Back Pain

Hi all, does anyone have a suggestion that will work for getting rid of back pain? (Other than narcotics.) So far I have tried: stretching, yoga, walking, massage, chiropractic, my GP, ibuprofen, ice, and heat. Oh yeah, and alcohol and hydrocodone, neither my solution of choice. It hurts the most when I am lying down, hence my distress. It is upper/middle back pain.

Any suggestions or solutions much appreciated!


Do you know why you have back pain? Check with your Doctor. With me the best thing was walking. But that was me. Also I went through PT.

Two questions.

  1. Are you averse to moving around parts of your own spine?

  2. Do you have $30

Work with a physician, perhaps a physiatrist (that’s what specialist I’d go to if I had enough chronic back pain). If your back pain has a neuropathic component, it might benefit from use of such medications as nortriptyline and/or gabapentin, or similar (amitriptyline and pregabaline, among others).

Otherwise, home exercise programs, stretching, ice/heat, meditation, alternating use of NSAIDs and APAP, massage, trigger point injection, ethyl chloride sprays, epidural blocks, steroid bursts, etc. could also be helpful interventions, depending on the reasons for the pain.

I am not a board-certified pain specialist, but I do a LOT of chronic pain work in my practice. AND I rarely prescribe narcotics for these cases.

Heh, Qadgop, is there any physician who does not have a large percentage of patients with back pain?

My understanding is that whichever engineer designed the human spine should be fired. Or is it that we never should have arisen from walking on all fours?

A friend just got and epidural. This was mentioned somewhere up-thread. This might be the current treatment of choice, aka ‘fad’.

The spinal design looks pretty good for walking on all fours. It’s in slight compression, and muscles between the bottom of the ribcage and the pelvis serve two purposes by providing a floor to the guts and counteracting the tendency of the trunk to bow downwards.

Then, when we stand up, it’s obvious why it all goes to hell. The muscles in the back have to hold the body up, because the spine was so much closer to the rear, and this is difficult because those muscles are pretty close to the spine making their lever arm small.

So, we tended to fix this by moving the mid lower spine forward, getting it closer to the center of the trunk. But that’s pretty difficult, because we give birth through the middle of the pelvis, so the birth canal has to remain big and the bottom of the spine has to get rearward to stay out of that canal.

We wind up with all those curves. The disks wear out. They bulge, and when they close off the little side canals where the nerve roots are, whammo.

Where I work I often assist doctors when they administer epidural or nerve root injections for back pain.

The neuro radiologists have told me that these injections are effective about 70% of the time–depending on what area is being injected as well as the degree of “damage.”

Also, there’s no way of knowing for how long the relief will last. On some people they last forever. Others a few months. Still others a few weeks. Others, not at all. Sometimes they work well the first time and then not so well later.

Kind of a crap shoot.

In order to receive one (at least where I work), you’d first have general x-rays of the area of the spine that is affected. Later, you’d have an MRI. Those would help to determine if you were a candidate.

I should also note that all the injections we do are either in the cervical or lumbar areas of the spine. I’ve never seen a thoracic injection. Doesn’t mean we wouldn’t do it, I suppose, but that there’s generally fewer complaints of thoracic pain than in the other areas.

As to what they inject…we use a steroid and a longer-lasting anesthetic. Any immediate relief is usually due to the anesthetic. It takes a while for the steroid to “knock down” the inflammation–which is what would generate long-term relief.

Unfortunately, my own back pain has reached a point where I’m looking into trying out an injection. I’ve had the x-rays and the MRI, but that was several years ago, and they confirmed the reason for the pain (spondylolysis, spondylolisthesis). I’m scheduled to have them again. After that, there will be another neuro consult where we discuss options. Then I’ll have the injection.

I believe I’ll have someone write something like, “Patient is a big sissy–use extra lidocaine,” or “Neuro Rads Rock!” on my back before I go in there and have the 3 1/2" needle stuck in my back.

ETA: I wouldn’t call them a “fad.” These procedures have been being performed for many, many years.

A psychological component perhaps? Low (lumbar) back pain is fairly common; upper and middle back, not so much. If you’ve had no recent injuries (e.g., fractured ribs), it’s probably not skeletal, but muscular. What’s going on in your life to cause stress and psychosomatic manifestations? Hurts most when lying down – all the time, or just at night? Do various body positions help or hurt? (Fetal position helps my low back pain.) Can you relate it to anything else – emotional, environmental? When nothing, including heavy-duty medications, work, that tells me it’s more than physical.

My brother-in-law swears by this book.

The central claim is that a lot of back pain has a psychological underlying cause. That is to say, the pain is a real physiological phenomenon, but it is your brain that is causing the physiological changes that result in pain, in an attempt to “distract” you from some kind of psychological burden/stress that’s going on in your life.

He said that simply by reading the book a few times he was able to get rid of a great deal of his back pain. I don’t think that’s the intention the author had when he wrote the book, but a significant idea in the book is that when you start consciously paying attention to the pain and realizing that there is (or may be) some underlying psychological cause, your brain tries to maintain the distraction by moving the pain around to different locations, but eventually gives up, and the pain just kind of goes away.

Hard to believe I guess, but for $10, it (the book) seems like a pretty reasonable gamble if expensive therapies and addictive narcotics aren’t making good things happen for you.

You didn’t mention muscle relaxants. Flexiril worked great for me. Also, I notice you don’t say how long you tried the various remedies. You can’t expect the pain to go away overnight. I had severe low back pain after standing and walking for hours at Sea World. I put ice on it and rested for three days before there was any improvement. As others have said, work with your doc. If there is a psychological component, the doctor can help with that too - refer you to someone and maybe give you something for anxiety, stress, or whatever might be contributing. Good luck.

When I have severe lower back pain, which fortunately only happens once or twice a year, my muscles spasm badly, often to such a degree that I look like I have rather scoliosis. My doc gives me a muscle relaxer (Skelaxin or methocarbamol), plus Celebrex. It goes away in about a week.

One thing I’ve learned not to do is use a heating pad. It feels good while in use, but afterwards the pain is as bad or worse.

My inversion table works for my back pain. My husband’s back is too far gone to get as much relief from it as I do, but it still helps him somewhat. I don’t know if it would do you good or harm.

Hi all, thanks so much for the info and suggestions.

Wesley Clark - looked at the link to that spine thingy on Amazon, but was not convinced. Did go out and buy the so-called Miracle Balls and they are okay, but certainly not Miraculous.

Sycorax - It hurts lying down - any position, any time of day or night. I’m sure there is a psychological component (though the pain is definitely real, and physical). I have been in school for the past two months and it has been stressful. Plus related to school I’ve done some lifting that I normally wouldn’t do so that could have contributed/caused an injury in the first place. Ironically, it’s massage therapy school, so we have to lift the massage tables to set them up. I decided to quit school because I don’t think bodyworkers should have to abuse their own bodies to heal others’.

So for an update - I went to a physical therapist last week and she ran me through a bunch of exercises and stuff which seem to be helping (a little). However I’m still taking hydrocodone and now a muscle relaxant, every night, so I can sleep. I went to Urgent Care twice and on the second time (the follow-up), the doc said he doesn’t think I should exercise at all, including stretching and PT, because the injury needs to heal. He also ordered an MRI because he said my back would not have continued hurting for five weeks with just muscle pain.

I can’t tell whether I’m relieved or not. I do not want to have back surgery.

How controllable is that? I would hate to lose sexual response just to gt rid of back pain [ask me again when it has gone into spasm and I probably would have a bit different answer…]

A doctor once told me he believed the root cause of 80% of back pain is weak back muscles.

Consult with a fitness adviser and/or book, then hit the gym a few days a week and do back exercises.

Equally at fault are weak abdominal muscles. There are exercises you can do at home to strengthen these.

Have you tried sleeping with a roll between your knees? It really helps me.

Also, try a new pillow. Look closely at how you’re sleeping, attempt to improve on it, where required. This actually gave me more relief than you might imagine.

I would recommend this.

I have had two discograms. This is a procedure where they inject dye into the discs of the back to see which of the discs is causing the issue. It is very, very “uncomfortable” in the sense that doctors use when they don’t want to say “this is going to hurt as bad as the worst time your back went out and you were becoming gray and shocky in the emergency room”. I underwent this procedure twice, and it was my neurologist’s experience that patients rarely agreed to go thru this after having experienced it once.

Based on the fact that I am stupid enough not to learn from my experiences, the neurologist wrote on my chart “Patient appears unusually tolerant of pain in that region”. This, as your third grade teacher used to threaten, goes on your Permanent Record. And yes, in this case it is just as bad a thing as she made it sound. Because it may result in the intern deciding to try to relieve the spasm by pulling hard on your leg. This is “uncomfortable”, in the sense of 'likely to cause you to scream loud enough to scare your wife, who was trembling in the lobby and came running down the hallway like the Wrath of God to make sure the next person to come into range is holding a dose of Demerol sufficient to keep every heroin addict in Bedford-Stuyvesant happy for a long weekend".

Bottom line is, don’t be a hero. It doesn’t pay, and the hours suck.

The only thing that helps for me is physical therapy - lots of core exercise, and basically managing the problem in between acute episodes. I’m different from dragoncat - I wanted to have surgery (fusion) as it apparently cured my mom and my uncle of their back pain. But the orthopedic guy recommended against it - he said it “usually” didn’t help. Go figure.

Tincture of time and scientific neglect are two of the most powerful agents in the modern medical arsenal. Get up and walk around every hour or so - I often deliberately drink a lot of water sitting at my desk so I have to get up every hour or two whether I want to or not. This includes at night.

I hate muscle relaxants - they make me feel like a zombie. And they make me sleep so hard that I don’t move around and I wake up nearly immobilized.

Good luck. Sucks, don’t it?


OK, let me suggest this again:

The Chinese Position 1

  1. Stand, feet slightly apart, toes pointing outward (about 90 degrees is good, but it’s not crucial; this is just for balance.
  2. Crouch down, backs of your calves touching the backs of your thighs. Clasp your hands together in front of you, arms extended. Relax your neck and let you head hang down.
  3. Hold the position for 30 seconds to a minute.
  4. Slowly rise.

This always makes a sore back feel better.

Chinese Position II
If you have trouble holding a crouch, do this one.

  1. Get on your knees.
  2. Crouch down, backs of calves touching the backs of your thighs, arms out, head relaxed.
  3. Stay in this position for a minute or so.
  4. Roll onto the floor and then get up carefully (or just get back onto your knees again, then get up).

This isn’t as effective, but does work. Both are great for any back pain.