The 10 Commandments of Back Pain

Twenty years of treating people whose backs ache, trying to help thousands find its cause and deal with its crippling challenges, I have developed my own set of ideas for what to do when your back hurts, when you have a pain in the butt or when nasty sensations radiate down your leg.

While some physicians think back problems are mostly psychological, I believe in a practical, diagnosis-based approach. To avoid back pain Hell and wandering from clinician to clinician, these are the rules to follow.

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You Will Get Back Pain

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Like the common cold, back pain will hit you at some point another, so don't panic. According to the National Institutes of Health, in a 3-month period, about one-fourth of U.S. adults experience at least one day of back pain. It is one of our society's most common medical problems. My patients over 40 are more likely to have back pain than the younger ones and those who weigh more are at more risk than thinner ones. Cigarette smoking, excessive consumption of carbonated beverages, jobs that involve lifting heavy objects, being sedentary or exercising too much -- all these are risk factors.

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Like the common cold, back pain will hit you at some point another, so don't panic. According to the National Institutes of Health, in a 3-month period, about one-fourth of U.S. adults experience at least one day of back pain.

It is one of our society's most common medical problems. My patients over 40 are more likely to have back pain than the younger ones and those who weigh more are at more risk than thinner ones. Cigarette smoking, excessive consumption of carbonated beverages, jobs that involve lifting heavy objects, being sedentary or exercising too much -- all these are risk factors.

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jeb50 said on 10 Tuesday 2011 pm31 5:08 pm: Any doctor that doesn't at least get an x-ray first doesn't know what they are doing. I had a disc removed in '82 and really felt good for a number of years then the pain started again. Saw a neurosurgeon and an orthopedic surgeon and both said that at that time more surgery wouldn't help but exercise and a painkiller now and then should work and it did again for a number of years. Then the pain got worse and lasted longer. Last Nov. I had rods and separators put in 4 vertebra of my lower back. I am better now but tell everyone that back surgery is always a last resort.

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Comments

[Lisa Shields]

11:56 PM on 05/23/2011

Before commenting, I read the replies.

Interesting...but by no means consistent.
For those able to get pain free without surgery, or med, my very best wishes.
But please don't assume all are so lucky.

I've been through PT, Tens units, massage, chiropractic, meds, heat, stim, and just about every form of pain intervention you can name, including having my nerves burned, so they would not conduct pain.

From my own experience, I can say that no method will work for everyone. Chronic pain is just that...no quick fixes, no panaceas. If you are fortunate, you will not have to cope with CONSTANT pain...but you really don't know one day to the next what your day will be. You could start out fine---and end up stuck somewhere, barely able to walk, much less drive.

Fifty percent of all back pain will right itself, no matter what you do...or don't do. The other 50 percent? That's the tough part.

I read constantly about new therapies---but what would be HUGELY helpful is if people would not assume we are all sitting around hoping someone will fix us. A decade of this, from three accidents taught me that "helpful suggestions" can actually make the pain worse.

We do what we can...get it?

[thebigbike]

01:12 AM on 05/18/2011

mentioning my surgery below I DID do a lot of yoga and stretching type exercises as long as I could with no relief, but after the surgery, physical therapy was extremely helpful.

[thebigbike]

01:09 AM on 05/18/2011

I had surgery a year ago for a sciatic nerve constriction thatcame on quickly and in less than a month had me in some of the worst pain of my life, coming on quickly to the point I could only get myself by crawling around on my hands and knees. It took a LOT of prodding, repeat visits to the emergency room for crippling pain, none of which was relieved by anything short of morphine, g even to get to the point of an MRI since the xrays showed nothing. When the MRI was done on Friday ( and required sedation for me to stretch out in the tube without screaming so loud they could hear me over the knocking) I was seeing the surgeon on monday and had surgery tuesday morning, and was walking on tuesday night. A year later the total recovery still seems miraculous.

[Diana Mwenya]

06:47 PM on 07/06/2011

what type of surgery did you have?

[FaceTheTruth00]

06:03 AM on 05/16/2011

My back pain was very much a physical cause. I ended up with an injury while heavy lifting during moving. Aside from excruciating lower back pain, I also had tingling/burning and numbness that radiated down my legs.

I couldn't sleep; couldn't drive a car any kind of distance; sitting was very tough, but so was laying down.

I went to the doctor who diagnosed me with a lumbar sprain and prescribed me naproxen, muscle relaxants and physical therapy.

We did about 3 or 4 kinds of PT exercises at my appointments, and I had to do them at home as well. I also got got a massage at my appts., followed by treatment with a TENS unit.

Tens is electrical stimulation for your muscles, for those unfamiliar. They put the little electrodes on your back and cover you with a warming blanket of some sort.

It took a few months till everything got back to normal, more or less. Although I still have a risk oc aggravating my back if I have to lift something somewhat heavy.

[Chris Worthington]

09:55 PM on 05/15/2011

I've had 4 back surgeries in the past 6 years. I was born with congenital spinal stenosis. I'm only 39 years old and my back is completely trashed. I'm among a super rare few that have had to endure thoracic spinal surgery. According to two of my doctors, normally you only hear of elderly women with severe calcium deficiency require thoracic surgery. When the thoracic disc ruptured, I constantly felt like I was having having a heart attack, combined with what felt like a broken rib, from a pinched nerve. The surgery fixed the nerve pain, but the actual back pain is still very much there. It feels like I've been slammed in the middle of my back with a sledgehammer. I have to get injections in my spine every 2 months, combined with percocet every day. I'm going to have to try the yoga and see if that helps. Any relief is more than welcomed at this point...

[Eva Norlyk Smith]

12:57 PM on 05/14/2011

Thanks for pointing to the value of alternative treatments like yoga and the Alexander technique for back pain! When I injured a disc in my lower back a few years back, I tried several chiropractors, who had helped me with other issues in the past, but without success--one person actually made it worse.

It was yoga that helped me gradually heal the injury, and as significantly, helped me reset the muscle memory of the muscles around the injured area, so they stopped going into a spasm when challenged. The latter was key to restoring full range of motion, and avoid lingering chronic issues.

In the process, I learned some wonderful things about the body and reconnected with it in completely new ways, another side benefit of yoga. :-)

[Fbigdeal]

12:55 PM on 05/14/2011

Sciatica -Pain that shoots down the leg, hip and lower back.

http://en.wikipedia.org/wiki/Sciatica

[Fbigdeal]

12:50 PM on 05/14/2011

Pain that radiate down the leg and inner leg and lower spine could be sciatica. Had it once- my lower half of body was motionless-tried to move it-it will not go. Paralysis in a way (temporary)

Bed rest- with a pillow between your legs or under your knee-doing Pelvic excercise help strenghten the back.

Link on Sciatica:
http://www.emedicinehealth.com/sciatica/page3_em.htm

[Carol Ardman]

11:25 PM on 05/14/2011

Dr.Fishman says not too much bed rest. That's no good either. Go to 60% of normal activity... That's what helps

[Fbigdeal]

12:43 PM on 05/14/2011

Stretching, Hot bath, with espom salt and cold packs works - Always sit in a comfortable chair- put a small cushion at the end of spine. Get a chair to fit your body size.

Have a friend do a deep trigger massage.

[kkdc]

10:57 AM on 05/14/2011

Notice anything missing? CHIROPRACTIC care. The Cox Distraction Manipulation technique is an excellent, gentle way to restore normal joint motion, reduce nerve root irritation and compression, that leads to pain, spasm and abnormal nerve transmission, as well as is an effective way to deal with disc herniation, facet joint subluxation ( fixations/immobilized joints). The science on this technique and the efficacy of chiropractic for back and neck pain conditions has been around for over 25 years. Research is funded by the NIH, and it's alternative and complementary medicine wing. Most chiropractors use a variety of different adjusting techniques, teach patients rehab exercise, use physiotherapy treatment along with manipulation, and deep tissue, trigger point therapies. Most take and read their own radiographs/x-rays, do differential diagnosis, make appropriate out-referrals to specialists if conservative chiropractic care is not working, and help patients make therapeutic lifestyle changes, through nutrition counseling and exercise instruction. We order and interpret lab findings to aid us in making accurate assessments. Unlike this medical doctor, many of my medical colleagues regularly refer to DC's and there are many multidisciplinary teams, where chiros, meds, acus, and pts work together. If it doesn't include the natural chiropractic approach, it's not complete.

[LovingFit]

06:35 AM on 05/14/2011

A little over a year ago, I severely injured my back, I could barely walk, sleep or sit down. I was in the most intense pain in my life, as month's went by the pain didn't go away, I was told It will never heal unless I get surgery. But I always had a strong belief that the body can heal it self. I went to accupuncture, did some specific stretches and exercises for my back that I researched on the internet about. And every day when I was in this pain, I just kept telling my self that my body is going to heal. Now a year later, I am back as new, everything healed. Even though everyone was telling me it never would because of how severe my injury was.
I believe that a body can heal if you provide it with proper nutrition, and positive thinking. I was finally able to get back into my intense fitness routine, and I never look back.
I recently started a health and fitness blog because I want to help people to learn about nutrition as well as staying fit in all aspects of their life.

http://www.lovingfit.com

[Carol Ardman]

09:03 AM on 05/13/2011

http://health.lifegoesstrong.com/stop-back-pain-yoga
A special blog that fits in with this article

[Carol Ardman]

07:41 AM on 05/13/2011

INTERVIEW ABOUT YOGA AND BACK PAIN, POSTED TODAY:
http://health.lifegoesstrong.com/aging-diva

[mpaul49]

02:04 PM on 05/12/2011

I am 61. At 26 I had my back go out so badly I couldn't walk. I was offered a spinal fusion at that time but I took up yoga instead. My back feels better now than it did then. Yoga has to be done carefully and intelligently to actually work but I never go a day without it.

[suzirotc]

01:01 PM on 05/12/2011

I used a chiropractor for years - for neck kinks, when a file cabinet fell on me, and generally just to feel better. I told him I would marry him in the next world, just to get me out of bed each day. We both laughed that his wife and my hubby probably would object, but he made me feel so much better than my MD who just gave me muscle relaxers which put me out in la-la land.

Been there, done that.