Lower back discomfort

[Sans rt1]

Glad my post eased your mind a bit. But I am also glad that you told your doctors and will keep up on things. Yes, recurrences in the RT pattern are rare - but from what I read they do happen once in a while, so it is good to be conservative and get things checked out.

I just had my last physical therapy session - my back is better - the strengthing and the things they taught me have definitely helped. However, I still have that original dull ache in my back that started this thread. THe description of having duct tape on it is a good one - just feels like there is something there - not pain, just a feeling of pressure and slight ache for me.

But, based on what I have learned, anyone that is out of shape and thinking of starting an exercise program - especially if you have any back issues - should talk with your doctor and perhaps consider consulting with a physical therapist or qualified personal trainer, to avoid the mistakes I made. It seems I was doing the right things all wrong, and it resulted in a very messed up back.

We all know not to lift things using our back - they teach that in health class, PE and at work. But no one ever taught me that it is just as important to tighten the abs to allow the core to work together (not just the back), whenever you lift, twist, or reach for something - this allows the load to be shared between the back muscles and the abs. When you work out on exercise machines or with weights, you should do the same - my PT taught me a little pelvic tilt and tightening of the abs - and it really does spread the load out and away from your back - amazingly simple, but it works. And when you workout (on machines or free weights) with abs held tight, you relieve the stress from your back - and actually exercise your core muscles in addition to, say your arms, chest, or legs. And, because you are exercising more muscles, it is really a much better workout

Anyway, good for you getting into better shape - just do it smarter than I did and don't hurt yourself in the process.

[Abilor]

Whew!!!

I've been freaking out for the past few days, but once again feel a little bit better.

I had seminoma diagnosed and removed in March, and then Radiation (25 Gy) in May, so I'm hitting the three month mark now. I've also developed that "werid feeling" - NOT pain, just some stiffness, tickles, etc. Someone else described it as feeling like there's duct tape stuck to you.

However, like Sans rt1, I had a hefty gut going into this thing, and I haven't been as pumped physically as I promised myself. This thing comes and goes as I do weird things with my back, how I've been eating, if I'm hydrated, etc. So good food, water, and exercise for me.

My oncologist also had similar things to say: recurrence is very, very rare, both in general, and particularly in the field. At my first bloodwork and X-ray post RT, he mentioned that nobody he has ever treated with image-guided RT has ever recurred, and I should expect to be just fine. I have first CT with urologist in October, and he is also very optimistic, near 100% chance of total recovery already. He's dour though, and says if I did recur, I'd be salvaged with chemo.

Anyway, I knew all this coming in to the site (I don't like coming because it gives me things to worry about), but since my case is almost identical to sans rt1, I'll keep doing what he's doing.

Good luck all.

[Fish]

Sans:

Good to see your update. I'm glad you've gotten some relief for your back. PT has really helped me with my back problems. I agree with you, no one should suffer through it -- exercise, PT, weight loss, whatever it takes (I still have to work on the last one )

Best wishes.

[Karen]

Wow....glad you posted this in case others are experiencing something similar. I'm especially glad that it was nothing more serious and you're feeling better!!!!

[Sans rt1]

I wanted to follow-up on a string I started last year on my lower back discomfort following RT last year. From the private messages I received, I know others have had similar problems, so perhaps my experience will be helpful.

About 3 months after RT, I started getting a weird back discomfort – a feeling of pressure and ache – always there, but would be worse after exercise (and before RT I had never had any back problems). Immediate concerns of a recurrence were relieved by clear CT and bloodwork. My oncologist said it was likely radiation-induced fibrosis (scar tissue and adhesions) – but the radiation doctor strongly disagreed because my dosage was below where scarring is a concern.

My doctors disagreed on the cause for months, and none would come up with any real recommendations. Finally, my GP suggested I focus on strengthening my core muscles, and try to lose some weight (get rid of the beer gut) and see if that would help – if it did not, he promised to get me approved for physical therapy. So, I worked out regularly and lost about 35 pounds, but my back got worse. I was referred to a spine specialist, and after back scans and X-rays, no reasons for back pain could be identified. The specialist said he felt there was fibrosis and nerve damage present from the RT, which was the source of the stiffness and the feeling of pressure (numbness), but he did not feel that was the cause of my pain. So, after 6 months, I finally got approved for some physical therapy.

Now, after 8 weeks of physical therapist visits and focused exercises and stretches, I can report that my back is much better. I still have that feeling of pressure and dull ache, and maybe it is a little bit better. But I do have much better flexibility – and the pain after activity or exercise is much less. My physical therapist tells me that he is certain that I have nerve issues and adhesions in my back – I was very stiff and he is working to loosen that up over time. But, he thinks the real cause of my pain was the fact that I was out of shape before my diagnosis, then very inactive for several months during and after RT, meaning my muscles turned to mush. When I became active again, my dominant side carried the load, tweaking my back and causing pain. Even when I started exercising, trying to strengthen my core on my own, it was my dominant side that carried the load, so it got stronger and the weak side stayed weak – and my back worsened. He and the other therapists in his practice could tell how off balance I was by watching me walk, bend and stretch. Hence, the goal of my physical therapy was to loosen things up, get the muscles all working together, strengthen my core (especially the weak side), and help my body re-learn how to distribute the load without tweaking my back when I exercise, bend and stretch. I am also told that except for a little more deep tissue massage and stretching, this is the standard treatment for back pain.

So, to make a long story short, my back pain was probably not “caused” by my RT. Yes, some nerve damage and fibrosis are present, but the pain was most likely from my being out of shape to begin with. I would definitely recommend that anyone going through RT try to stay active and exercise and stretch daily – keep those muscles moving and it will help your ultimate recovery. If you do develop back pain after your RT, it may be something has been aggravated by your RT, but probably just as likely from inactivity or just your back acting up. Yes, definitely let your doctor know, so that any worries about recurrence can be addressed. But, hopefully any discomfort can be handled through exercise or physical therapy and hopefully it will not take you 9 months to find relief.

[tlh]

SANS,

Just ran across your post. Oddly enough, I was at my GP today for some lower back pain along with other pain. Until I underwent Radiation (15x -- 27Gy) I had normal pains from working, etc. However, now I get pain in my lower back along with other areas. Maybe I should have done a little more research before treatment. If I had, I wouldn't have let them radiate my pelvic area. I now have pain in areas that I don't like to mention as well as my back. I asked my Radiation Oncologist as well as Urologist about my pain and was told that I probably have radiation proctitis. Great. I told my Urologist I thought this was odd because I finished treatment 12 weeks ago I was told it may never go away. Nice. My GP did an exam for other cancers today (the abducted by aliens type of exam) and told me he neither saw or felt anything out of the ordinary. He also mentioned that along with scarring this pain could be from radiation induced nerve damage and has set up an appointment with a Proctologist. The hits just keep on coming. And, to boot, 12 weeks out my digestive system is still not completely settled. I could be "normal" for weeks at a time then something triggers it and my stomache acts just like it did when going through the treatment. I can honestly say the pain does make me question my choice between radiation and surveillance. Sorry for the long post, but I want to see if it has taken anyone else longer than they anticipated to return to 100%.

[Sans rt1]

Spoke with the oncologist at length this morning. He is now using the word "adhesions" rather than scar tissue, but either way it sounds like something that I need to deal with - probably exercise and perhaps some physical therapy will help over time.

I googled 'adhesions after radiation therapy' and did find references to it, mostly from massage therapy sites (actually, a massage does sound like it would help), and here is what one said:

. . . radiation therapy can cause moderate to severe adhesion formation, attaching organs to other organs, muscles, bones, connective tissues and their support structures . . . causing a variety of symptoms. When nerves are involved, pain results . . .

So, it makes sense this could happen after radiation therapy - but since no one has mentioned it this on this Forum (the word does not show up on a search), it must be a pretty rare side effect from abdominal RT.

[Fish]

Sans:

Glad to hear your tests came back clear. Hopefully, you'll get rid of that back pain. Interesting thought about scar tissue. My body doesn't make very tough scar tissue at all. The color of the scar is more pink (darker) than my other skin, but the texture is identical to normal skin. Oh well...

If your pain persists, you might want to look into an MRI of the back/spine. At least for now you can relax and know it's not TC related.

Best wishes.

[Sans rt1]

Dadmo - -

Oh yeah, that hug from my daughter made all my cares go away! I am glad you enjoyed the story.

Wannalive, I am glad you found some found relief. Hang in there, you are doing great - I have been following your progress, as are many others on this Forum. Slouching over the computer can definitely affect the back - and if you are resting a lot that can make it worse.

I hope they can give some indication of the cause of my back problems, but I am just very relieved that it is not a recurrence. The scar tissue from the radiation treatment makes some sense - I've always scarred badly - my I/O is pretty wicked, but I don't get much chance to show it off. I do have several others that are 20 years old that look like I got them yesterday. Radiation therapy damages good cells in addition to the cancer cells. That includes bone, muscle, connective tissues, and nerves. So perhaps if you are prone to scar tissue formation, some could form in the areas around your spine. I am not sure what I will be able to do about it, but it would seem that some sort of stretching and exercise would help.

I guess I need to go back to the gym . . .

[wannalive]

upper back pain

Hi
I got upper back pain at level of right spare ribs
and few days later extension to spine and got unbearably worse that I quit work and went to rest at home, dafalgan didn't work

I was sure it was something to do with my 1st cycle of chemo
however during GP doctor control the same night it is found to be related to my body posture in front of computer
he just asked me to do certain moves to check muscles etc.

in detail the material between spine bones got out of place and damage the
layer covering spine marrow (in very simple terms

he recommend sitting upright and it is gone in 2 days
actually I had similar rib pain since years time to time but never this much
and it is not the rib hurting but the nerve being pushed in spine
similar example is a siyatik of you know

I hope it helps to somebody

[dadmo]

Congratulations on that all clear. It's good that you stay aware of anything that doesn't feel right. Have your tried some light streaching? I'm sure it's annoying but I bet your back didn't hurt when you were hugging your daughter after her party. I'm still smiling because of that story.

[Sans rt1]

Just got off the phone - bloodwork and CT scan all clear! What a relief, I was pretty worried.

I am still having lower back discomfort - about the same, but no worse thankfully. It isn't pain, just a nagging discomfort, but if it isn't a symptom of something more serious, I can deal with it. I guess the 'bone window for spine' images still need to be looked at more closely to see if anything indicates what might be the cause, but I was told nothing obvious stood out to the radiologist. My oncologist still suspects it may be from scar tissue caused by my RT, and speculated that some physical therapy, or maybe just time, will help. I guess I will report more when I know something on that part.

Thanks for the prayers and encouragment, they sure helped to keep me thinking positive.

[dadmo]

As soon as you get results please post them.

[Sans rt1]

My CT scan has been delayed until Friday. I thought I had a CT appointment this afternoon, but yesterday my insurance denied it (by mistake), so my appointment was cancelled (given to someone else). I spent the morning on the the phone and understand that there was a comedy of miscommunication - it turns out I never needed insurance company prior approval after all!

So, I wait until Friday. I am on the list for a cancellation, but they told me that those are rare (I guess except for mine, of course) - and they only try to squeeze in "emergencies".

No improvement in my back discomfort - just not going away - ache, not a real pain, just a feeling of pressure on my lower back. In addition to the CT, I am scheduled for "bone windows for spine" X-ray work, so hopefully we can get to the bottom of this one way or the other.

[Sans rt1]

Thanks for the encouragement. It is good to hear of others that have had scares that have turned OK.

I know that the odds are fairly slim that this is anything to be too worried about, but still needed to get it checked out as it was not going away. Just spoke with my oncologist's scheduling person, and I probably won't get everything cleared in time to get scheduled for a CT today, so looks to be Monday or maybe even Tuesday anyway. Backache and pressure feeling still there, but I have a plan in place and can relax a bit knowing that we are doing something and next week I will know more.

One good thing is that as I am getting to know my oncologist better. I was off to a rocky start with him, mostly I think due to my not asking enough follow-up questions so I misunderstood some things. I am gaining confidence that he is very thorough, so I am in good hands if I ever need it (and hopefully this scare is not the time). My RT doctor told me that my oncologist was a bit of a pain to deal with - always asking for more information and was very nit-picky about details. It sounded like he did not mean it as a compliment towards my oncologist, but to me, that is just the kind of oncologist I want working for me.

Again, thanks for the support.