Chronic Lower Back Pain - Can you help? Male, 33 years old

Hi,

I've had chronic low back pain for about 5 years now and it's got steadily worse. I've written a lot of detail here - but i'm just interested in how you think I should progress in treating my lower back pain - as i've seen a few physios now and nothings really helping and I don't really know what the cause of my backpain is or how to get it diagnosed or treated!! (at a bit of a loss!!)

History:

I'm Male, 33 and i'm pretty good shape (ran london marathon last year). I cant think of any incident five years ago that caused this - there was no trauma or accident - it just came on gradually about 5 years ago. I play a lot of sports / football / badminton / tennis so expect wear and tear from these sports has caused this to worsen slowly over time.

I started playing badminton about 2 years ago which made my low back pain noticeably worse - i presume because of the bouncing compression on the spine from the game. About a year ago I played a match when my back was already bad - the next day I couldn't bend my back at all. It took a few days to recover however since that day it has been noticeably worse.

Pain has now also spread to front of my pelvis.

Symptoms:

• Sharp chronic pain in low back, buttocks and more recently front of pelvis (pelvis in last 3 months). Does not radiate down in to legs. Pain is constantly there for the last 3 years - some days are better / some days are worse.

• I don't have any pain when in any position statically (e.g. sitting / lying down in any position for any length of time is fine) It's just during the movement from one position to another where the sharp pains occur - during movement or hips/low back)

• Pain hard to describe - its not localized - feels sharp and running through core of my body making me feel unstable.

-Pain not really worse in morning or evening - it's fairly consistent throughout the day.

• Sneezing causes a sharp pain and feeling my back is going to give way - I bend forwards and curve my lower back when sneezing which takes the pressure off and lets me sneeze without feeling i'm going to damage something

• I have 24/7 muscle twitching in both of my leg and feet muscles. They will twitch every 10 seconds and have been doing so for the last 6 months possibly longer. No pain, muscle weakness or cramping - just small twitches.

• Daily functional movements are now impacted. Anything which involves bending (e.g. picking up things, putting on socks) and I am having to support myself using my hands etc on a wall

• My movement in badminton now impacted also - can't move backwards or forwards properly. I have stopped playing badminton about 3 months ago now though in an effort to try and heal my back.

• My leg muscles have always been and still now seem very tight.

• There's no pain in my back caused by pressing it in specific locations - its just through movement.

Pain Triggers:

• Any activities which involve bending forwards from a straight potion (just 5 degrees) is very painful for me.

• Twisting/rotating at the hips also seems to be painful

• Putting on shorts/socks (especially right side) - tying shoe laces - gardening etc

• Noticeably worse day after playing badminton

-lying on my front for about 10 minutes will cause me very significant pain when I then go to get up and try to straighten myself in to an upright position. This is one of the worse things I can do.

• doing any weight loading on my back (e.g. deadlift) seems like it would cause a lot of damage.

Treatment so far

• I've seen a few physios over the year all of which have told me they suspect a slight disc issue. They've generally told me to strengthen my core muscles - which ive been trying to do with planks etc. One physio diagnosed me with non specific low back pain. I've also seen family GP who was useless.

• Hip flexor stretches recommended

Paid private for an Xray - nothing unusual in Xray. Showed a good amount of space between my discs however my L5 S1 vertebrae was slightly less space than the others. However, from what I've read - I don't think an xray can reliably diagnose any issues.

• Doctors have refused an MRI saying it wouldn't change treatment plan.

What seems to help

• hugging legs in to body provides relief

• massaging buttocks feels nice

• Generally feels nice to have my legs pulled and spine decompressed

• bending deeply in to a stretch (to touch my toes) feels nice stretch along lower back

• potentially running

Where I am now

I've stopped all sport apart from running for the past 3 months.

My back pain is constantly there and generally getting worse and its frustrating not to have a specific diagnosis or understanding of the cause of it or what I can do to help it. I'm concerned about the pain when sneezing and also the 24/7 twitching as these seem to imply that nerves are being affected despite the pain not radiating down to my legs...yet

Some days my back seems much better for a few days - then randomly will get really bad again.

I feel like many medically professionals don't know how to treat or diagnose low back pain properly and I'm clueless where to turn to get a proper testing and diagnosis.

I'm not sure whether I should be considering surgery already before it gets even worse?

**Can you help me 😃 **

Any advice, diagnosis, exercise tips, treatment plans you can suggest would be very welcome. Or if someone who has had similar to the above can explain how they treated this that would also be useful.

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