OpenHealth Q&A

Chronic Back Pain Following Disc Herniation

Patient Profile: Caucasian male, age 33, standing at 5 feet 11 inches and weighing 220 pounds. Current medications include Effexor (150mg), propranolol (160mg), and omeprazole (40mg). He does not smoke. Medical history reveals episodes of atrial fibrillation, which have not reappeared during recent evaluations, alongside anxiety and gastroesophageal reflux disease (GERD). I apologize for the lengthy message, but I wanted to share my experience. In November, while bending down to retrieve a sock, I heard a significant pop in my chest area, followed by sudden, excruciating pain and difficulty in breathing due to muscle spasms affecting my back and chest. Consequently, I sought emergency care where they performed an MRI of my thoracic spine and a CTA of my chest, abdomen, and pelvis. The CTA results were normal, but the MRI revealed a disc herniation at the T6/T7 level. The MRI findings indicated a bulky central and left central disc protrusion at T6-T7, which compresses the central and left central aspects of the thecal sac and outlines the left central and ventral spinal cord. Thankfully, a significant volume of cerebrospinal fluid (CSF) remained posteriorly, suggesting that the spinal cord was not being impinged, and there were no abnormal signals detected in the cord. The path to recovery was demanding. For about six to eight weeks, I was confined to bed or seated, relying heavily on medications for pain relief and muscle relaxation. I underwent a rigorous 16-week physical therapy regimen, attending sessions twice a week for the first two months. Unfortunately, I had to conclude therapy once I maximized my insurance-covered visits. I consulted with a team of physiatrists and neurosurgeons, but they did not seem particularly concerned about my condition or the reported symptoms. They offered little direction on additional therapeutic options. Now, nearly a year later, as September approaches, I’m still facing daily, severe back pain. Although I returned to full-time work, my quality of life is significantly affected, leaving me feeling miserable much of the time. The primary discomfort manifests as intense cramping or sharp pain located beneath my diaphragm and behind the sternum, reminiscent of the cramps experienced during intensive sprinting at practice. Accompanying this, I also suffer from muscle soreness around my back, chest, and throughout the abdomen, with additional tightness in my hips and along the fronts of my thighs. I experience sternum pain that often triggers feelings of nausea, typically paired with neck tension and headaches, especially after enduring lengthy episodes of pain. I have found relief through several methods including heat application, stretching, acupressure, meditation, progressive muscle relaxation, and focused breathing exercises. John Sarno’s insights into mind-body connection through Tension Myositis Syndrome (TMS) have been enlightening, offering a shift in my perspective. While narcotic pain relief is effective, I find myself utilizing them approximately every 10-12 weeks. Activities that exacerbate my pain comprise prolonged standing, leaning forward, lifting, pushing, and any form of impact. Sleep is challenging, frequently interrupted by pain and discomfort. I would greatly appreciate any recommendations for therapies or specialists who could assist me in regaining functionality in my back, ideally returning to a state that resembles my condition prior to the injury. Thank you in advance for your help!

Answers (1)

8/28/2025, 8:32:31 PM

OpenHealth AI

I'm sorry to hear about the chronic back pain you're experiencing after your disc herniation. It’s clear that this situation has significantly affected your daily life and overall well-being. I'll provide some structured guidance on how to approach managing your pain, highlighting prioritized steps.

Key Points

1. Understanding Pain Management: Combining physical techniques with self-care strategies can effectively improve your quality of life.
2. Prioritizing Active Engagement: Consider exploring specialized therapies that target your specific symptoms and promote functionality.
3. Regular Self-Care Practices: Keep integrating techniques that have brought you relief, while also being open to new approaches.

Explanation

Chronic pain following a disc herniation can stem from several factors, including muscle tension, nerve irritation, and changes in movement patterns. Given your symptoms, it sounds like alongside the structural concerns from the herniation, there may also be a component of muscle tension and myofascial pain. The combination of your symptoms, including sharp pain, muscle soreness, and feelings of nausea, suggests that addressing both physical and potential emotional aspects of your pain could be beneficial.

Next Steps

1. Consult a Pain Management Specialist: Seek out a pain management expert who can provide a comprehensive evaluation. They can offer options like nerve blocks, epidural steroid injections, or customized chronic pain management plans that involve medication adjustments tailored to your needs.

2. Continue and Expand Physical Therapy: Look for another round of physical therapy, potentially with a focus on outpatient physiatry or specialized physical therapy that includes Pilates, yoga, or aquatic therapy. These can enhance muscle strength and flexibility, which is crucial in your recovery.

3. Explore Occupational Therapy: An occupational therapist can help you develop strategies for daily activities, including ergonomics at work and techniques to manage pain flare-ups.

4. Regular Mind-Body Techniques: Continue with the methods that have provided you relief, such as meditation, progressive muscle relaxation, and acupressure. Consider joining a group or class focused on these practices to enhance consistency and support.

5. Pursue Integrative Approaches: Explore acupuncture or chiropractic care if appropriate. These alternatives can sometimes help alleviate chronic pain, provided they are done by certified professionals.

6. Sleep Hygiene Improvements: Since sleep disruption is affecting your recovery, consider developing a sleep routine that includes a relaxing pre-bedtime ritual, improving your sleep environment (temperature, noise level), and addressing any underlying discomforts.

Lastly, ensure that your healthcare team is aware of all your symptoms and concerns regularly, so they can adjust treatments and therapies to better suit your evolving needs. Remember that recovery can take time, and it's important to celebrate the small victories as you work toward regaining function and comfort.

If you need further information on any specific therapies or have more questions, feel free to ask. Your willingness to explore various avenues for relief shows great resilience!