Need help with increasing back pain.

LightChucker

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Golly, guys, you have really done a great job of giving me things to look into and try. I appreciate it so much. It has given me hope when I was feeling pretty hopeless.

Thank you so much!

Chuck
 

turbodog

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cognitivefun said:
I don't casually throw out this statement. There was a front page NY Times article some months back that backs me up.

It turns out that back surgery has a very poor prognosis. But the back surgeons said "how will we make our living if we don't do it?" I'm not kidding.

....


I agree.

I have been holding my pelvis as straight as I can for years, and have not had back pain since I can't remember when. FWIW, I used to go to a chiro for lower back pain.

Every now and then it flares up if I do some excess lifting, but a trip to the gym's back extension machine clears that right up. Matter of fact, that machine works wonders for lower back in general.
 

cobb

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You need help increasing your back pain? Where do you live, I can fix you up with my mag light and braker bar. :) I will have you in 4 times as much pain as you are in now.

I am guessing you want to make it less as its getting worse?

I went through all the BS listed in this thread for my pain. 3 things worked for me that got me out of the wheelchair of 9 years which I used cause of back pain soo bad I would crap my pants and go days without sleep.

1. Anabolic Steroids, T Bomb by MHP
2. Protein by METRX powder, RTD 40
3. Creatine, Creadrive

Go or get someone to go to GNC or viatmin discounters and get you a shake for less then 4 bucks and see if its less 15 minutes later after drinking. Muscle Milk or RTD 40.
 

Hookd_On_Photons

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I have a personal interest in this particular issue. I have had two lumbar discectomy procedures (L5/S1, the second one was for recurrent herniation).

Spine surgery works well to relieve "radicular" pain, which is radiating pain into the extremities from a pinched nerve root (hence the term, from radix, "root"). "Axial" pain (in the spine itself) is much more problematic, because it is difficult to ascertain the exact source of the pain. The pain might be from degeneration of the disk space (i.e. arthritis), maybe from bulging of the disk itself, or maybe from the facet joints (articulating joints on the posterior aspect of the spine, which link up each vertebra to the vertrebrae above and below).

It sounds like your pain is axial, so I would definitely try the nonsurgical treatments mentioned in the thread first. If you had primarily radicular pain, I would not hestitate to recommend surgical decompression.

Some spine surgeons might recommend a discogram. This is a minor procedure in which the surgeon (or pain management specialist, or radiologist) injects radio-opaque dye into the disc space. An X-ray imaging device is used to confirm that the injection was performed within the correct disc space. If the injection reproduces the pain, then you have some assurance that the pain is discogenic.

Sometimes a similar strategy is used to ascertain if the pain is caused by the facet joints.

I think the advice regarding exercise and maintaining muscular tone (the abdominals and paraspinals) is good advice. If you are overweight, losing weight would probably also help, but that's easier said than done (as I know all too well).

I can't tell you much about acupuncture and magnets. I can honestly say that most docs are not against "holistic" or "non-traditional" treatment. There is not some evil medical-industrial complex trying to suppress alternative medicine. The problem is that Western docs are good at intervention, and are not well-trained in prevention or actual health maintenance. Part of it is because there's not much profit in it from the doc's standpoint. Part of it is because patients don't like to hear they need to exercise, or lose weight, or stop smoking. Let's face it, most people don't need a doctor to tell them what they need to do to improve their general state of health.

Another objection docs may have is that many of the accounts of successful application of alternative treatments are based upon studies with poor methodology. Truthfully, many studies of "mainstream" medical treatments have poor methodology too. It is very difficult to perform randomized, double-blinded, placebo-controlled experiments on human beings.

I don't have any objection to trying chiropractic manipulation, but I don't agree with their theory of the pathophysiology of spine problems. Studies have demonstrated poor inter-observer and even intra-observer reproducibility of interpreting spine radiographs for "subluxations". And I can tell you from personal experience that it would be very difficult to correct any spinal subluxations with manual pressure. I am not flaming chiropractors as charlatans. Studies have demonstrated poor reproducibility among orthopaedic surgeons and radiologists in grading the severity of fractures and other bone conditions (e.g. Kienbock's disease, Legg-Calve-Perthes disease) as well. And our understanding of diseases is revised constantly. (I would say that if your chiropractor tells you he can cure diabetes, asthma, and cancer with spinal manipulation, then run away.)

I do believe that chiropractic manipulation has therapeutic benefit, and reduction of symptoms has been documented in clinical studies. There may be some beneficial physiologic effect from manipulation, probably through release of endorphins or cytokines from mechanical stimulation. The same holds true of acupuncture; nobody has ever demonstrated evidence of "chi", but needling has been shown to reduce pain. Interestingly, a recent study demonstrated that sham acupuncture (piercing sites that are not "true" acupuncture sites) is at least as equally effective as "real" acupuncture.

This is not to say that alternative medical treatments are bogus. Remember, many studies of mainstream medical treatments have equally flawed methodology. And our scientific knowledge of why those treatments work may not be accurate. I don't think anybody can honestly tell you why corticosteroid ("cortisone") injections help conditions like trigger finger, DeQuervain's tenosynovitis, and carpal tunnel syndrome. The pat answer is "anti-inflammatory effect", but those conditions are almost always not primarily inflammatory in nature. I can tell you that the injections have been shown in blinded studies to be more effective than placebo (saline injections), but I don't know the exact physiologic mechanism. The same could be true of chiropractic manipulation (i.e. it helps, but not for the reason we think it does), but I don't know how one would design a study that would include placebo manipulation.

Most back pain will resolve on its own within a few weeks, even without any intervention. The problem is that you may develop recurrent episodes of pain, depending upon the underlying source.

Spine surgeons in America, as a whole, do tend to operate too much. When you're trained to use a hammer, everything tends to look like a nail. It's difficult to have a patient keep on returning to your office, telling you that their pain is not getting better. At some point, it becomes tempting to recommend surgery because nothing else has worked and you're tired of seeing the patient keep coming back... even if you're not fully confident the operation will work. And yes, there are a few surgeons who are in it for the money, don't care if the surgery will work or not, and cut on anybody who shows up in the office.

It is only fair to point out that Americans sometimes expect too much from modern medicine. Some problems cannot be fixed, only managed. Often, patients will seek surgery rather than pursue a difficult treatment option (threapy, weight loss, abstinence from smoking/alcohol). Maybe it's because surgery is presented as a "quick and easy" solution, maybe it's because the patient can then pawn the responsibility off on the surgeon rather than accept some responsibility for their own fate. Some patients actually demand surgery even if the surgeon advises them it won't help ("You've got to do something!") Sometimes there is no cure for the problem at all. Very few people are willing to accept that.

I would try gentle exercises or therapy, heat or cold (as appropriate), and maybe a TENS unit until the pain improves. Then you could try an abdominal and back strengthening program, once you are able to tolerate it. Find an experienced therapist, one with a few grey hairs. The young ones right out of therapy school do not understand the aches and pains that come with age, and they tend to assume that you should bounce back from injuries within 3 weeks just like they do. There is no harm in trying magnets or nutritional supplements, and they might do you some good. Be careful with non-steroidal anti-inflammatories (like aspirin, ibuprofen, naproxen), because they will eventually harm the GI tract and kidneys. "Threre's no such thing as a free lunch."

What's worked best for me was weight loss, maintaining an abdominal and back strengthening program, and maintaining cardiovascular fitness. As I said before, easier said than done. I still have periodic episodes of axial back pain, which is due to progressive arthritic degeneration of the disc space after disceectomy. There's that free lunch thing again...

Sorry about the long post/rant. Sorry if I've stepped on any toes. I don't claim to be omniscient, but I couldn't let that "all doctors are idiots" statement stand.

That's my free advice, and it's worth every penny. :nana:
 

cognitivefun

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turbodog said:
I agree.

I have been holding my pelvis as straight as I can for years, and have not had back pain since I can't remember when. FWIW, I used to go to a chiro for lower back pain.

Every now and then it flares up if I do some excess lifting, but a trip to the gym's back extension machine clears that right up. Matter of fact, that machine works wonders for lower back in general.

Yes. And to be very clear, it isn't *strong abs* you are looking for. It's *using* what you have at all times. Lifting your abs to make your pelvis straight and remove the exaggerated curve in your lower back.

You can exercise to make this better, but what really does it is constant use. Retraining your abs to lift your pelvis at all times.

The main exercises people use to build up their abs, crunches, *do nothing* for this. What you need to do is simply lift your abs up all the time, and your back pain will generally disappear.

It is so simple.
 

Hookd_On_Photons

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cognitivefun: the abdominal exercises helped me quite a bit. I found out that technique purely empirically. I might check out that book you recommended.

Do you perform isometric abdominal contractions? I often do those while driving, sitting at a desk, etc. I don't know if they've actually improved abdominal strength, but they seem to help with resting muscular tone. Paying attention to posture helps, but it takes a while to retrain your body.
 

lightlust

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  1. Any MRI is a dynamic snapshot.

    Disks move. They bulge more or less based on position. An MRI showing "minimal bulge" only means just that when you're lying in THAT position.
  2. Much back pain is caused by a viscious cycle of tendonitis-like symptoms.

    Stress on your back causes the muscle and tendons to become more strained as your activity demands they compensate for existing pain.
  3. Avoid surgery unless neccessary.

    Pain can be managed. Loss of motor control needs surgical action.

    Remember that cortisone injections are also inherently somewhat destructive to the tissues they help shrink.
  4. See a sports/athletic/occupational physical therapist.

    It will hurt. A lot.
    It will be work. A lot of work.
    It will take time. (Yes. A lot of time.)



    See #3.

    Do #4.
Best Wishes and Good Luck,

V.
 
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cognitivefun

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Hookd_On_Photons said:
cognitivefun: the abdominal exercises helped me quite a bit. I found out that technique purely empirically. I might check out that book you recommended.

Dr. Bookspan's website has articles that really explain everything quite clearly.

Do you perform isometric abdominal contractions? I often do those while driving, sitting at a desk, etc. I don't know if they've actually improved abdominal strength, but they seem to help with resting muscular tone. Paying attention to posture helps, but it takes a while to retrain your body.

I pay attention to posture all the time. I have gotten into the habit.

The one exercise I do is to lie flat on the floor on my back. I tilt my pelvis so the small of my back is completely flat on the floor, along with the backs of my legs. I hold my arms over my head and lift a weight about 1 inch off the floor and hold it there as long as I can.

I must emphasize, though, that this isn't strength that you are building, but endurance. These muscles are made to work all the time you are awake. They simply need to be *used*. It is through one or two weeks of use that you will gain all the tone you need.

I run (barefoot) also, and with my abs up, I suffer no back pain whatsoever, contrary to what I used to experience before I learned about this.

The sad fact is that most of us have back pain because we are not using our abs when we stand up and/or walk around. Only by consciously using them, can we regain our posture and save our backs.
 

jeep44

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A few more small tips. Years ago, I hurt my back badly by stupidly trying to drag something very heavy up a hill. I was in severe pain for about 12 weeks. I had sciatica, and just a slight touch to the area on my butt where my wallet normally was caused immediate pain. On the advise of someone else, I moved my wallet to the other side-this helped, and I have never worn my wallet on the "old" side again. I also started sleeping with a pillow between my knees (or under my knees if on my back). I think this helps to keep by back straighter when I am sleeping,and now I cannot sleep unless I do have this pillow-i've grown so used to it that I stuff it back between my knees as I turn over at night in my sleep. I really think this is the best thing I did to help my back.

Another point. There is indeed a connection between the mind and the back. At the time I hurt my back, I was doing a total gutting/remodeling of a summer cottage, which I really was not qualified to be doing,and I was very worried that I was in way over my head. I didn't want to admit to my wife that I wasn't sure I could do it. One day, as I was recovering, I picked up a book about back pain,and read about this connection. I asked myself if I was "using" this back pain to avoid the whole remodeling situation. Once I realized that I was, I was well on the way to recovery, and in 10 years I have never had a recurrance of pain, even though I've since done much heavier work.
 

greenLED

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I hurt my lower back in a logging operation many years back. I went to an orthopaedic surgeon, who did not recommend surgery, but had me on pain killers and anti-inflamatory drugs for the longest time. I finally got tired of the "game"; quit taking the meds, stopped seeing the doctor, and went back to work regularly. My pain came and went for about 4 years...

I had a pretty active life back then (unlike today, sad) and after a long exercise session we were stretching. I did one of those stretches where lie on the floor and swivel your legs in one direction and your arms/torso in another direction. At the peak of the extension my back cracked and I felt something pop. It hurt like @|~# so I remained in that position for a while (until I could breathe enough to make myself straight again. I then slowly did the reverse extension, and my back popped a little softer. My back hurt for about 72 hours after that, but the lower back pain was gone! Gone with the wind!... until last year

I hurt my lower back again last year while carrying my baby on my shoulders. It was bad! I was hunched forward and could not get upright again. :rant: It took about 5 minutes for me to be able to walk again (straight home - to bed). My doctor sent me to PT, which I've been doing regularly. The PT crew are making me do McKenzie-type extensions. They hurt like @|€#!, but they do ease up the pain. It's gotten better, but now I feel like my entire back is weak; I almost can't bend forward because I know I'll get pain again.

I'll have to try the pelvic rotation thingy. I also looked on-line for exercises, advise, etc. but almost all of it sounded like quackery to me so I dropped the on-line research. That said, I had a separate injury to my inguinal ligament that only went away with acupuncture - I din't believe in that stuff, but after 9 months of taking anti-inflamatories (strong, arthritis-type drugs), it took only 3 weeks of acupunture sessions.

What was my point? I don't know.

Chuck, I hope you find something that works for you. I know from experience that it is a b#@ to deal with back pain. Like somebody said, it's more in the management than in the cure... best luck.

Still don't know what my point was. Maybe I was trying to relate, or... nevermind. I did remember a bit of caution with some of these exercises. Talk to your doctor or PT person before trying them. I know from experience and knowing how my injury works/where it is, that some exercises actually make the pain worse. For example, I cannot do forward sitting extensions; it means instant pain that I have to work against.
 
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Hookd_On_Photons

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Chuck, one more thing...

You mentioned that the pain is in your hip.

Have you actually had an X-ray done of your hip?

Yeah, it sounds stupid. But sometimes docs get lazy. If you have an established history of back problems, your doc might assume the hip pain is referred pain from the lumbar spine, when it could actually be a problem with the hip joint, sacroiliac joint, or pelvis. And yes, it is fairly typical for lumbar pain to be referred to the buttock or hip region. Still, if the pain is mostly in the hip region and nothing has helped, maybe further investigation is needed.

Have you been evaluated by an orthopaedic specialist?

Sometimes a doc will order a study (MRI, CAT scan, whatever), and make decisions based solely upon the radiologist's report. An orthopaedic specialist should be able to read the MRI, CT, myelogram, etc. by himself, and use the radiologist's report as an adjunct to his personal interpretation. The radiologist has the disadvantage of never having access to the patient for an interview or physical examination, so he might focus on findings that are clinically irrelevant, or miss something because he doesn't know where the symptoms are.

I don't want to unnecessarily worry you or second-guess your physicians, but there have been cases of arthritis, avascular necrosis of the femoral head, or even bone tumors missed because of faulty assumptions about the source of pain.

Of course, if I've misinterpreted your post and the pain is mostly in the lumbar region, then I apologize for wasting your time and CPF's bandwidth.
 

LightChucker

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I am so happy with all your replies and PMs.

I have tried to reply to the PMs, but IE crashes every time I try. I must have some kind of malware active. Maybe there is something wrong with the CPF software - I don't know. The important thing is that you all know that I have read and thoroughly appreciate your taking the time to reply.

(I hope this reply gets through.)

Thank you so much!
Chuck
 

philiphb

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Getting good medical help varies as to where you live. Go to a teaching hospital, I'm lucky we have Yale University The Uninversity of Connecticut, University of Mass., and Harvard close by. At the teaching hospital find the best orthopedic surgeon in the facility. Get their opinion. Then do it all over again to get a second opinion, maybe the second time from a neurosergeon. Find a doctor you get along well with and trust, one that knows their limits and acts as a resource specialist. Talk it all over with them, going over the findings from both of the docs who you saw at the teaching hospital. Then do what you need to do, massage, exercise, lose weight, prayer, pain management and/or surgery. Do what works for you, I don't care that some folks don't like shaking rattles and chanting...if it works- do it.
 
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