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Repeated lower back issues (Read 22905 times)

Monolith

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#25 Re: Repeated lower back issues
January 29, 2014, 10:43:14 am
It's been taking me about five minutes to sit upright so I've not left the house yet. I'll have to try getting one around. Feeling marginally looser today which is a start I suppose.

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#26 Re: Repeated lower back issues
January 29, 2014, 10:55:30 am
Mate, not moving it is the worst thing you can do. Get up lie on the floor with your knees up and move your legs side to side, do some cat stretches, or just some child pose stuff, anything to get it moving.

As it is now the pain is making you tense up your back all the time, making the muscles spasm, and going into a vicious circle.

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#27 Re: Repeated lower back issues
January 29, 2014, 11:01:50 am
Monolith you've said despite drastic recent attempts to train core and lower back. Could this be the cause of the recent spate? You need to go and see someone in the know asap

My initial thought too. I get lower back problems on and off, I think most people of normal stature (6ftish or more) Have problems at some point. I know I have and my brother gets it a lot too. I have been to a physio about it and know the exercises I need to do should I feel it coming on. Get a book especially the one recommended, but I would also see a professional physio too.

I find hanging (as in straight arm deadhanging) - relaxing the back really helps. Kind of streches everything out...

I find that too. Plus, very gentle rocking side to side from the hips while doing it.

fried

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#28 Re: Repeated lower back issues
January 29, 2014, 12:07:34 pm
Mate, not moving it is the worst thing you can do. Get up lie on the floor with your knees up and move your legs side to side, do some cat stretches, or just some child pose stuff, anything to get it moving.

As it is now the pain is making you tense up your back all the time, making the muscles spasm, and going into a vicious circle.

Be careful with, gentle exercise is fine, but your back will spasm to protect the spine if your body thinks you're going to damage it.

Sloper

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#29 Re: Repeated lower back issues
January 29, 2014, 01:21:54 pm
Tall people often have difficulties around L5 / S1, hard so say as 1. I'm not a quack and 2. even if I were haven't examined you but you may have a bulging disc which occasionally compresses a nerve.

As a sufferer of back sporadic and at times spasmodic back pain over the years I would offer the following advise:

1. Rest, (but not immobilise) when you're back even feels a bit iffy (I normally get some warning signs of an eposide) just don't climb, don't do your stretches,  just have a warm bath, massage & etc

2. Do not take lots of diclofenace or other NSAI drugs, these can cause real problems with the gut and in extreme cases lead to significant gastirc bleeds (fat doc should be able to say how much is too much)

3. Do not listen to quacks, i.e. alternative medical practitioners a.k.a. charlatans, frauds and liars.

4. Do not risk 'manipulation' you only have one spine and if you really injure it it's a long way back if at all.

5. Go see a qualified orthopaedic surgeon. Listen to what they say and act on it.

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#30 Re: Repeated lower back issues
January 29, 2014, 09:48:37 pm
I have a bulging disc in my lower back (confirmed by x-ray) and this flares up sometimes (like on NYE - awesome night  :'(). Despite what Sloper says, I have had it regularly treated by an Osteopath who has done a very good job in fixing me up. To give you an example, on NYE I couldn't even stand up straight or walk very well but after one session, I was standing straight and walking much better with less pain. The risks are relatively minimal so you make the choice.

One thing - If you are training core etc - Never do any exercises which involve straightening both legs at the same time (L-sits, levers, lifts etc). These are extremely bad for anyone with lower back issues (me doing these always seems to be lead to another 'episode'- I think I've learned my lesson now). Straightening one leg at time is ok tho if you must do them.

Paul B

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#31 Re: Repeated lower back issues
January 29, 2014, 10:08:42 pm
2. Do not take lots of diclofenac

Is diclofenac actually good for anything? That stuff turned my urine into Iron Bru and made me feel nauseous the second I went near food.

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#32 Re: Repeated lower back issues
January 30, 2014, 09:25:46 am
Monolith, commiserations.

Broadly speaking, I think spines (and people) need a balance of 'stability' and 'mobility'. More stability is not the answer to everyone with back pains. It is plausible that stability exercises are not for you. It's also possible that stability exercises might be helpful but you are currently doing them in an unhelpful fashion. Leg lifts  - which you describe as a stretch  - could be a ‘stability’ or ‘mobility’ exercise depending on what you do exactly.

The same goes with dealing with flare-ups. Complete rest or pressing on regardless are both usually unhelpful.

Seeing a surgeon is not appropriate for 99% of people with back problems.

I'm fairly positive about manipulation as a short-term help. Manipulation for back pain has been around for at least 3 500 years (references in ancient Egyptian documents).  Lay manipulators practiced in the UK for millenia and are still common in developing countries as climbing in Thailand will reveal.  In the late nineteenth century this lay knowledge was professionalised, analogous to Swiss shepherds becoming climbing guides, and Chiropractic, Osteopathy and Physiotherapy came into existence.

There is no great difference between the techniques of spinal manipulation used by Chiropractors, Osteopaths, and Physiotherapist.  They are all codified versions of what had been done by lay manipulators for thousands of years.  It does not matter who does the manipulation, Chiropractic, Osteopathy, or Physiotherapy has exactly the same effect on pain and disability (UK BEAM 2004) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535455/.  I have some issues with the training and professionalism of some alternative practitioners.

Manipulation is probably effective in the short and medium term compared to doing nothing or seeing your GP.  There are some risks from manipulation, mainly to the neck, but any treatment having an effect can have a side-effect and the benefits probably outweigh the risks.  Far more people are killed by stomach ulcers due to anti-inflammatory drugs than by strokes due to manipulation.  NICE (2009) recommends manipulation as a treatment for back pain.  Edzard Ernst disagrees: http://171.66.127.115/content/99/4/192.full 
« Last Edit: January 30, 2014, 09:50:49 am by duncan »

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#33 Re: Repeated lower back issues
January 30, 2014, 09:40:51 am
Quote
Is diclofenac actually good for anything?

On the last day of a two week font trip I was disappointed to find I couldn't even warm up without screaming elbows. Pickles slipped me a couple of pills and ten minutes later I did the first and only one-armer of my life, and then climbed all day pain free. However it is killing vultures in India.

cowboyhat

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#34 Re: Repeated lower back issues
January 30, 2014, 12:53:32 pm
I had your symptoms Monolith, in my early twenties.

The sudden onset of pain and visible spine misalignment that were diagnosed as scoliosis.

The important thing for treatment was to discover and treat the cause: in my case it was (unknowingly) having a limp for about three years due to a R ankle sprain and then later a partial dislocation of the L knee.

All the while I'd been climbing and cycling as normal but with weakened ligaments in my various leg joints. Eventually it dramatically effected my back.

Apart from yoga and core work etc only when fully recovering from the leg problems did the scoliosis 'attacks' stop. This took several years.

Do you have any outstanding problems?

Sloper

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#35 Re: Repeated lower back issues
January 30, 2014, 01:08:16 pm
Monolith, commiserations.

Broadly speaking, I think spines (and people) need a balance of 'stability' and 'mobility'. More stability is not the answer to everyone with back pains. It is plausible that stability exercises are not for you. It's also possible that stability exercises might be helpful but you are currently doing them in an unhelpful fashion. Leg lifts  - which you describe as a stretch  - could be a ‘stability’ or ‘mobility’ exercise depending on what you do exactly.

The same goes with dealing with flare-ups. Complete rest or pressing on regardless are both usually unhelpful.

Seeing a surgeon is not appropriate for 99% of people with back problems.

I'm fairly positive about manipulation as a short-term help. Manipulation for back pain has been around for at least 3 500 years (references in ancient Egyptian documents).  Lay manipulators practiced in the UK for millenia and are still common in developing countries as climbing in Thailand will reveal.  In the late nineteenth century this lay knowledge was professionalised, analogous to Swiss shepherds becoming climbing guides, and Chiropractic, Osteopathy and Physiotherapy came into existence.

There is no great difference between the techniques of spinal manipulation used by Chiropractors, Osteopaths, and Physiotherapist.  They are all codified versions of what had been done by lay manipulators for thousands of years.  It does not matter who does the manipulation, Chiropractic, Osteopathy, or Physiotherapy has exactly the same effect on pain and disability (UK BEAM 2004) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535455/.  I have some issues with the training and professionalism of some alternative practitioners.

Manipulation is probably effective in the short and medium term compared to doing nothing or seeing your GP.  There are some risks from manipulation, mainly to the neck, but any treatment having an effect can have a side-effect and the benefits probably outweigh the risks.  Far more people are killed by stomach ulcers due to anti-inflammatory drugs than by strokes due to manipulation.  NICE (2009) recommends manipulation as a treatment for back pain.  Edzard Ernst disagrees: http://171.66.127.115/content/99/4/192.full

I wouldn't put much store in the evidence based on historical practice, after all medicine now is unrecognisable from medicine 200 years ago let alone 3500 years ago.

The point about manipulation is, it is not wholly supported by a proper evidence base and the degree to which it is  recommended does not have an impact on the evidence or lack thereof fc TEETH, thousands use homeopathy and other types of alternative medicine which are nothing more than placebo.

That more people die from gastric bleeds associated with NSAI than strokes caused by manipulation is again a failure to understand the concept of evidence and risk; the number of people taking NSAI's is vastly greater than the number's having manipulation and further the benefits of NSAIs are well documented as are the side effects and contra indications.  None of this can be said for manipulation.

Having a spinal maipulation without investigations to determine whether there's an underlying bony or STI is quite literally putting your life in the hands of someone who is neither medically qualified nor possessed of what would be critical information.

Treatment with >85% DBRCT evidence based response with 10-4 risk of serious untowards outcomes = rational. Treatment with <0% DBRCT evidence based response with 10-5 risk of serious untoward outcomes does not equal rational.

Yes of course a lot of people swear by manipulation, as do others for magnetic copper bracelets, trips to Mecca and so on.

Paul B

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#36 Re: Repeated lower back issues
January 30, 2014, 02:04:03 pm
Quote
Is diclofenac actually good for anything?

On the last day of a two week font trip I was disappointed to find I couldn't even warm up without screaming elbows. Pickles slipped me a couple of pills and ten minutes later I did the first and only one-armer of my life, and then climbed all day pain free. However it is killing vultures in India.

maybe I should slip TomTom my leftovers?

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#37 Repeated lower back issues
January 30, 2014, 05:39:09 pm
I have had these issues since my mid 20's. In '96 it was so bad I lost the use and sensation in my left leg entirely.
I've had four Epidurals and shit loads of Physio.

It's a CT confirmed herniated disc a L4/5.

I had an episode four years ago and that was the first in almost ten years.

It was because I'd forgotten the only thing that actually helps.

Exercise.
Specifically maintaining lower back strength and muscle mass and flexibility.

Aka... Tons of Dorsal raises.

And stretches.

Best to get a Physio to give you the programme though.

Monolith

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#38 Re: Repeated lower back issues
January 31, 2014, 12:27:03 am
I had your symptoms Monolith, in my early twenties.

The sudden onset of pain and visible spine misalignment that were diagnosed as scoliosis.

The important thing for treatment was to discover and treat the cause: in my case it was (unknowingly) having a limp for about three years due to a R ankle sprain and then later a partial dislocation of the L knee.

All the while I'd been climbing and cycling as normal but with weakened ligaments in my various leg joints. Eventually it dramatically effected my back.

Apart from yoga and core work etc only when fully recovering from the leg problems did the scoliosis 'attacks' stop. This took several years.

Do you have any outstanding problems?

This is interesting cowboy. I do have poor posture as mentioned but whether the limp people observe me to have is partially responsible I don't know. I managed to stand up and walk a little today with a day in the office sat in a chair. This was especially uncomfortable and I only really went in as I had to. It's basically locked up now unlike ever before and I'm convinced even some gentle manipulation (despite some potentially credible assertions to the contrary) might assist me. I'm basically 'C' shaped when standing.

Many others experiences here seem particularly severe and I'm keen to prevent this condition ever returning where possible. Opinions on differing treatment methods aside, I'm now convinced of the merits of yoga and/or pilates. I dread to cite Ryan Giggs as an example but his career and still existing abilities seem to attest to the usefulness of ongoing yoga practice.



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#39 Re: Repeated lower back issues
January 31, 2014, 02:55:03 am
Like I said in my earlier post - I couldn't stand up straight or walk properly until I had manipulation.

I see Sloper's post and question, if not for manipulation - what would I have done to improve? I was incapable of stretching. It wasn't just going to miraculously get better on its own. What would a GP have done in that situation? Or a surgeon?

Find and Osteo you can trust (preferably recommended by someone) and give it a go.

***Anecdotal advice warning*** I work in insurance liability claims and we cover Osteopaths, Chiro's and physios. I've yet to see a stroke caused by an Osteo or Chiro. The only one I ever saw was caused by a physio who did a manipulation to someone's neck when they were not qualified to do it.

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#40 Re: Repeated lower back issues
January 31, 2014, 09:10:06 am
Mine felt fine yesterday - then after a 70 min drive back from Sheffield it felt like shit. This morning it took 5 min to put my socks on. Rubbish.

Monolith

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#41 Re: Repeated lower back issues
January 31, 2014, 10:47:31 am
Like I said in my earlier post - I couldn't stand up straight or walk properly until I had manipulation.

I see Sloper's post and question, if not for manipulation - what would I have done to improve? I was incapable of stretching. It wasn't just going to miraculously get better on its own. What would a GP have done in that situation? Or a surgeon?

Find and Osteo you can trust (preferably recommended by someone) and give it a go.

***Anecdotal advice warning*** I work in insurance liability claims and we cover Osteopaths, Chiro's and physios. I've yet to see a stroke caused by an Osteo or Chiro. The only one I ever saw was caused by a physio who did a manipulation to someone's neck when they were not qualified to do it.

I've found a local practice who appear to be quite reputable. What you say Carnage appears to make sense with regard to an inability to stretch, hence needing to loosen up somehow. In any event, I can at least leave the house to get a verdict now.

Tom, I hear you on the sock issue. Hope you start to mend fast champ!

SA Chris

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#42 Re: Repeated lower back issues
January 31, 2014, 11:18:36 am
after a 70 min drive back from Sheffield it felt like shit

After 4 plus hours to Aviemore in the van (not the best seat) last week my back was so sore I couldn't sleep. Was lying in the back in my winter sleeping bag doing stretches to try and free it up, not the best.

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#43 Re: Repeated lower back issues
January 31, 2014, 11:20:53 am
What stretches do you do to loosen it up?

SA Chris

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#44 Re: Repeated lower back issues
January 31, 2014, 11:24:42 am
child pose, cat stretches, curling knees up to chin and rocking it, on back with knees up, lock knees together and take down to floor either side a few times.

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#45 Re: Repeated lower back issues
January 31, 2014, 11:33:19 am
Thanks Chris.

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#46 Re: Repeated lower back issues
January 31, 2014, 02:56:16 pm
Thanks Again Chris - the Child pose seems to gently stretch my back. But a couple of idiot questions to the regular back sufferers if you dont mind..

Whats the best way of sitting down! Sofa schlumping - or even upright with a supportive lower back cushion - is not comfortable.. So I've been sitting bolt upright in a normal chair (ie desk or dining chair).. this best?

Second - will deadhanging do it any harm.. I suspect pull ups (esp assisted one armers) will twist things a little but just regular deadhanging? I'm going to have to drop climbing for a few days as I think thats not going to happen easily now :(

Third - Driving. I'm going to have to drive to Hull on Monday - car is modern (11 plate golf) and pretty comfy with lumbar support - should I add to this with an additional pad (used a rolled up scarf yesterday) or leave it? Yesterdays padding felt great in the morning, but I felt really bad after it later on..

Fourth - Standing up. This feels the most comfy.. but is this doing me any harm? Should I be lying, sitting standing? crouching tiger hidden dragoning?

Sloper

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#47 Re: Repeated lower back issues
January 31, 2014, 03:12:19 pm
Like I said in my earlier post - I couldn't stand up straight or walk properly until I had manipulation.

I see Sloper's post and question, if not for manipulation - what would I have done to improve? I was incapable of stretching. It wasn't just going to miraculously get better on its own. What would a GP have done in that situation? Or a surgeon?

Find and Osteo you can trust (preferably recommended by someone) and give it a go.

***Anecdotal advice warning*** I work in insurance liability claims and we cover Osteopaths, Chiro's and physios. I've yet to see a stroke caused by an Osteo or Chiro. The only one I ever saw was caused by a physio who did a manipulation to someone's neck when they were not qualified to do it.

My point is that you should see a surgeon before you have manipulation. The manipulation may well still be placebo, but the risk of serious adverse consequences will be singificantly reduced.

PS Do you remember John Howell from the SIF days?

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#48 Re: Repeated lower back issues
January 31, 2014, 05:26:13 pm
I wonder why you think that you need to see a surgeon? Without an MRI what are they likely to tell you or do you think that everyone with a bad back should get an MRI and visit a surgeon?

Cheers Dave

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#49 Re: Repeated lower back issues
January 31, 2014, 05:48:42 pm
 :agree:

I'm glad someone said it!

 

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