Back Pain - MRI
This week I had a serious back pain issue. I've gotten different kinds of back pain in the past. I've assumed it was from bad posture while programming. I used to get some pretty serious back pain in the states now and then. It didn't usually seem to last all that long, a couple of days.
Well, in the last few years there have been a couple of times where I've had some serious back pain. A very sharp pain in my lower back, so sharp that I can't use my back. There have been times were I literally had to drag my self across my apartment by my hands. I would just tell myself to pay attention to posture more, stretch more, take some ibuprofen and the problem would go away. Well, this week it got really bad. Starting last Sunday I woke up with back pain but it seemed manageable. It lasted through Tuesday. It was pretty bad but I could still get up. In the past I had done things like hang from the chin-up bar or something trying to stretch my back. Unfortunately there is nothing I can do that with in my apartment. It was hurting pretty bad so I asked some friends to stretch me but they didn't get it I guess and couldn't or wouldn't pull hard enough. Maybe a good thing but you know how they always show someone fixing someone's back in the movies. In my mind I imagined a pinched nerve and if I could just give it some space maybe it would slip back out. That night I even braided some rope, tied it around the only fixed thing in my apartment, the toilet, across to the bedroom were I could stick my feet out the sliding door of my apartment onto the balcony and catch my feet on the curb leading into the apartment. Then I could grab the rope, pull, and hopefully stretch my back. No luck as far as I can tell. I think the big problem is unlike hanging, with both arms and legs pulling I think they use all the muscles in the back so it can't stretch. Maybe that actually made it worse though I doubt it, but..... The next morning. PAIN!!! I got up, immediately felt like I was going to faint, made it to the bathroom and braced myself on the sink. Lowered my head and hoped maybe I had just gotten up to fast and the feeling would pass but actually it didn't pass, my face was pale and I felt nauseous. I went back to lie down and felt like crap. I could barely move. Even turning over to adjust my position in bed was hard. To get up I would have to very slowly roll over on my stomach, straighting my legs and putting my arms above my head to make myself into something easy to role but at the same time stick out a foot or arm to make sure there was absolutely no pressure on my back as I turned. Then, once on my stomach I would lift my torso up by my arm strength alone although if I wasn't careful, when I was on all fours my back would have some pressure and start hurting and I'd have to quickly get back down. If I managed to get on all fours without pain then I would have to push myself up by bracing my hands on my thighs, again, keeping my back out of it. I managed to take some pain pills and that got me able to waddle over to the doctor. One thing nice about Tokyo, there's pretty much a doctor's office within 2 ~ 3 minutes walk of anywhere. Of course the bad part is lots of them suck. Anyway, my doctor told me he didn't need to take an xray since he had taken one just about 5 weeks before (another story(1)). He felt my back, said my right muscles in the area that hurt were super tight and prescribed some muscle relaxing medicine. That was Wednesday. He also told me to just use the pain medicine he had given me for the last problem(1). I tried both but they didn't really seem to do anything through Wednesday and Thursday. Even sleep was hard because face down or face up was not comfortable on my back for more than about 3 minutes. Some muscle tension would build up and it would start hurting. I could only sleep on my side which I don't normally do because normally that makes my back hurt the next day 
So, today I woke up not feeling any better. I took 600mg of ibuprofen. Then I looked up the medicines just for fun. The drug he gave me is called Tizanidine and typical, the Japanese doses are MUCH lower than the American doses. The Japanese doses are 1mg. According that webpage the American doses are 8mg. I wasn't ready to try taking 8 pills at once and I thought maybe I should go to a specialist so I went to a local hospital. Japanese hospitals are not like Western ones in that you can go in for any reason, even a cold and see any specialist, just walk in. No referral. Hospitals are not just for things that need a hospital like they are in America, they are just a place doctors happen to be and equipment. Rather like a large clinic. In some ways it's good, in others..most don't seem to have an emergency ward and they are only open from like 9~12 and 3~6 or rather only take patients then. Because they are open to walkins you generally have to wait a long time. Anyway, by the time I got there, about 10am, I was actually feeling pretty good. I assumed it was the ibuprofen but I actually felt almost cured. I thought that was both good and bad. I was happy to be feeling a lot better but I wanted the doctor to be able to find the problem. The constant pain or tightness was gone but fortunately or unfortunately, when I tested the sharp pain was still there in certain positions. That doctor moved my legs and had me lay down in different positions which brought the sharp pain out. He ordered 6 x-rays. I think that's the most I've ever had. He couldn't see anything in them so he suggested I get an MRI. I was a little scared having heard about having to be completely still for 40 minutes at a time. I had heard on the net they had newer equipment that only took 10 but the doctor said I was mistaken, that was CT. MRI took 30~40 minutes. He said their MRI was really busy and I'd have to wait a week but I could go to some other places to get it done if I wanted. They called the closest one and I could have it done today at 5:50pm. It was 2pm when I got home. 4 hours to see the doc. I looked up on the net and found out they do have faster MRI. I got to the MRI place at 5:30. It was a clinic just for MRI and was happy to see they actually had the newest equipment. They took the scan. It took less then 10 minutes I think. I'm not sure what they found but as I was leaving I thought, "hey, I'd really like a copy of the raw data to try to display on my own" so I asked them if they had it and they said, "Sure thing and we can burn it to a CD for you for $25". EXCELLENT! I got home thinking if I wanted to see the data I was going to at least have to write something to convert it to 2d, let alone 3d. But........... First, the CD came with the data in multiple formats. One format called ".dcm". No idea what it is but it's 338k per file. Another though was a Javascript enabled webpage that would let you browse all the images quickly and even animate them. Here's an example
Finally there was windows software that would actually let you see the data in 3d, compute cross sections across the range of data and all kinds of stuff. Pretty impressive.
click for full size Monday I go back to the doctor to look over the MRI images and tell me what he sees. Interestingly, the way doctors work in Japanese hospitals, there are usually 3~5 per speciality. When you get called in you get whoever is free. So, Monday I'll have a different doctor than I had today as the doctor I had today said he's not in on Monday. I don't know if that's good or bad. Is it better to have 2 eyes looking at me or is it better to have one who is more familiar. (1) Just a few weeks ago I had a different but similar problem. I had a pain in my tailbone area. I almost felt like there was a rock in my tailbone but it hurt pretty bad. Actually somewhat similarly in that at certain positions it really sharply hurt. I couldn't move easily without setting it off and had to rest for a few days. I went to the local doc and he took an x-ray and didn't see anything. He gave me some pain piils and sent me on my way. That was a Friday. By Monday the problem was not gone although the pain pills worked pretty well. So, I went to the big hospital. The specialist there looked at the x-ray and explained that problems in that area are hard to diagnose and the problem should normally go away in a week or two. A week or two stuck in bed didn't sound very good but fortunately the problem was mild enough by the next day I was back at work. For a couple of weeks though I could still feel it in certain positions. No pain perse but at least something, the rock in my tailbone. I hope it's not all something worse. Followup: I went to the doctor with the MRI and basically he said nothing. He pointed out 3 discs of cartilage in my lower back are wearing out and said that might be the problem but otherwise he didn't have anything else to say except hope it gets better and once it does start exercising and also take stretch breaks at work. On the bright side, at least he didn't say it was anything worse. 
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