Back Pain
June 16, 2004 10:04 AM   Subscribe

Back Pain. How do I get rid of it? I've tried changing my chair, the level of my keyboard, what side of the bed I sleep on. I've been stretching. Nothing works. I am in agony. I've never had back pain like this before. I've always had back discomfort, aches -- that sort of thing -- but never debilitating pain. I'm only 22. What should I do?
posted by Grod to Health & Fitness (33 answers total)
What kind of shoes do you wear?
posted by bshort at 10:05 AM on June 16, 2004

Response by poster: Sneakers. But indoors I'm barefoot and 80% of the time I'm seated.
posted by Grod at 10:08 AM on June 16, 2004

Use your back, sitting up straight. Years ago read countries where they use their heads carrying loads of things, have less reported back & neck pains fwiw. Also standing attention for long hours a military person does won’t contribute for neck & back pains for them . Guess one of those "use or lose it" type things.

What should I do?
Rest it then exercise your back when it feels better. If it persists see a doctor for any physical condition that may be causing it.
posted by thomcatspike at 10:15 AM on June 16, 2004

I asked because for a while in college I wore shoes that didn't have any arch support and experienced excruciating back pain until I realized what the cause was.
posted by bshort at 10:24 AM on June 16, 2004

IANAD, but I think Mary Pullig Schatz's Back Care Basics is a good book if you're interested in trying yoga for back pain relief. I'm just starting out with it, since my family has a history of slipped discs and the like so I'm hoping to do some preventive maintenance.
posted by bcwinters at 10:25 AM on June 16, 2004

You may want to check with a Dr. to make sure you don't have a pinched nerve or a slipped disc (the former more likely at your age, I would think). I have a coworker that went through months of neck pain to find out that it was a pinched nerve and fairly easily resolved, all things considered.
posted by Ufez Jones at 10:30 AM on June 16, 2004

How old is your mattress? If it's old, it might not be keeping your spine properly aligned when you sleep.

An interesting piece of advice I learned years ago is that letting your abdominal muscles get out of shape (I'm not saying that yours are, of course) can force your back muscles to work overtime, and therefore cause back pain.
posted by boomchicka at 10:39 AM on June 16, 2004

I had the same problem. Chronic ache, with periods of serious pain. I went to a doctor when I was around 26, and he basically threw a bunch of pills at me. I then got No More Aching Back: Dr. Root's New 15 Minute-A-Day Program for a Healthy Back and followed the program religiously for a year, every night, no exceptions. Problem solved. Mostly stretches, but also (as boomchicka would advise) some abdominal exercises. All very gentle, but, in my experience at least, very effective.
posted by MrMoonPie at 10:43 AM on June 16, 2004 [1 favorite]

A good chair, good chair posture, and the right bed are key. But it helps to get some advice from someone who knows what they're doing. If you're on a health plan, see if they will cover a consultation with an ergonomics specialist. You might find one in the fields of Occupational Therapy, Physical Therapy, or Sports Medicine.
posted by scarabic at 10:44 AM on June 16, 2004

Stretch every morning. Increase your flexibility.
posted by gramcracker at 10:44 AM on June 16, 2004

i would avoid the chiropractic treatment. personally, i found it to be more of a bandaid rather than a long term solution. i come from a long line of wimpy backs and originally threw my back out in art school moving litho stones around. went to see a chiropractor on and off with short term relief.

managed some how (no idea) to throw my back out a year ago and upon recommendation went to see a neuromuscular therapist. i was right as rain after three visits. i've got a great recommendation for you if you're in the bay area.
posted by heather at 10:45 AM on June 16, 2004

For some pain relief until you figure out what the problem is, try massaging the muscles in question with one of those hand-held back massager dealies (like this) while you stretch. If you don't want to shell out for one, keep in mind that they usually have a test model set up at Bed Bath & Beyond. :)
posted by boomchicka at 10:47 AM on June 16, 2004

At work I had to switch to a hardback chair rather than an office chair with a "flexible" back, because I found that my back muscles were working overtime trying to keep my posture in line.

I also got a new mattress for good measure, since ours was terribly old.

I visited the chiropractor a few times to get back into alignment, and then I started doing pilates, to strengthen my "core" - abdomen and lower back.

Finally, while I was waiting for all of that to kick in, my doctor was kind enough to prescribe tylenol with codeine, the drug of the gods. Good good stuff, I slept like a baby, which made dealing with the pain by day (unmedicated since ibuprofen doesn't like me) much more bearable.
posted by vignettist at 10:47 AM on June 16, 2004

How tall are you? Many tall menl have chronic back problems related to their height.

I have had chronic lower-back pain brought on by extremely flat feet since I was a teenager. When I stand up straight and bend my knees they touch, throwing my hips and back out of alignment. Orthotics helped immensely, but what really did it was strengthenign my core muscles. Abdomen and back muscles. I highly recommend either picking up a good book on the subject (mrmoonpie's looks decent) and/or talking to your doctor and a sports medicine specialist. Yoga also helped me. But you have to make a habit out of it.

Doctors (ime) have a high rate of "rest and come back in 3 weeks" which I find completely unhelpful.

All the other recommendations re: ergonomics are spot on, but I've found nothing helps like being strong
posted by sauril at 10:51 AM on June 16, 2004

Response by poster: I'm pretty certain this is a muscular thing, and the comments here tend to reafirm that. I should probably have mentioned that my posture is terrible. From the side I often resemble un upsidedown "5" (except that my feet point the right way). Yet recently this pain has extended down my thighs. I've no insurance and am unemployed at the moment so any solution will have to be low-cost and low-tech. I'll look at the books being recommended. I try to remember to sit/stand straight but unless someone gives me a poke every couple minutes, once my mind is busy I slouch right down again. I'm 5' 8" and my girlfriend is 5'. When seated across from each other we're at eye level, that's how much I hunch my back.

Would sleeping on a hard surface for a couple nights -- a carpeted floor, for example -- help at all?
posted by Grod at 10:56 AM on June 16, 2004

Response by poster: sauril: for various reasons I have been thinking its time to get in better shape. With all the advice in this thread it is now a priority, but I need the pain to at least diminish before I do anything but the gentlest of stretches.
posted by Grod at 10:59 AM on June 16, 2004

Have you seen a doctor, not to have a bunch of pills thrown at you or anything, but to rule anything more serious out?

The back is such a tricky thing. People have had fantastic suggestions so far, but if you can get to a doctor, try to... just in case. It's better to be sure there's nothing else and it's just a muscular issue.

Case in point: My dad had the worst backache before he knew he had prostate cancer. They told him to exercise, they gave him pain meds... He had the cancer surgery a few months ago, and hasn't had a back ache since.

Hope you're back to form soon :)
posted by jerseygirl at 11:02 AM on June 16, 2004

When a man your age or so starts complaining about his back, and it's clearly not injury related, I start thinking ankylosing spondylitis. But then I would, wouldn't I, since I came down with it when I was 25. It's not common, but it's not rare either.

Links to symptoms: 1, 2.

Some questions:

WHEN are you in the most pain? In the morning or later in the day? Does it get better as you move around, or does rest help? Do you wake up in pain?

WHERE along the back does it hurt most? Can you pinpoint a spot where it seems to be the worst?

There are more questions, but we can start with these.
posted by mcwetboy at 11:07 AM on June 16, 2004

Go to a doctor first.

Not to freak you out, or anything, but lower back pains were the first sign of a tumor that a student of mine had. She kept shifting around, trying to get comfortable, and we were all *positive* it was induced by stress and all the driving she was doing. She was going to get to the doctor as soon as the semester was over. We were all wrong, and I grieve a lot that no one pushed her to get it checked out earlier.
posted by jasper411 at 11:17 AM on June 16, 2004

Response by poster: mcwetboy. OK. WHEN: I wake up in pain. Usually within 6 hours of going to sleep I am awake because of the pain. My solution is three or four ibuprofin and a couple tylenol. My back aches throughout the day.

WHERE: Until today it was concentrated in my lower back -- the small of the back -- but pain would shoot through my legs. After the incident I linked above (link) I've had trouble seperating the pain in my upper back, neck and shoulders -- pain that is already fading -- from the persistent pain in my lower back. This all started last Sunday morning, got worse on monday, and has been fairly consistant since then. Prior to that I had the common aches and stiffness associated with bad posture and a relatively sedentary lifestyle. As I write this I have given up on every chair in my apartment and am reclining on the sofa, roman style. My laptop is on a low table next to me and I can already feel the stiffness forming in the right side of my neck and my left shoulder however the rest of my back is not bothering nearly as much as it was when I was sitting properly.
posted by Grod at 11:20 AM on June 16, 2004

I have a dodgy back and occasionally go to an osteopath. Before any session they always ask if the back pain esxtends to the legs/thighs. I think this question is related to sciatica, which can relate to disc herniation amonst other things. That site also says you need to seek out a health care professional at the earliest opportunity.

posted by biffa at 11:27 AM on June 16, 2004

So far what you have described is consistent with my own experience, but I obviously can't tell you that you have AS. Let's just say that I suspect it, but I suppose there are a lot of reasons for a back to be on the fritz. I have no idea what a herniated disc feels like. Get thee to a doctor.

AS typically begins at the sacroiliac joint -- where the spine meets the pelvis -- and moves upward. Essentially it's an autoimmune disease that tries to fuse your spine solid.

Your upper back may be in spasm in response to your lower back problems; when I had it, I was complaining more about the upper back, which felt muscular in origin, than about the lower back -- this threw my doctor off the scent. Several months of sleep dep probably didn't help my ability to detect what in hell was going on with me, either.

If my own experiences are in any relevant . . . in terms of rest: Sleep flat on your back, as spread-eagled as you can. Use a thin pillow or none, or get an orthopedic pillow -- you're looking for neck support. You'll probably also need to work at a decent desk with a proper chair with full back support. Better to use a desktop than a laptop for posture. Flat-panel iMacs with the movable arm are fantastic, let me tell you. And posture matters.

With AS it gets better with exercise. The catch-22 is that you may be feeling too stiff and sore to even consider moving. The idea is to get the pain and stiffness and swelling under control so that you can get moving again. Mobility helps; that's why it hurts so much first thing in the morning.

Do any of your family members have a history of back pain, or of Crohn's Disease, colitis or other inflammatory bowel diseases?
posted by mcwetboy at 11:40 AM on June 16, 2004

IANAMD, but...

In 1988 I was involved with the first MedX lower back strengthening facility in the country. 80% of our chronic patients saw a major reduction in pain (or cessation) - the lower back muscles are heavily atrophied (due to the size of the nearby gluteal group.) Huge strength increases (which would be impossible) w/o atrophied muscles. Exercise of 1-2x a week.

This is from the inventor of Nautilus, who everyone imitated with their lower back machines - which allow hip motion. Isolate the hips, and you work the lower back (L1-S1)

MedXonline - Lumbar spine anatomy and function

MedX Online: Lumbar Extension Machine

P.S. I think there was a previous ask me thread that discussed some info around this.
P.P.S. Spinal degeneration starts at age 21.
posted by filmgeek at 11:58 AM on June 16, 2004

I try to remember to sit/stand straight but unless someone gives me a poke every couple minutes, once my mind is busy I slouch right down again.

Well, a poke every few minutes is better than constant pain, right? Get an egg timer or something. Listen to music and sit up straight every time the song changes.
posted by scarabic at 3:12 PM on June 16, 2004

Grod, I'm with the get thee to a doctor first crowd. In my case the back pain turned out to be a deteriorating disc. Anti-inflammatories and low-impact exercise to keep the supporting muscles strong helps to keep the pain manageable but I'm looking at having the disc replaced in a couple of years (as soon as the replacement procedure is approved in the US). Not to try to worry you, but you do need to find the source of the pain and rule out a medical cause.

I'll also second MrMoonPie's book suggestion: It's on my shelf as well and has been very helpful.
posted by NsJen at 3:34 PM on June 16, 2004

Your description sounds like it could have been written by me a year ago.

As with mcwetboy, whom I never properly thanked for his great advice and support on my AS question, I was diagnosed at 29 with AS and psoriatic arthritis. I would recommend trying to get in to see a rheumatologist or orthopedic specialist to see if it is structural. A free clinic or teaching hospital can usually help you find someone cheap.

If it is serious, it can get really serious and irreversable really quick, and treatment earlier is less expensive and less invasive. So it's something you don't want to ignore.

Best of luck.
posted by karmaville at 3:52 PM on June 16, 2004

I slept on a hard futon as a teen and suffered lower back pain for several years. Laying on the hard futon felt good, I can remember spending days flat on my back with a heating pad when it hurt the worst. Eventually I got a different, more normal mattress, and after 2 weeks or so the pain went away. Now the only time it comes back is when I sleep on someone's couch or floor. So I concur with the other suggestions to get a new bed. Even if the bed feels good for you, it might not be good for you. Also, see your doctor.
posted by bonheur at 3:52 PM on June 16, 2004

If a doctor clears you for it, I might suggest using an excercise ball as your office chair for at least a couple hours out of the day. I sit on one of these for at least part of my day at work - it doesn't allow me to either slouch or lock into a position while I'm at my desk, and it's strengthened my back muscles.

'sides, it just makes me happy to bounce on it while I'm thinking something through.
posted by vers at 3:59 PM on June 16, 2004

Grod: Lots of advice here, but I think it could use a bit of organization.

1st bits: Get the accute stuff better.
You're almost definitely suffering from some sort of soft tissue inflamation. Asprin/Ibuprofin/Tylenol will help with this in the short term if you take it all at once. Better to take smaller doses through out the day. You've probably gotten yourself into a inflamatory cycle. You're going to have to break it over time. When I had a similar situation I was taking 2400 mg of ibuprofin over a day (across many, many days). They key is to keep it constant rather than spiking up and down.

Regarding the most serious pain (early in the morning): I'd say your best bet is ice. Ice packs or cubes, or peas, whatever. Do not apply directly to the skin, wrap in a cold cloth. 20 min on/20 min off.

In many cases, pinched nerves (the thigh pain, probably) can be caused by inflamed tissue impinging on the nerves.

If you're still in bad pain after a week of this, go to the doctor asap. In fact, make the appt now, and cancel when you start to feel better.

2nd: Work on the Chronic stuff
Sounds like you have two chronic problems: lack of torso exercise, and bad posture.

Any aerobic activity you do (aside from machine weight lifting or other very focused activity) will exercise your back and abs. Running, swiming, juggling, whatever. But, you have to get out and get active on a regular basis. Swiming was great for me.

Take it very easy at first, but challenge yourself a bit more after a couple light weeks. If you feel like you want to do something more focused, try situps. Abs are about the most important contributor to back stability. I've not had great results with back focused exercises, except w/ MedX machines, and even that was a troublesome.

Stay away from heavy strain (brick lifting) until you're feeling better.

For posture issues, there are only 2 cures. A girl friend who will poke you in the ribs ever 5 minutes or tape. Tape worked wonders for me. If you're in school, it'd be worth going to see the exercise program to see if they have a PT class who will help you with taping, it's best to have somebody who know's what they're doing do it at least the first few times.

If not, try this. Get good, 1" wide paper first aid tape. (Avoid the fabric tape). Consider shaving your upper back if your, erm, hirsuite. Sit up straight. Have a helper tape 2 strips of 1 inch tape paralell to your spine about 1 inch on either side of the bony protrusions of your spine.

Now, slouch, and then suddenly sit up right again! Voila, tape is the GF who will never stop poking you in the ribs. Be careful taking it off, very strong tape can rip the skin, or at least keep you from doing it again.

I've been to dozens and dozens of doctors, chiropractors, PT appointments, massage therapists, OTs.... uh, throw in a neurologist at one point.

Net result: Back Pain Goes Away. Massage can help, and feels great if you can afford it, but like everything else it's just something to make you feel better about yourself while time is working it's magic.

There are serious conditions related to back pain (AS, as above, fractured vertebrae, etc etc), so don't hold off if you're not seeing serious improvement in a week. But there's a HUGE industry out their making money off back pain.

I ain't no doc, so if you've got quesitons, go see one!
posted by daver at 4:12 PM on June 16, 2004

If you wake up in a bad back position try putting a pillow under your knees when you sleep. My doc suggested this to me when I was a kid and it worked. It puts your back into a better position, and it makes it so you're less likely to roll around.
posted by holloway at 5:25 PM on June 16, 2004

Assuming you came here for personal experiences, so I'll share mine, which is completely different from the other advice here.

I had terrible lower back pain for most of my 20's, including 2 weeks flat on my back right after starting a new job. Spent a fortune on chiropractors to no avail. Now 48, and have very little trouble.

I finally figured out that when I would get a little twinge of pain from any unusual movement or strenuous activity, I became afraid of the pain, afraid that it meant I would be immobilized to at least some degree and that the stress of fearing the pain would send my back muscles into much more severe spasms. I was completely unconscious of this at the time. But one time after getting a bad back ache and severe spasms from painting a ceiling, I took 2 aspirin, and laid down on a comfortable couch, put on headphones and a relaxation tape with new-agey music and a guided relaxation excersise, like "slowly tense your toes for 10 seconds and release, now your ankles, calves, knees, etc all the way up to your scalp"., fell asleep, and woke up half an hour later with no pain and no spasms. I used the relaxation tapes for the next few times I had back pain with success each time, and gradually figured out the link between the initial mild to-be-expected pain from unusual over-exertion, and the ramping-up of that pain thru fear of the pain itself. I learned to let go of the fear (of back pain anyway, still working on applying this lesson to the rest of my life), and have been completely free of severe immobilizing back pain ever since.

In fact, I would argue that using special mattresses or seat cushions or other gadgets or special back excercises, etc, only keeps your focus on your back pain and increases your fear and the resulting spasms.

Of course, YMMV. See your physician first.
posted by marsha56 at 8:51 PM on June 16, 2004

FWIW I have heard a few people say they did have back pain which disappeared after they gave up coffee.

Something about dehydaration of the spine...
posted by Frasermoo at 7:20 AM on June 17, 2004

Wow, lots of great advice in here.

After reading your site and some other responses here, I'm going to also recommend seeing a doctor. If it turns out that it's just posture... well there are many ways to work on that. Again, yoga really helped me, and so did just plain old exercise. You can also get a shoulder sling to keep your shoulders back and not forward. I'm sure that any reputable Physio would sell them.

For yoga, I have book, and it's not bad. It doesn't go overboard on the spiritual aspect, and posture is one of the things it talks about.

And in the midst of Daver's excellent post I found this: Massage can help, and feels great if you can afford it, but like everything else it's just something to make you feel better about yourself while time is working it's magic.
I disagree. A good massage therapist can relieve a LOT of muscle pain and problems and find out where the problem stems from.

Good luck. Back pain sucks.
posted by sauril at 11:02 AM on June 17, 2004

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