Holy Back Spasms, Batman!
March 19, 2013 11:42 PM   Subscribe

I've got bad back pain. I'm poor. I work in an industry that requires me to lift things and walk around a lot. I can't take time off. Help!

I don't know what I've done to my back, but this current episode of back issues is far worse than anything I've ever experienced before - this in a life of chronic back issues. I'm a server at a restaurant, and while I like the job, it does require me to lift a lot. I've been at this level of pain for about a week: I can't bend more than an inch or so at the waist, at least once a day I am unable to stand on my own after getting up from the sitting position, I get sharp shooting pains every time I move in an awkward way. I don't have the money to take time off of work. I do have health insurance. Any advice is appreciated.
posted by outlandishmarxist to Health & Fitness (19 answers total) 1 user marked this as a favorite
 
This sounds like a work-related injury/condition and thus you probably qualify for workers compensation insurance payments to replace some of your lost income if/when you take time off to recover from this injury. Your doctor should also be able to put you on restricted duties (e.g., not allowed to lift things) and your employer should accommodate those restrictions by giving you a modified job until your doctor clears you to work without restrictions.

Note: I am not a lawyer, I have no idea where you are located, and my personal experience with workers compensation is from a back injury sustained at work 15 years ago in Washington State. YMMV.
posted by Jacqueline at 11:55 PM on March 19, 2013 [1 favorite]


Ugh, so sorry you're going through this. Try to see a doctor as soon as possible -- this is the kind of thing that I've gone to Urgent Care for, rather than waiting for an appointment with my primary care physician. When I've had back spasms, I've been prescribed various combinations of muscle relaxants, anti-inflammatories, and painkillers (none of which are expensive with insurance -- or even necessarily all that expensive without it). See if your doctor might want you to go to physical therapy as well -- your insurance might cover a certain number of visits. You also might want to try something like a lumbar support belt.

In the meantime, for OTC remedies, NSAIDs like Advil or Alleve will work better than Tylenol (my obligatory caveat: be careful of NSAIDs if you have stomach or bleeding issues). Ice will take down inflammation, and heat will relax the muscle, so you may want to alternate the two.
posted by scody at 11:55 PM on March 19, 2013 [2 favorites]


Oh, and custom orthodic shoes/inserts can alleviate a tremendous amount of back pain if you are on your feet a lot. Especially if you have to wear heels or dressy shoes as part of your restaurant's dress code -- in my personal experience, the right inserts and shoe modifications can make heels as comfortable as sneakers.
posted by Jacqueline at 12:03 AM on March 20, 2013 [1 favorite]


Definitely get to a doctor. (I am not one.) It could be that some sort of gentle stretching and heat/ice could help.

I don't know what kind of place you work in, but can you get a busser, expediter, or trainee to shadow you and do the lifting?
posted by loveyallaround at 12:46 AM on March 20, 2013


Seconding scody on the lumbar support belt. Other things that have helped me manage my back pain (in chronological order):

- Rolfing with chiropractic care: I was super skeptical of all the woo, but at the time I was falling down in the middle of the street because my nerves were getting pinched even when I walked just a little bit awkwardly. Out of desperation I went (on the recommendation of someone who has worked as a house cleaner and thus has ongoing back problems), and even though I still side-eye the notion that fascia have anything to do with overall health, the pinched nerves and falling down stopped almost immediately. I do believe I was sticking my butt out in a way that was placing undue stress on my joints and I think the Rolfing helped with that.

- Sacral wedge: if your hip joints and or upper butt area are giving you the shooting pains, this might help. I used to do this every night.

- Pilates and/or yoga: not the extra strenuous kind, but rather the classes that will help you understand how your body works.

I've had chronic back/pelvic issues ever since I fell down hard on my tailbone three years ago and when I neglect the pilates and then volunteer at the community garden or anything with a lot of squatting and lifting, the sharp shooting pains immobilize me for a day.
posted by spamandkimchi at 4:46 AM on March 20, 2013 [1 favorite]


As someone who is reading this while lying down because of my own back pain, you have my utmost sympathies.

Have you got any diagnosis? IANYD but look into sacroiliac joint dysfunction. I'm still waiting on results of MRIs etc but from what I've found this seems to best explain my symptoms, and particularly the pain on standing which you seem to have too. Though try not to get too discouraged as some of what people post about it is quite negative.

Drugs don't seem to work for me at all, but I have found that deep tissue massage has helped. Also find a good manipulator who can help with specific joints. Pilates is apparantly really good for it but I've been told to hold off until a final diagnosis can lead to a care plan. Don't stay in any one position - sitting or standing - for more than 30-40 minutes at a time. And always bend from the knees. And make sure your employer knows you have difficulty. You need to protect yourself because 20 years down the line you won't be in the same job but you will be in the same body, so look after it. Take care.
posted by billiebee at 5:05 AM on March 20, 2013


I've had episodes of similar-sounding back pain a few times before, over a period of more than twenty-five years, and my experience is that you have three options:

1) go to the doctor and get some pills, which will make you wasted enough to not care as much about the pain, but be otherwise useless. Your doc will have no other remedies or clues or even interest besides pills.

2) lie on the floor with a pillow under your knees until the pain mysteriously goes away, which will take anywhere from one to thirty days.

3) go to a chiropractor, who will make it all go away completely in approximately one minute, and have you feeling an inch taller to boot.

I recommend option 3!
posted by Fnarf at 5:18 AM on March 20, 2013 [1 favorite]


Yeah, here's the thing: you absolutely have to take time off from work. In the sense of, at some point very soon, you will be absolutely incapable of doing this job anymore because you won't be able to move at all, and because you kept working when you were injured, your recovery will take much, much longer, and you may be doing permanent damage to your back by not allowing your body to heal now. I know you say you can't take time off of work, but if you're given the choice between taking scheduled time off now to heal and taking unscheduled time off later for a much longer time because you are totally incapacitated, which would be better? What if the choice is between permanent disability and taking time off now, does that change the calculus?

You are temporarily disabled right now. If you were injured at work, you likely have legal rights, and you need to talk with an attorney/union rep/someone knowledgeable to find out what they are. They may include paid time off or job guarantees, depending on where you're located. But even if you weren't injured at work, you need to find some way to stop doing this thing that is hurting you, and to seek medical attention. Because if you don't, and your back pain is something more serious than a pulled muscle, you may find that someday soon, you're unable to work at all.

IANAD, IANAL, but I've had back issues, and my doctor has told me that lifting heavy things when my back was injured would risk my long-term health.
posted by decathecting at 6:28 AM on March 20, 2013


Also, long hot bath at the end of the day. and mid-day on weekends. can get everything relaxed and take a lot of the pain away long enough for things to heal a bit.
posted by acm at 6:48 AM on March 20, 2013


Try acupuncture. When my back gave out a year or so ago a couple acupuncture visits took care of it. You can also get adhesive back pain pads at the pharmacy - they are kind of like icy hot or tiger balm but attached to a pad that stays on your back all day. I find them super helpful. And yes, you need to - MUST - take a couple days off and lie flat as much as possible.
posted by mygothlaundry at 7:54 AM on March 20, 2013


If you have health insurance, could you not go to a physiotherapy clinic? Once or twice could really make a difference. They might do massage, or ultrasound, or acupuncture. They can teach you excercises and streches. My husband has a bad back and this has always helped him when things have gotten out of hand. Like you, he has a job where he walks and stands and lifts heavy things all day. He does back stretches / excercises Every. Single. Morning. Either that, or he's unable to work and can't take time off with pay either.

I agree with trying to take a couple of days off and rest, with some gentle walking time. Could you borrow money to make up for the lost income? Sell something you own? It's really important.
posted by kitcat at 8:15 AM on March 20, 2013


You need professional help. The problem is that you wont know whether the professional you have visited is helping you until you have been for a couple of treatments at the bare minimum. A doctor's note and time off work would seem like a good start.

Whatever you do it is going to cost money I am afraid. My advice would be to try:

1. Osteopathy
2. Pilates
3. Yoga
4. Alexander technique
5. Tai chi

I have a herniated intervertebral disc which occurred following a disc bulge. Many people have disc bulges that are not diagnosed.

I have also separately had one vertebra rotated 60° from normal, which was pretty horrible, but fixed with one visit to the osteopath.

As your back deals with the damage it will lock up sections of vertebrae to protect itself which will in turn have knock on effects for other muscle groups. A good osteopath will be able to free up the muscles and allow the back to move again. They may also manipulate the spine itself.

Osteopathy has proved much more effective to me than chiropractic. Better long term results. I have been to a good chiropractor who had me going back once a week for a couple of months, whereas the osteopath would see me once a month or less.
I have had acupuncture as well, but I couldn't tell you if it had any effect as at that time the liquid from my disc was attacking the sciatic nerve, causing muscle spasm/complete inhibition of the various muscles of my leg.
I have had some success with shiatsu massage.

My sister (who had back problems following being hit by a car) has also tried Bowen therapy and experimental rheumatology as well as physiotherapy. She would probably recommend osteopathy and Pilates. We go to the same Pilates instructor for individual sessions. Good quality yoga tailored to your specific needs is also worth trying.

In my experience it is very difficult to tell if you are dealing with a charlatan or a genius in the world of back pain therapy. For instance, this is the class blog of a fantastic yoga teacher that I would recommend to anyone, but if I read this without having been to some of her classes I would be a bit dubious.

Alexander technique is another way of dealing with these issues yourself.

I know someone who has cortizone injections every 6 months or so, but his condition seems to be completely dependent on the length of time since his last injection.

Lying down for an extended length of time has never been prescribed for me. It is not good to stay in the same position for long. Walking is a good exercise for the back, 20 minutes at a time. NSAIDs and icing (2 mins on, 2 mins off) can help with inflammation.

Good advice from my osteopath was to try not to move the back in more than one plane at a time. So, rotation but not flexion and vice versa.

Good luck!

*General tip for back pain sufferers who can't afford first class seats* If you wait until everyone has checked in on a long haul flight there is a chance you can get the ground staff to re-allocate seating to allow you to have a row of seats to yourself if you tell them you have horrendous back pain. You can lie down once the plane has taken off. On one flight on which I did this I was visited by pretty much all the cabin staff including the head bursar and first class staff who all had back issues due to the work. Much sympathy, advice, care and support.
posted by asok at 9:01 AM on March 20, 2013 [1 favorite]


DO NOT BE ME.

I injured my back in a similar way shortly before leaving grad school and the insurance that would pay for it. I got a job a little less than a year later with insurance and was finally able to get treatment for it, but the damage had been done. I couldn't even stand without pain, much less bend or lift.

After treatment, I spent the next FIVE YEARS in pain getting back to close to normal, and my back is still not 100% ten years after the original injury, and probably never will be. Had I been in an profession that required me to lift and bend, I would have not been able to work.

So: DO NOT BE ME.

And speaking to the earlier comment who said the only medication option was stuff that will make you useless: no. I have been given medication for my back that does not do that. Tell your concerns to your doctor.

(Also agreeing with the commentor who said this may be a workman's comp issue, depending on your location.)
posted by telophase at 9:43 AM on March 20, 2013


Forgot to add that what my injury turned out to be was a pulled ligament. I've also injured muscles in my lower back before, but those have never given me the chronic problems that the ligament did. So it's certainly worth getting diagnosed.
posted by telophase at 9:46 AM on March 20, 2013


Prednisone is a godsend for me upon horrible flareups. But if your problem doesn't go away while the inflammation is down, your going to be right back where you started when the prednisone is gone.

Back pain, nerve damage, dropfoot, is my experience.
posted by couchdive at 1:19 PM on March 20, 2013


I'm sorry to say this, but modern medicine still doesn't have an answer to back pain. Those of us who suffer from it may have perfectly normal MRIs and those who don't have back pain can have totally outrageous MRIs. The best answer I have created so far is to take ibuprofen on a strict schedule at maximum dose and try to work from home whenever possible. I've found strengthening of the peripheral muscles to be helpful.
posted by kamikazegopher at 5:04 PM on March 20, 2013


Just reading this thread is making my spine hurt.

IamsoNYD, but my back hurts pretty frequently. I used to throw it out now and again, and when I did it was agony to move at all. (Fortunately it's been a few years since that happened, but I do still get a sore back if I stand up for too long.) Back pain is one of those things that convinces me that if this universe was actually created by a god, he's a total asshole.

I developed this thing that would help me a lot, for 20 minutes or so: I would stand just outside of a doorway, firmly planting my feet and bracing my hands in the doorway above my head, sort of forming an X with my body, then I would push out hard with my hands and feet. While doing this, I would kind of focus all the pressure on my lower back, where the pain was. It's a simple action but it's sort of hard to describe. I would do this for maybe 30 seconds or so. It would give me about 20 minutes of significantly reduced pain. If the pain was a 10, it would take it down to a 6, enough that I could sit down and get up from a chair (for example) without yelping in agony.

I don't know if it's a bad idea, or if it's actually damaging the back more. All I know is that when I do it, my back immediately feels grateful. I've never heard anybody else talk about this. I always suggest it to people when their backs hurt.
posted by Ursula Hitler at 5:07 PM on March 20, 2013 [1 favorite]


Ursula Hitler, I just tried your X-in-the-door trick after having an intense spasm from walking around a power strip. Not sure if it worked but it was fun to try.

outlandishmarxist, hope you found something that works for you!
posted by spamandkimchi at 1:32 AM on March 25, 2013


Thanks all. I ended up going to a sports medicine clinic. It was a sprained ligament. They put me on Prednisone for a week, which got me through the crisis, and I'm now doing physical therapy and trying desperately not to re-injure it.
posted by outlandishmarxist at 6:53 AM on April 5, 2013


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