Thursday, July 30, 2009

Newsletter: Back pain, part 1

This will be a multi-part newsletter regarding back pain. It will include injury complexes, diagnosing, the experience of back pain (back pain existentialism), back pain and the physician response, multiple treatment options, physical therapy, and finally, living with back pain and the very practical means you can follow to decrease -or even eliminate- the pain completely! But first:
One morning, you get up out of bed, a little tight but nothing you haven't experienced before, and head to the bathroom. On the way you decide to put your slippers on, but seem to be struggling with one of them, so you bend over to straighten it out. Then it hits you. Wham - an incredible shock wave of searing pain emanating from your lower back and heading down your legs. You cannot move. Even the thought of moving causes more searing pain. You wait for it to subside, and in the meantime, while bent over, you ask yourself,"What did I do to deserve this? How did this happen? I went running, but that was over 4 days ago, and I haven't done anything since!" The pain starts to wane a bit, and you chance a move - one that will get stress off your back. You head to the floor, knees first, then hands. You think you have made it, crouched on all fours on the floor. You figure that if you can at least hold this position, maybe the pain will go away completely because it seems to be getting better (and you remember from some book, infomercial, trainer friend - can't remember the source specifically while concentrating on breathing through the pain - that getting to the floor, flat on your back, may be the best thing for you). And so you try. You begin to lay down on one side of your body and wham -there it is again! An immobilizing, tear producing, searing pain that feels like someone stuck a knife in your lower back and thenattached electical cables to both your legs and plugged you in. Fortunately, you fall over anyway and there you are, on the floor, on your back. It is here -in this position- that you realize that you are not infallible, that you cannot do everything, and that maybe, just maybe, your way of life -the path you have been following - may be the wrong path. You wonder if you will ever get up again. You wonder...what's next?
Elite athlete, weekend warrior, working professional just trying to get in shape, new mom, and more...all have gone through this experience. Some experiences are a little different than others, some more painful than others, but the tearing of lower back (multifidus, erector spinae, quadratus lumborum) muscles, their ensuing seizing, and the compression of lumbar spinal nerves generally can be traced through this experience.
Why did it happen?
Some sort of stressor had to exist, such as a workout, a bad fall, or long days at the office, coupled with the following:
1) overexertion of lumbar muscles
2) tight hamstrings during a stressful workout that includes long strides (sprinting, stairs, etc.)
3) weak lower abdominals
4) tight, or strained, psoas (hip flexor)
5) tight lower back muscles
6) improper technique when lifting, or bending over
7) weak glutes
8) bad posture when sitting at work
9) loose joints resulting from hormonal changes (new moms)
10) poor eating habits (weakens the body)
11) being overweight
12) high stress levels
13) weak, or injured knees
14) tight hips
15) recent ankle injury
16) Other

I've seen one - and in rare cases, even all - of these triggers lead to back pain. It is inevitable if nothing is done to correct the trigger.
What do you do about it? Diagnosing the problem is the first step to recovery, and that will be the topic of the next newsletter.

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