ashongut

I recently received the results from an mri I did to give me more insight into why I'm having so much upper back and neck pain on the bike. I rode 5500 miles in 2018, which I guess my back really didn't like. I became interested in cycling and started building u the miles quickly. My back pain started when I had my highest mileage season in August of 2018 (Rode almost 1000 mi that month). Turns out I ruptured my t34 disc. I actually did 2-3 months of pt back in December 2018 to help strengthen my back with slight improvements, nothing major though. The doctor says I can still bike. Anyways I really don't want to give up on cycling. So, if anyone ruptured an upper spine disc let me know what you did for a full recovery. I want to be able to go on long 100 + mi adventure rides again so badly. Right now I start having back/neck pain 20 mi pin. It sucks. Thanks.

I am still trying to keep up with my PT exercises. My back feels really good after the exercises but gets so screwed up once I get on the bike. I did get a bike fit after I started having pain which didn't help. Maybe I should try riding a different bike? Not really sure what to do at this point.

MoAlpha

Its impossible to say what’s causing your pain from the description so one can’t make any specific suggestions. However, discs protrude and herniate in a generally posterior direction, so spine flexion is to be avoided. That could mean going to an upright bike or, if you want to ride in an aggressive posture, learning to hinge at the hips and maintaining a flat back. That’s good back hygiene and might help with the pain. If you are having pain referable to one or two nerve roots, transforaminal epidural steroid injections can be very helpful in getting over the painful phase of the disease.
Good luck!

canklecat

Hang in there. My C1-C2 were permanently damaged in 2001 when my compact car was t-boned by a full size SUV at highway speed. I needed a cane to walk until 2014. I got almost no useful medical help and just did what I could.

In 2015 I was back on the bike, very slowly. A big, heavy, upright comfort hybrid with lots of padding and springs. Lots of home physical therapy, taking tips from qualified PT experts in online articles and videos.

By 2017 I was able to ride a drop bar road bike again -- and it wasn't easy. By 2018 I improved from dead last on every Strava segment to middle of the pack, pretty typical for my age (60s).

In May 2018 I was hit by a car, again -- this time while I was riding my bike. Broken shoulder with grade 4 separation, and re-injured the neck. The C1-C2 are worse now.

I was on the indoor trainer 6 weeks after the injury, and riding outdoors again by late summer. By the end of 2019 I was faster than ever (an older carbon fiber bike helped, but it was still lighter than my steel road bike for climbs). And with lots of in-clinic supervised PT and continued PT at home, I'm able to ride up to about 50 miles without too much discomfort. The neck still limits me on longer rides, but I'm still on the road bike, and have them set up even more aggressively. Turns out my upright hybrids were actually less comfortable on my neck. The somewhat more "aggressive" road bike drop bar position turned out to be easier on my neck.

Some days are better than others. Sunday was our first warm and dry day in a week so I planned on 50 miles. Neck spasms made me turn back and settle for 28. But it was still a good day.

Eventually I might have to concede to a recumbent. But not yet. I tried a friend's old Trek recumbent version of a comfort hybrid and absolutely hated it. Didn't even leave the parking lot after a couple of laps. I'd rather do spin classes in a room full of yoga pants than ride a recumbent like that.

Be patient and persistent. It'll come back.

ashongut

Wow you are a beast. Really inspiring. My situation is minor compared to that. I agree, everyone says I should try a hybrid or mountain bike but that's not why I ride. I really fell in love with road biking and drop bar bikes. I've been doing exercises involving bending backwards (Mckenzie Exercises) which feels pretty good. After I was injured I was riding 45 - 50 miles with a group, but got frustrated with it. I would ride 20 miles, and then have to suffer the rest of the ride just trying to support my neck. I'm only 23 and the last doctor I saw said I probably injured my back because I am pretty flexible. My back could easily adjust to the riding position but there was nothing providing support. Never worked out or anything other than for cycling. So I'm trying to strengthen my back now. Thanks for the info.

ashongut

A friend did mention those injections might help. Yeah some people have told m my posture on the bike sucks. Which probably led to this.

Seattle Forrest

I've known people with disc ruptures who were helped by gabapentin.

canklecat

I found my own inspiring person along the road. In April 2018, during a ride west of Fort Worth toward Weatherford, I happened to catch up with Aodhan O'Ferrell, a former paramedic who was badly injured on the job when he was struck by a vehicle after he'd stopped to assist with another wreck. He was busted up pretty badly, including his neck, and was in obvious discomfort. I saw the photos of him in the hospital -- it looked pretty bad.

But, while in the hospital and physical therapy, he'd set a goal to ride across the US. His neck injury threatened to worsen over time so he decided to tackle the cross-country ride sooner rather than wait until it might be too late. I met him at the halfway mark. We rode together for several miles, just chattering -- some about our various aches and pains, mostly about bikes and people he met along the route. His girlfriend drove an RV and every riding day they'd choose a point where she'd stop and wait for him. I forget how long it took to complete the trip but it was several months.

A month later I was struck by a car while I was riding my bike. At the time I thought it had just knocked the wind out of me and didn't realize how serious the injuries were until I stood up after catching my breath -- my shoulder and arm were dangling. And the news was worse after I got to the ER. I suppose the shock helped but I didn't feel much pain until several hours later, and declined the morphine they offered at the ER. I remember wishing I had that a couple of days later when the pain really hit.

canklecat

Recent studies indicate gabapentin has little or no use in back pain or most injury related pain.

It had zero effect on my pain from injuries to my back, neck and shoulder; and zero effect on my headaches (variously diagnosed as migraine, cluster, trigeminal neuralgia and "I dunno").

Rumors and myths about the efficacy of gabapentin persist for a couple of reasons: (1) pharma reps engaged in unethical practices to encourage doctors to prescribe gabapentin for ... anything and everything; (2) under threat of being disciplined for prescribing opiates or muscle relaxers, many doctors, NPs and PAs would authorize only gabapentin rather than hydrocodone or Tramadol, both considered low risk, low potency analgesics before the recent anti-opiate hysteria and propaganda.

There's some evidence that gabapentin helps some patients with neuropathy. My mom had residual pain from a late life bout with shingles, and gabapentin did help her with that. It did absolutely nothing for her chronic pain from multiple injuries and surgeries for back, shoulder and knee pain.

And I heard one patient who claimed to have fibromyalgia say gabapentin helped her. But some medical professionals still don't consider fibromyalgia to be a real thing, or at most an incorrect diagnosis for other real diseases. I have no opinion on whether fibromyalgia is real, but in my case my similar symptoms turned out to be due to Hashimoto's, an auto-immune disease that eventually killed my thyroid. The symptoms were virtually identical to those claimed for fibromyalgia. So I wonder how many people out there who think they have fibromyalgia actually have misdiagnosed serious diseases that aren't being treated properly because they lack access to competent medical care. In my experience, many medical professionals tend to disregard generalized complaints of pain, lethargy, malaise, etc., that don't present with obvious symptoms that can easily be diagnosed. Particularly for Medicaid/Medicare patients who live in areas without access to a broader choice of health care systems.

Some folks do report some relief from anxiety, but you can get the same benefit from non-prescription GABA, an amino acid supplement. I take it some nights before bed and it helps, pretty comparable to a low dose of melatonin. But it ain't for pain.

While gabapentin and GABA are loosely related, they aren't the same thing and studies show gabapentin doesn't bind to GABA receptors. I'm sure gabapentin has been effective and satisfactory for some patients with certain ailments, but it's not the do-everything wonderdrug claimed by pharma and some doctors.

ups

I'm not a medical person, but I would think the more upright your position and higher volume tires would help lessen the jarring on your neck.

bpcyclist

I was on gabapentin for three years. It did absolutely nothing for my neuropathy or my anxiety.

UsedToBeFaster

Wow. What amazing spirit and determination.

I have to ask, how did you keep such a positive attitude?

big john

What bike are you riding? Tires and pressure? How much drop from the saddle to the bar?

Some bikes are much more brutal than others on rough roads. I used to run 4 inches of saddle to bar drop, now only about an inch or so. My back has been hurting more lately so I'm trying bigger tires and less pressure but thinking about a new bike, which I can't afford.

noodle soup

Stories like this remind me how lucky I am to be pain-free.

December 8th of 2010 I wrecked at 48mph in a descent, and was found unconscious by a passing motorist. When I came to I got up, and tried to get back on the bike. They stopped me from riding, and took me to the marina where I live. Long story short, C-1, C-2, and C-3 were fractured(12 weeks off the bike) but now I'm good as new, and never experienced any neck pain.

February 26th of 2014 I was hit by a truck and had much more serious injuries. I broke all ribs on the right side, Clavicle, Scapula, and Fibula. Tore my large intestine, and punctured my lung. After nearly 6 weeks and several surgeries, they let me go home. 2 weeks later(and almost 40 pounds lighter) I was riding pain-free again.

ashongut

2011 Jamis Ventura Race Aluminum 52cm. Continental ultra sport II 25mm tires (80 psi in the front, 100 psi in the back, probably could run a lot less - I'm only 120 lbs). I have 2.5 to 3 inches of drop. When I got the fit, the fitter said this drop flattened my back the most.

ashongut

Tough people on this thread! Very happy you are riding pain free!

firebird854

Argh... I've been hit by a car at speed, bike destroyed, lost consciousness, but really only had a minor concussion and skinned knees. Your stories are certainly making it more challenging to consider riding on the road...

ashongut

Fascinating... I was always interested in the long endurance rides. I think my next goal for myself was to ride 150 miles... then 200. I really did want to ride across the US. My dad did it when he was my age.

big john

4 of us rode across the country, staying in motels, when I was 36. The oldest guy was 52 and he turned out to be a pain in the ass. We did 65-100 miles a day. Always wanted to do it again but didn't.

canklecat

Probably my teensy nth of Cherokee ancestry. My great-grandma was either full or half Cherokee. I'll need to check my dad's genealogy research. I vowed to endeavor to persevere.


But, seriously, it wasn't easy.

I was fortunate to have a supportive family. For more than a decade after the 2001 injury I couldn't work a regular job. I helped my grandparents take care of their rural home, orchard and garden as they became too old. They had similar debilitating injuries (back, knees) and understood that some days we can work, while other days we can barely stumble out of bed to pee and cuss our lot in life. And I helped fend off the predatory scoundrels and hithertoo unknown distant cousins who showed up to mooch or steal.

I saw a counselor at the county mental health outpatient system for PTSD and depression. I'd been rejected by the VA, which was a shock but common 20 years ago because the VA was underfunded, understaffed and generally poorly run.

It's much better now, unlike my disappointing experience in the early 2000s. In summer 2018 the VA sent me another reminder that I was already in the system and all I needed to do was show up with my ID and I'd be taken care of. At the time the county hospital's public assistance program had basically shrugged me off for the collision injury, although they offered to take care of my thyroid surgery. I had cancer, but it was encapsulated by a dead, calcified thyroid lobe, so no chemo needed. I showed up at the VA in July or August, not expecting much. But they got me into the system within an hour and I saw a doctor for intake the same day, and got my first batch of meds from the pharmacy that day, with others mailed to me within a week.

After my grandparents died I had maybe a year to myself before my mom showed early signs of dementia. When I visited I noticed her in-home aides and nurses weren't doing a good job. And mom was neglecting her medical appointments, prescriptions, diet, etc. I became her caregiver, which turned into a full time unpaid job as her condition worsened. So that kept me busy for years and distracted from my own problems -- and distracted from taking care of my own health. But it all caught up with me in 2018.

And my local cycling friends were supportive as well. I was pretty much a hermit through the rest of 2018, unable to ride outside for several months. They'd message or call to see how I was doing. A couple of them kept my bike after the accident and replaced the damaged wheels and handlebar.

Cycling is therapeutic, even if it's just an easy spin on the indoor trainer -- pretty much all week while it's cold and rainy outside. I've never found another physical activity that suits me so well.

canklecat

That's amazing. And encouraging. You should volunteer for a pain study to help figure out why some folks recover so well while others continue to experience pain long after injuries have technically healed.

Coincidentally, that's the gist of the one topical analgesic I've tried that actually works -- Ted's Pain Cream. I've mentioned it before. The stuff was developed by neuro-scientists with UT-Dallas. They began investigating cannabinoids but shifted to resveratrol when it appeared to work better, particularly as a topical for surface level chronic pain. The theory is that resveratrol resets pain nerves that get "stuck" and continue signalling pain long after the injury has healed.

I was skeptical. It didn't work for me when I tried it immediately after my injury in 2018. But a year later I tried it again when I still had small, dime-sized spots of intense pain around my shoulder blade. This time it worked. It seemed to confirm the theory that resveratrol doesn't numb pain from active injuries, but does reduce residual pain from healed injuries. For athletes and active people this is important because we're inclined to re-injure ourselves if we take meds that numb all pain and resume full activities before an injury has healed.

There's probably a good scientific explanation for differences in experiences and perceptions of pain.

noodle soup

The thing you should take into account is that I ride more than most people. In the past 8 years, I've ridden over 100k miles, and probably well over 300k miles in my lifetime. If you put yourself at risk that often, an accident with a motorist is probably likely to occur eventually.

bruce19

I've posted this before but I'm feeling really lucky reading all this. About 6 yrs. ago I broke my neck in a crash. Put my teeth (chipped) through my lip, several vertebrae fractured but the big one required a fusion of C1 & C2. It happened on July 24th and I was back on the bike in November. And, I am riding really well. No discomfort but I am using an Italian Road Bike mirror since my ROM is compromised. As I said, I'm feeling really lucky.

big john

Have you experimented with your fit at all? The conventional wisdom on fit doesn't work for all of us, some people use odd set-ups to make things work.

Have you experienced the same discomfort on a different bike? The ride qualities of bikes can vary greatly. I had a Cannondale CAAD5 which beat me up on rough roads and I bought a Gunnar Sport (longer wheelbase, slacker angles, steel frame) and the difference was huge. Much more comfortable. I don't know if your Jamis is a particularly stiff frame but maybe you could borrow or rent a different bike just to see how it feels.

ashongut

I remember I did have the bars higher at first back when I first got the fit. Still had pain, so the fitter dropper the bars down a bit so my back was flattened the most. Still feels the same. Since then I haven't played around with anything. I feel like I don't want to change anything since I spent $400 on a fit that was supposed to make things better. But it didn't help at all anyways (stupid logic). I was thinking I should try a different bike too. Would like to borrow another short persons bike. I only have one road bike I've been riding and have never put much mileage on any other bike. I have about 7000 miles on my Jamis at this point.

ups

I don't want to sound critical because you are having a tough time. So I will try to lay it out softly.

First thing is set an appointment with a psychologist. Why? You seem to have some addictive characteristics to your behavior. Meaning if you keep doing something despite increasing negative consequences, you are intentionally harming yourself. Either you dont realize it, or can't stop it. But taking to something and immediately immersing to an obsessive level is a sign something may be driving you.

Secondly, take a look a look at what you get out of your high mileage and road riding persona. Whatever you get from it is more important than your health and pain free life. Whatever you are suppressing is at least as, if not more painful than the harm you are causing yourself.

Third, yes try a new bike. Flat bar road, touring, endurance etc. Something that doesn't cause you to bend your neck for so many hours. If you can't fathom riding one of those styles, refer to point 1.

Last, find a PT who rides and ask them to do a long ride or two with you. If the exercises make you feel better and riding makes it worse, there may be something around your technique which is causing the pressure and pain.

Good luck.