Doctors and back pain

In My Humble Opinion
1

I’ve been having periodic low back pain for a couple of years now. It started sitting in my home office chair and now I get it when I’m in a car for long periods of time (which is often.) It’s usually toward the end of the day. Sometimes I just get it for no apparent reason at all, even in the morning, and I thought it was probably related to how I was sleeping.

Toward the end of last year, the pain became significantly more frequent. For about three months I’ve been doing physical strength and conditioning exercises on a regular basis - not just back-related, but weight lifting and HIIT type stuff. I got a new mattress and a knee pillow for side-sleeping and it seemed to lessen somewhat (laying flat on my back hurts.) I got a myofacial foam roller to squish out the muscles. I got cushions for my back in the car and at my desk. Last week for my birthday I got a new office chair - pretty much top rated for comfort/ergonomics. I’m just telling all this so you can see I’ve already tried quite a few things to help.

Usually the pain is mild to moderate and only intensifies when I persist in holding whatever position I’m in. Well, today I was sitting in my brand new office chair for less than an hour and it happened again, only this time I was in so much pain I had to lie down on the couch with an ice pack and not move for a couple of hours. It felt better at first, but sitting up on the couch with my laptop, it has intensified.

I’m 50 lbs overweight, and I’m almost certain that is contributing to this issue. I mean just thinking about it from a common sense perspective, most of the people I know with back problems are overweight. I’ve always had a large chest and gaining weight has of course made it even larger, putting more strain on my back than in the past. I’m starting a weight loss plan with a fitness/nutrition coach and continuing to strengthen the muscles in my back.

Ordinarily, this is a time when I would go see a doctor. But the truth is I don’t have very much confidence in modern medicine to fix back problems. I’ve never met a person who said, ‘‘I went to the doctor for my back pain, and it helped.’’ Mostly what I’ve heard are horror stories of people getting expensive back surgery and then being more screwed up than before. Then they have to go on disability or something and spend the rest of their lives in pain. To me the only way out seems like just getting really strong and fit to prevent further deterioration.

So I put it to you good folks - have you ever been helped with back pain by a doctor? Am I better off just sticking with the exercise and getting rid of these extra pounds?

Olives,

Christy

2

One reason I would suggest going to a doctor is to see about getting a referral for physical therapy. They can help determine exactly what is going on - (is it muscles, bones, nerves, or a combination? if it is muscles, then which muscles, specifically - stuff like that) and then help with special stretches and exercises to strengthen/stretch the offending elements. Exercise and physical training and weight loss are great, but PT can suggest specific exercises to help with your specific problems.

Cite: my dad, who had back pain that was significantly improved by PT

If you go to a doctor with a first-time complaint of low back pain and they immediately suggest surgery, you should run away as fast as your back will let you.

love
yams!!

3

I agree with you 100% about no confidence in modern medicine to fix back problems… I’m a big believer in modern medicine, but I truly believe the go-to fixes for drs. tend toward drugs, scans, surgery, and the like, because most patients don’t have the patience (heh) to explore long-term solutions.
I battled with a bad back, for no apparent reason (note: I am not overweight) for two years and it got progressively worse. What finally started the healing was (I believe) a combination of things:

  1. A deep tissue massage therapist who specializes in treating injury/pain, who gave me very specific things to do at home (it involved laying on a tennis ball to “release” tensed up muscles) to continually treat the muscles.

  2. Yoga / yoga exercises that are classified as “restorative”. I got these from a small yoga studio, where all of the instructors were very experienced and very, very intuitive about poses and positions that provide relief / release. One class in particular targeted back- and shoulder- “opening” poses that were held for several minutes at a time, and felt very natural and good. (no yoga skill needed).

  3. I did go to an MD, who did blood work to rule out a specific thing, and did an x-ray. This was helpful in the “is there anything obvious that might be causing it” sense (there wasn’t). The x-ray showed arthritis in the general area of the pain, which I thought was the root cause. However another doctor friend mentioned that it is very, very common to have spinal arthritis to some degree, and it does not necessarily mean that it equates to pain. (In my case he was absolutely right… I have no pain to this day).

  4. For maintenance and prevention, I concentrate a lot on ab and back muscles, well-stretched hamstrings, and good tennies when I exercise.

My advice to you is to keep doing what you’re doing re. different natural-based solutions: exercise, weight loss, pillows, etc., and keep exploring similar things. One book I read (“Healing Back Pain Naturally” or something like that) also gave some insights (there was a bit of woo in it but it also had a lot of practical things like nutrition and exercises… I don’t have the patience for the nutrition part of it but you probably do) that may give you ideas, also.

4

You might be better off having an ergonomics assessment. They made me have one at work and my moderate upper back pain decreased by 90% once I sat in the chair they recommended at the right height, with a footrest and the wrist supports for keyboard and mouse that were bought at his suggestion.

5

I second this. PT can be amazing. No drugs, just light stretching and exercise.
Now if I ever get the beginnings of back pains, I know what to stretch and to strengthen my core muscles more.

6

Not me, but my boss just had back surgery and feels incredibly better. The problem with the complaint of “back pain” is there are probably as many causes as recommended treatments. Losing weight and relaxing might help, but maybe not if your problem is that you have a crushed vertebra or something.

7

Not back pain, but I once had really bad hip pain which turned out to be caused by an inadequate chair. The doctor’s diagnosis “it’s just muscular, have some tylenol” “the reason I’ve come is that tylenol ain’t doing shit” “so have another”.

My mother’s had back and joints pain since she was a teenager - her exact diagnosis has changed so many times that nowadays we just say “bad bones”. There were a series of winters during which she’d get into bed just after the end of the Christmas season and not get out for a while, and the time she spent bedridden kept getting longer and longer. The winter Dad had been fired from a job which made him very unhappy but her very happy, the back pain and the depression combined with inadequate treatment from her doctors (the painkillers got her addicted but they didn’t really do much for the pain) to keep her bedridden until that frabjous day when she was sent to a doctor in The Big Hospital In The Province’s Capital; the new doctor saw her walk in, said “herniated disk, surgery - you’re from out of town, aren’t you? OK, I’ll want you admitted tomorrow, we’ll operate day after.” Haaaaallelujah! The recovery still took months (among other things, because it wasn’t only from the surgery and because she’d been in bed for so long), but by the time I was to leave for college I was actually able to (yeah, I’m selfish and wanted to have a life, sue me).

8

I went to my doctor, and got helped with my back pain.

But it wasn’t really “back pain.” It was basically muscle tension from sitting in one position for far too long, and with poor posture at that. I’d never had back pains, but slowly the twinges and stiffness got worse, until one day I woke up and could barely stand straight, painful to walk; felt like someone was stabbing me in the lower back with a knife.

Lurching off to the doctor, they found all the muscles on one side of my back were tensed up into knots. Painkillers + muscle relaxers (not for long), and alternating hot and cold on the area fixed me up. I’m doing more stretching before and during working out now, and have to pay fanatic attention to my posture while seated: spine arched, shoulders back. And stand up and walk around every half-hour or so. Otherwise, I’m back to limping around pitifully.

I’m not overweight, but otherwise what the OP described is basically what befell me. So… go see your doctor.

9

Lightray, my husband had the same problem and same prescribed treatments. Lower back pain on one side, treated with muscle relaxants and mild pain relief, heating pad, and lots of stretching exercises.

10

A note on ergonomics: the bestest and most ergonomically designed chair in the whole world is not as good as a fixed chair which happens to have built with your body (type and size) in mind; like dresses, chairs actually have sizes. My coworkers when I had the chair problem were perfectly happy with theirs, but I’ve got very short legs and “duckbutt”; all of them had legs at least 10cm longer and flat behinds (the only one who wasn’t German or Swissdeutsch was an Indian male; the only other woman had no butt to speak of). Surprise surprise, the style of chair that I find most comfortable is a ladderback type that’s traditional here in Spain.

11

Firstly, adjust your chair to fit you properly. Next, hie thee to an osteopath. They worked wonders for me. Another thing that helped me was a 30 minute swim every other lunchtime.

Also, how often do you get out of your chair? Try getting up at least once an hour - go make yourself a cup of tea or coffee or something. You should be taking a break from your computer that often anyway.

If memory serves, you now have an extended commute in your car, don’t you? You might want to take a look at your driving seat and your driving posture.

12

I had problems and studying the Alexander Technique (approach to posture and movement) helped me a lot: http://www.alexandertechnique.com/ With Google, I was able to find a lot of instruction online for free. It made a huge difference in my body tension and the problems that I was having.

Also, recently I started having trouble with something that I’d been able to do in the past. It was like my body was just getting weaker. It turned out the just about everyone I know takes Vitamin D supplements. After researching and finding that muscle weakness is common in low Vitamin D. I tried taking supplements and after a couple weeks, it really has made a huge difference.

13

I went to a doctor for back pain, had surgery, and have so far lived happily ever after. I had a really nasty ruptured disk. All the physical therapy in the world wasn’t going to fix it, not that I didn’t try. In cases like that, putting off surgery actually increases the chance of permanent damage due to constant pressure on the nerve root. Walking out of the hospital after my surgery was the best feeling in the world!

14

This is a good point, and one reason why the chair I bought is adjustable in every conceivable way. Floor height, back height, armrest height, armrest width, back angle, back tension, seat angle - all adjustable.

These have been incredibly helpful responses and I thank you. My coach has recommended the tennis ball thing before. I thought the rumble roller was doing the same thing but maybe something more targeted will be effective.

I’m relieved that there is more I can do to try and address this. I will go to a doc and look into PT, and while I think I have pretty good posture, I might be wrong. I can look into that.

15

I recommend getting an MRI so you have a better idea what you are dealing with.

16

Lower back pain is often disregarded as drug-seeking, which is where I think a lot of the problems begin. But if you have an established relationship with your doctor, he’ll probably be able to help you. As stated above, you gotta find out if it’s an issue with your bones or with soft tissue–bone injuries won’t improve with exercise, but tissue injuries generally will.

17

Agreed. But if you can get it, pain meds work very well for back pain.

I’m a long time back pain sufferer. If there was a cure, there wouldn’t be a national problem so at some point realize this is something you will have to stay on top of.
I have to get up at about 5 everyday to take Advil just so I can move when I get up at 8 for work.

Watching your posture is a must. Always have lumbar support. Also another thing that has really made a big difference in my pain and mobility is traction. I got one of these:

The cheaper ones work just as well but the foot holders on this one make a huge difference in comfort.

Finally, a very good friend of mine had the same back problems. His doctor recommended (and he had) surgery - it only helped for about 6 months. He’s back to his past pain level. I wouldn’t do it.

18

Have you ever tried yoga? I won’t suggest it to “cure” the back pain, it’s not magic, but it helps with posture, and which muscles to use, and also with just keeping lean and fit in general. I’d suggest it as a side to whatever else might help you.

It has helped me so much in just understanding how to do certain movements. My whole posture is much better and I use the correct muscles for certain movements. I used to never even understand how not to use your back for certain movements. People can tell you not to use your back, but how do you not do it? How do you even know? Yoga helped me with that. It’s slow, and you concentrate on yourself and your body.

It’s not easy to find the right kind of yoga for you, there is so much woo. But if you find the right thing it can really help with fitness, muscles and posture. It will take a while of practice before you really begin to notice, but it can help while just being fun and relaxing in general.

19

If you have good insurance, I would go to a doctor (I would try a family practitioner who has a fellowship in sports medicine, as IME they are more interested in doing a thorough physical exam than orthopedists [who prefer to just be in the OR] or internists [who don’t really remember how to do the exam]). Simply because they can determine, through history and exam, whether your pain is related to muscular strain (not really surgically fixable as far as I know and the most likely cause given you age and and presentation) vs. some pathology of the spinal cord or vertebrae (again, less likely but possible) or possibly autoimmune disorder (also less likely but a possibility).

If it is likely a muscular strain then I have heard that PT and yoga are fantabulous.

20

Welcome to middle age.:eek:

I have a bad back. In my case, it is degenerative discs and arthritis. Everybody in my family has back issues, it seems.

My mom and my uncle had vertebrae fused, and both were essentially cured by it. I went in for evaluation, and the orthopedist said it probably wouldn’t help me. Go figure.

Physical therapy helps a lot during an acute episode, which seems to happen to me every couple of years. In between, it is more a case of managing it rather than trying to cure it. I do a lot of stretching, and a bunch of exercises to strengthen my abdominals and lower back muscles, including the obliques. I take naproxen (OTC Aleve[sup]TM[/sup], which helps. During an acute episode, I usually get Vicodin (whee!) for night and a codeine/ibuprufn mix for during the day, so I am at least coherent enough to work. I was on Vioxx for a while, before they took it off the market, which really helped. And it was non-habit forming and not psychoactive.

Try to lose the fifty pounds, which will go a long way to relieve the stress on your lower back. You mentioned that you do HIIT - you should consider doing it on an exercycle rather than by running. The pounding is not good for the lumbar spine.

Backs are funny - I can walk for hours, but I can’t stand for more than a minute or two or it starts talking to me again.

But [ul][li]lots of stretching, both of the hamstrings and lower back, but the front of the thighs and calves as well. [/li][li]Be careful how you sleep. I have to have a pillow between my knees, as you mention. Sleeping on hard surfaces does me no good at all - YMMV. [/li][li]Drink a lot of water. This won’t help your back, but then you will be forced to get up every hour or so to use the bathroom, so you won’t be sitting in one position all the time. :)[/li][/ul]In my experience, doctors come up with a lot of ideas, but none of them work very well for a bad back. The physical therapist told me that there was going to be a fixed amount of pain that I was going to experience with my back - either it would hurt from exercising, and I could retain a lot of function, or it would go downhill because I didn’t exercise it, and then it would hurt because I couldn’t move.

The ortho guy also said that artificial discs, which is what I would probably need, are like fusion power. They are about ten years away from becoming practical - and have been for the last twenty years.

Good luck and God be with you. Getting old sucks, but it beats the alternative.

Regards,
Shodan