Explain back pain to me like I’m a n00b
June 10, 2023 10:41 PM   Subscribe

In the last three years, like most people, my life has been weird. I’ve spent much of it on my sofa, a lot of it in my bed tossing and turning and the rest in my desk chair which was originally just meant for 3-4 hours at home after work but switched to 8-9 hours at work plus 3-4 hours. I don’t know how to describe my back pain and can’t figure out how to find solutions.

Most of the pain is in my lower back, just above my butt. It stoops me over when I’m standing. It’s not consistent but I feel like if I move a certain way it flares. Is that a spasm?

My other question is how do I prevent or soothe this? I’ve experimented with different bed pillows and couch cushions and desk chairs but can’t figure out the grail I seek.

Do I stuff a tightly-rolled towel under my lower back? Do I buy a waterbed? Do I install a camel in my desk chair?
posted by bendy to Health & Fitness (36 answers total) 20 users marked this as a favorite
 
Best answer: Have you tried seeing a doctor? Physio? Massage therapist?
posted by shockpoppet at 11:35 PM on June 10, 2023 [3 favorites]


In short, you probably need to strengthen your core.

I'm in Physical Therapy right now for pain in my lower back/hip/butt. Last time, the physical therapist said that my core is weak, and my lower back is the one compensating for it, which results in pain.

To manage this pain, I've been taking an anti-inflammatory and using an ice pack (I have the one with some sort of clay inside, which I really like). I also have a daily set of exercises I've been working on. It's been improving. I have most of my range of motion back and I can sometimes not take the ibuprofen... I'm trying to walk more too.

Don't get a water bed. I've heard the firm beds are the best. You probably need to be moving more and if seeing a doctor and PT is an option, I would recommend it. You can find info online on core exercises too (NYT gift link).
posted by skunk pig at 11:41 PM on June 10, 2023 [13 favorites]


Best answer: I'm having similar pain lately after a mild strain last month. Absolutely try an ice pack for short term relief; Aspercreme with Lidocaine in the roll-on also helps me, as does Bio-Freeze (which you can't use with heat or cold). I sit with a lumbar pillow if I need to sit up in a chair for any length of time; that support might also help you. I get stiff very easily the last few weeks, and car rides are the enemy. The ice pack I have and like is the Cryo-Max Medium, but the clay kind is also great.

But the comments about physical therapy and core exercises are probably correct and probably something you'll need for long term relief.
posted by verbminx at 12:34 AM on June 11, 2023


Response by poster: Serious n00bness here. I have a desk chair cushion about the size of a chair back. On one end it’s slim and the other end has a lump that is a curved, almost C-shaped part. Do I put the lump on the sore part or slightly above it or flip it upside down and put it on my neck? Nothing feels OK. Should I be sitting on it?
posted by bendy at 12:42 AM on June 11, 2023


I have mild hyperlordosis, it runs in the family. The best treatment is moving more and strengthening the core muscles. I have started doing targeted exercises (around 3 minutes a day, every day) less than 3 months ago and I'm seeing improvement. Walking more and biking more is good too.

But you should really be getting a diagnosis from an expert, all lower back pain is not created equal.
posted by Too-Ticky at 1:13 AM on June 11, 2023


Sure, get evaluated by your doctor to rule out actual damage. For most of us desk dwellers though this is a function of sitting too much and with setup that is far from ergonomic.

As a starting point - get up from your desk at least once an hr. Consider getting a desk you can turn into a standing desk and do some of your work standing. There are also countless laptop stands that allow you to raise them if the desk can’t be adjusted.

Google stretches how to unlock your hips. Plenty of PTs on YT.

Magnesium helps with muscle tightness. Take some.

Massage can be a great relief. But you don’t want a relaxing massage, you want one where the therapist is getting into the tight spots. That can feel a bit uncomfortable.

And yes, exercises to strengthen the core and loosen back, neck and shoulders. Again, countless offerings on YT, some by more knowledgeable providers than others.
posted by koahiatamadl at 1:19 AM on June 11, 2023


Best answer: Serious n00bness here. I have a desk chair cushion about the size of a chair back. On one end it’s slim and the other end has a lump that is a curved, almost C-shaped part. Do I put the lump on the sore part or slightly above it or flip it upside down and put it on my neck? Nothing feels OK. Should I be sitting on it?

When you make an appointment with a physical therapist, bring the cushion with you, and maybe a photo of the chair, and ask them.

There's no real way to tell you what'll work for you over the internet, because it depends on your individual condition.

Don't mess around with your back - this is really important, and it's not impossible there's something like a herniated disk or something else that's not just a matter of sore muscles. Make an appointment with a physio or doctor (or both) today.
posted by trig at 1:45 AM on June 11, 2023 [2 favorites]


If (after doing all the sensible things other commenters suggest like seeking out a professional) you don't get relief from lower back pain by doing exercises or pursuing massage that deals with the back itself, consider stretching your legs more. My long-term lower back pain was more or less cured by spending more time stretching out my calves and hamstrings, which were super tight. When I stop doing this (or stop exercising regularly), the lower back pain returns.
posted by terretu at 1:56 AM on June 11, 2023 [1 favorite]


Lotta back pain over the years for me. Three things that have worked for me

Long walks. Like ... looooong walks--60, 90, occasionally 120 minutes. Be in the world, moving, whenever possible.

Biking instead of driving, whenever possible. Bike, walk, bus, drive in rough order of priority to the greatest extent possible.

McGill Big 3.
posted by kensington314 at 3:30 AM on June 11, 2023 [6 favorites]


Best answer: Ditto leg stretching. Those hammies can be your worst enemy. You gotta get 'em in line.
posted by kensington314 at 3:31 AM on June 11, 2023 [2 favorites]


Best answer: Pilates, standing desk for part of the day, more gentle exercise. Maybe see an osteopath (NOT a chiro), but regular clinical Pilates is great for this.
posted by ec2y at 4:12 AM on June 11, 2023 [1 favorite]


Best answer: Go see a doctor and PT. Seriously. All the advice here is good, but go see a professional. Depending on what's wrong, there are stretches that help and stretches that you want to avoid.

One thing that also helps is dead hangs. Get one of those over-the-door-frane pull up bars and just hang from it for 30 to 60 seconds every hour. You can't do it enough. It helps decompress your spine, which carries the weight of your body all day. Don't buy one of those inversion tables (unless you can't do dead hangs for some physical reason) because they're expensive and take up space and just aren't as convenient.

A stool or kneeling chair worked for me too (and is cheaper than a standing desk.)

But also, see a doctor for a PT referral if this is at all financially possible. Trust me, if you out this off, it does get worse. If you figure out what to do to fix it, it can get better surprisingly quick without the need for surgery. (Do not see a chiropractor, see a real doctor.)
posted by AlSweigart at 4:16 AM on June 11, 2023 [3 favorites]


Look for a sports physical therapist if you can. Choose someone with solid reviews. Make sure they help you figure out the root cause. Do the home exercises religiously. Once you're out of the woods, see if you can find a small group strength training gym to help strengthen everything else. Don't wait, it'll not get better on its own.

Bonus tip: standing desk
posted by pyro979 at 4:44 AM on June 11, 2023 [1 favorite]


This is unlikely to be fixed by sitting better. Strengthening your core should help. I started getting spasms maybe 10 years ago, and daily stretching and exercise fixed it. Then I slacked off and found that I need to keep this routine for the rest of my life if I want to not go back into spasms so bad they send me to the hospital. So go to your doc and/or PT and get a list of exercises and then do them religiously. Being more active outside of that is great, but those targeted exercises are what has fixed things for me (also don't do something dumb like try to move a whole load of firewood by yourself).
posted by rikschell at 5:06 AM on June 11, 2023 [2 favorites]


I would highly recommend seeing a physiotherapist. They will most likely start you off with some basic exercises. You can eventually progress to other exercises once you know what is good for your body and what you need to avoid.

I would recommend getting up and walking around frequently and also breaking up your day with "exercise snacks". Try to be consistent with movement, as it will help a lot.
posted by kinddieserzeit at 5:14 AM on June 11, 2023 [1 favorite]


Best answer: I get a lot of pain relief in various areas from somatics. Here is a very gentle 11 minute video of an exercise called the arch and flatten that I find extremely helpful when my low back is being pinchy.
This instructor has two levels of classes on her website - her classes are not free, but they are a one-time fee and I return to them regularly.
posted by hilaryjade at 5:30 AM on June 11, 2023 [2 favorites]


Best answer: I’m recovering from a low back strain, and want echo other comments here to work on this under the supervision of a physical therapist. You’ll get a lot of the same advice as here, but they’ll tailor exercises and approaches to your very specific issues. I waited too long to make the call, when really I could’ve been on a road to recovery months earlier if I hadn’t just thought I could figure it out by myself.
posted by sk932 at 5:37 AM on June 11, 2023


Best answer: My explanation for bach pain is that back muscles themselves are rather weak. On the other hand, your leg muscles - hamstrings, quads, and especially glutes - are your body's powerhouse. The imbalance between these is what causes back pain. Specifically, it's most often your hamstrings and glutes that tighten up (from sitting in an office chair all day), and those beat up on your poor little postural back muscles.

Stretch out your hamstrings, and especially your glutes. Sit on the floor with legs in a V, and bend forward. If that's hard to do, that's what you need to do more of. Use yoga to figure out what's tight for you.

Nth-ing seeing a PT. That's how I came to this understanding.
posted by Dashy at 5:55 AM on June 11, 2023


Best answer: The bad news is that this may take a good deal of trial-and-error - because there is no one single thing that anyone can automatically suggest that would guaranteed fit for your specific back. Case in point - I also started getting that same kind of back trouble in my 30s, but the back pillow you have just seemed to make it worse. So did the "ergonomic" chairs my then-workplace got for everyone (a massage therapist I discussed this with at the time joked, "the problem with ergonomic stuff is that they are 'one size fits some'").

The good news is, going to some kind of physical therapist will give you a lot of insight into where exactly the problem is. For me, the problem is coming from a bit of a combination - tight hip flexors and a slight curvature in my lower spine. I actually threw my back out in my early 30s (I was carrying something WAY too heavy), and the physical therapist I went to not only was treating me, they gave me a bunch of exercises and stretches that would help. A friend has similar issues with his back and gave me even more, and one of them is a stretch I still do sometimes (holy CRAP does my back crack loud when I do that one).

I also found that for me, a really firm mattress was a dream; I just got a slab of super-firm memory foam from a cheap place on the Lower East Side. The guy even let me lie down on the firm and the super-firm to try them out and see what would fit best; the super-firm was the only one supportive enough, which sounds paradoxical but my back knows what it felt when I lay down on it. (And that mattress has lasted nearly 20 years now.)

My point being that there is sadly no one-size-fits-all solution, because your back is different from everyone else's and may need something different than everyone else thinks. But someone who is trained in anatomy and physical movement will definitely give you some insight into HOW your unique back is wired and where it SPECIFICALLY needs help, so you can at least get some kind of avenue to test.
posted by EmpressCallipygos at 6:08 AM on June 11, 2023 [1 favorite]


Continuing the physio reccomendation. Also a note of types of physio. I've gotten decent results from the type of place that has banks of tables and they do some feeling around some strength, mobility tests, and they give you some exercises and maybe some time with hot packs or specific area massage.

I've had EXCELLENT results from a place with individual offices who try a number of variations on similar exercises, re-evaluating my pain/movement after each set to see which is most effective. This one solved a problem that I've had for decades and didn't even realize was a fixible problem.

Also some physio offices will offer ergnomoic evaluations. They can take a look at your setup and give suggestions in where to make improvements.
posted by platypus of the universe at 6:22 AM on June 11, 2023


Best answer: Humans aren’t meant to sit for long periods of time. I say this as someone with a very similar lifestyle to you, who basically sits all day and has exactly the same issues. I went to a PT.

Everything everyone above is saying is exactly right. Improve your core, Pilates, do exercises but the best (and cheapest) solution I’ve found is walking. Looooots of walking. The more the better. Half an hour is better than nothing but and hour and a half a day is what you really need to see results and it won’t take long either.

When I started taking really long walks my back pain basically disappeared. (Of course I slipped into bad habits and it came back again but at least now I know what the answer is.)
posted by Jubey at 6:37 AM on June 11, 2023 [2 favorites]


A small amount of PT can go a long way. In my case, a lot of my back pain was due to stiff hips, so I do a lot of hip and leg exercises plus some core-focused things. It’s worked wonders, although I end up back at PT every 3-4 years for consultation and new exercises.
posted by GenjiandProust at 7:41 AM on June 11, 2023 [1 favorite]


You need a PT before trying random exercises, even good ones; you don't know if it's a slipped disk or weak glutes. Considering the risk vs reward, seeing a PT is negligable risk and high reward.

Maybe try at a sports med program bolted onto a local university - the institution will make sure there's decent people.

Get a phone referral for PT for back pain from your GP.
posted by sebastienbailard at 8:03 AM on June 11, 2023 [2 favorites]


Physical therapy is amazing. Physical therapists bring in a whole range of modalities into treatment, not just a single focus. So you will most like receive a complete-body assessment, and then any number of individualized exercises or treatments that will evolve from session to session. It is a very supportive environment; you work one-on-one and the therapist helps with what you need at the right level for you. I have never felt so 'seen' as a person in a healthcare environment as in physical therapy. I highly recommend it.
posted by nanook at 9:57 AM on June 11, 2023 [1 favorite]


No discussion of back pain would be complete without some mention of John Sarno. His theories sound like pseudoscience or psychobabble, but so many thousands (millions?) of sufferers swear by his techniques that maybe there's something to it.
posted by alex1965 at 12:28 PM on June 11, 2023


Can you get a better chair? I had a succession of ergonomically poor home desk chairs for many years. Then, about 10 years ago, I realized that the chair I'd been sitting in at work for a few years was the best desk chair I'd ever used -- because it never, ever felt uncomfortable.

It turned out to be a Steelcase Leap. I decided to buy one for home use. It wasn't cheap, but it was one of the best purchases I've ever made. A decade later, it's as good as new, save for some wear on the upholstery, and it still never gives me any kind of discomfort.

And in that decade, I've transitioned to working from home pretty much full time. I also spend hours after work in the chair most days working on my own stuff. I spend more time using this chair than using any other piece of furniture in the house, including my bed. So I consider it well worth the price.
posted by Artifice_Eternity at 3:46 PM on June 11, 2023


I herniated a disc a decade ago and have dealt with back pain on and off. The biggest help for me was discovering the problem usually lies elsewhere. For me, it's my hips and I've found this yoga video to be a huge help when things start tightening up.
posted by yerfatma at 10:31 AM on June 12, 2023 [1 favorite]


My bookmarks for back care. TL;DR. seeing a therapist put an end to over a decade of recurring back pain. My primary care physician asked me, "So, you have anything else going on?" and I said, "Oh, just this nagging lower back pain that has been slowly increasing and affecting me for so long that I don't even realize that I avoid bending over in daily life" and he sent me to this weird Mormon capitalist-energy healing-chiropractor seemingly neurodivergent (not criticizing this) guy who decorates his building with giant landscape photos he took with his $10,000 full frame camera.

He kept scheduling me after the pain was gone, trying to milk as many of my fifty allotted visits as possible. I quit going when the pain went away, then when it returned went to go see another more basic guy who gave me new exercises and an app and the pain was gone after three relatively cheap visits.

The Ghokale book has a lot of fans. Not all of her claims about primal health are supported but the reviews are amazing.
posted by mecran01 at 12:21 PM on June 12, 2023


I think you need to start moving more. Start walking or riding a bike or birdwatching or gardening or whatever. Less sitting, more movement. That's a really important first start and a necessary lifestyle for healthy aging.
posted by bluedaisy at 3:27 PM on June 12, 2023 [2 favorites]


I've had chronic low back pain issues for over 20 years (and I'm only 43!) and the only thing that works for me is regular exercise (both cardio and weights) and a standing desk. I agree with bluedaisy -- you need to build WAY more movement into your day. That alone should help a lot.

Also echoing those who say that your hamstrings can be secret back pain ninjas. I would recommend strengthening and stretching those as well. That said, the body is interconnected, so work on keeping all your muscles strong and stretched!

I tried chiropractic care for over 10 years before finally seeing a PT; the PT figured out my issues and got me pain free within a couple of months. Physical therapists are STRAIGHT UP MAGICAL and you should absolutely build a relationship with one as you work towards building strength and eliminating pain.

I also benefitted from a personal trainer, once all the PT exercises were easy but I wanted to keep building strength. It's not cheap, but even a few sessions could give you a couple of workouts that you can build on.
posted by leftover_scrabble_rack at 4:19 PM on June 12, 2023 [1 favorite]


The answer is (core-building) exercise but exercising sucks, and where will you find the time, all of which makes it difficult to stay doing it for the rest of your life, ugh.
So the life-hack is to find a recreational activity or sport that you can actually enjoy so you don't mind making it a permanent part of your life.
(For me, that was taking up dance, but there are so many niche weird cool little active hobbies and sports out there that once you start looking you can probably find something that you're glad to have an excuse to give it high priority in your busy schedule)
posted by anonymisc at 10:06 PM on June 12, 2023 [2 favorites]


No discussion of back pain would be complete without some mention of John Sarno. His theories sound like pseudoscience or psychobabble, but so many thousands (millions?) of sufferers swear by his techniques that maybe there's something to it.

Important counter-point: John Sarno's assertion is that back pain is psychosomatic, and the number of sufferers who claim he helped them is indeed just the thousands - and like with any kind of back pain treatment, his methods may not work for everyone.

I would suggest other more concrete avenues first before turning to Mr. Sarno's book.
posted by EmpressCallipygos at 6:15 AM on June 13, 2023 [1 favorite]


Mod note: [btw, this post has been added to the sidebar]
posted by taz (staff) at 3:17 AM on June 18, 2023


I've found a few simple stretching exercises every morning dramatically reduces my incidence of back pain throughout the day. I do the exercises - I'm fine. I miss a day or two - the pain comes back.
posted by Paul Slade at 8:15 AM on June 18, 2023


Just saw this post for first time due to sidebar, and have one more suggestion that didn't seem to show up in my ctrl+f: hanging. I don't know the science behind it, but heard once on a podcast someone say that hanging (i.e., hanging from a bar, arms extended) really helps their low back pain. Yesterday I was doing some stupid stuff around the house and moved something with very poor form and woke up with low back pain today. When I was at the gym this afternoon, I tried hanging from the bar between sets of whatever exercises I did. Even after only the first 1-2 times (~30 seconds ea.), I felt substantial relief. While hanging, I also rotated my hips back and forth to loosen things up (no idea if this is recommended, but felt good for me). Now a few hours after hanging and still my back pain feels much better than earlier in the day.
posted by unid41 at 10:41 AM on June 18, 2023 [1 favorite]


Quickly re physical therapy, it's surprisingly cheap. With my insurance it's a $35 copay per visit, and they cover nearly a hundred visits per year! I'm guessing that the insurance companies figured out that it's much cheaper to do preventative PT now than expensive stuff later. I've done just a handful of visits but each one is amazingly educational.

re "ctrl-F hanging", always do your searches on the root word, in this case "hang" :)
posted by intermod at 1:23 PM on June 26, 2023


« Older 2023 Adachi Fireworks Festival near Tokyo - help!   |   Getting all the tiny hairs off my head after a... Newer »
This thread is closed to new comments.