Author Topic: Back pain - new guidelines  (Read 6913 times)

Wetstuff

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Back pain - new guidelines
« on: February 15, 2017, 05:46:25 AM »
In short:

"Lower back pain is one of the most frequent reasons people visit the doctor. Yet doctors are finding drugs should actually often be the last line of treatment for it. A new guideline out Tuesday from the American College of Physicians suggests doctors recommend exercise and treatments like heat wraps, yoga, and mindfulness meditation to their patients before turning to medications like opioids or even over-the-counter painkillers."


http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

Paddle on....


Jim
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kayadogg

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Re: Back pain - new guidelines
« Reply #1 on: February 15, 2017, 05:53:02 AM »
Wish Tiger would read that.

ukgm

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Re: Back pain - new guidelines
« Reply #2 on: February 15, 2017, 06:59:36 AM »
In short:

"Lower back pain is one of the most frequent reasons people visit the doctor. Yet doctors are finding drugs should actually often be the last line of treatment for it. A new guideline out Tuesday from the American College of Physicians suggests doctors recommend exercise and treatments like heat wraps, yoga, and mindfulness meditation to their patients before turning to medications like opioids or even over-the-counter painkillers."


http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

Paddle on....


Jim

In my experience, if a problem flares up, stretch hamstrings, pelvis and glutes intensely for a week or two and see where you're at. I find that often removes the problem (as its tight imbalances that generally cause it - not the back itself).

stoneaxe

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Re: Back pain - new guidelines
« Reply #3 on: February 15, 2017, 07:32:30 AM »
My back is screwed. My physical therapist told me he hadn't seen anyone with a back as bad as his own but that mine was worse. The therapy he did and that I continue to do has worked great but I did need some cortisone injections initially to make it possible. I refuse to use opiods....maybe someday when if I make it to 80 i'll reconsider.
Bob

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Night Wing

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Re: Back pain - new guidelines
« Reply #4 on: February 15, 2017, 09:16:43 AM »
I've got lower back problems.

Before I got into standup paddleboarding, I had sharp lower back pain. My orthopedic surgeon suggested I get into supping since he thought this would alleviate my sharp lower back pain. He made this suggestion since he (and I) wanted to avoid surgery since surgery doesn't always work.

Since I've been supping, my sharp lower back pain has morphed into a dull ache so I know supping is working for me. This is why I'm waiting for the warm air and water temperatures so I can get back on the water.
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Area 10

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Re: Back pain - new guidelines
« Reply #5 on: February 15, 2017, 09:49:38 AM »
Opioids just make your back worse IMO because they relax the muscles around the injury leading often to an exacerbation of it. I think they should be used for only very special and serious situations acutely - the kinda thing needing almost immediate surgery - and not for the 95% of back problems in middle aged men which are largely muscular in origin.

So if you have the average middle-aged man chronic back problems (rather than some serious traumatic injury) my advice after a couple of decades of dealing with one is to keep moving as much as the pain will allow. Drugs don't work. Static rest doesn't work. Physiotherapy and stretching and keeping moving works. As BB King sang: "keep the hammer down, keep it full speed ahead".  Back problems in
Middle aged men are so common that it's almost a rite of passage. Later in life the problem tends to go away of it's own accord, so that's one of the few benefits of getting older.

deepmud

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Re: Back pain - new guidelines
« Reply #6 on: February 15, 2017, 10:06:42 AM »
Low back pain since my 20's - likely from doing dumb things like putting all the free weights that my school had on the bar and doing squats just " to see how much I could do" :(

I'm pretty sure it's soft tissues - mostly - and kayaking - proper, not using your arms, rotating your waist - was really the first thing that ever helped PREVENT and treat the pain. Usually, dull ache, then one day I'd "move wrong" and be totally seized up for a few days. During one episode about 10 years ago I finally got a good PT - but it only helped  - kept me out of that seized condition for a couple years - then I saw  - on Youtube :D - how to paddle correctly - and it happens to be THE BEST THING for me. SUP is good too - really builds my lower back strength, but that "power-rotate-pull" of rotating my core against resistance - that is the ticket.

Of course, can't kayak OR sup all winter. I just this last fall figured how to duplicate the lower back workout. I have to do it EVERY Evening - and most evenings, or I start to lock up. If I try to skip it, I can't even put on my socks without "that ol' twinge" in the lower back.

I'm giving all this in case it helps somebody else :D - bear with me.

I have a 65cm excercise ball - I get in a cheater-pushup position - kneeling on the ball, hands on the floor -rotate your knees to the side - your hips will drop, still inline with your shoulders - now rotate, using your back  (this is the part that replicates kayak "pull/twist" in the core) your knees back under your hips - and to the other side. Both side equals 1 rep - 50 reps will let me put on  my socks and feel good all day. 100 reps will do a number on your abs - I can't do more than about 125 in a row - I'm still 280+ so your mileage may vary.

**I looked for pics/vids again to show what I am doing  - this morning - this Pinterest comes pretty close to it.

https://www.pinterest.com/pin/542261611354622291/

This plus some of "arching" exercises will have my back ready for this spring - now if I can just get below 270 and fit my drysuit more comfortably I could get out there sooner....


Bulky

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Re: Back pain - new guidelines
« Reply #7 on: February 15, 2017, 10:52:48 AM »
I did the same thing as deepmud when I was a teenager.  Developed big shoulders, chest and arms but underdeveloped other areas and got a pretty pronounced curve in my back.  In my early 20s I had some bad episodes and MRIs were a relatively new thing (1991).  Doc saw a herniated disc and surgery was an instant decision.  Fixed things but probably about a year of recovery.  10yrs later, same pain on the other side.  Got an MRI showing herniated discs but this time the doc said, "we wouldn't do surgery because you walked in here."  Approach had changed significantly and PT is a more likely first response.

It took me several years for it really to sink in.  I was undisciplined and not in great physical shape.  Things would flare up during extended sedentary seasons.  Finally got in rhythm with a good PT who gave me a series of exercises I would do every morning and night.  Somewhere along the line saw somebody on a SUP and realized he was doing a lot of what I was paying $30 a PT session for.

I have to say, SUP has made for a happily ever after ending.  I might get very occasional episodes where I'd describe my back as "tender" but my regular paddling has made it so that I don't even need to do the morning exercises any more.  So much of back pain for me has been connected to lack of general physical tone which SUP is great for.  I'd much rather be on the ocean than rolling around on the carpet before dawn.
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stoneaxe

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Re: Back pain - new guidelines
« Reply #8 on: February 15, 2017, 12:45:30 PM »
My pain is caused by a couple of herniated discs and synovial cysts. I'm very happy with how it's turned out...I was really concerned initially because of family history but exercise and just pushing through some pain has changed it dramatically. I have some minor discomfort and some occasional twinges but other than that its good.

I've had similar experience in my neck...herniated and extruded disc there about 20 years ago...lost most of the function of my left arm...extreme pain....neurosurgeon said my option was surgery or wait and see if it resolved itself......5 weeks later the pain and weakness was mostly gone (like someone flicked a switch...one day it was just gone) just because I sat around and let my body do what it had to do. I do still have some issues occasionally...last winter/spring it flared up...but still better than surgery. At the time it happened I was considering options, my niece...a nurse...told me of her patient who is a quadriplegic because of the surgery. That made my decision pretty easy and I'm very happy I just waited it out. Now with my back all I have to do is look at my sister who has had multiple operations for issues similar to what I have now and had some of the best docs around doing them....and she is all but crippled from them....no thanks.

Weights, sports, and a life full of adventures and challenges....I guess we are paying for our fun...and stupidity when we were young. Being big only makes it worse...I was always crazy strong but I don't think the additional strength in muscles that size brings is matched by additional strength in joints and especially the soft tissues in between. I always used to max out all the stations on the universal at my high school...the thought of it hurts now....and pretty sure my neck problems result from an old waterskiing crash into the beach.... :o

All this is still better than dead so we have that going for us..... ;)
« Last Edit: February 15, 2017, 01:02:36 PM by stoneaxe »
Bob

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connector14

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Re: Back pain - new guidelines
« Reply #9 on: February 15, 2017, 01:12:12 PM »
"Weights, sports, and a life full of adventures and challenges....I guess we are paying for our fun...and stupidity when we were young."

I think you nailed it. Oh what I wouldn't give to go back to my youth knowing what I know now about proper exercise and diet. Now as I slip into retirement my "job" is to get into the best shape I can from diet and exercise so that I can still enjoy some of the sports and adventures that may lie ahead. If you don't have your health,  you really can't enjoy life....no matter how much money you may have. ;)
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deepmud

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Re: Back pain - new guidelines
« Reply #10 on: February 15, 2017, 03:05:51 PM »
I have to do it EVERY Evening - and most evenings, or I start to lock up. If I try to skip it, I can't even put on my socks without "that ol' twinge" in the lower back.

"Every Evening - and most MORNINGS."


Admin - I could sure use a bit more time to fix mistakes on my posts - maybe only lock us down on the Political posts :D -

dave808

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Re: Back pain - new guidelines
« Reply #11 on: February 15, 2017, 04:38:06 PM »
Look into Foundation Training. Amazing stuff. Super easy to do and incredible results.

Wetstuff

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Re: Back pain - new guidelines
« Reply #12 on: February 17, 2017, 10:02:36 AM »
10... You're obviously not there yet: "Later in life the problem tends to go away of it's own accord, so that's one of the few benefits of getting older.In your dreams...

Maybe if you're 40 ..50/60 looks later.  Push the needle a good bit farther and closeouts come mas rapido.  I have a lady who works for me on 20+ pills daily. ..I'm just trying to get her to Medicare because BC/BS is whacking her with an $850.monthly insurance payment and a $11k total, deductible. (husband is already on MC ..but collectively make too much money to get into 'Affordable Care Act')

The issues you have when you are 40 are ones you wish you could go back to.

Jim
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ninja tuna

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Re: Back pain - new guidelines
« Reply #13 on: February 17, 2017, 12:02:20 PM »
Just curious if any of you guys have looked into Original Strength by Tim Anderson and Geoff Neupert.   I ruptured my L5-S1   years ago and have strengthened it back now.  I have been following his exercises for a few weeks now and they have seemed to be loosening me up in a good way.  Hope I can explain this correctly.  Basic concept is the X across our bodies and strengthening it via the way we did as we grew up from infants using head nods, rolling and crawling.  He has a youtube channel where he puts up explanations, demonstrations, and extra exercises.  The book was only a couple of bucks and you can read it pretty quick.

Area 10

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Re: Back pain - new guidelines
« Reply #14 on: February 17, 2017, 12:27:14 PM »
10... You're obviously not there yet: "Later in life the problem tends to go away of it's own accord, so that's one of the few benefits of getting older.In your dreams...

Maybe if you're 40 ..50/60 looks later.  Push the needle a good bit farther and closeouts come mas rapido.  I have a lady who works for me on 20+ pills daily. ..I'm just trying to get her to Medicare because BC/BS is whacking her with an $850.monthly insurance payment and a $11k total, deductible. (husband is already on MC ..but collectively make too much money to get into 'Affordable Care Act')

The issues you have when you are 40 are ones you wish you could go back to.

Jim
Yeah, what I meant was that the muscular pain that is so often a cause of lower back pain in early middle-age men can improve as you get older because of changes in flexibility that go on in your back as you age. But you are right, as you go from young-old to old-old, the possibility of pain from something else altogether - degeneration - increases.

 


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