What to do now to avoid chronic back pain later?
April 4, 2013 4:35 AM   Subscribe

I have pain in my back and I am wondering what to do. There are a few options of which kind of expert to see and I'm hoping to get some recommendations from people who have experienced similar problems.

I've always had pretty bad posture, I know I am a little lop-sided. Over the last couple of months I've had a sense that my terrible posture is taking its toll - my back has been occasionally sore. I find myself often cracking my back.. Recently I was riding my road bike doing sprints, and the next day my back was very sore with the occasional muscle spasm. It seems to be settling but I don't want to become someone who has chronic back pain.

My pain is mainly in the upper middle of my back between the base of my shoulder blades on my spine.

I am looking for advice on how I should treat this problem. I don't know if it would be better to see a physiotherapist, a chiropractor, or an osteopath. Or someone else altogether. My preference is towards doing exercises that might strengthen or correct my posture.

Otherwise: I'm reasonably fit, I exercise regularly (predominantly cycling with some gym/weights). I'm a healthy weight with reasonable flexibility.

Importantly--> I work as a computer programmer, sitting for hours a day hunched at a desk. Occasionally I make futile attempts to sit straight but find that it takes so much conscious effort which I struggle to maintain while programming.

Any advice about who to see or what to do appreciated.
posted by beccyjoe to Health & Fitness (16 answers total) 10 users marked this as a favorite
Best answer: I would go to the physiotherapist first. This is coming from someone who has had a fusion of his lower back and a fusion in his neck. If there is one thing I regret not doing when I was younger, it is getting a set of daily exercises for my back and then doing them daily. Prevention is a lot better than rehabilitation.
posted by JohnnyGunn at 4:39 AM on April 4, 2013

Best answer: I work for a very large pain group.....pilates is great but find a good program. Just don't let anyone do anything drastic but i agree with above. Keep us posted.
posted by irish01 at 5:10 AM on April 4, 2013

sitting at a 135 degree angle has done wonders for my back issues at work and at home. The human body was not designed to sit up straight, just another lie our teacher's told us.
posted by any major dude at 5:18 AM on April 4, 2013 [2 favorites]

I'd second physio (or I've also had good experience with osteopaths) but the key thing is to get someone who can give you a sense of what good posture looks and feels like (it will feel unnatural) and exercises to help you strengthen the appropriate areas. Then you need to work those into your day so that you regularly become conscious when you're slumping/hunching and reset yourself.
posted by crocomancer at 5:35 AM on April 4, 2013

Best answer: I have personally had fantastic and long-lasting experience by following the Gokhale Method (which I believe I first read about here on the green by way of an Authors@Google talks).

The book is 8 Steps to a Pain-Free Back (it is sitting on my desk right now, many years after I bought it).

If you, unlike me, are in the US, then there is a good chance that you can get live instruction on it.

This can, seriously, change your back-pain forever. (I just checked on Amazon and I bought the book in November 2010 - I have not seen a doctor or anyone in relation to my back since then.)

As 'credentials' I herniated a disk in my lower back (L4-L5 area) 15 years ago. I have suffered intermittent periods of mild to excrutiating pain since then as well as lengthy periods of severe discomfort (lengthy = several months). I have seen doctors, physios, chyro's (please don't) and acupuncturists. I am not generally flexible but am healthy, relatively fit, a bit skinny and exercise fairly regularly.
posted by HopStopDon'tShop at 6:36 AM on April 4, 2013 [1 favorite]

Best answer: In addition to everyone's suggestions here (especially seeing a PT), you might want to start doing barbell deadlifts, if your gym has the proper equipment for it. Done improperly they can do a lot of damage, so start light and make absolutely sure you're doing them with proper form. Deadlifts are an incredible exercise for strength, especially for the lower back, and some people with back pain experience relief when they build those muscles up.

Additionally, would your workplace consider setting you up with a standing desk? One of my former coworkers had back pain issues and would construct her own makeshift standing desk on days when her back was acting up.
posted by Kosh at 6:46 AM on April 4, 2013 [3 favorites]

As a person with degenerative disk disease and as a person who suffered the loss of two disks in an accident, I'm here to tell you, good posture and flexibility exercises are key.

Staying active and flexible are key to remaining pain free.

Now, that said, if you have actual damage, no matter what, you'll occasionally have problems.

You can mitigate, but you can't cure.

Anecdata: Chiropractic didn't work for my pain. Injections of cortisone did. YMMV
posted by Ruthless Bunny at 7:45 AM on April 4, 2013

Best answer: beccyjoe: "My pain is mainly in the upper middle of my back between the base of my shoulder blades on my spine. "

beccyjoe: "Importantly--> I work as a computer programmer, sitting for hours a day hunched at a desk. Occasionally I make futile attempts to sit straight but find that it takes so much conscious effort which I struggle to maintain while programming. "

Given these two data points, and the bit about road bike sprints, I feel pretty confident saying that it isn't your back that's the problem here. Dollars to donuts your pectoral muscles are too tight.

I have a 14 degree curvature to my spine. Not really noticeable but it gives me occasional problems. But the recurring issue with my back - and with bad backs in general - is lumbar pain, not thoracic spinal pain.

However, from time to time I have had issues with a knot that feels as if it's under my shoulder blade, right where you can't reach it no matter how you contort yourself, and it feels like a knife being driven in. Sound familiar? I finally saw a massage therapist about it. After about 5 minutes checking my back she told me it was my pecs, not my back. She could tell the lower edge of my trapezius was inflamed, because it's overexerting itself trying to compensate for the tightness in my chest. She gave me some chest stretches to do. It was like magic. The pain was significantly reduced after stretching and was gone after several days of following up with the stretches.

Anecdote isn't data, right? OK. My wife has had similar issues. Her back is fine, but she works in a library doing data entry - a lot of computer work. I had her do the chest stretches the therapist recommended, and her pain went away. When it recurs, she does the stretches again.

I still get the little knot under my shoulder blades from time to time (I'm a research scientist, again, a lot of time at a computer, which can exacerbate the issue), but never as bad as it used to be, and now I know what to do when it happens. It's worth a shot, and it's free to try. Can't hurt, right?

Pectoral stretches on StackExchange
Doorway pectoral stretch on YouTube

The latter is one of the two my therapist recommended, the other one she suggested is similar but uses a straight arm with hands placed well above the head, to stretch the pectoralis minor. Give it a try. If it hurts like hell, you're probably onto the root of your pain.
posted by caution live frogs at 8:02 AM on April 4, 2013 [1 favorite]

For years now I have been a patient of a physio who has excellent Pilates credentials, and she is amazing. If you can find that combination, your back will thank you.
posted by TheHollowSeasThatRoar at 8:27 AM on April 4, 2013

How old is your bed? If it's more than 8-10 years old, get a new one. That is the single thing that helped my computer-using back pain from years ago.
posted by CathyG at 11:13 AM on April 4, 2013

Walking every few hours around the office. I had the same problem and it got better by my consciously getting up from my desk - against my will cause I had "important stuff to do" and walking three times around the office. Takes effort to pull away but it helps so much.
posted by shaarog at 12:20 PM on April 4, 2013

Response by poster: Hey thank you all so much for the responses. Very grateful. and btw, I should mention, this was written for my husband, not me (beccyjoe). He is a 36 yr old man.
posted by beccyjoe at 3:50 PM on April 4, 2013

I had terrible chronic back pain for years. Only physiotherapy worked - the physio will tell you what's wrong with your posture and give you exercises to correct it. Ring them up and ask, what kind of physio they do - sports physio is for the extremely fit and strong, very different from the weak and feeble - long experience of general practise is good, gentle is good if you have a lot of pain and tenderness as being hard just makes it far worse, and i don't go on that osteotherapy thing where they force the joints out or pop them, manipulation it's called. Physio is scientific, osteo isn't. Pilates, in the long run, boring and takes a long time, you want one on one tuition if you can afford it and not large classes and certainly none of that poncey equipment, fifteen minutes rubbish that's common in big cities. Tell the physio that eg you have problems with neck and back and knee if necessary, then you can book a double appointment if necessary. It's not cheap, about £40 in rural UK upwards, but it was the only thing that worked. Pilates took 6 months to help, Swedish massage was the only other thing that helped, with pain relief. I tried everything, i mean everything, i was in excruciating pain. I should have sorted it out years ago. If you have chronic problems, you will take a long time to get better. You will hear a lot of 'i had back pain, i did x, it disappeared!' stories, but gradually you will notice that they had sudden ('acute') not chronic pain. There is one single thing i have heard of that i did not try, those electronic massagers that heat and stuff that you hold over your shoulder. Also i've never had a partner, if you do, train them to massage you! Best of luck.
posted by maiamaia at 4:01 PM on April 4, 2013

Make sure you have the correct ergonomic setup at your desk. My life was made 1000X better when my employer got me a chair that was actually for a person my size.

I installed a widget that nudges me to do stretches at regular intervals and even suggests stretches, called Stretch Ware. I also trick myself when I know I'm going to be at the computer a long time by drinking lots of water. Between bathroom breaks and getting more water, you're moving around a bit more.

Acupuncture has been very, very helpful for me. Especially with muscle spasms.

The key thing is to address pain as soon as you feel it. My doctor told me that back pain can set off chain reactions--you feel pain here and without even noticing you compensate in other ways and then you have pain spreading. For me, I slump because it takes pressure off my spine. I didn't realize that is why but it is. When I find myself slumping, I do something more than just trying to sit straighter, because it is a sign that I need to figure out what is making my spine feel uncomfortable. Core strengthening has been very important for me. A physical therapist pinpointed what needed to be done. Some of the exercises seems so basic that I doubted they'd help but they did.

I tried Alexander Technique but wasn't super impressed. Takes lots of expensive lessons with a teacher and lots of time.
posted by dottiechang at 9:02 PM on April 4, 2013

Best answer: Ok, I had the same thing, sitting at a computer hours and hours a day. Horrid back pain. I saw a chiropractor who would fix it week to week, but I had to keep going back for like gazillions of dollars. I finally started working out with a proper, educated personal trainer. He had me do back excises a lot (he said it was my most important day). When I quit the chiropractor was when he said those exercises were hurting me even though they were helping a bunch. So a proper personal trainer who knows back exercise is what fixed my totally f'up bad (like I couldn't stand for 5 mins without pain). Work your back muscles, work them hard and a lot and you will hopefully find relief. if not, physical therapist.
posted by twiggy32 at 10:07 PM on April 5, 2013

Response by poster: Again, lot's of great responses! Thanks so much to this community.

I think going to a physio will be the next step for me. There definitely seems to be consensus that a physio gave a good diagnosis and was able to help people manage their condition. Very interesting response on pectoral flexibility. I'm going to research that further.

I'll also look into Gokhale Method. The youtube videos were compelling.

I also like the idea of dead lifts and standing desks.

Thanks again! If i can report back, I will.
posted by beccyjoe at 4:42 AM on April 7, 2013

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