapist was attempting to determine the nature and extent of my condition, so she ran me through a thorough series of tests which were exhausting and rather painful, but in the end she determined that my bulging disc was not the source of my pain. Instead she determined that the source of my pain was some tension in the nerve running down my leg and some instability in my core causing certain muscles to do jobs they were not really designed for.

Week 6: I had two more physical therapy sessions. In the first (11/15/2010) she tried to bring more mobility to my joints. In the second (1/17/2010) she tried to help me build up some strength in my core. She taped my sacroiliac (SI) joint which helped a lot. It was great.

Week 7: At my physical therapy session, I received an SI belt (11/23/2010) which did very much the same job as the tape. I was also counseled against doing any jumping in my taekwondo classes. I was told that jumping created too much compression on my spine, and I just needed to lay off a bit. I actually decided not to go to any classes this week. I was in too much pain, besides the school was closed for the Thanksgiving holiday.

I also saw the surgeon this week (11/24/2010). It was mostly a very disappointing experience. He did not seem to consider the possibility that the bulging disc was not the source of my pain. He mentioned physical therapy as a course of treatment only once but not seriously. He really gave me three treatment options: (1) do nothing, it might get better on its own, (2) receive a cortisone shot to deal with the pain while it gets better on its own or (3) let the surgeon trim off the bit of the disc that is bulging. I told him that I wanted to go with the least invasive treatment first, and he agreed that was reasonable. He said he would call me in 30 days to see if I wanted the cortisone shot.

Week 8: I had two more physical therapy sessions this week in which my therapist discovered a lack of mobility in my knee which was effectively making one leg shorter than the other - not good for core stability.

Week 9: I arrived on Monday (12/06/2010) morning a little late and too sore to do very much real work. I was really worried about being able to perform at all during my belt test that evening, but my therapist was able to straighten me out and get me moving smoothly again. I was able to perform very well during my belt test, but I decided that I would take at least two weeks off to focus on my therapy. Later this week I fell which created an upslip in my hip, but my therapist was able to correct this as well.

Week 10: After a full week off taekwondo (and no falls),I arrived for my session much less sore, and we were able to do more work. My therapist discovered that my pain had localized over just one vertebra, my SI joint and my knee. This was a sign of good progress. I also asked if she though I might be able to enter a tournament in February, and she said yes. I'm very excited about that - 54 days away.

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