February 2005 I was in the gym doing an assisted squat on a smith machine and hurt my back, it was not the first time. I have hurt my back several times in the past, the first time I remember hurting it was when I was about 15 years old and I was working at a grocery store. I am not sure what happened, but I must of leaned the wrong way to lift something, the next 2 days I could not move. It healed on it’s own and I was okay within a week. Another time I hurt my back was snowboarding at Sunshine Mountain in Alberta, this time about 23 years old. I was going down the hill and slightly moved one way and I felt my lower back. It was fine that day, later the next day I was in severe pain. I went to my first chiropractor, Dr. Fox in Calgary, he was wonderful, he got me back on my feet in no time at all (a couple weeks) with muscle therapy, adjustments and stretching, that was probably about 2-3 years ago now.

Last February I went to the physiotherapist (or called physical therapist in the USA) until about mid or the end of April the same year. When I stopped seeing him I felt I had my full range of motion back. July 2005 my back started hurting again, but due to no incident this time. It would just feel stiff and uncomfortable when I got up in the morning. It now has progressed over time, now I cannot stand for over a couple minutes and lying flat causes me extreme discomfort. I went to a chiropractor in Vancouver a couple of times (only went a couple times because I moved to the California) and saw no great improvement. I moved in USA in November with my now husband and did not treat my back, lack of medical insurance, and worry that we were not covered, and expense. Lloyd felt it would be much too expensive to go and we could not afford it so I did not. I tried to continue stretching, but it did not seem to help, nonetheless I continued. Now sleeping also causes me discomfort and I wake up due to the pain after about 6 hours. Finally in March I went to the doctor and found out I was covered if referred for a few visits. She referred me to the chiropractor, who I went to see for about 7 visits in about 4 weeks time. I did not feel any better when I finished, she did mainly adjustments. I went back to the doctor and was referred to a physical therapist, who I went to see for 8 visits in 4 or 5 weeks, again feeling no real improvement at the end of treatment. The physical therapist did stretching, muscle work/massage. Seeing little to no improvement she recommended that I return to my doctor to see what was next.

I went to the doctor this afternoon (my regular doctor is away so I saw a different one, but still very pleasant lady). She has now recommended me to a physiatrist. She said… a physiatrist is in between a physical therapist and a orthopedist. An orthopedist would mainly be able to recommend surgery, and if I needed it would perform it, but if not would not be able to do much for me. She said for a person my age we want to avoid surgery at all costs and a physiatrist would be able to do some injections to decrease the inflammation in the area bothering me. She did examine me and said that it did not appear to be in my spin, so I was not to worry about spinal problems, but it seems to be in the joints next to my tail bone, the sacroiliac joints. She thought it could be Sacroiliitis, an inflammation of these joints (which is what my doctor in Vancouver thought it possibly might be in October but recommended a new bed, stretching and yoga).

Injections sound scary to me! I am wondering if I have gotten to the point and need this type of treatment or maybe I just need more physical therapy time? I am returning to Canada in September for some coursework, which I made my doctor aware of, she said I would at least be able to see the physiatrist once maybe twice before I leave. I asked if I should have an MRI or Xray done, and she gave me an order for one just in case it was something else and said they would call me once they received the results.

In the USA there is a limit to how much physical therapy and chiropractic you receive. Being on an HMO plan, I am entitled to 6-8 visits maximum. I cannot help but wonder if I continued to go to the physical therapist for another month would I get better? When I was injured last February, it at least took 15 or more visits (2-3 months worth!) before I left okay. However, if I was in Canada I do not think I would ever get to a physiatrist, and if I was finally recommended to one, which would be after at least 6 months of physical therapy that was going nowhere, I would then be put on a wait list for 6 months minimum to a couple years to see a physiatrist. So is the USA to quick to jump to a conclusion and should I be continuing to see the physical therapist, or is it indeed time to step it up to a physiatrist and Canada is too lax?

I am going to go through with it and see the physiatrist while I am in the USA, maybe this is indeed the treatment I need? But I am not going to be quick to get the injections if the physiatrist suggests them, being scared of needles and apprehensive about such an invasive therapy. Returning to Canada in September I will again have no extended medical for chiropractic treatments, which run at minimum $35 a visit. Lloyd being thrifty will probably want me to wait to see if we can get some kind of coverage before seeing anyone. My girlfriend Ali has seen a chiropractor in Victoria who did wonders for her, but wondering if mine is too far gone, or perhaps we she has a different problem with her back. I hope to try Ali’s chiropractor when we return if I still am in pain, if we can afford it of course. I am at the point where I think I am doomed to live with his pain for the rest of my life, and also think I am too young to have back pain, how did this happen?