How to beat back ongoing back pain

May 4, 2015 2:00 PM

Me-fites with past back pain experience: if you've experienced multiple episodes of back pain but have managed to conquer it after all, how did you do it?

I've been experiencing debilitating back pain on and off over the past month (the must have prescription muscle relaxants variety of back pain). I've had a cranky back forever, with days of soreness after moving apartments and a round of heavy baby-related back pain, but this extreme pain has got to stop. What long-term solutions worked for you? My last bout was triggered by weeks of house painting and one stupid yoga class.

posted by Maarika to Health & Fitness (32 answers total)

1) Exercise (within limits): I've lost a bunch of weight, and I'm careful about it, I use the elliptical instead of running and I don't do squats/clean & jerk, etc that would put stress on my back
2) Good shoes: I wear comfy sneakers to work when I can, otherwise I've got inserts when I need to wear grown up shoes.
3) Soaking: I soak in a hot hot hot tub with epsom salts when I've had a stressful day
posted by Oktober at 2:02 PM on May 4, 2015

Seeing a physical therapist. They proscribed what seemed like dumb exercises that reversed many years of on-and-off back pain. Find a good PT.
posted by GuyZero at 2:10 PM on May 4, 2015 [20 favorites]

I've had all sorts of different kinds of back pain (inc. bouts when I had to take relaxants) and regularly lifting weights has helped much more than anything else I've ever tried. You just have to be extra-super careful about form and not lifting more weight than you can handle.

On preview: PT is probably a better idea to start off.
posted by griphus at 2:12 PM on May 4, 2015 [1 favorite]

My father has managed ongoing back pain for over 30 years with a combination of daily core strength exercises and daily cardio exercise, usually walking or biking or chopping, splitting, and stacking wood. His back pain stays almost 100% at bay as long as he keeps it up. I have had similar, but less severe, issues for ~15 years myself, and I find that keeping my core strength up is enough to keep the back spasms entirely at bay for me (as long as I don't do something stupid like fall down half a flight of stairs).

So I would suggest physical therapy to improve your core strength. I'd do a PT assessment rather than starting an exercise program at random, as some core exercises that might work for you in the future could be a bad idea now. (Also, don't do crunches or situps ever. There are much better and less hazardous ways to improve core strength.)

However, this assumes that the source of your back pain has been diagnosed and is not anything serious; back pain can be a sign of something more serious, so if you haven't had the cause assessed, and especially if this has recently worsened or changed in nature, you would need to start there first.
posted by pie ninja at 2:12 PM on May 4, 2015 [1 favorite]

My wife went to a physical therapist for this kind of issue, after years of struggling with it, and it made a massive, massive difference. She still has the occasional issue, but it's much less severe than it used to be, and the PT taught her the right ways to both prevent and treat it, so it's not as big of a deal. She went to the PT for a long time, it wasn't just a one-time visit. I want to say it was maybe 6-9 months of at least a couple of visits a month. Not a quick fix, but worth it.
posted by primethyme at 2:14 PM on May 4, 2015

I finally saw a physical therapist who assessed why I was in pain, prescribed exercises and then I went back to the PT to report how well they had worked and we adjusted them.

I do the following and haven't had a debilitating episode since:
-exercise regularly (anything cardiovascular, walking when that's all I can do. Any exercise helps tremendously.)
-prescribed back exercises religiously (twice a day, every day, no exceptions)
-have kept off the weight I lost
-avoid movements that I know trigger an episode (bending/lurching forward, spinal twists, sleeping on my right side, doing any exercises or chores while angry, etc.)
-roll out my back with tennis balls when it gets tight

The key to all of it was the help from my physical therapist.

I've also noticed that doing planks and having a stronger core seems to help somewhat, but the other stuff is more important.
posted by purple_bird at 2:15 PM on May 4, 2015

Doing lots and lots of strength work on my abs has completely removed my back pain, which I think was largely due to sciatica and poor posture.
posted by joan_holloway at 2:19 PM on May 4, 2015 [1 favorite]

I went to a physical therapist for this kind of pain. She prescribed a set of core strengthening exercises to be done daily. She also suggested losing weight; I was about 45 pounds over the normal weight range for my height and verging on clinically obese.

The core exercises reduced the pain to a manageable level within a week, and after a month I was virtually pain free. Losing weight (65 pounds) was a longer-term process but I suspect it's a big factor in why I am still pain free.

I get regular aerobic exercise (cycling and running), but that was the case when my back pain developed. And I also do all-around strength exercises.
posted by brianogilvie at 2:23 PM on May 4, 2015

Yoga every morning before work. Every morning. Every single freaking morning, 5 days a week, for years now, and I'll likely never be able to stop, or I'll end up in the hospital with a numb leg and agonizing pain again.
posted by MrMoonPie at 2:25 PM on May 4, 2015 [3 favorites]

Another vote for physiotherapy, although core strength exercises did not help with my back pain. The physical therapist I saw assessed me much more thoroughly than the MD and chiropractor I had previously seen, and identified a point of tightness (actually more hip/buttock than back in my case). I roll out that specific point with a tennis ball when it gets tight, and that not only relieves pain but seems to prevent future episodes.

I have not made any changes in my exercise routines, my weight is the same (slightly heavy but not a big deal), and I do not do anything on a daily basis, just the tennis ball exercise when I have pain. YMMV, but PT is definitely worth a try!
posted by snorkmaiden at 2:30 PM on May 4, 2015 [1 favorite]

Exercise! My tai chi teacher has us do a set of warm-up exercises which have eliminated my multiple back problems, and also got rid of arthritis and RSI. It's like magic. I used to need Vicodin, muscle-relaxants, and similar, now have been pain-free for several years.
posted by anadem at 2:32 PM on May 4, 2015

I've had lots of back problems in my life - starting in my early 20s I had an episode every few years where it would "go out" for a few days, but then one day it started hurting and hurt for a solid year. I started doing gentle (VERY gentle) yoga every day and walking as much as I could stand it. After a couple of months, it got better. I don't know if that's why, but I haven't had a bad day in 18 months now.

It's worth going to the doctor, though, if it doesn't clear up. I had an MRI that showed pretty systemic disc problems and no amount of yoga is really going to cure me forever.
posted by something something at 2:35 PM on May 4, 2015

Identify what kicks things off and wherever possible avoid these things. If someone asks you to move something, decline as you have a bad back. Crappy chairs at a conference or in a long meeting? Get up and stand against a wall. This can make you feel a bit socially uncomfortable but it can be worth it.

Twisting from the base of my spine and any heavy lifting do it for me. I try to be as mindful as possible of what will start it and shift my body differently to deal with it. I once couldn't stand up for a week after twisting around in a minibus, but its possible to substitute for that sort of movement by moving your whole torso. Keep in mind where the problems arise for you and address accordingly.
posted by biffa at 2:36 PM on May 4, 2015

I had quite a lot of back pain in my early life, and after I started sleeping on a futon and later a tempurpedic mattress, it went away completely. I've been pain-free for 20 years.
posted by Huck500 at 2:47 PM on May 4, 2015

And if you're in terrible pain now, you can still exercise in warm water, then graduate to colder when you can move aerobically. You don't have to know how to swim -- there are many classes aimed at non-swimmers, with foam belts to prevent drowning.

Swimming is whole-body relaxing -- like yoga or tai-chi -- and is more forgiving of any weaknesses. #1 is you don't have to worry about falling, and #2 is painless contact with floaty water.
posted by Jesse the K at 2:47 PM on May 4, 2015

I had no lasting relief from massage or physiotherapist. However I lucked out with a chiropractor that specializes in longitudal myofascial release. He's got a blend of ART, fascia work, and massage techniques. It's the only thing that began to reverse years of escalating back pain.
posted by tatiana131 at 2:58 PM on May 4, 2015

I herniated my L4/L5 disks and have had intermittent back pain for years. When it flares up, I do a very basic set of stretches recommended by a physical therapist, and that always alleviates some of the symptoms. One's the dead bug; the other is similar but done on hands and knees. They don't take long and lead to a noticeable reduction in pain.

I was talking about back pain with my dermatologist the other day and he SWEARS by the work of Dr. John Sarno, who posits that a lot of back pain has psychological roots and can be overcome through mental exercises, or something. I wouldn't mention this except that my dermatologist is a good doctor and has very much the same amount of damage to his back as I do, and Sarno's work seems to have measurable scientific credence, despite the 1990s shittiness of his website. I have no personal experience with this approach.
posted by bassomatic at 3:20 PM on May 4, 2015

Everyone's back pain is different, BUT...

-Regular exercise, especially swimming, keeping off excess weight.
-Physical therapy when back flares up.
-Ibuprofin and an overnight cyclobenzaprine if I spend a long day gardening or standing on very hard floors (before it starts hurting)
-switching to zero-drop shoes. I know some people experience relief from super-cushy supportive shoes or orthotics, but not me. Minimalist shoes have revolutionized my ability to stand on hard floors for long periods of time without pain. This may be related to my very tight calves and hamstrings, and the tiny increase in stretch I get from having zero drop.
-using a knee pillow at night. It takes a little getting used to, but helps so much.
posted by juliapangolin at 3:42 PM on May 4, 2015

Physio taught me back extension exercises which I swear by when the pain goes down the leg.
Good mattress.
Lumbar support.
Avoiding movements that trigger (for me it's bending--go to bend the knees, not the back).
Lifting at the gym (with good form!)
Lots of interesting stuff at painscience.com.
I looked at Sarno's book--worth a try. Not currently considered evidence-based, as it is basically neo-Freudian, but the mind-body connection in whatever form is no doubt important.
posted by kevinsp8 at 3:45 PM on May 4, 2015 [1 favorite]

Exercise. Stretching. But, ultimately, surgery. YMMV, of course. Mine got to the "lying on the floor unable to move and screaming in pain despite the fistful of oxy I took" stage.
posted by Thorzdad at 4:03 PM on May 4, 2015

1. Regular exercise. Running helps me a lot.
2. Yoga
3. Floating. Even when I feel spasms (thankfully a rare event these days) I feel no pain while floating, and much less afterward.
4. A thermophore heating pad.
5. A very talented masseuse who uses active resistance techniques with massage -- basically activating and then relaxing the affected muscles.
posted by bearwife at 6:02 PM on May 4, 2015

Walking every day for 35-60 minutes. Swimming for 30 minutes 2 or 3 times a week. Pilates once a week. All these work for me. I had back problems on and off for years before I started the daily walking.

Yoga seems to aggravate some people's back problems.

If you wear high heels switch to lower heels or flats.

Maintain a healthy weight.

Bend your knees when you have to lift things.
posted by mareli at 6:22 PM on May 4, 2015

My physio gave me a set of stretches that keep my back happy provided I do them every day.

A good physio is key, though. Mine was the fifth or sixth that I saw, and the preceding lot were useless. My guy went on to work with Usain Bolt, though, so I think I might be a bit spoilt.
posted by Kreiger at 6:37 PM on May 4, 2015

Nthing physical therapy, and learning how to do self-massage with a foam roller and other implements. During my most recent flare-up, I was able to get instant relief by using a glorified rolling pin on the front of my hip.

I've also found heavy weightlifting/kettlebell work to be incredibly helpful for maintaining back health once the acute episode is over. While everyone hammers on core exercises for lower back pain, they usually focus on the abdominal muscles. Strengthening your back muscles and your glutes is almost as important, if not more so.
posted by asterix at 7:22 PM on May 4, 2015

I have a herniated disc at L4-L5 that, for years, has caused me a great deal of nerve pain when aggravated. I exercise, eat healthfully and do daily yoga - all of these help because they maintain my weight while improving my strength and flexibility. But the most eye-opening thing for me has been Esther Gokhale's semi-anthropological book 8 Steps to a Pain-Free Back:

Nearly 90% of American adults suffer from back pain, and the number continues to climb. Why does this condition affect so many people in the industrialized world, while in some countries only 5% of adults report back pain? In a quest to find the root cause of back pain, Esther Gokhale studied at the Aplomb Institute in Paris and traveled to parts of the world where back pain is virtually unknown. Her research took her to remote Burkina Faso, rural Portugal, and fishing villages in Brazil.

What she learned in each of these places has changed the lives of thousands of people. Preserved in the movements of weavers, millers, and farmers in more traditional societies is ancient body wisdom that prevents pain and enhances health. For the first time, these insights have been brought together in a step-by-step guide designed to help those suffering from back pain re-educate their bodies and regain the posture for which our bodies evolved.
posted by nightrecordings at 8:02 PM on May 4, 2015

For me it boils down to just a few things:

*Strengthening my core muscles **in matched pairs**. So do the abs and the psoas muscles--not one or the other.

*Lots of strategic stretching when anything I do runs the risk of causing me lower back pain.

*A fantastic PT, whom I will see at the slightest sign of back pain.
posted by yellowcandy at 9:08 PM on May 4, 2015

Improving my core by doing Pilates and going to a physio. I barely recognised myself afterwards.
posted by Jubey at 9:35 PM on May 4, 2015

I have chronic mid-back pain and tightness in my shoulders. Nthing everyone who has recommended physical therapy, regular exercise, and strength training focusing on your core and upper body. I do assisted chin-ups and dips at the gym and work on my core with this routine.

Also key for me is stretching every day. I rely on this yoga routine to keep my legs from tightening up, which exacerbates my back. That's the a.m. routine; there is also a great p.m. routine.

Before I do the a.m. yoga routine, I lie on my back for ten minutes with my knees bent so that my feet are flat on the floor and with my head on a thin pillow. This allows the curve of your lower back to relax. I found that exercise in this Alexander Technique book. The exercise is described in more detail here. That site and the book recommend doing it for 20 min, but I can get away with 10 min as long as I'm doing it every day.

I also strongly recommend 8 Steps to a Pain-Free Back by Esther Gokhale.

This massage tool is very good for working out knots. Better than some real massages I've had.

I have a desk job and absolutely rely on this chair cushion. Also key is a desk chair with a flat back and not one curved inward for lumbar support (the Gokhale book explains why this is important.) I'm short so, a footrest is also essential. I make at effort to get up once an hour at least to walk around and take some pressure off my back.

I use this at the base of my skull if I feel a tension headache coming on, but you can use it on other areas.

Good luck! I hope you can find some relief.
posted by fozzie_bear at 9:55 PM on May 4, 2015

Response by poster: Thanks, everyone. It's been so helpful to see the variety of things that have worked for different people. I've gone the physical therapy route before but inevitably stop doing the exercises after a few months when the pain has gone away, mostly because there are lots of other things I'd rather be doing in the 30 minutes before bedtime. Walking and other activities where I can feel some sense of accomplishment or improvement seem like activities I'd have more luck doing consistently over the long haul.
posted by Maarika at 6:31 AM on May 5, 2015

Here's what's worked for me --
physical therapy, especially using the foam roller
Pilates to keep up core strength + flexibility (it actually involves many of the same core exercises that my PT doc wants me to do, but I find it a lot more fun).
posted by rainbowbrite at 8:11 AM on May 5, 2015

If you do find some relief from PT, you might ask your PT to help you streamline the exercises to the bare minimum after you're pain-free so that you'll only have to devote 5-10 minutes to it a day, if 5-10 seems feasible for you.

PTs understand that you have lots of other demands on your time and I think they'd rather have a patient doing a little bit of something regularly than nothing at all. Good luck!
posted by purple_bird at 4:15 PM on May 5, 2015

Suffered off/on low-lower back pain for a while, with mild sciatica-like symptoms.
Alleviated with regular (2-3x/day) stretching ala "Cobra pose."
I later injured it doing some construction. Was bearable, but had one spasm episode that left me flat on my living room floor waiting for it to subside.
Alleviated by doing back extensions 2x week, along with the previously mentioned stretch.
Haven't felt a twinge in a year.
posted by Jack Karaoke at 9:25 PM on May 6, 2015