Back pain. Most of us get it. I just hope you don’t get it during the viral pandemic. It is harder and harder to get treatment for back pain any time, virus or no. There just aren’t enough docs out there to take care of the huge number of patients who suffer from this pain.
When I think of back pain, I divide it into a few groupings, and I’ll try to break it down and keep it simple. There is acute back trauma. I’m not covering that in this series. If you injure your back in a car accident, you’ll be directed to the ER by the EMS experts at the scene, and to the ER you should go. Then there is lumbago, or mechanical back pain, which most of us will get sooner or later during our very…long…lives. And lastly, there is back pain associated with pressure on nerve roots. This results in pain radiating down the legs, also known as sciatica.
If you develop back pain spontaneously, and you look it up on the internet, you will likely think you have cancer which has metastasized to your back. Many patients are anxious about this information, before coming to see their doctors. Statistically, however, this is very unlikely. You are most likely suffering from a strain of the muscles of your back. Sometimes this pain feels like what you imagine cancer might feel like, because it can be very severe. As I’ve written before, we can only wish for every earliest, tiny cancer cell to present with an announcement of excruciating pain, because we would then know it was here and could deal with it early. Unfortunately, cancer usually doesn’t cause pain until it erodes into something important.
Back pain can range from an annoying ache, deep in the muscles of your low back, to excruciating pain associated with muscle spasms. But it is all just that. Back pain. Mechanical low back pain. Lumbago. Lumbosacral spine strain. It can be associated with other conditions, but for this discussion, I will stick with simple back pain.
And since you’ve been reading this series, you will know many of the following recommendations already:
–Rest. That’s right, take a rest from whatever it is that is aggravating your back pain: lifting, moving your grandkids to college, gardening, squats. Just stop doing it.
–Ice. Ice works, even for a large area like the back. You’ll need a larger bag of ice, and you can make them yourselves. See this post for my icing recipes.
–Heat may work as well. Try alternating heat and ice, until you find what works best for you.
–Gentle stretching, as long as it’s not causing excruciating pain.
–Walking, simply because it’s what we do. If your legs are working, then try to walk. Get some hiking sticks or a walker. Remember, we’re humans. Think of what you would do to keep up with your pre-historic, nomadic tribe of hunter-gatherers. You would walk. And if you didn’t, you’d lag behind, starving or providing a meal for a saber-toothed tiger. So, walk, even if just a short distance.
–Be mindful, and find positions of comfort. Are you in pain right now? If not, then get to this position more.
–Take NSAIDS or Tylenol, if you can.
Sciatica, with or without back pain, is a slightly different animal. The nerve roots are being stretched or compressed by a herniated disc, bone spurs or degrees of spinal stenosis (narrowing of the spinal canal). You will experience varying degrees of pain, tingling or numbness radiating into the buttock or down the leg. It can be so painful, you might think you need to go to the emergency room to see if they will give you something strong for pain relief. Don’t be surprised if they won’t. Physicians in every ER are different in their willingness to prescribe pain relievers. We are living in times when our government, medical societies and even pharmacies are directing us away from the use of these highly addictive medications, and for good reason. If the pain is severe, besides seeking consultation with your primary care doctor or orthopedic surgeon, you could follow all of the above recommendations for back pain.
Additionally, there is a series of exercises, described by the late Robin McKenzie, a physical therapist from Australia, called “McKenzie exercises.” You can find many examples on the internet, and you can order his book, Treat Your Own Back, for about seven American dollars, on Amazon. In many cases, these exercises will result in immediate relief of some, if not all the pain radiating down the leg. If you suffer from back pain, you should consider getting this book. There is one for the neck as well (Treat Your Own Neck).