a) posture's important, lying face down when you've a back condition or only averagely healthy can be a major trigger for back pain; when sitting, you may find some chairs benefit from extra lumbar area padding (even a rolled up towel may be better than nothing) -- a lot of people really appreciate the Obus Forme line of chair / carseat add-ons (with or without their extra lumbar cushion -- I find those cusions too generous, so I trim the foam pad a fair bit))
b) do you have any stretching routines? a physiotherapist ought to be helpful with suggesting some. (I've done several routines most days for decades, very helpful)
c) an excellent bandaid med for muscular spasms is valium (diazepam); too high a dose does make the patient sleepy (in that case, not safe for heavy equipment operation or driving)
d) ice makes it worse? hmm, that's curious (I find cold packs during a back spasm episode are often quite helpful; heat tends to make mine worse); indeed, heat's been a major trigger for me (I'll do something challenging one day, and if I have a hot bath or hot shower the next day, I'm at high risk of triggering back spasms which will take weeks to recover from)
e) during an episode or just as a way to obtain relief, a protective posture can be very helpful and provide relief; such as: lying in bed on your back, with your calves propped up on a pillow that's on something that's a foot or so high (eg. a medium sized box); I'll listen to an audiobook for an hour or so, and feel so much better after such a session
Having a pillow between your knees or under your knees while sleeping, can helpfully reduce the tension in your lower back.
Two years is a long time, have you been x-rayed yet? That said, I've read (from a back specialist's popular book) that some people with awful back problems have terrifically healthy looking x-rays, and others with no back problems can have x-rays that look like their back is at death's door.
Hi spankey and welcome to the spine forum.
Your problem may be muscular, but I suspect that you may have injured your spine.
People with insurance generally begin with their PCP, who can order xrays and refer to a specialist if needed.
It is difficult to suggest a specialist until you have had this kind of diagnosis. My spine condition has been non-operable due to comorbidities, and I've had the best treatment from interventional anesthesiologists, who in the US are called spine and pain doctors. These physicians are qualified medical doctors with the additional credential DABPM.
If you have a condition that merits surgery, then you'll need to see an orthopedic surgeon. This is where a good referally comes in, because for surgery, proper patient selection is tantamount to a good result. This kind of surgeon operates on only 5%-10% of the consults seen, but has performed 1000s of these surgeries.
A bad surgeon is the kind of operates on 50% or more of consults -- this kind of surgeon does not select proper candidates for surgery, and therefore has a poor percentage of success.
Failed back surgery is no fun at all. It causes more pain than you're experiencing today.
If your condition can be treated with conservative means, go for it.
If your condition threatens the integrity of the spinal cord or spinal nerves, then you must have surgery.
I have severe spine disease that began to be painful about 35 years ago. I have so far avoided surgery. I may not be so fortunate in the near future. But I've managed with PT, medication, and interventional treatments so far. I still have all of my spinal ligaments, and all of my bone structure, without the scar tissue that comes from surgery.
Go get a diagnosis, and come back if we can help you again.