Back Pain

[carolyn]

So I told myself I was gonna take a ten days off from climbing before heading out to the PNW. I was feeling healthy and didnt want to risk an injury before my trip.

 

I suck at discipline sometimes and climbed anyway.

 

I found myself with a bit of a kink in my neck after belaying. After my next climb I realized I pulled something in my back. Not too painful. Experienced with lower back pain and felt i was okay, so I kept climbing thru out the day.

 

The next morning, my back was sore, but no terrible pain. Bent down to pick something up and my entire lower back seized up.

 

I spent the day babying it...heating pad, ice, massage,ibuprofin etc.

Next day...heating pad, ice, stretching, short walks,ibuprofin etc.

 

Usually at this point the pain has subsided in the past.

 

I have had no choice but to work the past few days...14hr days. Not too active, but lots of standing. I continue to put heat on it and take the ibuprofin, along with stretching. My back/shoulders/neck continue to feel likea rubberband about to snap with random hours of extreme pain in the lower back.

 

Ive been thru hours of PT for problems with my back in the past. So, I know the basics of healing. Tonight someone noticed the 'knots' on the right side of my back move. They explained the knots are a build up of lactic acid. Possibly massaging them isnt doing anything but moving them around? ANyone have any unique hints as to how to get these out of my body and help the pain disappear. I hate to get out there for two weeks of climbing and wind up laying on heating pad at a friends house the entire time.

 

Btw..I dont have insurance...so a chiro or massage therapist is not an option.

 

Thanks in advance!

 

 

 

[mattp]

Carolyn-

Sorry to hear that. Back pain sucks! Is there an acupuncture school nearby? Even a beginning acupuncture student can often provide great (temporary) releaf from acute back problems - and that may allow things to settle down quite a bit.

[jon]

Carolyn,

 

Muscle tender points are not caused by the lactic acid. In fact post exercise muscle soreness is not caused by lactic acid but muscle damage. Lactic Acid is removed from the muscle 60 minutes post exercise but can stay accumulated in the blood until the heart and other organ remove it from the blood stream.

 

From what I know you want to heat the area pretty good and then have someone apply pressure for about 20 seconds to break up the fibers. That is just what I was taught by trainers. I would send glassgowkiss a PM and ask him, I believe he is a message therapist.

[Courtenay]

Jon's right on this; if you don't have a significant other who can help with massage, try a tennis ball -- great for working out trigger points -- if you can get at them. If it's middle, upper or the upper part of the lower back (i.e. anything you can't reach but could lean against a tennis ball against a wall or door) try easing the ball onto the point, then just off, as you can tolerate the pain. Chances are it's not the points that are seized up, they're just trigger points for other spots causing you problems. If you can do some gentle yoga try that, or look for some appropriate stretches by searching the Body Results archives at www.bodyresults.com. Good luck. Keep us posted.

[terrible_ted]

Actually, I'd rethink the desire to rub/massage the area. Your back might respond better if you just leave those muscles alone for a little while. Those 'high tension, twitchy' areas are probably damaged/inflamed muscles. The increased size and secretions of the damaged tissues result in hyperactive nerve signalling ("back spasms"). You don't want to stimulate this area, you want the signals to die down. Conservative docs will usually put you on a high ibuprofen diet - something on the order of 400mg every 4 hours (yes, that's 1.6 grams of ibuprofen a day - so keep food in your stomach and drink LOTS of water) - to deal with the swelling. For immediate relief, anti-spasmodics such as "Flexeril" are often prescribed. You'll know when you need something like that... the pain is excruciating and you'll need help just to move.

 

I've found that "Tylenol 3" (inflamm + codeine) works significantly better at alleviating back pain and spasming. Caveat emptor, as some folks are sensitive to narcotics. Besides, they'll turn you into a haggard, gun-toting, foaming at the mouth, panhandling, bank-robbing junkie... or so I hear.

 

The canucks sell 2-2-2 over the counter, which is another mild codeine/anti-inflamm formulation.

 

I'm very sorry to hear about your problem. In my own experience, once you get two or three days lined up where you're not aggravating things, you regain strength and flexibility very quickly.

 

-t

 

 

[J_Fisher]

I've had what you describe and Flexeril was the only thing that worked for me. Massage, mega doses of vitamin I, etc. barely took the edge off the pain, whereas flexeril allowed me to function more or less normally (if in a somewhat altered mental state...)

 

Good luck, I know what you're going through and it sucks

[rbw1966]

I trashed my shoulder recently and the doc gave me Bextra. I don't know whats in it but man does it work. Aside from some stiffness it feels a lot better.

 

I've done accupressure for back pain before and it worked quite well. There is a local naturopathic college that gives treatment on a discount which was nice since insurance diddn't cover it. They'd rather pay for PT, drugs and doctor visits all of which resulted in no relief. One accupressure treatment and I was symptom free. I am sure I will do the same after my shoulder has quieted down.

 

Best of luck to you.

[glassgowkiss]

Carolyn, John is right, it's NOT lactic acid. what you have they are called adhessions of the muscle. muscle groups, muscles and muscle bands (within the same muscle) are wraped with a connective tissue called facia. it provides smooth surface and decreases friction between the muscle while they contract and relax. sometimes there is tearing occuring in this tissue, muscles become "glued" and stuck together. because you still use the muscle extra collagen is introduced to the area building scarr tissue. (collagen is intoruced in a "random" parttern, not in a linear way).

The symtoms you are describing you might have sprained your sacro-illiac joint. You might have too tight Gluteus muscles, Illiotybial Band and hyperactive Illiopsoas (deep hip flexors).

don't use too much heat, yes, it feel good at the moment, but it increases inflammation over all. you can use heat, but use ice afterwards. light stretching is ok, as long as you don't feel ANY pain during the stretch.

there is a great book for stretching by Aaron Mattis called Active Isolated Stretching.

for hamstings- flat on the back and raise straight leg up- don't bend your knee- since hamstrings cross your knee.

for gluts: flat on your back and bring seperate knee towards your arm pit (same side) after doing both legs 8- 10 times do them together. hold these stretches only for 3 to 4 seconds.

do some back extensions- flat on your stomach raise your trunk as far as you can go.

there are several illiopsoas stretches- is quite hard to describe it here, but common one is kneeling on one knee and doing a "dip" with you trunk straight.

contact someone regarding this thing. looks like you have an ongoing history of back problem, you'll need to find a long range solution. these condition can be very painful and impacting the quality of your life. Pain meds and anti-inflammatory are NOT the answer.

some cross fiber friction and some myofacial work would bring you some relief. also you must figure out an excercise program to maintain your tissues. hope it helps.

BTW if it is SI joint, it usually takes a week or 2 to get better.

[glassgowkiss]

terrible_ted said:

Actually, I'd rethink the desire to rub/massage the area. Your back might respond better if you just leave those muscles alone for a little while. Those 'high tension, twitchy' areas are probably damaged/inflamed muscles. The increased size and secretions of the damaged tissues result in hyperactive nerve signalling ("back spasms"). You don't want to stimulate this area, you want the signals to die down. Conservative docs will usually put you on a high ibuprofen diet - something on the order of 400mg every 4 hours (yes, that's 1.6 grams of ibuprofen a day - so keep food in your stomach and drink LOTS of water) - to deal with the swelling. For immediate relief, anti-spasmodics such as "Flexeril" are often prescribed. You'll know when you need something like that... the pain is excruciating and you'll need help just to move.

 

I've found that "Tylenol 3" (inflamm + codeine) works significantly better at alleviating back pain and spasming. Caveat emptor, as some folks are sensitive to narcotics. Besides, they'll turn you into a haggard, gun-toting, foaming at the mouth, panhandling, bank-robbing junkie... or so I hear.

 

The canucks sell 2-2-2 over the counter, which is another mild codeine/anti-inflamm formulation.

 

I'm very sorry to hear about your problem. In my own experience, once you get two or three days lined up where you're not aggravating things, you regain strength and flexibility very quickly.

 

-t

 

one more note- anti- inflammatories knock off a bunch of enzymes from your system. these enzymes help remodel your tissues. there were several studies showing tissues healed with anti-inflammatory drugs were up to 50% weaker. about 30 000 a year die from drug poisoning because they are prescribed antiinflammatory drugs (Viox and Celebrex).

so in a long run you're much better of not using them and let you body go through natural process of healing- it worked for millions of years! just give it some time!

[glassgowkiss]

J_Fisher said:

I've had what you describe and Flexeril was the only thing that worked for me. Massage, mega doses of vitamin I, etc. barely took the edge off the pain, whereas flexeril allowed me to function more or less normally (if in a somewhat altered mental state...)

 

Good luck, I know what you're going through and it sucks

now that's new one even Group health (one of the most conservative insurance companies) in thier study released a few months ago concluded massage therapy for back pain brought the most long lasting effects in pain reduction and tissue function

like with everyhting there are good therapist and bad one....

[Dave_Schuldt]

Carolyn, sucks to hear about your pain. I have had problems with my back as well. I have found Yoga to be a great help. I would STRONGLY recomend taking classes for a while, you can realy hurt yourself if you don't know what your doing. It may a while to find the right instructor so don't give if you don't like the first class. There are several different kinds of Yoga so talk to them first so they can point you in the right direction. Also go to a masage supply store and check out there selection of back self masage tools. If you can't find anything in your area get hold of me when your in town and I can tell you where to go. Also those giant balls are nice as whell as cylenders of hard foam.

Check out this website, I have one and it realy works.

http://www.isokineticsinc.com/Merchant2/merchant.mv?Screen=PROD&Store_Code=isokinetics&Product_Code=sg_13700

Edited September 25, 2003 by Dave_Schuldt

[terrible_ted]

glassgowkiss said:

these enzymes help remodel your tissues. there were several studies showing were up to 50% weaker. about 30 000 a year die from drug poisoning because they are prescribed antiinflammatory drugs (Viox and Celebrex).

so in a long run you're much better of not using them and let you body go through natural process of healing- it worked for millions of years! just give it some time!

 

What a bunch of pseudo-scientific horseshit. Most NSAIDS knock down production of prostaglandins, IL-1, IL4, IL-8, TNF, etc... through inhibition of the COX pathway. The relationship between catabolic muscle growth and the portion of the immune system associated with inflammation is poorly understood at the cellular level, much less the at the musculoskeletal level. I'd bet my bottom dollar the studies you quote are either overinterpreting their results, misinterpreting their results, or represent an unrealistic system.

 

At best you might be able to refer to tissues healed 'in the presence of anti-inflammatories.' (How did they isolate them? How did they determine "50% strength"? How did they determine it was anti-inflamms and not the nature of the injury itself? How did they control this? Yada, yada, yada... Science ain't that easy, that's why only overeducated masochists pursue it...) You might also want to take note of the differences between rofecoxib, celecoxib, ibuprofen and aspirin. They're all NSAIDS, and they all have very different metabolic profiles. You'd have to eat a lot of ibuprofen to kill yourself. Roughly 50 grams in one sitting, assuming Carolyn is a 110 pound mouse...

 

Millions of years ago, monkeys with chronic back problems were eaten before the age of thirty. They didn't worry about whether or not they could fly across the states and go climbing in a week.

 

NSAIDS will help reduce swelling. Muscle relaxants and pain killers help in dealing with pain. Time and rest will effect healing. I'm not arguing against stretching and heat (although I think cold therapy would be a better call - particularly in the case of obvious swelling), but I think massaging inflamed tissue is jumping the gun. I should have added that I'm in no way a fan of maintenance dosing of ibuprofen (although many docs are...). When your back feels better, stop popping pills.

 

-t

[Courtenay]

And if you're looking for some yoga tapes with excellent cuing and instruction that you can try at home (i.e. start and stop as you can tolerate and not have to endure a whole class -- $$ -- if you're not up for it at any time) you might want to try one of the following -- I particularly like the YogaSculpt and Yoga Focus products, on VHS or DVD, especially for the back and hips: http://www.bodyresults.com/P1KarenVoightVideos.asp

[glassgowkiss]

terrible_ted said:

glassgowkiss said:

these enzymes help remodel your tissues. there were several studies showing were up to 50% weaker. about 30 000 a year die from drug poisoning because they are prescribed antiinflammatory drugs (Viox and Celebrex).

so in a long run you're much better of not using them and let you body go through natural process of healing- it worked for millions of years! just give it some time!

 

What a bunch of pseudo-scientific horseshit. Most NSAIDS knock down production of prostaglandins, IL-1, IL4, IL-8, TNF, etc... through inhibition of the COX pathway. The relationship between catabolic muscle growth and the portion of the immune system associated with inflammation is poorly understood at the cellular level, much less the at the musculoskeletal level. I'd bet my bottom dollar the studies you quote are either overinterpreting their results, misinterpreting their results, or represent an unrealistic system.

 

At best you might be able to refer to tissues healed 'in the presence of anti-inflammatories.' (How did they isolate them? How did they determine "50% strength"? How did they determine it was anti-inflamms and not the nature of the injury itself? How did they control this? Yada, yada, yada... Science ain't that easy, that's why only overeducated masochists pursue it...) You might also want to take note of the differences between rofecoxib, celecoxib, ibuprofen and aspirin. They're all NSAIDS, and they all have very different metabolic profiles. You'd have to eat a lot of ibuprofen to kill yourself. Roughly 50 grams in one sitting, assuming Carolyn is a 110 pound mouse...

 

Millions of years ago, monkeys with chronic back problems were eaten before the age of thirty. They didn't worry about whether or not they could fly across the states and go climbing in a week.

 

NSAIDS will help reduce swelling. Muscle relaxants and pain killers help in dealing with pain. Time and rest will effect healing. I'm not arguing against stretching and heat (although I think cold therapy would be a better call - particularly in the case of obvious swelling), but I think massaging inflamed tissue is jumping the gun. I should have added that I'm in no way a fan of maintenance dosing of ibuprofen (although many docs are...). When your back feels better, stop popping pills.

 

-t

in short i am too busy to argue with you via internet about this. working with athletes almost every day i can see what works and what doesn't. and your spew is as pseudo-scientific as my is.

while in european teams for many years massage/body work was a norm in the US common treatment was novocaine/cortisone injections. maybe you should read about Kurt Marsh (who btw is super nice guy) and see how treatents like that (or mistreatments) led to amputation of his leg.

by no means i don't say i have answers to pain and injuries. i try offer some alternatives to fucked up medical system operating here.

yes, like i mentioned, ice is better then heat. but heat has some positive sides to and can be used as a great tool combined with ice.

[carolyn]

Wow! Thanks for all the great thoughts!

 

I did take part of the day off work and spent a number of hours rotating heat/ice/heat/massage along with a few stretches. The stretches were an improvement from the past two days. I hadnt read glassgowkiss' response until now, but a few of the stretches I did were the same as you described.

 

The pain and a few of the knots are still there...down one side of my neck and around my shoulder blade. Not quite as intense as last night at this time, thankfully. Only one "siezed" up moment today and no spasms in the lower back.

 

I would be more than happy to lay of the heat AND massage. After today, I think it is starting to make me feel MORE sore.

 

Medication-wise. Flexeral is something I have taken in the past, which worked well for the spasms. I usually dont take more than 800mgs of ibuprofin, two times a day because I dont want to 'mask' the pain and wind up doing more than my body is ready for..therefore making it worse.

 

Im wondering if doing some light/easy traversing on some rock in the next couple days would be a good idea? Something that requires more feet and balance vs arm or finger strength. Just to get the movement going again in my arm/shoulder/neck/back.

 

Anyway, long term I know I should address this issue. I appreciate all the ideas, which I will explore.

 

Oh...and Courtney...the tennis ball trick is awesome.

 

Thanks again!