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Sustained an apparent lumbar sprain along with torn groin. In early afternoons, feel 90%, but by evening it goes downhill. Averaged an hour of sleep per night for the past week since the injury. With the lack of sleep there has been a corresponding rise in blood pressure. I'm probably in line for a stroke.
Back in the 70s when I was a serious weight lifter, there were a number of lumbar sprains, really nasty ones, but they never prevented sleep due to intractable pain like now, as long as I maintained the proper sleeping form: lying on side with knees drawn to chest and a pillow between legs. That's not working now.
Using the trusty search engine, I found a number of discussions pertaining to why pain is worse at night. Some of the reasons are pretty plausible too, but all have been from laypersons, none from professional medicos.
Anyway, all of this has been surprising. Learn something new even at 70.
Why is lumbar pain (sciatica and the like) worse at night? Because the spine physics works this way. Lying, sitting and standing usually worsens the lumbar pain caused by lumbar spinal root compression, and walking relieves it. Physiotherapy can help, and if not, surgery usually does.
Why is lumbar pain (sciatica and the like) worse at night? Because the spine physics works this way. Lying, sitting and standing usually worsens the lumbar pain caused by lumbar spinal root compression, and walking relieves it. Physiotherapy can help, and if not, surgery usually does.
The nerve root -- in this case at the L5-S1 level -- is not involved. The pain does not follow that dermatome pathway, i.e., back of thigh, but rather is axial or localized. Also, the neurological findings pertaining to nerve root compression at that level, i.e., motor, sensory, and reflex are negative.
I suppose the doctor who said it's not that (or any other?) root has written down some sort of diagnosis. Osteoporosis? Multiple myeloma? Spondyloarthritis? These could cause axial lumbar pain without spreading to other parts of the body and would slowly worsen. Muscle sprain could be quite axial but obviously asymmetric and should improve in days/weeks.
Something happened a week ago? Wrong move, injury?
I suppose the doctor who said it's not that (or any other?) root has written down some sort of diagnosis. Osteoporosis? Multiple myeloma? Spondyloarthritis? These could cause axial lumbar pain without spreading to other parts of the body and would slowly worsen. Muscle sprain could be quite axial but obviously asymmetric and should improve in days/weeks.
Something happened a week ago? Wrong move, injury?
No MD was consulted, yet. When she is consulted, hopefully after the condition is resolved, I suspect that she'll enter that I complained about a LS strain or sprain in the chart. My point in starting this thread is the pain -- or perception of worsening pain -- at night. I wondering if there's psychogenic overlay here.
A week ago I did load up a pair of dumbbells for shrugs. 1st time in decades. Stupid, stupid, stupid altho there was no apparent injury. It should be noted that the groin pull pain is worse at night too.
You can go to the doctor, preferably to an orthopedist or a sport doctor, or you can just wait and see which things you can still do without significant pain. If you can't sleep you can get up and walk. OTC painkillers can help a bit.
A muscle can be sprained or torn; both would cause significant local tenderness (either in the back or groin). In the groin, hernia would be possible (usually visible, palpable and tender, but not necessary all that). Next, groin pain can arise from L1 or L2 spinal root compression. Lumbar spinal root pain does not necessary spread down the leg and even if it appears severe at some time it can go away in several days/few weeks. Walking can result in temporary relief and if this happens it speaks for spinal root compression. Heat/ice pads can provide temporary relief in muscle sprain but not nerve compression...but they do not really cure anything...
You can go to the doctor, preferably to an orthopedist or a sport doctor, or you can just wait and see which things you can still do without significant pain. If you can't sleep you can get up and walk. OTC painkillers can help a bit.
A muscle can be sprained or torn; both would cause significant local tenderness (either in the back or groin). In the groin, hernia would be possible (usually visible, palpable and tender, but not necessary all that). Next, groin pain can arise from L1 or L2 spinal root compression. Lumbar spinal root pain does not necessary spread down the leg and even if it appears severe at some time it can go away in several days/few weeks. Walking can result in temporary relief and if this happens it speaks for spinal root compression. Heat/ice pads can provide temporary relief in muscle sprain but not nerve compression...but they do not really cure anything...
Basing my inference of negative nerve root impingement on the absence of sciatic pain, ability to raise big toe against resistance, and pin prick sensation on tops of toes.
As for the groin, the pain is located at the adductors' origins and there are unpleasant sensations at their insertions along the inner thigh.
Location of the back pain appears to be at the same level where the others were located over the years: L5-S1.
OP, have you ever tried something like Thermacare? I have back trouble (L4-L5, L5-S1) that will flare up a lot at night. Sometimes a Thermacare patch will soothe things enough for me to get to sleep. I'm recovering from hip arthroscopy (repair of CAM & Pincer FAI with labral repair, bursectomy, gluteus medius repair). I take hydrocodone/apap 10/325 for breakthrough pain. That helps with the back pain, but the addition of the Thermacare really makes a difference at times.
I also take amitriptyline which helps with pain and sleep. (I was on Gabapentin, which did nothing except make me gain a lot of weight.)
OP, have you ever tried something like Thermacare? I have back trouble (L4-L5, L5-S1) that will flare up a lot at night. Sometimes a Thermacare patch will soothe things enough for me to get to sleep. I'm recovering from hip arthroscopy (repair of CAM & Pincer FAI with labral repair, bursectomy, gluteus medius repair). I take hydrocodone/apap 10/325 for breakthrough pain. That helps with the back pain, but the addition of the Thermacare really makes a difference at times.
I also take amitriptyline which helps with pain and sleep. (I was on Gabapentin, which did nothing except make me gain a lot of weight.)
Best to you.
Thanks for the input. Never heard of Thermacare and didn't know that amitriptyline was used alternatively for insomnia. I'll mention both when I see the medico in a few days.
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