Twenty years of treating people whose backs ache, trying to help thousands find its cause and deal with its crippling challenges, I have developed my own set of ideas for what to do when your back hurts, when you have a pain in the butt or when nasty sensations radiate down your leg.
While some physicians think back problems are mostly psychological, I believe in a practical, diagnosis-based approach. To avoid back pain Hell and wandering from clinician to clinician, these are the rules to follow.
Like the common cold, back pain will hit you at some point another, so don't panic. According to the National Institutes of Health, in a 3-month period, about one-fourth of U.S. adults experience at least one day of back pain.
It is one of our society's most common medical problems. My patients over 40 are more likely to have back pain than the younger ones and those who weigh more are at more risk than thinner ones. Cigarette smoking, excessive consumption of carbonated beverages, jobs that involve lifting heavy objects, being sedentary or exercising too much -- all these are risk factors.
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20 hours ago (11:28 AM)
Very good ideas all. Item 8 references acupuncture and trigger point injections, but may I also recommend acupressure trigger point techniques, which don’t involve needles and may be done at home. Since you can work many of the points yourself, you can target particular areas of pain when they first occur, potentially saving yourself days (or weeks) of pain and preventing more extensive problems. I press trigger points on the ribs for mid-back pain, trigger points at the pelvic "divots" and in the buttocks and just below the back waist for low-back pain, and TPs in the upper arms and chest for upper back/neck pain and tension headaches. A good trigger point workbook or guidebook will show you these and TPs for other types of pain as well.
20 hours ago (11:50 AM)
I don’t have time to scroll through these but having experienced back pain many times over the years, for me what worked was chiropractic help and also the understanding of what stress does to MY body. Stress settles in my lower back. I wouldn’t wish back pain on anyone – regardless of the cause.
20 hours ago (12:12 PM)
I believe "back problems" seem so common because we as humans have become taller too quickly as a species.
…that said, thanks for your common sense approaches to this malady Dr. Fishman. I absolutely decimated by lumbar as a youngin’ in my twenties when I did warehouse work (heavy repetitive lifting) because not only did I over-exert myself but I didn’t appreciate the value of a good pair of shoes. However, I can happily report that since I took up a yoga practice a few years ago the "OMFG how am I going to get out of this bed/sofa" moments have become fewer and farther between.
18 hours ago (1:58 PM)
Good post, good advice. Explore options!
15 hours ago (5:01 PM)
Yes, related to trigger point therapy, which relaxes muscles (and the myofascia, the membranes covering the muscles), and relieves pressure on the nerves causing the pain. Shiatsu massage uses similar acupressure techniques.
18 hours ago (2:01 PM)
Try myo-fascial massage for back pain, my physical therapist is trained in this method of treatment and it has done wonders for me when nothing else worked!
9 hours ago (11:15 PM)
17 hours ago (2:48 PM)
Pain is a relative condition, my relatives are a pain in the…
18 hours ago (2:11 PM)
In the interest of trying to help others, I’ll offer some unsolicited advise based on years of experience.
Learn proper body mechanics. Lift with your legs, not your back. Don’t lift and turn at the same time, make it two distinct separate motions.
Ice can relieve pain, if you can make it through the first 5 minutes. For me the initial application makes it worse, but after that things tend to go numb. You’re not supposed to put ice directly on your body, use a rag as a buffer. (Do what I say, not what I do)
A fusion may be necessary, but it is not a cure. The spine was built to distribute the load relatively evenly, Take out a few joints, and the rest have to do more than they were designed by nature to do.
It make take a few years for the effects to show themselves, but in most cases a spinal fusion will lead to other problems down the road. After a fusion, remaining active is no longer an option, it’s a necessity.
Pain is a relative condition, and individuals have differing tolerances for it. In my case I had no choice, when paralysis develops surgery is the only option. IMPO Surgery really should be the treatment of last resort, I would avoid it by any means necessary if I could.
Good luck.
17 hours ago (3:00 PM)
not sure, but I do know carbonated sodas can alter the pH of urine resulting occasionally in bladder/kidney infections.
9 hours ago (11:12 PM)
Yes. Carbonated beverages aren’t recommended — they’re bad for your bones in your spine and everywhere else.
17 hours ago (2:58 PM)
They leech bone calcium, contributing to bone density loss/osteoporosis.
17 hours ago (2:30 PM)
Can anyone explain the "carbonated soda" relationship in causing back pain? I’ve had serious back pain since an auto accident ten years ago, but have never heard that drinking carbonated drinks could contribute to the pain. That’s practically all I drink.
Any help is appreciated.
15 hours ago (5:24 PM)
A subtle varient on the long-standing "Shake & Bake" approach to just about any human pain. If Physical Therapy does not require you to actually do something – it is not PT.
17 hours ago (3:23 PM)
Wow, no mention of massage as manual therapy.
The following link provides research data having to do with massage as a valid therapy.
http://www6.miami.edu/touch-research/About.html
In many cases, a properly trained and licensed massage therapist can help with back pain. For most people, it’s certainly worth trying before surgery.
16 hours ago (3:39 PM)
How about chiropractic??? It has worked wonders for me and has gotten more and more recognition and approval in other medical fields as a very viable option to relieve back pain.
12 hours ago (7:38 PM)
Low THC, high CBD cannabis will have almost none of the negative effects you are talking about as CBD is not psychoactive like THC is and competes for the same receptor sites. CBD rich cannabis helps fight cancer, works great as a pain reliever and is also a great muscle relaxer. And it is natural and most people can grow it at home. Time to legalize cannabis at the Federal level and legalize industrial hemp to save America and create jobs.
12 hours ago (7:25 PM)
Can you cite and hyperlink from where your info comes from? Many of the sources for cannabis leading to psychosis have been debunked scientifically form what I have read. Also paranoia and anxiety seem to preset themselves mostly in those people that have a sensitivity to Sativa dominant strains of cannabis and are usually cautioned to use more Indica dominant strains. Sativas tend to have a stimulant type effect on most people and Indicas tend to have a more relaxing and sedating effect on most people. It is important for people who use cannabis medicinally to know their strains and what strain they are using in order to maximize the health benefits and reduce the possible negative side effects. Remember that even drinking water and breathing oxygen have negative side effects. Moderation in everything is key. We become unhealthy if we eat too much good food, drink too much water, get too much exercise, and consume too much medicine. The Medicine is fro everyone, not everyone is for the medicine.
13 hours ago (6:32 PM)
Do be aware that long term use can cause psychosis and "burnout". Bet you can’t say you never get paranoid. While I am a supporter of legalization for even recreational use, there is no free lunch so to speak, marijuana does have some side effects.
14 hours ago (6:05 PM)
F&F you got that right!
11 hours ago (8:46 PM)
15 hours ago (5:05 PM)
And the only side-effects are joy, hunger and drowsiness.
16 hours ago (3:42 PM)
Cannabis does wonders, especially high CBD low THC strains, for back pain and muscle relaxation instead of prescription or over the counter pain killers and/or muscle relaxers.
9 hours ago (10:58 PM)
Dear Daadee:
There are also some yoga exercises that do wonders for me. My dance instructor taught me to hold my head back, push my shoulders back – trying to get my shoulder blades to touch and hold that for a few seconds. Once you release, you can feel the blood rushing in around the spine. The effect can be so profound some people feel faint. I work at a desk and run this routine every hour or so. Big help.
12 hours ago (7:56 PM)
I’m glad he helped you. I’ve had some success with recommending him to others but it can be difficult to accept. What was amazing was the degree and speed of recovery was astounding. My wife had neck pains. She was quite resistant but once she accepted it she was fine.
15 hours ago (5:11 PM)
You are exactly correct, Dr. Sarno saved me from becoming disabled from back pain at the age of 40. Back pain not caused by an injury such as a car accident or fall is almost always caused by stress which causes a constriction of the arteries. Meditation is the best cure, a great practice is to simply think your feet warm [it's easier to gage for yourself if your feet do feel warm], then progress to thinking your arteries open and your back muscles relaxed.
My reading went beyond Dr. Sarno and included Norman Cousins, Deepack Chopra, Allen Watts, Candace Pert and others.
My pain was so severe I had been rushed to the emergency room once when I woke up screaming and unable to lift my head off the pillow. I was in so much pain 20 days a month it took half an hour for me to get out of bed. i occasionally get some pain now and then, I’m a blacksmith by the way, but am able to make it go away in about 15 minutes now by simply remembering it’s all in my head. Mostly thanks to Dr. Sarno.
23 hours ago (9:19 AM)
I was rear ended in a car accident and had back pain for several months. I read a magazine article about Dr. John Sarno who posits that back pain is mostly caused by your brain trying to distract you from emotional pain and I felt much better. I have not had problems with back pain in years.
I’d consider Alexander technique as well.
9 hours ago (11:11 PM)
I agree!
20 hours ago (12:16 PM)
I appreciate "non-medical" remedies for pain, too. I have fibromyalgia, and yoga ties me in painful knots, but tai chi (Yang style, at first) was a great alternative. The tai chi posture: knees slightly bent, pelvis tilted slightly up, shoulders dropped and a bit rounded, spine dropping straight from the base of the skull, immediately relieves pressure on the joints and back. Then, the form, using the whole body in slow and continuous movement, with continual shifts from one foot to the other, gently stretches and strengthens without causing knots and cramping. It’s definitely worth a try as well.
22 hours ago (9:56 AM)
I appreciate your approach, lots of practical advise, especially for those of us who are "self helpers". It is gratifying to read recommendations that are not just surgery and heavy medications. I do understand that for some people those approaches are necessary, but many of us can take advantage of lifestyle remedies, first. I particularly like the parts about physical therapy and yoga. I had never thought much about physical therapy until I had a shoulder injury. I was WOWed by the experience. I would never have gotten full use of my shoulder back without the skill of a physical therapist. My shoulder injury was several years ago, my shoulder is still 100%. I have been considering learning to practice yoga, thanks for the encouragement.