Oh, My Aching Back - How To Manage Back Pain

I guess that having a sore back is about as common as having dandelions
in your yard.  It just happens sometimes and everyone experiences it at
some point.

I’ve had my share of low back pain.  It began when I was playing high
school football and I took a knee in the right kidney during a practice.  To
say that it was painful is a gross understatement.  While laying flat on my
back for about 30 minutes, I could not even wiggle my fingers or toes
without pain shooting up and down my leg and back. Fortunately, I was
able to walk after practice without too much suffering.  

At the time, I thought I had just bruised my back.  That may have been
the case (or not) but it was definitely the beginning of my battle with
ongoing lower back pain and sciatica pain.  If I had known then what I know
now, I would have visited a chiropractor for an adjustment.  He might have
saved me years of almost continuous pain.  

If you are having severe back pain, it’s very possibly caused by a pinched
nerve and a chiropractor can help you.  Or, if it’s something more serious
like a ruptured disc, he can refer you to a surgeon.  I used to be skeptical
of chiropractic in general but I am now a firm believer.  You could very likely
get immediate relief from your pain during a brief office visit.

This article is to share several tips that I’ve learned over the years
to help you manage your back pain.
 

In fact, the amount of back pain that I have today is only a small fraction of
what I endured through the two decades of my 20’s and 30’s.  I credit my
friendly chiropractor for most of the immediate relief during my times of
crisis.  But, the continuing personal management of my back health has
been the real key to my lasting pain relief.  I believe that my back is
stronger and healthier today than at anytime in my life.  
You can find
relief too!

Disclaimer
: I am not a doctor or chiropractor and I can not offer medical
advise.  The following is simply my experience with back pain management
and a summary of what has worked for me.  

I recommend that you discuss anything that you learn from this article with
your healthcare professional.  It would be very wise to rule out any serious
condition such as a ruptured disc before doing any exercise.

Pain And Inflammation Cycle

A good place to start this discussion is to talk about one reason why your
back may be hurting - inflammation.  If you just worked too hard in the
yard and you have some sore muscles, this article is not primarily directed
toward you.  You will be fine in a few days.  

This article is for those who suffer from chronic back pain.  If you are a
prisoner to chronic pain, you need to understand how inflammation and
pain reinforce each other.

It does not matter which came first – the pain or the inflammation.  But,
once either is present, they set up a viscous cycle.  Pain causes
inflammation - the inflammation causes pressure on the nerves and
more pain – which causes more inflammation….  Inflammation is your
body’s natural response to an injury and it’s not all bad.  However,
if it becomes chronic, then you have problems.  

The first key to relief is to
break the cycle.

Doctors will sometimes use pain medicine to break the cycle. Sometimes
they will use anti-inflammatory meds.  Sometime muscle relaxers will do the
trick.  Whichever way you go after the problem, the goal is to stop the pain
by breaking the never-ending cycle.

Let’s take a moment to look at the pharmaceutical options to breaking the
cycle.

1) Pain killers – these are effective but most are addictive.  Over-the-
counter products like ibuprofen and acetaminophen are not addictive but
they have two major limitations.  First, they should not be used daily for
long periods as they are hard on your body.  Also, they are usually not
strong enough to give real relief to this type of pain.

Discuss pain management with your doctor but only plan on using
prescription painkillers for a very short time.  Quite frankly, I can’t take
most pain medicines because they either make me drowsy or I feel like I
have ants crawling all over me.  I count that as a blessing so that I’ll never
be at risk of becoming addicted to them.  Clearly, I believe that prescription
pain medication should be your last option.

2) Anti-inflammatory drugs – this is a safer option than pain medication.  
Before you go the route of prescription anti-inflammatory drugs, you might
try ibuprofen as it is not only an analgesic (for pain) but it’s also an mild
anti-inflammatory and it might help. Again, this is only a short term fix.

In addition to NSAID’s like ibuprofen, there are other pharmaceuticals that
can interrupt inflammation by other methods.  Corticosteroids like
prednisone, COX-2 inhibitors like Vioxx and Celebrex, and antihistamines
each shut down different inflammatory mechanisms.  However, they also
present risks with long-term use and some have been removed from the
market because of serious side effects.

Before you go this direction, I strongly recommend trying Omega-3
supplements to reduce inflammation.  Chronic inflammation can cause much
more damage that just causing you back pain.  I recommend that you read
my article on  
Inflammation and Chronic Disease for more details on using
Omega-3’s to vastly improve your health.  Not only can they help with
chronic pain, they can work wonders for your overall health.

3) Muscle Relaxers – this is what did it for me.  As I mentioned before, I
can’t make any medical diagnosis or give medical advice, but this is the one
class of drugs that worked miracles for me.  My doctor prescribed Flexeril  
(cyclobenzaprine) and it did the trick.  My back relaxed enough that it was
able to heal.

When I used cyclobenzaprine, I only needed it for 1 day at a time.  That
was enough to get me on the road to recovery.  Actually, it’s a good thing
that only one day was enough because I can’t function normally when
taking this drug.  It turned me into a puddle of Jello and I just wanted to
sleep.  But it fixed the back pain!

It allowed the acute pain to subside enough that I could get things back in
order.  When the next painful event got my back out of whack again, one
more muscle relaxer was all that it would take to get me back onto the
road to recovery.  And, as time went on, the events of my back going out
became less and less frequent.

Tricks Of The Trade

The drugs mentioned above are only stepping stones to real recovery.  
When you hurt so bad that nothing else matters, you need some
immediate help to get you on the path to healing.  But, don’t think that
the temporary relief from pain is the same as your back being healthy.  
We will get to making your back healthy in just a moment but I first want
to share another method of relief when you’re in a lot of pain.

This primarily works for lower back pain.  If you have neck pain or a
problem in the middle of your back, this probably will not help.

Here is the trick:  Lie on your back on the floor with your calves and feet
up on your couch.  Then scoot your rear as close to the couch as
possible.  Your bottom should be touching the front of the couch.  

What this does is it relieves all of the pressure on your lower back.  
If the pain makes the muscles in your back knot up into a ball, this will give
some relief and let you relax.  However, it takes a while and as soon as you
move out of this position the pain will come back.  I spent many hours
laying on the floor watching TV from this position because it was the only
thing that helped me short of drugs or a chiropractor.  Give it a try and
you should get some temporary relief.

One other trick that you need to try is to use a leg pillow at night.  This will
greatly reduce the stress on your lower back and pelvis.  Here’s how you
use it.  When lying on your back, put the pillow under your knees or
calves.  Experiment with the exact position of the pillow to see what gives
you the best results.  Then, when laying on your side, put the pillow
between your knees.  This too will take some pressure off your lower back.  

If you’ve never tried using a leg pillow, it might sound a little funny.  But,
give it a try and you will be amazed at how much it helps.

Self-Adjustment

As much as I admire, respect and recommend a good chiropractor, you
may not always need to make an office visit.  I learned how to “crack” my
own back and do an adjustment on myself.  It has been a key to my
recovery to be able to self-adjust as often as necessary.












First, there are 3 regions of the back.  At the neck are the cervical
vertebrae.  Below them is the thoracic region and at the bottom are the
lumbar vertebrae.  I’ve discovered ways to self-adjust all 3 regions but I’m
only going to discuss the lumbar region in this article.  The reasons are
that the lower back seems to be where most people have problems and
also because I feel that it is the safest method.  I don’t want to describe
something that someone might copy to hurt themselves.

To get my lower back to pop, I lie down on my back on a bed.  This
technique has never worked for me when laying on a floor.  You will
see why in a moment.

It’s also necessary to be in shorts or loose fitting clothes.  When I’m
wearing jeans, I find that they are too restrictive and I do not have the
range of motion that I need.

First, I stretch for a couple of minutes.  I lift one leg straight up as far as
possible to get a good stretch on my hamstring and glutes.  I hold my leg
with my hands and gently pull back and hold.  Then, after about a minute, I
stretch the other leg in the same way.  When I feel loose,
I’m ready to proceed.  

I never know which side will pop.  It’s a 50/50 chance so I’m going to
describe how I do the
right leg.  With my left leg flat on the bed, I raise my
right leg up at a 90 degree angle pointed toward the ceiling just like when I
was stretching.  I consciously keep both shoulders pinned to the bed and
swing my right leg
to the left.  Doing so, I twist my torso as much as
possible and my foot actually goes below the level of my body over the
edge of the bed.  That’s why this does not work on the floor.  If I do it
right and this is the side that is going to pop, I’m rewarded by a
*pop*
and I feel immediate relief from the pain.  

I find that it’s important to keep my right foot as far up toward my left
shoulder as possible.  In reality, my right foot is about even with my waist
when I swing it over the left side of the bed.  If my foot is too much lower,
say near my left knee, I do not feel enough torque on my body.

If my back does not pop - or even if it does - I repeat the process on the
other side.  I place both legs flat on the bed again, raise my
left leg and
repeat the  whole process on the other side by dropping my left leg off the
right side of the bed.  I’m sure to keep my shoulders on the bed as much
as possible.  Twisting the torso is the whole purpose.

As I do this, I find that it’s natural to hold my breath and I have to remind
myself to relax and breath.  Also, whether I get a
*pop* from my back or
not, I always hold the extended position with my leg thrown over to the
side for a while because it’s a great stretch.  In fact, I often have to do
both sides a couple of times.  The first time stretches me out and the
second time I often get my back to pop.

And, if I did not emphasize it enough, you
must relax.  I always find that I’
m way too tense when my body is fully torqued.  It takes a conscious and
purposeful effort to make my back relax.  About half the time, it’s only
after I make my muscles relax that I get the
*pop* and that wonderful
relief.

That’s it.  And, like I said, be very careful and don’t hurt yourself.  

Exercise Is The Key To Health

Once I got rid of the pain, I wanted to keep it from coming back.  The best
way to do this is to strengthen some key muscles.  Of course, it took me a
long time to figure this out and I had to pop my back over and over again
to keep it in line.  

After starting these back exercises, I discovered that I required an
adjustment less and less frequently and I think that adding the back
exercises that I’m going to describe was a key to full recovery.

There are 2 simple exercises that I’ve been doing that really help me.  
And they only take a few minutes a day.

To do the first exercise, lie flat on your back with the bottom of both feet
on the floor.  Your knees should be bent at a 90 degree angle.  The first
step is to raise your waist up so that your body makes a straight line from
your shoulders to your knees.  You will have to push your waist up further
that you might think to get a straight line.  Hold this position for about 10-
30 seconds and then relax.  Repeat a few more times.  

That’s it.  I suggest having someone else help with your posture at first to
be sure that your back is straight.

After you get good at this exercise, there is a modification that makes it
work your muscles a lot harder.  When you have your waist raised up, lift
one foot off the ground and point it straight out to make a straight line
with your back.  Hold that position for a few seconds and then switch legs.  
Don’t try this modification to the exercise unless your back is feeling good.  
It could cause a lot of pain if your back is out of alignment.

What you should feel with this exercise is not only your abs contracting
but also your glutes and lower back muscles.  The glutes are critical to keep
your pelvis tilt properly aligned. (That’s a good topic to discuss with your
chiropractor.)  The lower back muscles are obviously important to the
overall health of your back.

To do the second exercise, roll over on your stomach after you finish the
first exercise.  All you are going to do is to hold your body off the floor
supported only by your toes and your elbows.  It’s kind of like holding the
starting position for a pushup but you are on your elbows.  Keep your
back as level as possible and don’t let your waist go too high or too low.  
This exercise is called a plank and it’s awesome!  So simple but it really
makes a difference.

Conclusion

Backaches are no fun but you do not have to live in pain.  That is unless
you are unfortunate enough to need back surgery.  Please check with your
medical professional before doing any exercises or stretching.  Be smart
and be safe.

If you can manage the acute pain of back problems, that will allow you to
work on strengthening your back.  Light exercise can go a long way toward
maintaining your health and preventing pain.  Trust me, it’s worth 2 or 3
minutes a day to help prevent that kind of pain.

Don’t forget that chronic inflammation is your enemy.  Even at a low level
that you don’t even notice, it will damage your health in many ways over
time.  Please read my article on
inflammation and put out the fires of
inflammation today.

Best wishes for good health and a life without back pain.



===================================================================

March 12, 2010 Update -

I just ran across the video below that demonstrates one of the exercises
that I described.  The first exercise that they call "double leg hip lifts" is the
one I use.

It is
so much easier to understand when you see it versus reading a
description.  Check it out!  These exercises made a
huge difference for
me.  And, it only takes about 2 minutes per day.


























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Before I go on to describe how I do this, I need to make a  
clear disclaimer.  If you have any back pain, be sure to get an
x-ray or other exam to determine if you have any spinal
problems such as a ruptured disc, cracked vertebra, etc.

If that is the case, you do not want to consider doing
anything that I describe here as it could do very serious
damage.  I only popped my own back because I was sure
that it was just out of alignment.
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