Print Story Your Back and You, Motherfucker.
By blixco (Tue Feb 21, 2006 at 09:58:29 AM EST) (all tags)
Even if you aren't currently vexed by low back pain, odds are you will be.

You should know what to do and how to do it.  And you should know right now that there is no definitive answer, should your pain continue, on how to solve your pain.

Note: this article applies mainly to lumbar pain, though it can apply to any disk neuropathy.

You're In Pain.

If you happen to read this while you are in a moment of acute back pain, then I have a few steps that will get you on your feet, maybe get you ambulatory enough to make it to a hospital.

First, get out of bed.  Lying in bed is not good for you.  Your muscles are spasming due to an inflammation, and lying on the area of inflammation won't help it any.  Won't necessarily hurt it, either.  But you need to get the muscles to quit freaking out.  There are two ways to do this: drugs and exercise.  If you don't have any flexiril on you, then use exercise.  Don't worry, it's not tough.

If you can't get out of bed, then roll over.  If you can, then lay down on your stomach.  Now, lying as flat as possible, slowly raise your upper body up using your forearms in a classic Sphinx position.  Pull your head slightly back, keep your head and neck aligned with your spine, which will be all fucked up and crooked but do your best.

Do this ten, fifteen times.  Hold the Sphinx pose for 5 to 30 seconds, whatever feels good.

Now, relax.  Next, do the same move except prop yourself up on your hands...keep your pelvis glued to the floor, and do a press-up.  Hold this for no more than 5 seconds.

Finally, get back up.  Do you know how to get up?

Learning How To Sit, Stand, Move, and Sleep.

You don't know how to get up.  Some of us do.  There are folks who have cages and screws and bolts holding their spines together, and they know how to get out of bed so well, they don't even think about it.  Here's what you do: roll to the side that has less pain.  If the pain is right down the middle, then roll to either side.  Next, use your arms to press your upper body into the air.  ONLY your arms and shoulders should be holding you.  If you are in bed, swing your legs down to help lever your body out of bed.  If you are on the ground, tuck them underneath you and stand to press up with your thighs.

You'll be standing in no time, but you need to work your upper body, upper thighs, and abs to do so.  If your back has moved at all, you'll know.  You'll drop like a sack of rocks if the pain is right.

OK, now re-learn everything else.  Walking: your ass pushes you, you do not pull your feet.  Arms: they move from the middle of your back way back by the shoulder blades, and not pendulum-ing from the shoulders.  Sleeping: cage yourself in with pillows.  Sleep on your back or your stomach, whichever is most comfortable.  Do not move.  Especially don't twist your lower half away from your upper half.  Sitting: posture!  Use a lumbar roll.  Ensure that your back has the right curves, but is relaxed...don't tighten it into this posture!  Breath from your navel.  Don't crane your neck.  Never bend at the waist.

The Pain Will Still Kick Your Ass.

The worst part about back pain is how completely it takes you.  It consumes everything.  Every breath, every second is colored by it.  There isn't a single motion the human body makes that doesn't amplify the pain.  The worst part about back pain at it's worst is the humiliation you feel when you realize you can't get off the toilet.  You can't get out of bed.  You can't tie your shoes.  You can't wash yourself.  You can't cough or sneeze without graying out.  You can't drive, walk, run, or involve the body in any sort of unplanned activity.

You are tethered to your nerves.  If the pain is both acute and chronic, you're not going anywhere for a while.

The pain is most likely due to an inflammation or some other mechanical interference on a nerve root.  A tear or strain can be the cause, as can a herniated disk.  It might be a tumor.  It could just be a mild muscle strain.  In my case, it's a couple of disks.

Traditionally, the pain means the drugs.  And boy oh boy oh boy, do they have the drugs.

The Drugs.

When you go see a doctor these days (post-Rush Limbaugh OxyContin Scandal), he / she will be reluctant to give you an Olde Fashioned Narcotic.  There's a set of really good reasons for this.  However, if you've ever been in the sort of pain that requires an opiate, you know that there is simply no substitute.  There's a really good reason for that, too.  Opiates work.  Your brain has receptors that are made to snarf those little suckers up.  You were designed to be pleased by them.  And they're field tested, having been out there in the known world for about a brazilian years.  The side effects are well known.  The only downside is the side effects.  Addiction isn't one you have to worry about if you take them for real pain.  If the pain isn't real, all consuming firey scary goddamn pain, then, yeah, you can get addicted.  They are highly addictive.

If you do get narcotics (in the U.S.) for acute pain, you normally get one of the Big Three (Vicodin, Codeine, or OxyContin)plus a "muscle relaxant."  Muscle relaxants aren't muscle relaxers per se.  They just jam the signal that tells the brain "ouch! spasm!"  The muscle itself is still doing it for a bit, but after a while the brain isn't telling it to freak out anymore.  The inflammation is still there, the nerve still irritated.  To treat the inflammation, you need an anti-inflammatory.  The best anti-inflammatories in the world are steroids.  They're great!  They increase production of a whole sled of chemicals that help the body beat back infection and inflammation.  They also make you crazy and make boys grow boobs.

So the Industry created Non-Steroidal Anti-Inflammatory drugs, NSAIDs.  Tylenol.  Aspirin.  Acetomenaphine.  And all the other drugs that, when taken, try to destroy the liver and / or kidneys as well as relieve inflammation.

None of this "kills" the pain.  It takes a while to get inflammation to go away.  So the Industry gave us what it gave us in battlefields: opiates.

Vicodin.  Codeine.  OxyContin.  The big boys, Morphine, Fentanyl.  The muscle relaxants, Soma, Flexiril.  There are many others.  You will most likely encounter Vicodin (hydrocodone) or codeine (tylenol with codeine).  Note that these drugs combine NSAIDs and "pain killers."

Why do I keep putting "pain killer" in quotes?  Because they don't kill pain.  What they do is make you feel so fucking great and fuzzy and warm and lovely that you forget the goddamn pain.  It doesn't matter anymore, this pain.  I can move without it.  The muscles stop spasming.  You start to move, and blood flows.  Healing begins as the habit takes root....

Well, not necessarily habit.  If you take these things for pain and only for pain, your brain handles them differently.  It's proven.  You're not taking them to satisfy an urge to get high, you are taking them to avoid screaming in agony.  The brain seems to know the difference at a very small level, and thus your brain handles the drugs in a very different fashion.  These are recent findings, and if this were a decent article, I'd cite the findings.

Just know that it is different.  What happens, though, is that people often find fear of pain, and they keep taking the opiates for months after the pain is no longer acute.  Then the brain starts to associate the drugs with something other than pain.  Then you're fucked.

My advice with the drugs: it's up to you.  No one is tougher than pain in the long term.  Pain will fuck you up psychologically, it will sap your every will.  Best to mitigate the pain with drugs when it's unbearable, but plan for the long term.

Unfortunately, there's no clear map for the long term.  There's no one direction to go.  Best I can do is show you what I know, and maybe you can find a path.

Surgery, Conservative Care, or Loony Party?

I am undergoing what is called "conservative treatment."  This means no surgery, and it is viewed by many as a pocket-lining step to surgery.  It is viewed by some as the destination for their pain.  It is, to some, the answer and to others a continuation of effort that will culminate in Surgery.  In other words: for some people it works, and for others it doesn't.  Two people with identical (roughly) conditions can have radically different results from treatment.  My current path is conservative, and has been for three years.

Surgery: back surgeries are normally not necessary.  In the US, where 40 percent of the population has, at one time or another, reported acute back problems, back surgeries are as common as liposuction.  The problems with this are many and varied.  The biggest problems seem to be tied to treatment and surgical treatment, since both of these options make billions of dollars for everyone from my doctor to the guys who make the lighbulbs in his office.  Specifically, there isn't a big rush to find a decent surgical "cure" using the resources available.  The most recent microscopic techniques are hardly used, but seem to be the most effective for disk-related problems.  Reconstructive techniques used in other parts of the body are whole generations past what is used in the back (which amounts to a latticework of screws, meshes, rods and wires).  The approaches used are complex and horrifying, with certain vertebral surgeries requiring entrance through the abdomin.  The more recent laproscopic and microscopic methods are underutilized and oftentimes uneffective.

Uneffective?  Yes.  While there are no solid numbers on the success rate of back surgery, you will hear that a statistically large number of surgeries either don't work, or cause more problems than they solve.  Because the back is hugely complex.  But what should scare you is: there are no solid numbers!  Studies have been done but nothing near what needs to be done.  I've heard the tinfoil beanie version: companies that supply medical equipment (some of which make 70 percent of their income from back sugery needs) will do everything to fight any bad press.

I know more than a few people who have had surgery.  One, a guy who fell from a deck on a Navy ship, told me this: if you can still walk?  Don't get surgery.  Four out of five people who've had surgery have pleaded with me: do not get it done.

That leaves quackery.  This covers a lot of ground, especially if you place chiropractic in the quakery field.  Myself, I don't.  Chiros have allowed me to better understand my back and my body, and I may actually avoid surgery with their help.  But there are good and bad doctors, chiros, priests, and mechanics.  There's always someone who'll tell you to avoid accupuncture, accupressure, massage, pilates, yoga, and osteopaths.  But you don't have to buy into a religion to get mechanical relief.  I'm a believer (you get this from the first paragraph if you know what to look for) in the McKenzie method.  My chiros and doctors support it.  It comes from Robin McKenzie's methods, and he has a book.  He has a couple, actually, but "Treat Your Own Back" is cheap and effective, and it is the one referenced by doctors and chiros everywhere.  Basically, McKenzie uses movements involving flexion and contraction to re-inforce the natural curves of the spine.  The exercises push and pull the nucleous of the disks and help stretch and align muscles.  They are easy, quick, and effective.  But that's just one school of thought.  There are literally thousands of methods, and any single one or combination of them can help or hurt you.

So, What To Do?

You have nothing but options, with no clear path.  I can tell you that in the worst acute pain, McKenzie exercises provide me with relief.  But my condition (two herniated disks at L4/L5 and S1/L5) is my own, and yours may be a fracture or a muscle or something insidious.  I can tell you that no-one will be able to give you a definitive answer if the pain continues.  I would caution against listening to anyone who recommends surgery as a first step.  I would also caution against waiting too long, as I have, since now a lot of the less invasive methods won't work for me.  Ultimately, I can only tell you this:

Pain hurts.  You have options to eliminate it.  But you may end up where a whole lot of us are, where our goal is literally to grit our teeth, bear down, and just fight through each day.  Yes, sometimes with chemical help or electrical help (see TENS units) or with TISG or any number of voodoo magnetic oil-of-Rome nonsense.  But always, always dealing with it, each day, until someone finds an answer we can apply.

So, It Is All Hopeless?

Depends on how you view it.  I see it as being full of hope, but not full of data, answers, or reliable information.  I do what I can do to make it through each day, and some days I just stop and cry and that works.  Some days I feel 90 percent normal.  Ultimately?  Many many of us, millions of us, we deal with this the way addicts deal with their addictions: one day at a time, $god willing.

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Your Back and You, Motherfucker. | 42 comments (42 topical, 0 hidden) | Trackback
I was going to by blixco (2.00 / 0) #1 Tue Feb 21, 2006 at 10:04:35 AM EST
put this in the voting queue, where it would never see the light of day.

Put it here for google.

Two entries in one day?!?  Yes.  I know what I'm doing.
I am ten ninjas. Ten ninjas with root access. - mrgoat

Why do you hate america by joh3n (4.00 / 1) #2 Tue Feb 21, 2006 at 10:18:46 AM EST
you double posting motherfucker!

(I would/will vote it up, myself)


[ Parent ]
my dad has had lower back issues for by MillMan (4.00 / 1) #3 Tue Feb 21, 2006 at 10:22:13 AM EST
most of his life stemming from a few incidents as a kid. Not nearly as bad as what you have going on - he "only" had minor problems moving around on a daily basis, but maybe once a year he would be bedridden for a day when I was young due to the pain. Still, it was part of his daily life.

During the early 90's he bought a nordic trak, which he used regularly for about 5 years, and combined it with a better diet. He lost about 20 lbs and strengthened his lower back. Within the first year, his lower back pain had completely disappeared.

Eventually he went back to his old habits, and nowdays it's an issue for him again, and getting worse as he's now pushing 60.

I never really considered face-to-face contact a possible thing. -CRwM

great article, one point by 256 (4.00 / 1) #4 Tue Feb 21, 2006 at 10:30:59 AM EST
If you take these things for pain and only for pain, your brain handles them differently.  It's proven.  You're not taking them to satisfy an urge to get high, you are taking them to avoid screaming in agony.  The brain seems to know the difference at a very small level, and thus your brain handles the drugs in a very different fashion.  These are recent findings, and if this were a decent article, I'd cite the findings.

This is quite simply bullshit. Our neurological understanding of addiction is so poor as to make any  statement like this inherently nonsense.

We understand chemically HOW the neuroreceptors suck up opiates, but we are still a long way from understanding WHY the opiates make us feel the way they do. Sure people will say things like "dopamine reuptake" and "nucleus locus coeruleus" but the truth of the matter is that we are very much still at a mostly blind association stage as far as correlating brain activity to mental states goes.

Addiction and reinforcement particularly are very hairy problems at the neurophysiological level that we are nowhere near solving.

This doesn't however mean that we can't talk rationally about addiction, just that we have to do it with folk psychological terminology rather than neurological terminology.

I readily believe that people who take opiates only while in pain are less likely to develop an addiction than people who take them well not in pain. But this is simply a special case of a well known principal of addiction (and human psychology in general): habitual behavior is tied to circumstances.

One of the most successful methods for treating drug addiction is to simply place an addict in an environment that does not contain the things (be they people, places or activities) that they associate with the drug.

If you pattern your opiate consumption around being in pain, then you are much more likely to be able to make a clean break from the habit when you find yourself no longer in pain.

anyway, +1 fp
I don't think anyone's ever really died from smoking. --ni

Well, by blixco (4.00 / 1) #6 Tue Feb 21, 2006 at 10:45:53 AM EST
Ibased that rather off-the-cuff statement on research that happened around my wife, who is a neuropharmacologist working on addiction research.  But yes: it is a poor cite.

And yes, much like back pain, no-one knows a damn thing about addiction.  Except my wife, who knows a hell of a lot about addiction...just not what causes it.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
also, what do you recommend for prevention? by 256 (4.00 / 1) #8 Tue Feb 21, 2006 at 10:53:20 AM EST
i'm a big boy and i do a lot of physical activity and haven't always treated my body with the sort of respect a machine of that variety deserves.

i do not have what i would call chronic back pain, but about once every month or two i will wake up with a pain in my lower back so acute that i can barely breath. I find that i can usually walk it off in a few hours with the help of a couple of aspirin and it does not seem particularly tied to any activity i may or may not have been doing the day before.

as it stands right now it barely affects my life, but i fear it is a harbinger of worse to come.
I don't think anyone's ever really died from smoking. --ni

[ Parent ]
I used to get that by georgeha (4.00 / 1) #9 Tue Feb 21, 2006 at 10:55:11 AM EST
it may be related to my ankylosing spondylitis, an auto-immune disease that is a form of arthritis, affecting mostly men, and starting in the 20s. Any history of that in your fam?

Since I've been more active, I rarely get it, but it sucks when it happens.

[ Parent ]
sadly by 256 (2.00 / 0) #10 Tue Feb 21, 2006 at 11:00:29 AM EST
i have very little medical information on my family.

my parents both have back trouble, but my mom's was caused by a bad car accident and my dad's by very poor exercise practices.

my mom is adopted and never bothered to track down her real parents, even for medical records. and my dad's family consists mostly of poor irishmen who never visited doctors and drank themselves to death at relatively young ages.
I don't think anyone's ever really died from smoking. --ni

[ Parent ]
There is a test for it by georgeha (2.00 / 0) #18 Tue Feb 21, 2006 at 11:30:25 AM EST
I think it's the hlb1a marker.

[ Parent ]
The McKenzie exercises by blixco (4.00 / 1) #12 Tue Feb 21, 2006 at 11:07:14 AM EST
and pilates.  You're an active guy but you're on a bike.  That means your spine is a stressed member of the suspension.

So it's important to maintain flexibility, keep the disks as mobile and loose as possible.  McKenzie is a good start, add to it basic yoga.

You're probably well hydrated.  Don't let that change.

Flexibility and strength in the core.  Outside of that, watch how you sit, sleep, stand up, lift, and etc.  Sitting is really bad for you, so do it right: maintain a relaxed, naturally curved spine with no slouching.  Neutral.

But yeah: flexibility and abdominal exercises.

And ultimately?  I really don't know prevention.  There may not be a prevention.  But I do know what is missing from a hurt back: strength and flexibility.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
my sitting posture is terrible by 256 (2.00 / 0) #13 Tue Feb 21, 2006 at 11:10:44 AM EST
i need to demand that they buy me a new chair at $programming_job as a non-slouch position is basically impossible in the one i have.

I actually suspect that time in front of the computer is much more at blame for what little back trouble i do have than time spent on the bicycle.
I don't think anyone's ever really died from smoking. --ni

[ Parent ]
Absolutely, by blixco (4.00 / 1) #16 Tue Feb 21, 2006 at 11:16:42 AM EST
unless it's a series of micro fractures. Sitting for 10 years is what's crippling me.  If I'd been more...something...I'd be less hurt now.  That's a dangerous thread, though.

You can get your employer to buy you a lumbar roll.  They're cheap and in most office supply catalogs, and they'll force you to sit right.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
one cool thing about back pain by 606 (4.00 / 1) #22 Tue Feb 21, 2006 at 12:31:24 PM EST
you learn very quickly which chairs are really, really bad for your back. Those are the ones that make it hurt like nobody's business. And it's surprising how few good chairs there are in the world.

imagine dancing banana here
[ Parent ]
Indeed. by blixco (2.00 / 0) #27 Tue Feb 21, 2006 at 01:11:03 PM EST
Every goddamn chair and sofa I see seems to be designed for pain.  My sofa at home is a really nice flat 90 degree set of angles Italian thing, and it's the least comfortable piece of crap ever.

I tell my wife: one good chair.  An iJoy or the like.  Yeah they cost a mint.

But to be able to sit without pain?!?
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
the worst by 606 (2.00 / 0) #30 Tue Feb 21, 2006 at 01:38:22 PM EST
are those Ikea oversized couches and loveseats.

I've found these can be good. A friend of mine has some of these and I've sat on them while at dinner and such. I don't know if my knees/legs could stand a whole day of work at a computer, but maybe the pressure on the knees means it's time to get up for a coffee break.

imagine dancing banana here

[ Parent ]
Yeah, by blixco (2.00 / 0) #31 Tue Feb 21, 2006 at 01:40:31 PM EST
I think I need support of my upper back.  I've tried kneeling chairs and they're OK, but it's not all that comfy.

I want an iJoy.  Massage chair!
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
that or by 606 (2.00 / 0) #32 Tue Feb 21, 2006 at 01:45:04 PM EST
a chair with those electrical pads in it that stimulate your lower back muscles. Oh, that would be heavenly, though more than a little weird.

imagine dancing banana here
[ Parent ]
Nada-chair by fencepost (2.00 / 0) #38 Thu Feb 23, 2006 at 02:51:50 PM EST
I picked up one of these ( for my girlfriend for her birthday. Not a great romantic gift perhaps, but she regularly has back pain and is interested in options for addressing it.

We picked up an inversion table not too long ago as well, but she's not really using that much.

[ Parent ]
Oh, and by blixco (2.00 / 0) #7 Tue Feb 21, 2006 at 10:49:40 AM EST
because your comment is so damn good, and I believe in Scoop, I'm not going to edit the article to remove that statement.  Re-reading it, yes, it's awful.
I am ten ninjas. Ten ninjas with root access. - mrgoat
[ Parent ]
While you're at it, by ni (4.00 / 1) #19 Tue Feb 21, 2006 at 11:44:35 AM EST
you might want to check with your wife on the claim that opiate painkillers do not "kill pain". While they may not be their primary effect, or even the reason they're prescribed, my understanding is that opiates (and many other drugs -- ie, amphetamines) do result in desensitization to pain, and that this is shown by the ultra-classic tail-flick/paw-lick experiments.

A brief google search turns up various corroborating studies ( here, here).

One of the more unfortunate effects of this (as I understand it) is the increased sensitivity to pain experienced by former heroin addicts.

Think metahistorically, act locally. -- CheeseburgerBrown

[ Parent ]
So, by blixco (2.00 / 0) #20 Tue Feb 21, 2006 at 12:05:03 PM EST
for the vast majority of folks I talk to...and you know me, I'm all about anecdotal evidence...the pain is still there.  It's just not as "grabbing."

That only makes sense if you've been in this sort of pain.  There's a low-level of it that is there no matter what you do.  The only thing that has completely stopped it for me recently was lidacaine as part of my cortisone injection.  That lasted roughly 2 hours.

Two hours with no pain?


I can't...look, I'd tell you about it, but I'd end up in tears.  It was that lovely.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
Don't get me wrong, by ni (2.00 / 0) #23 Tue Feb 21, 2006 at 12:32:14 PM EST
I don't doubt what you're saying. Again, I'm not claiming it's the primary way that they work, or their primary effect, or anything like that. I'm just saying that they do block some pain. That's not why people take them (even in "legitimate" medical cases), and they probably don't block very much of it, but it is a measurable amount.

Nothing but sympathy over here. Sharp, brief pain I think I deal with pretty well, but were I faced with anything longterm I'd be giving serious thought to high velocity lead therapy.

Think metahistorically, act locally. -- CheeseburgerBrown

[ Parent ]
It's funny, by blixco (2.00 / 0) #26 Tue Feb 21, 2006 at 01:09:35 PM EST
though, what you'll put up with given the right number of reasons to put up with it.

But yeah, no doubt there is a pain killing effect.  It's just not as advertised.  That used to make me angry, so I "quote" it now.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
Addiction by dn (4.00 / 1) #35 Tue Feb 21, 2006 at 10:16:34 PM EST
If you take these things for pain and only for pain, your brain handles them differently. It's proven. You're not taking them to satisfy an urge to get high, you are taking them to avoid screaming in agony. The brain seems to know the difference at a very small level, and thus your brain handles the drugs in a very different fashion. These are recent findings, and if this were a decent article, I'd cite the findings.
This is quite simply bullshit. Our neurological understanding of addiction is so poor as to make any statement like this inherently nonsense.
I'm familiar with the research blixco mentions, and it indeed shows that opiods used for chronic pain do not cause "excessive" addiction rates.

This is not unreasonable. Much chronic pain is best treated by slow- and long-acting formulations, which avoid the intense euphoric peaks and behavioral linkages that contribute to operant conditioning.

Sure people will say things like "dopamine reuptake" and "nucleus locus coeruleus" but the truth of the matter is that we are very much still at a mostly blind association stage as far as correlating brain activity to mental states goes.
Indeed. I have chronic migraine and have done a lot of digging into the technical literature. It's a nightmare. The ignorance of mid-scale neuroanatomy is breathtaking. Nobody can take a particular neuron in, say, the retina, and tell which other neurons it directly connects to. We end up with all this research that says "we stained the left retina and and got striations in V1". Big whoop. That gets us no closer to figuring out how photons turn into pain in migrainous photophobia.

Hmmm... I just calculated how much data it would take for a diffraction-limited 3D photomicrograph of a mouse: around 300 terabytes. So gathering the basic research data is nearly becoming practical. Maybe in my lifetime...

    I ♥   

[ Parent ]
Despite having broken my back by creo (4.00 / 1) #5 Tue Feb 21, 2006 at 10:31:14 AM EST
well - technically four of the floating rib attacher guys, I have never experienced the crippling back pain you describe - thankfully.

The worst I get is occasional stress spasming in the lower back, and sometimes an inability to get comfortable in my preferred sleeping positions. I also get dull aching pain every few months or so.

Considering I have slammed into trees, cars, the ground several times and various other shit, I am thankful I have not had to suffer as you describe.

However, I have had a strangulated hernia. That (for me) redefined the term pain, and gave me a true understanding of the joys of pethadine and morphine - oh yeah. It sounds like the same level where you describe how you can't move, can't breathe, can't do anything except quietly suffer until the nurse comes with that lovely, lovely needle. Mmmmm, needle.


"I shall do what I believe to be right and honourable" - Guderian

I'm hoping by riceowlguy (4.00 / 1) #11 Tue Feb 21, 2006 at 11:03:20 AM EST
that the various disc replacements that are being used fairly successfully in Europe will eventually be as accepted here as knee and hip replacements.  In the meantime, I'm extremly thankful that my back pain is generally not that debilitating.  This recent occurence of it has gone away fairly quickly, although for a while I was going around with an extremely disturbing "right leg feels kind of like it's asleep all the time" feeling.  Gah.

Ever try inversion or axial decompression?

I have an inversion table, by blixco (2.00 / 0) #14 Tue Feb 21, 2006 at 11:13:56 AM EST
and my chiro puts me on a repex machine for axial decompression.

Your "my foot is alseep / is numb / is on pins and needles" is actually far more severe than my pain.  See, pain is what happens when there's damage happening, but it ain't too far gone.  Numbness in the feet or leg means the damage is really far gone...but that doesn't mean it won't back the hell off.

However, you may want to get that checked.  When I tell them my calf and foot feel tingly and numb, they start talking about surgery and traction.  It's very serious shit.

As of 2003, there is one disk replacement technique that the FDA has approved.  The manufacturer of the method and the associated bits charges $arm + $leg for it, so a lot of insurance companies won't cover it.  However, it's not as wildly successful as people believe.  The number of surgeries in Europe are small and select, with only those patients who would most benefit being chosen.  That will never be the case in the US; we'll try anything once.  So their numbers will always look better.  The method may work for me, but I have 2 disks that I'd need replaced (unheard of) and there's a lot of scar tissue around the nerve sleeve from the amount of damage I've done in therapy.

So: I'm hoping that someone will take one of the microdiskectomy techniques, but use a laser to burn away both nerve and tissue from an area.  It would be enough pain to stop the heart, but it would last a lifetime.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
For my back pain by mmangino (4.00 / 1) #15 Tue Feb 21, 2006 at 11:14:42 AM EST
I lost 30 pounds. It hasn't come back since. I can't believe how painful it was at the time.

Indeed. by blixco (4.00 / 1) #17 Tue Feb 21, 2006 at 11:18:47 AM EST
For a whole slew of people, weightloss is what works.  There's a whole lot of extra work the spine and disks have to do when you're carrying extra weight around.

I lost 50 pounds a couple of years ago, but that was when my back first started becoming that point it was maybe once or twice a year that it would hurt.  Starting 3 years ago, it was 4, 5, 6...then ten times....hen all the time.

But yeah: losing weight and the associated exercise can do more good for you than a handfull of opiates.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
yeah by Man (4.00 / 1) #21 Tue Feb 21, 2006 at 12:07:08 PM EST
I threw my back out a few times...but since losing a lot of weight and taking yoga, my back has been ok. (Part of what the yoga did was teach my how to stand properly.)

Trouble with yoga, though, is that it's much better at preventing injuries than curing them.

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I just... by toxicfur (4.00 / 2) #24 Tue Feb 21, 2006 at 12:47:46 PM EST
typed out a very long comment about my mom's experience with herniated lumbar discs, and deleted it. It's obviously something I need to get off my chest, but it'll be its own diary.

The short story? My mom's advice to anyone with that sort of back trouble is to avoid surgery at all costs. Of course, the singular form of "data" isn't "anecdote."
damn it, lif eis actually really *far4 too good at tghe momnent, shboyukbnt;t whilen. --Dr Thrustgood

Yep. by blixco (4.00 / 1) #29 Tue Feb 21, 2006 at 01:16:35 PM EST
I keep hearing that.  People who have had good luck with surgery tell me that they'd still not do it without having a compelling physical reason beyond scads of pain.

People who haven't had good luck with surgery...they're the only ones I hear "Hey, look, it's inevitable, you're going to get operated on, just get it over with and hope for the best" etc.  Seriously, every single person I talk to who has had multiple operations and it hasn't worked out quite yet?  It's like they're justifying their decision to me.  Thinking out lous.  Hoping they were right.

Pain sucks, and it is an excellent if devious motivator.  It will make you do things, irrational things.  Sometimes these things, they're OK and all is well.  Sometimes.  But there's no "if you have X and Y, you need this" in back care.  Two people, same problem, same diagnosis, and if they both get treatment, one may end up crippled and the other perfectly OK.  It's completely irrational and random.  Just like people.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
back surgery by LilFlightTest (4.00 / 1) #25 Tue Feb 21, 2006 at 01:05:12 PM EST
nick's grandparents both had fusions, and having spent a lot of time with them both before and after the surgeries, i can say that for them, it was the best possible option. they can sleep again, and they arent in constant pain. however, in your case, i dont think it's the best option...eventually, though, it may be.
Send me to Austria!
Indeed. by blixco (2.00 / 0) #28 Tue Feb 21, 2006 at 01:12:34 PM EST
For some people, it works.  In some cases, it works really well.  If his grandparents were still young, the fusions would impact their lives in ways they can't recognize now.

But for some people, it is the way to go.  Not yet for me, though I don't have much of a disk left back there.
I am ten ninjas. Ten ninjas with root access. - mrgoat

[ Parent ]
I don't have any back pain anecdotes by Rogerborg (4.00 / 5) #33 Tue Feb 21, 2006 at 01:50:24 PM EST
But I feel compelled to point out that you don't have to tie your shoes if you get some sandals.  You don't have to go through the ignominy of purchasing them; you can just drive through an anti-capitalism protest in your truck and then harvest them from the corpses.

Metus amatores matrum compescit, non clementia.
You've gone far past any of the back problems I by grendel (4.00 / 1) #34 Tue Feb 21, 2006 at 04:15:43 PM EST
have or had. I had what was judged a heriated disk by a chiropractor. Maybe it was just slipped. It hurt like mother. That was in 1999. It still hurts sometimes. The chiro's adjustments helped. What seems to be helping more than anything else is the excercize I've been getting everyday. And stretching.

It was crippling for a time. I can only remember how fucked I felt and hope it's going to get better for you.


Wow by nebbish (4.00 / 1) #36 Wed Feb 22, 2006 at 12:00:49 AM EST
Superb article. I don't know if anyone else has noticed, but non-quackery medical writing is in seriously short supply.

I have two things to add - I used to get mild lower back pain, but this went completely after a few months sleeping on a futon. I know they're for hippies, but they do seem to work.

Also, if you're not suffering from back pain saying you are is an excellent way to get long-term sick leave from work, doctors tend to take you at face value rather than go through extensive tests.

Not that I've done it, but I think it's information everyone should know just in case.

It's political correctness gone mad!

Excellent work! All true. by greyrat (4.00 / 1) #37 Thu Feb 23, 2006 at 01:09:34 AM EST
I have one thing to add. But first, my CV is: Two disks partially removed from my lower back (L3-L4 and L4-L5) and a herniated disk non-operated-on disk just below the neck (probably C6-C7). During the lower back surgery, the doctor found that one disk had crumbled and had to be picked out in pieces. And one piece had worn a hole in the dura of the spinal cord which had to be carefully stitched shut. I was out of work for two months flat on my stomach most of the time. So I know about the pain, the surgery and the alternative methods.

Now to my one point to stress. When the pain is manageable, EXERCISE! Beyond McKenzie - which I still have on my bookshelf. I run because it keeps everything in line and settled in place. It also keeps the muscles that support the spine strong and in tune. Sure, my right thigh and hamstring might be on fire and the soles of my feet may feel like they're asleep, but after a half mile it all starts to come back into place.

Once again, good article and good luck!

Man by hulver (4.00 / 1) #39 Sun Feb 26, 2006 at 11:58:31 AM EST
I feel your pain


It's not nice. I'm glad mine stopped.
Cheese is not a hat. - clock

Keep it stopped. by blixco (2.00 / 0) #40 Sun Feb 26, 2006 at 12:05:29 PM EST
Find a McKenzie reference, and start working on core strength.  That way, you'll never have to worry about it again.
Taken out of context I must seem so strange - Ani DiFranco
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Core. by grendel (2.00 / 0) #41 Sun Feb 26, 2006 at 02:50:40 PM EST
That's the happy new word for belly nowadays, ain't it? The last about 7 months that I've really been keeping to a work out routine has meant lots of crunches and leg lifts. I'm still a fat boy, but, I've had far fewer twinges, tweaks, and debilitating ouchies. I keep asking why I didn't start doing this 10 years ago. I haven't answered myself yet.

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Abs, bacdk, lats, by blixco (2.00 / 0) #42 Sun Feb 26, 2006 at 02:56:19 PM EST
oblique, the entire torso.  All those stupid little tiny muscles, too.

Keep at it.  That's the only thing that'll keep us upright.
Taken out of context I must seem so strange - Ani DiFranco

[ Parent ]
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