February 24, 2012 5:19 AM   Subscribe

Do I need a a doctor, chiropractor, or morphine dealer?

I went from being moderately in shape and 10 pounds overweight to extremely out of shape and 20 pounds overweight. It happened fast. For the last two weeks I've modified my diet and managed to lose a few pounds, so I'm on my way back. The problem is when I try to start any exercise. 30 minutes on the treadmill, 3-4 miles per hour, no incline? Tremendous lower back pain for several days. 15 push ups, 50 ab crunches, 10 squats? I'm in agony. Not the kind of "oh it burns" pain that you associate with a good workout -- but dull, intense pain spread across the small of my back that makes me want to cry.

My first theory is that this exercise I'm doing is way way too much for starters, even though in the past what i've described has always been fine as a "Day 1" kind of routine.

I guess I want to hear anyone's thoughts on this, helpful anecdotes, or suggestions. Am I simply overdoing it? Do I need to tell my doc about this? Do I need a chiropractor?

posted by Buffaload to Health & Fitness (20 answers total) 1 user marked this as a favorite
You're in excessive pain after exercise. Talk to your doctor about it, and they can recommend your next step, whether that's physical therapy, medication, or rest until whatever you've done to your back heals up.
posted by lydhre at 5:27 AM on February 24, 2012 [2 favorites]

As a general rule, if you're in agony, yes you need to see your doctor. Stay off the treadmill and stop exercising until you do. You have no idea what's wrong because you are not a doctor and you may well be worsening whatever this injury or condition is.
posted by DarlingBri at 5:27 AM on February 24, 2012 [2 favorites]

Response by poster: Right. OK -- my fault for a poorly-worded question. Now that I've had some time to think it through, it turns out what I really wanted to know is this: Have you ever been to a chiropractor -- why, and what was it like? Did it help?

posted by Buffaload at 5:54 AM on February 24, 2012

Oh, welcome to "almost 40", my friend. As someone who was "moderately in shape" and still managed to develop sciatica as few years ago at 40, I would strongly recommend you stop now, see your doctor, and nip this in the bud before it gets worse. You think the pain is bad now, just wait until you literally cannot stand up straight because of the intense pain.

I mean, IANAD, but my first guess is that not only are you doing too much too soon, but your technique may be wrong and you have a variety of non-obvious muscles that have weakened and are not being strengthened by the exercises you are doing. The thing is, your 25-year-old body didn't care much about any of this - you could do everything wrong and just shrug it off after a couple of days of mild soreness. Your 36-year-old body . . . unh-uh.

Ideally not only will your doctor have some suggestions and ideas about proper exercise techniques, but they will send you to a physical therapist or sports medicine specialist who will REALLY be able to give you info about what muscles you need to work on and exercises and stretches and techniques that will allow you to work out properly and safely.
posted by soundguy99 at 6:07 AM on February 24, 2012

I've been to Chiropractors before but my understanding is that it's pretty hit-and-miss out in the big mean world, especially in the USA and super-duper ESPECIALLY in the UK. I hear (and my limited experience tends to bear this out) that generally chiros that focus on treating back pain and spinal alignment issues are most likely to help, when compared to those who are trying to sell you homeopathic remedies and psychic healing and cure your depression with spinal adjustments.

My personal experience though has been that they do offer some relief and can eventually make positive changes to your spinal alignment. My range of motion in my neck for example has improved dramatically after being injured several times during martial arts competitions or motor vehicle accidents.

as always, YMMV.
posted by some loser at 6:16 AM on February 24, 2012

and by dramatically, i mean 'noticably'. It wasn't THAT dramatic. no one else noticed for example.
posted by some loser at 6:18 AM on February 24, 2012

Have you ever been to a chiropractor -- why, and what was it like? Did it help?

I've been to a chiropractor, yes; I went because I'd thrown out my back for the first time. I had a pretty good one (I'd thrown my back out on the job, so worker's comp was paying for it and I could afford to be selective). The chiropractor took X-rays first to identify the root of the problem - he found that I had a curve in my spine in my lower back I'd never even known was there, and that that was because one of my legs was a little longer than the other (by, like, 1/3 of an inch) to a point that my spine had been spending my whole life curving funny to try to compensate. It was just a weak spot that was going to go at some point.

I saw him once a day for the first week or two, then once a week for a couple months, then once a month for a couple months - then the insurance ran out. Each visit I first lay on the table with a heating pad on my back for a few minutes to loosen things up, then he did the manipulation bit -- that didn't hurt, it was just him flipping me over onto first one side, then the other, then bending my free leg up and giving it a shove to use it as a lever to manipulate my spine back into place. The only time I had a problem with the treatment was, I was in the lobby after my visit and remarked to the receiptionist that "huh, my arm feels tingly all of a sudden", and she dropped everything and brought me back to see him again; he gave me a quick examination, stretched something on my arm and asked if the tingling had gone away. It had. Something had apparently just shifted a bit funny that time, and he fixed it.

He also gave me some stretches to do on a daily basis, that were designed to strengthen that particular part of my back. They were pretty gentle -- nothing too deep or athletic -- and that also helped. He also gave me a couple of other recommendations-- wearing a shoe insert in the foot that was too short could help in the long run, he said, and he discouraged me from wearing high heeled shoes any more; no great loss, as I never did anyway. (One inch heels seem to be okay.) Also, after a couple months of treatment, I was about an inch taller.

Since then, I've thrown out my back two more times, and was able to manage that through massage instead. Both those times it happened because I was over-exerting myself - so I scaled activity down and took it easy until I was feeling better. Gradually adding the strengthening exercises back helped a lot too - if I stay with the stretches and exercises, I don't have any back issues. I haven't thrown out my back in 5 years, despite doing some fairly heavy lifting now and then.

A chiropractor can help you get into the initial assessment of the problem (maybe there is some similar anotomical reason for why your back's acting up, and they can help sort that). But if you've also not exercised for a while, maybe starting slower is in order. They can also recommend some back stretches and strengthening exercises -- gentle at first -- that can help with the support.
posted by EmpressCallipygos at 6:37 AM on February 24, 2012 [1 favorite]

I have gone to chiros all my life since we have several that are family friends. It really depends on the chiro for how effective they are. I've gone to some that do the same routine adjustment on everyone (pretty unhelpful). I've gone to others who are really expert and target the problem area effectively to take care of the problem. Totally amazing. And what you're experiencing might be something simple. I pulled a back muscle at the gym, and my chiro friend identified what it was right away. Same thing with a strained rib. And he gave easy, effective advice after a quick adjustment (re: icing, heat, staying off it).

The other thing that the good ones do is tell you to go to the doctor when it is warranted.

Nowadays, a lot of them also hire nutritionists and massage therapists.

Do your research and find a good one. Actually, if you MeMail your location to me, I can ask my chiro friends if they know anyone good in your area.
posted by DoubleLune at 6:42 AM on February 24, 2012 [1 favorite]

Aaaaaand . . . . you posted your follow-up while I was writing my first comment, but I went ahead & posted because it's still relevant.

I don't think a chiropractor is really what you want - I'd bet that your problems are more bad technique & under-developed muscles (see above) rather than any sort of skeletal misalignment.

Anecdata: While I was having my sciatic attacks, I made a few visits to a chiropractor - partly because I was being a tough guy and figured I could sort out my lower back issues mostly on my own, and partly in search of some quick relief.

Some minor Googling makes it obvious that chiropractic has quite a bit of history as, erm, suspiciously quackery-like. But the guy I went to seemed pretty down-to-earth; he didn't claim that I had to visit him every week for the rest of my life, he didn't claim that chiro would make my hair grow back, or prevent me from getting a cold, none of the more "woo-woo" stuff.

Plus, he was cheap, covered under my insurance plan, about 5 minutes from work, and I could walk in anytime without an appointment.

So first he would start with some spinal & hip manipulation (as EmpressCallipygos describes). Then he would have me do some stretches, and maybe some heat treatments with a heating pad on my lower back, and some gentle exercises (often with various sizes of inflatable balls), and then more stretches. The results varied - sometimes I walked out feeling great, sometimes it helped a little, sometimes it didn't seem to make much difference.

So eventually I quit being a moron and I went to my actual doctor, who then referred me to a physical therapist. Fixing the sciatica actually required some sessions on a traction machine, but the PT also used heat treatment, and lots of the same stretches and gentle exercises the chiropractor had me doing, and more besides.

My conclusion was that the chiro's more effective treatments had essentially been borrowed pretty liberally from more, well, legitimate fields like physical therapy and sports medicine. So while the chiro wasn't wrong, I got better and more complete treatment taking a more traditional route.

So that's my 2 cents. Again, I don't think you're actually at the point where a chiropractor is actually what you need. I would suggest you look into yoga or yoga-based stretches and exercises as part of your work-out routine.
posted by soundguy99 at 7:07 AM on February 24, 2012 [1 favorite]

Since I know a large number of people that have used chiropractors without them being able to solve the underlying chronic health issues I have never gone to one for back pain.

I have, however, quite successfully use a masseuse to work out major (as in, unable to stand, and crying while lying down) back pain along with pain relievers, ice packs and heating pads. But I did that under the care of a doctor I trust.
posted by saucysault at 7:12 AM on February 24, 2012

Have you ever been to a chiropractor -- why, and what was it like? Did it help?

Yes. Several times. For reasons that are not clear to me, physical therapy coverage often requires that chiropractors are involved.

Chiropractors have never helped me, two have hurt me, and I know a chiropractor who quit, went back to school, and started and entirely different career at 40 because he was unable to reconcile soon this as a job when he saw what other people were doing to their clients.

When I say hurt, I don't mean "ouch," I mean an initial terrifying pain, and then me worse off than I was before.

I know a chiropractor who basically does massage therapy at a higher price and I think that's not uncommon and responsible for a lot of positive attitudes toward the profession.

My Orthopedic surgeon writes me PT orders that specifically exclude it and if he didn't, then I would never do PT again.

My boneitis is the result of an accident and the wear and tear on things that were rebuilt or replaced so managing back pain and neck pain is a hobby.

See a doctor, fix this slowly and carefully, and do your best to stay in shape.

Good luck.
posted by Lesser Shrew at 7:13 AM on February 24, 2012

I once threw my back out getting into my car and went to urgent care because I'd never been in that kind of pain. I sat there for three hours, looked at me for exactly 3 minutes and they gave me a prescription for Aleve. THEN I went to a chiropractor where he listened to me attentively, put hot pads on my back and then put me into this machine that flipped me upside down because I was so locked up that was the only way to get to the issue. He gave me advice about how to take care of it and a back brace to help support the area. My issue turned out to be muscle spasms.

All of that was not to convince you to go to a doctor because back issues are no joke, but also to illustrate in the context of the other stories on this page that really, truly YMMV.
posted by Kimberly at 7:17 AM on February 24, 2012 [1 favorite]

I am definitely anti-chiropractor, especially the ones who completed a five-year undergrad/grad combination degree to take them from high school to playing around with your back and billing your insurance company.
posted by yellowcandy at 8:05 AM on February 24, 2012

I know a lot of people here are anti chiropractor that is their choice in my experience chiropractors can help for certain problems, my FIL is one and I've seen him help a lot of people, having said that there are a lot of doggy ones out there trying to sell you a whole lot of stuff and treatments you don't need or claiming that chiropractic will fix everything.

Things to look out for. You want x-rays, no one should be adjusting your back without x-rays to make sure there is no underlying problem that would be better treated by a doctor or that would be made worse by adjustments and they should be willing to send you to a doctor if needed.

The chiropractor should sit down with you and your x-ray and clearly show you what is wrong, what he is going to be adjusting and why. He should give you a treatment plan up front, it should include exercises at some point and it should have an ending date, even if it is just an estimated time. They may offer other treatments including ultrasound and muscle stimulation these work for some people and not for others you should not have to take these treatments they are usually in addition and at a very marked up price so ask why you are having them if they try to add them, though some people do tense up so much before a adjustment that massage or muscle stim can help by relaxing them.

What they shouldn't do is offer you a lot of add ons in a high pressure situation and insist on continuing maintenance. My FIL has a great reputation in his area and a lot of doctors will recommend patients to him and he has even been called out to emergencies by these doctors to do emergency adjustments when drugs could not be used to help with the back pain for various reasons. This is because he knows he is part of a patients treatment plan and not the end all and be all of fixing problems

If nothing else ice your back. Put ice on it until it goes numb then take it off when it starts hurting again put the ice back on. That will help with the pain and inflammation while you work out if you want to see a doctor or a chiropractor.

If you have any questions about chiropractic in general feel free to memail me and I'll ask him for you.
posted by wwax at 8:40 AM on February 24, 2012

Everyone I know who's been to a chiropractor has been told that their legs are uneven.
posted by mareli at 8:40 AM on February 24, 2012 [1 favorite]

See a doctor. Get your medical problem treated.

In the meantime you might assess yourself for common postural misalignments such as anterior pelvic tilt, which is fairly ubiquitous among the overweight and untrained.

Before beginning again with exercise you may be well served booking a session or two with a good personal trainer (i.e. one who knows how to teach people to squat and deadlift) who can offer feedback on your abdominal bracing and general lumbar movement patterns during exercise.
posted by Kandarp Von Bontee at 9:20 AM on February 24, 2012

I woud start with an MD before seeing a chiropractor in any case. A lower back pain anecdote: Mr. Adams was in his mid-30s (and is male) when he came home from his second, part-time job at a big box store (that he'd just started a few weeks earlier) complaining about lower back pain. He thought maybe he'd injured something when helping to push a refrigerator, since he'd never had a problem with back pain before in his life. The pain subsided but two days later when we were taking our daily walk he stopped after several blocks and leaned against a tree, his face contorted in agony. His lower back was killing him, and no amount of stretching it out or sitting on the ground was relieving the pain. I ended up dashing home and getting the car to go fetch him. The pain slowly subsided over the rest of the evening. But after yet another episode I brought him with me to my rheumatologist who not only took X-rays but also blood tests, which confirmed what he'd suspected given Mr. Adams' age and gender - he had ankylosing spondylitis. So I would see a medical doctor and rule out any sort of auto-immune problem or other inflammation before trying a chiropractor.
posted by Oriole Adams at 9:27 AM on February 24, 2012

Response by poster: Excellent information and anecdotes, thank you all. I made an appointment for monday with my regular doc. I also called a chiropractor recommended by my sister. I may or may not keep that chiro appointment, depending on what the doctor says. Basically, I'd see a witch doctor if I thought that would help.
posted by Buffaload at 10:20 AM on February 24, 2012

Everyone I know who's been to a chiropractor has been told that their legs are uneven.

It's actually not that uncommon a thing, apparently (or so I've been told). I think almost everyone has some bits about them that aren't 100% symmetrical, so the issue isn't whether one leg is longer, the issue is how much longer. We all may have one leg longer than the other, it just may be that in some people it's only by, like, a millimeter, which doesn't make any real difference.

I made an appointment for monday with my regular doc. I also called a chiropractor recommended by my sister. I may or may not keep that chiro appointment, depending on what the doctor says. Basically, I'd see a witch doctor if I thought that would help.

If it's a free consultation with the chiropractor, you may want to just go anyway and see what they say. If you get a "this is weird" vibe from them, you can always decline any further appointments. The chiro worked for me; so did a massage therapist, and then so did exercise. Check out everything (as your wallet allows) and find what's best for you.

good luck; memail me if you want other "wonky back" advice.
posted by EmpressCallipygos at 11:20 AM on February 24, 2012

Response by poster: Just an update in case anyone stumbles across this: I had an appointment with a chiropractor today -- he's been doing it for more than 40 years. He spent 10 minutes with me and said, "You don't need a chiropractor. You need a physical therapist." He then explained his diagnosis of my lower back problem (weak muscles around my spine, which he called "inner core" muscles).

Since he basically declined to take my money on an ongoing basis, I considered that pretty honest advice.

I'm seeing the phys therapist in a few days.

Thanks again.
posted by Buffaload at 1:59 PM on March 6, 2012 [1 favorite]

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