My back hurts.

May 5, 2014 1:20 PM

I've had a lot of pain in my lower back for the last five days or so. There's no obvious cause that I can think of but it seems to be getting worse, not better. It's at the point now where standing up is taxing, even after taking ibuprofen. Any suggestions?

I'm a 29-year-old male in reasonably good shape but with a history of intermittent back problems. Last Thursday I woke up with some pain in what I guess you'd call my lumbar area, near the top of my pelvis. I figured that I'd just slept on it funny but it's only worsened over the last few days, and I've exhausted all my usual strategies for fixing it. I've rested it, stretched it, iced it, heated it, and I've been taking ibuprofen around the clock. The ibuprofen helps but it still hurts so much as of today that I have a hard time standing up.

It generally is worst when I first wake up (presumably because the muscles have stiffened overnight) and improves over the course of the day with gentle use. It's better when I can sit or stand up straight than when I have to lean over. I don't remember doing anything that hurt it; I did carry a couple of palettes (you know, those big wooden platform things) on my back for a few blocks last Wednesday, but at the time it felt perfectly OK. I guess that could've done it as they were a bit heavy and awkward, but that doesn't seem to explain why it would've worsened over the weekend.

I don't have a lot of time to be seeing doctors and getting referrals and visiting specialists and all that right now, as I'm leaving the country in a couple of weeks and will be gone on fieldwork for three months. I really need to get this fixed. I've got a number for a chiropractor from a friend I trust (I realize that not all chiropractors are worth seeing but I trust my friend's judgment on this) and I may give him a visit. I've also ordered a new mattress because my current one is old and has a dip in it that's uncomfortable for my back.

What other suggestions do y'all have? I'd really like this to be over with. This sucks.

posted by Scientist to Health & Fitness (24 answers total)

I'd go to a primary care physician and have them take a quick look. If they don't see anything seriously concerning, they might prescribe a muscle relaxant like cyclobenzaprine (Flexeril) which might help you recover faster (and is likely to help alleviate the pain, at least temporarily).
posted by Juffo-Wup at 1:26 PM on May 5, 2014 [1 favorite]

Yeah I would also do regular doctor and try painkillers. I would definitely not do a chiropractor except as a last resort, after meds, massage, and physical therapy had failed over several months, as in my experience they are more likely to hurt (especially over the long term) than help.
posted by brainmouse at 1:31 PM on May 5, 2014 [2 favorites]

Agreed, if you have the ability to see a physician and all that (because America!) that is. I'd always hoard my muscle relaxers from instances like this such that if/when I hurt myself in the future I could take one and speed my recovery then. It's crazy how one muscle relaxer would turn a pain that I could tell would have a 2 week natural recovery time into an overnight recovery with a high success rate.

I did try a chiropractor and, after years of wondering if they were worth it or just full of woo and hand waves, was not impressed. Some folks swear by them and maybe there are folks that benefit from being under their care but my visits were rife with woo and had no noticeable impact on my pain and suffering. It's to the point where I tell people about this so they can save the deductables/costs on chiro visits. Again, maybe I'm wrong but I certainly can't afford to throw money at one until I'm broke or sure of it, whichever comes first.

Muscle relaxers on the occasion that something goes wrong, which happens once or twice a year maybe, now those can be taken to the bank.
posted by RolandOfEld at 1:35 PM on May 5, 2014

Are you still in Nola? I liked my orthopedist a lot, Dr. Lee Moss. Their in-house PT clinic is great, I saw John Moran.
posted by radioamy at 1:37 PM on May 5, 2014

Oh and my chiropractor was also recommended by an [otherwise] trustworthy friend who swore by said chiro's abilities. YMMV but see above for my experience.
posted by RolandOfEld at 1:38 PM on May 5, 2014

Don't go to a chiropractor. And based upon my experience of ten years of visiting doctors for intermittent back pain, I really think a doctor is going to tell you to take Aleve and be careful and wait for it to get better. They may give you flexeril but be forewarned muscle relaxants will make you feel very tired, and not in a fun way. I have a flexeril prescription and rarely use it.

Have you tried stretching it or gentle yoga? That makes an immense difference for me. I have degenerative disc disease and was in pain every day for the better part of a year until I started 30 minutes of daily yoga.
posted by something something at 1:39 PM on May 5, 2014 [1 favorite]

Generally speaking, if you over-extended it or otherwise hurt it from use, there's not a ton a doctor, PT, chiropractor can do. The doc will prescribe you pain meds to get your through while the muscles repair themselves. Massages can offer very temporary relief, but they don't actually fix anything, and the relief is pretty fleeting.

If it were me, I would make sure I was stretching properly to release my lower back muscles as much as possible. I would try these gentle stretches:

-Lie on your back and hug your knees into your chest. Try to gently reach your tail bone toward the ground but not aggressively so. You should feel a sense of relief in your lower spine.

-Baby and child pose. Starting kneeling and lower your body to the ground in a ball, with your forehead resting on the ground. Try placing your arms next to you legs, hands up, and then out in front of, hands down, reaching forward.

-Standing up, bend over while holding your opposite elbows in each hand. Pull your belly in and really let the whole top half of your body sort of fall over the front of you, letting the whole top half go.

-It might also help to do a bit of gentle twisting. Lie on your back and hug one knee into your chest. Hold that knee with the opposite hand and twist so the knee comes across the body to the floor on the other side. Reach the other arm out (same arm as leg that's rotated) out in the opposite direction. Try to let your spine do the twisting. Do the other side.

Good luck. Feel better man.
posted by Lutoslawski at 1:45 PM on May 5, 2014 [3 favorites]

I had something very similar recently and went to the doctor who tried to pawn off some Naproxin and sent me a hefty bill. The chiropractor gave me better results for less cost and no awful drugs. He did a wonderful lower back crack which almost instantly cured me.

Stretching and yoga will help to prevent disc problems and should be done regularly but when you have a debilitating pain, short of morphine, I would try a chiropractor.
posted by JJ86 at 1:45 PM on May 5, 2014

Are you sure it's your back and not kidney-related?
posted by mosk at 1:56 PM on May 5, 2014 [3 favorites]

Is the pain only on one side, or more toward your flank than back? That would indicate a kidney thing.
posted by Lutoslawski at 2:01 PM on May 5, 2014

Ice the hell out of it. Seriously ice it until it goes numb then stop and when it warms up and starts hurting some more, ice it again. It will help dramatically with inflammation and as a bonus has a nice analgesic effect.

My FIL is a chiropractor, he is of the no woo or hoo variety. Sometimes it can help sometimes it won't, if they try to convince you chiropractic adjustments can cure everything from ADHD to the common cold they are not reliable.

Things to look for in a good chiropractor. They will insist on an xray before they lay a hand on you they do not want to be adjusting something that you should be seeing a mainstream doctor for or to make something worse. They will be able to show you the xray and show you what they are going to do and why, this may mean two visits so they doc has times to study your xray. They will offer pain management advice (most likely to ice and NSAIDS), be able to give you a treatment plan with a definite end and should not try and shove a whole bunch of supplements etc onto you. After a visit or 2 when pain is reduced they should offer you an exercise plan. You will most likely need to have more than one visit, but if it's a problem they can help you should see good results before you leave.

The above suggestion of being sure it's not your kidneys is a good one.
posted by wwax at 2:04 PM on May 5, 2014 [1 favorite]

Seconding what wwax says about chiropractors in general. I've thrown out my back about 3 times now - the first time I had a chiropractor, who identified that I had some lifelong scoliosis at that precise spot in my back and it was just gonna be weak there. He gave me good tips on lifestyle changes that could prevent it in future (no high heels, stretching more, and "pay attention if something is too heavy, don't be tough and try to lift it"). The next two times I had a massage therapist take care of it and that was also fine.

But also seconding what people say about making sure it's not anything kidney-related.
posted by EmpressCallipygos at 2:19 PM on May 5, 2014

Could it be sciatica? My boyfriend and mom have both had problems with it, and they said it was worst in the morning. Using a heating pad at night and those Thermacare pads during the day seemed to help quite a bit, and after a while the pain went away completely.
posted by jabes at 2:48 PM on May 5, 2014

I have two herniated discs in my lumbar spine and I am all too familiar with back pain. I've become an old pro at how to treat it. I am sorry you are having to go through this.

I second the advice on icing it and not going to a chiropractor. It has been my experience that some chiropractors can do more harm than good. If you can, see an orthopedist or a sports medicine doctor. Before I was diagnosed with my disc issues, I went to 3 different doctors and 3 different chiropractors before I got fed up. I was lucky to find my current doctor, who is a sports medicine guy that specializes in non-surgical treatments for musculoskeletal issues, including neck and back pain. He's the only one out of the lot of doctors I saw that sent me for an MRI. In the past, my sports med guy has prescribed me pain meds, oral steroids (prednisone) to get rid of the inflammation and when I was able, physical therapy (PT). My ongoing treatment involves being gentle with myself and daily PT that I do at home. (Just an FYI - if any doctor tries to send you for an x-ray to see if you have disc issues, find a new doctor. X-rays don't show discs. I learned that lesson the hard way by seeing a bad doctor.)

Don't beat around the bush - time and money is precious. Go find someone that can give you relief.
posted by ATX Peanut at 3:47 PM on May 5, 2014 [4 favorites]

The thing is that there are competing approaches to that kind of pain. If you happen to start with someone working in a modality that won't help the thing you've got, you've extended the time to diagnosis and treatment. Imo it's best to go to an allopathic doctor, who is positioned and trained to route you. My experience agrees with above that GPs will often wave you away with an NSAID and want to wait and see before referring you on, while sports med doctors do have more specialized knowledge of MSK issues, and seem to be more likely than GPs to pursue imaging faster (if necessary), and to refer you more quickly to a rheumatologist or ortho surgeon (if required). I would not see a chiro.

Have you already read something like this? I'm no expert, but speaking as someone who's had and therefore read about a lot of different MSK issues, for which I have seen a number of doctors and kinds of doctors, odds are you probably pulled or tweaked something. But if you've also got stiffness in the morning, it could be something else, and a doctor doctor (sports med or GP) needs to be involved to help work that out, in that case.

I know this is the last thing you want to bother with right now, but you know, pain is a signal things are wrong and have to be dealt with. Also, definitely review your travel/health insurance before you go.
posted by cotton dress sock at 5:12 PM on May 5, 2014

Back pain out of nowhere that's getting worse instead of better with rest and time is potentially serious and worth seeing a doctor for. Nthing everyone who suggested getting your kidneys checked.

If it turns out to just be regular back pain, instead of a chiropractor you should see an osteopath. They can do spinal adjustments like a chiropractor, but also write prescriptions if you need muscle relaxers. They are also less likely to push nonsense. Look for a doctor with DO after his/her name.
posted by Jacqueline at 6:05 PM on May 5, 2014 [1 favorite]

If the pain is worst as soon as you wake up, but gradually gets better as you walk around, it might be Ankylosing Spondilytis. IMNYD but I'd suggest seeing a rheumatologist and getting your HLA-B27 tested. AS is a complicated diagnosis to make since it's a systemic condition and x-rays don't usually pick up inflammation.

I strongly suggest you see a specialist before you leave the country.

If you'd like to talk, feel free to memail me.
posted by rippersid at 7:22 PM on May 5, 2014 [1 favorite]

Yeah, leaving aside the whole science-or-not aspect of chiropractic, three weeks before you have to sit on a plane and then do potentially strenuous tromping around in the wet and bending over to bother frogs is not the time to start a course of spinal adjustments. Start with your primary care provider, make it clear that you're operating on a compressed timeframe and get a referral to a sports med orthopedist - make the time for it, because fieldwork has potential to really mess up your back.
posted by gingerest at 7:59 PM on May 5, 2014

See some kind of qualified medical professional*. While you are very young for this sort of thing (unless you have Marfan's Syndrome or similar high risk factors), aortic anyeurism can present as unrelenting back pain. Please tell the doctor you have international fieldwork in the near future.

*not a chiropractor.
posted by Lyn Never at 10:18 PM on May 5, 2014

How are your shoes? I recently had a bought of lower back pain, and it was because my shoes were so worn out I was walking oddly without realizing it, and I do a lot of walking.
posted by unannihilated at 1:14 AM on May 6, 2014 [1 favorite]

When I had this problem a chiropracter suggested I sleep on my back rather than my side and the back pain went away pretty quickly. It may be difficult at first but it gets easier, for me anyway. I have a high-end Temurpedip bed, so I doubt it's the mattress I have. Maybe it's worse for women because of generally larger hips, but a guy may have the same problem, especially if one has a larger belly that strains the back.
posted by waving at 4:59 AM on May 6, 2014

I went to physical therapy for lower back pain, and it was useless until they had me try the foam roller. Then I bought my own foam roller (which you can find wherever yoga mats are sold, generally, e.g. Target) and that's the best thing for my ongoing problem. Gaiam makes a travel one.
posted by Comet Bug at 7:54 PM on May 6, 2014

This sounds a little bit like a herniated disk, if maybe only a very mild one. The first time it happened to me, I also was unable to pinpoint the exact moment of injury. Thing is, though, if that's what it is, I'm surprised it's taken "a few days" to get to the point where you are having trouble comfortably standing. In my experience, this sort of injury goes from zero-to-sixty quite quickly; the first time, I denied my situation for about eight hours, then went to a clinic (they couldn't figure it out), then was in the ER within another four hours. Now when it flares up, I'm at the doctor within six hours, no question.

I'm glad others have mentioned kidneys. Actually, my initial suspicion during my inaugural herniated disk was that I was having kidney problems again. It was a very similar pain, at first, kind of "hollow," for lack of a better term. Hard to place/describe a specific "location" in the lower back. Do you drink alcohol ... um, regularly? Tons of coffee, or other beverages/whatevers that can stress kidneys?

If it's a structural problem with your back (herniated disk, etc.), be prepared to fight for appropriate pain management. Why? Because doctors have often dealt with their fair share of "back pain" fakers, looking for opiates. Furthermore, many claim to be constrained by network guidelines that discourage narcotic pain relief. There are legitimate reasons for this, but that doesn't mean much when you're in serious pain. Your doctor may well try to get you to try a series of non-opiate pain relief methods, first. In my experience, these are the tools I need in order to 1) get comfortable enough to stand/sit/think human thoughts again, and 2) combat the underlying injury:

- High-dose Ibuprofen (typically 800mg)
- Lower mid-range opiates (e.g. hydrocodone), which also include acetaminophen
- Muscle relaxer (Flexeril)
- Prednisone, a steroid that combats inflammation, given over a short period of time to avoid side effects (they introduced this approach to me during my most recent flare, and it really helped)

Your doctor (or your work comp insurer/HR dept, if it happened at work) may recommend some physical therapy. I suggest doing that, if you can spare the time and moderate expense. I put it off for years, but have since found it to be very helpful in properly strengthening my core and learning to keep my spine neutral at all times. I'll nth everyone who's advising against chiro, too; even if you have one you really trust, they can indeed make the problem worse. At best, they'll be angling to get you in an endless cycle of maintenance "alignments," and you can obtain the same results for much less money just by doing the PT/core-building stuff.
posted by credible hulk at 10:10 PM on May 6, 2014

I should maybe point out that ibuprofen and other NSAIDS are metabolized principally by the kidney, so anyone with a renal condition, including a kidney infection, should talk to a pharmacist before using these medications. It's important to stay hydrated if you're taking NSAIDS, too.
posted by gingerest at 12:00 AM on May 7, 2014 [1 favorite]