Chronic lower back pain
 

Gents,
Any experience with exercise or herbal remedies that may help offset lower back pain brought on by mild arthritis (and being 49 yrs old and 6'3' 245)?

Talk about voodoo. Its seems most Docs really don't have a staright forward or "one size fits all" solution for lower back pain outside of several different drugs for when the pain flares up. I know losing will have to help to some degree but exercise often hurts. Running seems to inflame the situation while walking seems to be OK. Stretching seems like it helps but hurts while doing it. Im not sure if this hurting along the way is good pain or bad. Any personal opinions on the subject would be appreciated. Sucks getting old!:boohoo
Thanks

There isn't a one size fits all with CLBP...spine stabilization excercises / stretching / and weight loss are key. Meds help, but not are not a long term fix. The stronger your abdominal muscles and better our posture are (and less overhang you have in front), the less exaggeration you will have in the curve of your lower back.
If you have other symptoms, numbness, tingling below your knee, shooting pains into your foot or that wrap around your calf...you may need an MRI to rule out a nerve compression syndrome from an HNP or "slipped disk".

There are ROOMS full of texts on CLBP...all have similarities, but no two are the same.

Eagle

Eagle5US,
Thanks for your response. The terms you provided give me some good search phrases.

plenty of experience...Eagle hit it on the head, weight loss and stretching...chiropractic treament works for some, acupuncture works for others...i don't know of an herbal remedy, but i spend a good deal of time stretching and working on my abdominal strength...

i would advise against flutter kicks, however...:D

Thanks lkSteve,
I'll work through the stretching exercises. Herbal wise, my wife is advocating I try something out there called Devils claw, supposedly reduces inflamation....if it does I'll let you know.
Thats good news on flutter kicks!
Chet

Eagle is spot on MM. I have followed the back/ab stretching and excercise routine for years and it's relieved a great deal of pain. After wearing 25 lbs of gunbelt around my waist for seventeen years I have experienced plenty of back pain. Christ I've thrown my back out just getting out of bed once! Good luck with it. For what it is worth I have never been to a chiropractor simply because it's always hit or miss with anyone who has gone (50/50 responses do not make me enthusiastic).

Thanks GP!

Also look at your shoes/feet.

Over time, your feet change. You my develop a higher arch or you begin to pronate/supinate (sp)when you walk, whereas you didn't before.

Something a simple as one of those Dr. Scholl's inserts will help, or if the pain in your back is so bad, you may need to see a Podiatrist and get proper shoe inserts. I know they've helped my back quit a bit.

I have been dealing with arthritis brought about by trauma and a leg that was shortened due to a broken hip I did not know I had broken at the time so it healed a little wacky. I went through the bulk of my career dealing with some of the challenges you are now facing. What I did was concentrate on building my abs and upper body strength to the point where I could do most everything with my arms without having to rely on using my back as leverage. Situation awareness also plays a big role and I was always cognizant of what I was about to do and compensated for it by changing body position or approach to prevent that mind numbing pain when you screw up. There were, however, events beyond my control that left me bed bound for days and even medevaced once to Walter Reed for about a month, but I was able to demonstrate what needed to be demonstrated to avoid any profiles or assignment limitations. Of course, I am now paying the price in spades, but even now I would not have done anything different. As mentioned in earlier posts, everyone is a little different. I weighed in for the bulk of my career at 215, but I am wound a little tighter than you as I am a jump boot heel short of 5'8". Good luck!

Sdiver,
Thanks!
I hadn't considered shoes at all, great points.
Looks like there are a few athletic shoe companies ie Brooks that address the pronating possibilities.

Here's something that most people don't pay too much attention to. Good Posture, as in lack of. As we get older, (been there doin that), we tend to 'hunch' over. It's not a conscience thing and usually it's very slight, but it happens none the less. My ortho caught me doing it and corrected me. I was seeing him for back pain.

Other than that, if the doc says there is no physical reason for the pain, stick with the exercise and stretching. Just remember to warm up prior to stretching. There's a stretching guide here if you're interested.

Thanks all the great feedback
 

Gents:

Thanks for all the great feedback! Your experiences, thoughts and opinions are appreciated and will help me pursue and measure several :rolleyes: COA's some of which I would not have thought to even consider.
Chet

Is your back hurting when you wake up in the morning or just when you walk around and do your daily routine. if its hurting when you wake up you might want to get a full lenth body pillow to sleep with it will keep you in better position during the night. and how old is your mattress springs do wear out.

to help eease the pain, once it's kicked in, and before exercising - Tiger Balm in the red can - makes Ben -Gay smell 'light', but the stuff kicks butt for easing tight muscles. sorbithane inserts or heel cups for your shoes/boots, stretching, situps, back extensions, and back 'lengthening' exercises (flat on your back on the floor, stretch, then bring your knees up to a 45 degeree angle, feet still on the floor, repeat for about 10 reps), Yoga, or Tai Chi have been known to help. Have you tried therapeutic massage?

All of the above except tiger balm were covered by others, just reiterating.

Hi guys,
thanks again for all the good advice. We have new type bed. Ill add the tiger balm to the list. A footwear guy suggested anti pronate sneakers..they are called "the beast' by Brokks. Other companies ie New Balance have similar versions. If I could just lay off the chow!
Take Care
Chet

First, I am NOT a doctor, or physical therapist or SME on the topic. I did suffer lower back pain, a result of a series of causes. The pain was occasionaly severe, which was terrible as I am pretty active.
I tried very hard to educate myself as I would not accept limited mobility as an option.

One of the home treatments that worked very well was found at NISMAT.org. It is free - look for their "lower back program exercises." I now do a much more advanced program (much more physical, incorporating everything from yoga moves to kettle bells) as I have had a primary cause (IT Band and sever hip tightness) corrected.

I hope this may provide some help, and relief. Originally I took this to my MD (and later therapist) and he approved, suggesting I build upon it. I no longer have the pain, although I occasionally have tightness or discomfort - it does not seem to progress to level of pain.

Matta,
A supplement I have found useful is "Omega 3 fatty acid" supplement. Although, I take a supplement that has Omega 3, 6 and 9 fatty acids. I take 2 in the morning, and 2 in the afternoon. I personally use: Triple Omega 3-6-9 from Vitamin World. There has been alot of research and of course controversy surrounding the use of anything natural as a pain reliever but, I am a beleiver as it works for me without the side effects of NSAIDS. Do a google search for: "what are the benefits of omega fatty acids and back pain". Hope this helps you out.

Thanks for the input guys.

Will give it a go.

Superfeet Insoles.
 

Matta Mile,

I'll spare you the details, but I can't recommend the Green Superfeet insoles enough. Those, some solid running shoes (I've had both Brooks and NB) and a bit of yoga have helped me out immensely.

Good luck,
Books.

Matta Mile.

This is no attempt to prescribe, cure, treat or diagnose.

I'm 6"-4", 240 pounds and tried just about everything out there and was headed toward surgery. The inversion table works perfectly for me. Also, the surgeon and the Senator I work with both had bad backs (one had unsuccessful surgery) and are too heavy for their height.

The inversion table worked the same for them. They both used the term "lifesaver" relating to results obtained.

We did seek professional advice before proceeding. :lifter

Thanks again for all the eager assistance and sharing of experiences. Alot of excellent considertions and COA's.
MM:)

Possibly deep muscle issues
 

I am a licensed massage therapist as well as a competitive long-distance runner. Understanding the strain you have put your back through over the years, there are a few key elements cited in previous posts which may come in to effect. Just as others have stated, this is not a diagnosis or prescription since I can't examine you personally. These are merely some suggestions to consider:
1. Poor posture- strengthening the abdominal muscles will help counter-act a forward rotation of your pelvic girdle as well as some upper-body strains.
2. Stretching- Strangely enough, tight hamstrings can cause a lot of back problems. You should comfortably be able to touch your toes with your fingers while maintaining straight legs and straight back. If not, a stretching routine may help.
3. Psoas Major- This is a very deep muscle which attaches to the front of your lumbar vertebrae and high on the inside of your femur. It is a major hip flexor and is often ignored or unknown. Runners will typically have very tight psoas. Additionally, if you sit for long periods of time it can cause the muscle to shorten. Then when you stand it can put great strain on the lumbar vertebrae.

PM me if you have any specific questions.

--

"It is not enough for us to be good. We must be good for something." Gordon B. Hinckley

Not in this life time. The only way that could ever happen for me would be to have someone coil 14 wraps of detcord around my waist, detonate it, and lay the two halves together.:D

comment removed by ASG
 

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What a site, pretty much everything my Doc told me following L5-S1 surgery and degenerative disc disease in so many L's and C's I cant keep up, has been covered...

Stretching
Weight Control
Strong Core (read abs)
Quality Bed / sleep position
Posture

The one thing no one has mentioned is as a society we are always in a huge hurry...watch someone lift a Tuff Bin to load it in a truck, they will stand with their side to the truck, bend over and in one motion, lift and turn to slide it onto the bed. If you lift it straight up, then rotate at the feet, and slide it on the bed, its much better on the back...if you are concious of it, you'll notice tons of stuff that could/should be done in two steps in stead of one twisting one...it'll help as well.

Back in 1977, I experienced a hard landing during a demonstration jump...like a terminal reserve opening that collapsed after opening because I was on the pavement! Diagnosis then was a compression fracture at L1 and another at L5.

Fast forward to today - had an orthopedic specialist explain why I'm hobbling around. Seems those simple compression fractures have turned into major narrowing of the disk spaces between all of the lumbar vertebrae. I have torn disks at L1, L2, L4, and a major herniation at L5/S1. The L5 vertebrae is displaced forward about 30%. The frontal view of my x-rays was described as looking like a 'snake'. Throw in a touch of arthritus and you get the picture of one major pain in the lower back.

The doctors want to try some steroid injections first. My question is will the injections do anything to help ease the pain? There are times when the pain in really a bitch...starting in the hip socket and radiating down the leg (left side) to my instep. Best description is thinking of a white-hot poker inserted in the hip socket and running down the thigh. The pain makes me really cranky and I feel bad about barking at folks when I'm hurtin'.

IMHO - the injections were only a temporary relief for me (L4-L5 2003). Tried three rounds over four months, ended up with surgery. My disc was protruding up and into the canal at an angle - would not release with therapy or the injcections. Outpatient discectomy did the trick - still some occasional muscle type aches, but nothing compared to what it was before (sour attitude, hot poker sensation, pain traveling down back of leg, muffling screams getting in and out of car/aircraft, etc. ...)

The steroid injections will hopefully work to decrease local inflammation, swelling, and ultimately pain. The steroid works by suppressing secretion of inflammatory mediators, essentially chemicals which are secreted by cells in times of injury. These chemicals dilate blood vessels and allow them to become leaky, increasing swelling and redness. These chemicals also cause local pain (the idea is that when a part of you becomes injured, the pain makes you baby that area until it heals). The problem is that swelling in certain areas may cause more harm than good, and continued secretion of inflammatory mediators will cause pain without the benefit of expected repair. The pain that you are experiencing down your leg is because the swollen, inflamed tissue is pressing on the nerve roots where they leave the spinal cord in your lower back. Though you may eventually be looking at surgery (such as the microdiskectomy that PoPo mentioned), I've seen many patients who got very good results from the injections. The local injections give you the benefit of targeted anti-inflammatory action without a lot of the systemic effects of oral steroids. Usually orthopedists will limit you to 3 rounds injections of a single area over a lifetime, since after that there is very little benefit for repeated injections. Everyone is a little different, but you should expect some relief even if it's incomplete.

'zilla

Doc: Thanks for the info. I go in next Wednesday for the first injection. The second is on July 5th and the third on the 12th. Does this constitute a round of shots or is that it - a one-time deal?

I have to put in a vote for osteopathic manipulation (think chiropractic only better supported by medical research). I fell through a roof as a firefighter- went completely through the attic, through the floor and landed in what I think was a dining room. Needless to say it was on fire so I didn't stick around to find out for certain. I walked outside and everyone on scene (who were expecting me to be dead) started clapping. Being a smartass, I took a bow and promptly collapsed. Turns out I broke 7 ribs, bruised my right lung, dislocated my right shoulder and my right ankle, in addition to straining, bruising and generally messing up the muscles and ligaments around my spine. According to the emergency department physician who treated me (former SF medic from VN ironically enough), I was lucky I was able to stand up given my injuries seeing as I was burdened with ~80lbs of gear: "Either you're damn lucky, someone upstairs likes you or you're just plain tough." Seeing as I am 160 lbs wet and skinnier than I should be, I don't think it's the latter. :D

The orthopedic doc put me on muscle relaxers and pain medication. One of the local osteopathic physicians who specializes in physical medicine and rehabilitation contacted my department and offered to treat me for free (apparently volunteer firefighters had saved his daughter from a structure fire several years prior and he felt the need to "pay us back" for what we do for our communities). Two weeks after the accident and I was still unable to sit comfortably or stand up for long periods of time without my back seizing up, so I went to see him. He manipulated my back- working on getting the muscles to relax and what not- and I felt much better. Two visits and I was able to return to duty. That's why I recommend finding an osteopathic physician (the ones with DO after their name rather than MD), especially one who specializes in physical med and rehab (PM&R).

I have a couple of buddies who are DOs and I have used them for manipulation when unbeknownst to me, I had a C5-C6 compromise problem causing pain to radiate down my left arm with the hot poker sensation. The treatment left me with less pain and able to move more freely.

IMHO, tdd is correct, the DO is more trustworthy than the Chiro, has a medical degree, and will not claim to be able to cure everything from influenza to eczema by manipulation. They are not cheap though.

The DOs told me that this is a common injury for jumpers from the opening shocks of parachutes snapping your head back while several extra pounds of Kevlar are attached. Who knew?:rolleyes:

I would give a DO a try before surgery, but if the injections help, then no worries.

TR

TR / theDitchDoctor:

Thanks, guys, for the input. The doctor I'm seeing is a DO and will be doing the injections. When I saw him Friday, he was surprised that I wasn't in more pain than what I described based on what he saw in the x-rays and the MRI prints. He currently has me on Lyrica (75mg - 2 caps every 12 hrs) and Tramadol (50mg - 2 tablets every 6 hrs). They seem to be helping - when I can stay awake.

It's also a common injury in those of us involved with rope rescue (I was trained as a high angle rescue technician for the VFD). If you don't control your speed on descent and then abruptly stop, there's a chance that you will snap your head back and do various things to your cervical spine. There was a utility worker killed several years back in California (I believe it was CA) when he broke (well, technically subluxated) his C-spine in this manner.

BTW, you might look here: http://www.osteopathic.org/index.cfm...D=findado_main
Call the docs in your area and see if they are willing to reduce the cost of treatment (or waive it all together) for a veteran. I know several docs who do this. The other option is to go to an osteopathic medical school- you can find a list here: http://www.aacom.org/data/cib/01-geographic.asp - and inquire about allowing to the students to work on you (under close supervision) in exchange for care at a reduced rate. If you mention that it's a service connected condition, you might be able to arrange a way to reduce the costs out of your pocket.

If I can be of any further help, please let me know.

I haven't seen them done in a series like that, so I honestly don't know if he'll recommend repeating the injections if they don't work. The literature I'm acquainted with only looks at single injections.

A word about D.O.s- as osteopathic physicians become more mainstream and complete allopathic (traditional M.D.) residencies, fewer are performing manipulations and traditional osteopathic medicine. I know several DOs, but none of them manipulate, or will only do so as a favor to a buddy when his neck is hurting. Having the DO degree doesn't necessarily mean that your doc will do manipulation, so you'll have to ask.

'zilla

Thanks, Doc...I'll ask.

True, I forgot to mention that. :)

I normally just lurk, but would like to add:

There is a new therapy out (last 5 years or so), called the DRX 9000 spinal decompression, I believe. Might be worth looking into. DO’s and Chiros have been using and seeing great results with it. 80% pain relief if I recall correctly. My wife is a chiro and I can see the other point of views stated here, but you might still look around. There are a number of reservists who are chiros in the civilian sector, might want to look one of them up for a better understanding. After 20 years of ice hockey, and 5 years under a ruck, she did wonders for my lower back.

Link: https://axiomworldwide.com/DRX9000.aspx

I did not really look around, but they should have a link to offices with the DRX in them if you want to check it out.

My Chiro has a decompression system and has mentioned it to me a couple of times. It is a bit pricey for treatment so I am holding off at this point.

Guess that means I don't hurt that bad.

Be glad that you don't have the pain. Back in 1991 I had a major flair up with my back. It was so bad that at night when I would move, I'd wake up screaming. I was single at the time and had a small 1 bedroom apartment. The young lady who lived in the apartment across the entrance way demanded a key to my apartment so she could come over and check up on me. She was a GS-9 who worked over at Kelly AFB in San antonio. Sandy, Laura and Deb used to take turns checking up on me. Lucky me!

careful - you're coming close to braggin:D