Back pain: Am I just sore or have I hurt myself? And if I've hurt myself, what do I do?

March 11, 2009 6:40 PM

Back pain: Am I just sore or have I hurt myself? And if I've hurt myself, what do I do?

I've recently begun a great exercise routine that I'm really excited about. I am still ramping up, so I'm only going to the gym about 3 days a week, but I use an elliptical machine for at least 30 minutes every time I go. I really like it.

But for the last few weeks, my back has been really achy for a few days at a time, and then it gets better. It doesn't really seem to coincide with my workouts; sometimes I wake up sore after days I haven't worked out. And tonight, I went to the gym for awhile, and am now feeling almost immobile because my lower back hurts so bad. Ibuprofen isn't really helping, heat does a little. Am I just that sore from working out? Or maybe I am using the machine wrong? I strained my lower back when I was a teenager, really badly, but this pain feels different. That pain was really localized and this is my entire lower back and upper butt.

What kind of doctor do I need, if they can do anything for me? I don't really have a general practitioner right now. Thanks for any advice!

posted by juliplease to health & fitness (6 comments total)

You need to talk to your trainer (get one if you don't have one, even if it is for just one day a week for a month or two) to help you get started on these exercises in a healthy manner. Don't go with the macho "I can make you a man" type as much as the type who proclaims to be able to teach you proper technique and pacing so as to not hurt yourself yet maximize your effort. You need some core strengthening exercises to balance out the elliptical routine. Some crunches etc.

If you don't want to pay for a trainer, the basics are crunches, on your back, knees up, heels on the floor, press your lower back into the ground by rotating your hips down and then knees to the left, up, knees center, up, knees to the right, up, and by up you pull up slowly until your shoulders are about a half foot off the ground and you feel it in your stomach, and most importantly you keep your lower back pressed flat to the ground. If your stomach sticks out then you are doing it wrong.
posted by caddis at 6:49 PM on March 11, 2009

I had terrible pain in that area and eventually traced it back to a tight IT band, probably due to rollerblading and cycling. Stretching it in this manner using a foam roller did the trick.
posted by Napoleonic Terrier at 10:36 PM on March 11, 2009 [1 favorite]

Don't make guesses about back pain & (no offense to caddis but) don't rely upon a trainer to make a diagnosis. It might be your exercise that's causing it. And it might not. You need to see a doctor.

Seriously, back pain is nothing to take lightly. I speak from bitter experience.

In the meantime, icepacks are the best remedy. Good luck.
posted by jammy at 4:26 AM on March 12, 2009

It is rare, but some of your symptoms sound consistent with Ankylosing Spondylitis, especially if you are aged 18-30 or so: waking up sore, feeling immobile in the lower back, etc.
posted by fatllama at 4:33 PM on March 12, 2009

By way of a natural mechanism for protecting the spine, simple DOMS usually feels practically indistinguishable from nagging injury in the region of the lower back. That you're just beginning with regular exercise and thus can expect to go through a flurry of aches and twinges while your body adapts to the unfamiliar stresses suggests your soreness may not be as serious as Congenital Skeleton Failure.

Never, never, never skip proper warm-up and cool-down routine: dynamic stretching beforehand and static stretching afterwards (avoid stretching in lumbar flexion however, as this is never healthy for the spine, contrary to common yoga marketing). Specifically you want to be doing those stretches that target the IT/TVA bands, hamstrings and psoas, which are the most common culprits from a muscular standpoint. Deep lunges are a good one.

Myofascial self-release aka foam rolling is also of amazing benefit and will keep you healthy and limber in the long term. Pick up a roller or make your own from PVC pipe (duct-taping two squash balls together is another thrifty option that works well for tough lumbar/hamstring work).

Anterior pelvic tilt is a very common problem in exercise-induced backpain, and you'll almost certainly have it if you spend a lot of time sitting down. This is something any decent trainer ought to know how to remedy.

Oh and one important thing to note is that crunches and their ilk may actually do you more harm than good: generally, you should only train your core to resist motion rather than generate it (again, for the sake of lumbar stability). Front and side planks, full-contact twists, russian twists, ab wheel rollouts and reverse crunches are the route to a rock-steady and healthy spine.

If the pain persists, seek medical advice.
posted by Kandarp Von Bontee at 9:57 AM on March 15, 2009

The pain persisted, then worsened, and I went to see a GP today. I went in part because the people in this thread (and my mom) reminded me to take back pain seriously. I was relieved to be told that it's just strained. I got some harder core pain meds for a few nights, instructions for Motrin during the day, two simple exercises to do, and am the proud new owner of the best heating pad I think I've ever felt in my life.

Thanks for the support, AskMe.
posted by juliplease at 7:19 PM on March 23, 2009