Possible mechanical lower back pain in an athletic 25 years old man

Patient

Q: Hi,
I'm a big athletic 25 year old guy, lift weights and martial arts train ALOT! Well two days ago I barely stretched to grab a pen at work while I was standing and felt a SHARP pain hit my lower back. It hurt so bad that I was limping when walking on my right leg. I've been over the counter pain meds and keeping icy hot back wraps on it. Last night I had to have help to get to the bathroom. I thought it was getting better yesterday so I went to work in the office again and was pretty cool. Then last night when I relaxed and layed down, its like it got stiff and tense again. Hurt to bend in the slightest way. I'm a college student who doesn't have insurance at the moment therefore I don't go to the doc unless I can afford it. The icy hot heating pads are not working. When this happened 3 years ago, I was fine after leaving the pad on overnight. Its a hassle even bending to pull up my underwear now. What should I do? any suggestions doc?

Doctor

A:   In the view that you do not have any history of spine problems in the past, most likely you are having a mechanical lower back pain. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. Sometimes it may complicate with a persistent muscle contracture and/or a sciatic nerve inflammation and the healing process takes a little longer. The suggested conservative treatment would be: a physical therapy program aimed to: control the pain and the inflammatory process, relative rest, flexion and extension exercises of the spine to reduce the nerve tension, exercises that improve the muscular strength and endurance of lumbar muscles. You can also try anti-inflammatory drugs (“Aleve”).Try avoiding all the activities that produce pain or discomfort, such as weight lifting, keep a good posture at all times and sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees. Try a local cold pack to see if it helps to ease the pain. If you don't have a cold pack, use a large bag of frozen vegetables; it makes a good first aid cold pack. Or have someone close to you massage you in a triangular pattern with an ice cube over the sore areas, no more than 15-20 minutes at the time. After the cold massages, try alternating with heat from an electric heating pad to see if it helps the pain. If you don't have an electric heating pad, put a hand towel under hot water, wring it out, and place it on your back. Sometimes the moist heat penetrates more deeply and gives better relief of pain. You may feel better lying on your back on a firm surface with a pillow under your knees.

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