Lower right back pain

Hi Dr,

I'm not sure whether this is the right place to post this qns. But in the free section i can't get any luck on a response so i decided to try my luck here instead.

First on my background, I started this job early jan this year. My work relates alot on heavy lifting. One of the lifting requires me to hold on to a end of the long metal object(close to 300kg) and lift to up and down (in a bending position for a min continuously) which is very strenuous to my lower back.

First few attempt was alright. The pain only comes after lifting for a bit (abt 30sec). But ever since Late March, whenever i tried to bend down and lift the object up, i felt a sharp and intense pain on my lower right back. I rested for 4 months (apr - now(27th July)) without any heavy lifting, and last week when i tired to move my furniture, i stil felt the intense pain on my lower right back the moment i bend down and lift my bed up.

Besides experiencing pain during heavy lifting, ever since March, i noticed that occasionally(not everytim) when i sneeze my lower right back will feel the pain. Most of the time is when I'm lying on my bed sneezing and sometimes when i'm standing, I will feel the pain. On bad days(Not every time though), i will feel pain shooting down to my leg whn i sneezed.

I had a X-ray today and the doctor says my back is fine and suggested me to go for a MRI scan. Due to the cost of MRI scan, i am abit reluctant to go for it unless there is a problem with my back.

I read the symptoms for Herniated Disc online. It says i will feel numbness on my back. But i don't feel any numbness at all. Pain there is, numbness nope. So Dr what do you think could be the reason for my back? I know most likely you would advise me on the MRI scan as well, but based of the facts i gave you above, what do you think could be my problem?

Your Help would be greatly appreciated!

Thanks,
Xavier

[Abhijeet Ghosh]

Hi Friend,
Since the X-Ray is perfect, this means there is no issue with the bones. Then what can be the cause? well the structures which are not visible on the X-Ray are the cause. They can be visualized by the MRI. Hence you need to get the MRI done. What you are saying is correct regarding the disc. Disc herniation are of many types and each has different type of presentation. You are having classical symptoms of the disc prolapse. But MRI will hep the treating surgeon to visualize the type of surgery required(Disectomy or Laminectomy) as well as help in decide the level involved ie whether its a single level disc or multiple level involvement.
If cost factor is a major issue, then i would suggest you to continue the rest, till the pain is almost nill and then approach a good physiotherapist who can suggest you some spinal muscle strengthening exercises and which would help your back muscles, to cope up with the disc issue.
However if the physiotherapy is causing discomfort, then immediately stop that. The purpose of physiotherapy is just to buy out some time, before surgery becomes mandatory.
I hope it clarifies the issues.
Regards

[xavtt]

to add on, i dont feel pain when i bend forward. but i feel pain when bend forward and lift heavy object.
i also feel at lower right back when bending backwards.
im a 20yr old male, underweight.

[xavtt]

Hi Dr Abhijeet V,

thanks for your reply! I went for the MRI scan the following in the result,

At L3/L4 and L4/L5 levels, posterior disc bulges indent the thecal sac within mild central and moderate lateral canal stenosis. Bilateral mild exit foraminal stenosis is seen.

There is no significant disc herniation. No neutral compression is demonstrated.

what does it mean?

Regards,
Xavier