Lower back disc pain

[IBen]

Which stretches do you guys recommend?

Calf stretch on a slant board. Learned from Ben Patrick 90 seconds each side for a total of 9 minutes

 

[HandgunHTR]

This is false and dangerous information.

How exactly is it wrong and how exactly is it dangerous?

Are you implying that surgery is dangerous? Exactly how many back surgeries have you had? Do you have a medical degree or spend any length of time with someone who does and specializes in spinal orthopedics?

 

[WCB]

and plenty of sex which is always good for back.

I think that's how I got my back problems

 

[307]

How exactly is it wrong and how exactly is it dangerous?

Are you implying that surgery is dangerous? Exactly how many back surgeries have you had? Do you have a medical degree or spend any length of time with someone who does and specializes in spinal orthopedics?

It's simply false. The vast majority of disc herniation resorb on their own, absent any surgical intervention. Look at the literature.

False beliefs lead to unwise decisions. Back surgery should be used as a last resort. If any person believes that it's the only option for a disc herniation, they're less likely to follow a current evidence based care model. Current evidence emphasizes conservative care (P.T., Chiro, exercise, etc.) and self management as most likely to lead to a favorable outcome in most cases.

 

[Wingnutty]

It’s false because your statement isn’t true. I’m walking, pain free proof of it. It’s common knowledge that discs can heal and calcify over time.

 

[PTArcher1]

I think the best thing for back pain is to get stronger. A stronger back will be just that, stronger, and less susceptible to injury. People with back pain shy away from exercises like deadlifts when that is what they really need to be doing.

I really wouldn't even bother with stretching, it hasn't really be shown to heal or prevent injuries but it might feel good. If you enjoy doing it then have at it but it probably won't be that useful, especially compared to strength training.

I'd also caution against imaging. Lots of asymptomatic people have bulging discs when imaged and it's not actually an issue. After seeing it on the imaging they nocebo themselves into thinking they have an issue though. It's similar to a meniscus tear. A whole lot of people have a tear in their meniscus but have no clue. If they get an MRI and find out, they likely will start experiencing knee issues when nothing has changed except their perception.

Chiros and PTs are mostly a waste of time unless they focus on strength training. Most chiros are complete quacks with no meaningful training and most PTs don't utilize an evidence based approach.

Here's a good article about an approach to back pain:

Navigating Potholes: My Back Pain Experience

And for when you are strengthening your back, this is one of the best articles you can have in your back pocket. Training with an injury is not nearly as complex as people make it out to be but at the same time, it's important to take an intelligent approach. The key is finding an entry point where you can still elicit a training stimulus but without causing more pain. Then you can start to add to that as you're able, eventually back to full strength.

Pain In Training: What Do?

I have dealt with a myriad of injuries over the years, hip, knee, elbow, and wrist being the majority and when I started taking the approach of the articles above I have been in the least amount of pain for most of my adult life. I used to stretch for around an hour a day and do all sorts of "corrective" exercises I either got from a physical therapist or found online and now I just focus on getting stronger with intelligent progression, while adjusting my routine (but not resting) if I tweak something.

Skywalkr, you make some very valid points and I agree with much of what you posted. However saying
"Chiros and PTs are mostly a waste of time unless they focus on strength training. Most chiros are complete quacks with no meaningful training and most PTs don't utilize an evidence based approach."
diminishes your credibility. There are many good PT's and Chiro's out there that assist people in controlling and eliminating their back pain on a regular basis. Sorry if your experience has differed but disparaging professions has little value.

 

[Geardo]

Just to toss another option out there.

My doctor recommended a counter-strain PT therapist, and that guy is a damn magician. PT can’t usually immediatly fix some issues, but the first time I saw him he bent my leg over my head and jammed his thumb in my back and the pain disappeared instantly and stayed gone.

I agree with others that once you have a back injury or pain it will be constant work to keep it away. I’m 32 and not overweight and have dealt with it for the last year or so.

 

[co_archer]

Stretch, stretch and then stretch some more. Drink tons of water. Oh and stretch! If you have gone to a doctor/chiro and are sure that there isn't some sort of underlying injury, spend time in the gym focusing on moves that strengthen your back. Things like deadlifting when done with proper form can actually be great for your back, but you really have to do it right. Otherwise it can do the exact opposite.

I recently when to a chiropractor and had x-rays done because I have also had issues with lower back and lumbar pain, and he told me that I have a spina bifida. I always thought that spina bifida was a major spine problem and a singular disease. Turns out it can be minor or major and I have two spina bifidas in my lower verterbrae that means they never closed properly. What this means for me is that the normal gap between my vertebrae is much more compressed than it should be, meaning it's way easier for me to pinch nerves and throw out my lower back. The more ya know!

 

[skywalkr]

Skywalkr, you make some very valid points and I agree with much of what you posted. However saying
"Chiros and PTs are mostly a waste of time unless they focus on strength training. Most chiros are complete quacks with no meaningful training and most PTs don't utilize an evidence based approach."
diminishes your credibility. There are many good PT's and Chiro's out there that assist people in controlling and eliminating their back pain on a regular basis. Sorry if your experience has differed but disparaging professions has little value.

Considering the entire "chiropractic medicine" practice is snake oil and not evidence based I have no problem disparaging the profession. There are actually some good chiros out there but they do not practice chiropractic care like spinal manipulation, they simply got their degree to have access to patients and then follow an evidence based approach.

There are far too many physical therapists that practice outdated techniques and are not evidence based so picking one at random is not an effective strategy. Lots of physical therapists are good at their job but if the OP is seeing one who does not utilize strength training then it is an utter waste of time and money because whatever stretches or manual manipulations they will do don't have the evidence behind them to show they are worthwhile.

The rehab world is full of charlatans and snake oil, I'd rather the OP spend his time and money wisely instead of wasting it on ineffective and potentially dangerous treatments.

 

[307]

Considering the entire "chiropractic medicine" practice is snake oil and not evidence based I have no problem disparaging the profession. There are actually some good chiros out there but they do not practice chiropractic care like spinal manipulation, they simply got their degree to have access to patients and then follow an evidence based approach.

There are far too many physical therapists that practice outdated techniques and are not evidence based so picking one at random is not an effective strategy. Lots of physical therapists are good at their job but if the OP is seeing one who does not utilize strength training then it is an utter waste of time and money because whatever stretches or manual manipulations they will do don't have the evidence behind them to show they are worthwhile.

The rehab world is full of charlatans and snake oil, I'd rather the OP spend his time and money wisely instead of wasting it on ineffective and potentially dangerous treatments.

Back pain patients are so multifactoral that it becomes a major challenge to capture effective treatments across larger populations. The literature only cares about large sample size, but each patient really only gives a damn about n=1.

A highly individualized approach including biopsychosocial aspects is necessary. Back pain treatment is far more of an art than we'd like, but I think your position is too extreme.

I'll agree with you on a large number, maybe even a majority of practitioners and treatments are to be approached with caution but to cut broad swaths as "snake oil" or "outdated" is unnecessarily harsh.

 

[Deepwoods]

Same situation as OP. I am 35, in great shape and work out almost every day to some degree. I have been hard on the body throughout life but have been blessed to avoid any major injuries. I raced dirt bikes, mountain bikes, water skied, ran and just played hard in general. These days my back requires daily exercise to prevent injuries from actions like throwing on a heavy backpack or lifting something incorrectly. I have learned to proceed with caution on most tasks and not over do anything if I notice irritation. Wisdom with age I suppose. The best thing I ever did was finally see a qualified chiro with a sports medicine background. He quickly found that my sacroiliac joint was tilted from some previous abuse. This is common in athletes. It causes excess strain on muscles and nerves in a broad general statement. Two sessions of setting the joint and following the recommended exercise for two months, I was back in action, I only wish I had done the treatment sooner. Now I rarely skip a day of back stretches and workouts. Workouts include yoga poses and planks. mostly. I do a lot of time under tension to keep the muscles surrounding my lower back in shape. Best of luck in your recovery!

 

[skywalkr]

Back pain patients are so multifactoral that it becomes a major challenge to capture effective treatments across larger populations. The literature only cares about large sample size, but each patient really only gives a damn about n=1.

A highly individualized approach including biopsychosocial aspects is necessary. Back pain treatment is far more of an art than we'd like, but I think your position is too extreme.

I'll agree with you on a large number, maybe even a majority of practitioners and treatments are to be approached with caution but to cut broad swaths as "snake oil" or "outdated" is unnecessarily harsh.

Fair enough, I agree with your basic assessment. I will always think chiropractic adjustments is pure snake oil though. Unless the research one day reverses that thinking but currently there is nothing to suggest anything of the sort. The placebo effect is one hell of a drug though.

 

[Eldoradotim]

Welcome to the club. 41 here and first started having lower back/bulged disc problems about your age.

I agree with skywalkr. Here’s the deal: everyone is going to have back pain at some point. You know what helps back pain? A strong back. I don’t know what kind of workouts your doing, but you want to help your back? Squats, and then some more squats.

Barbell squats and deadlifts make you (and your back) stronger, period. Any time I‘ve had a layoff from lifting, back pain has crept in. Start the routine again, totally goes away.

Start squatting if you’re not. Check out the Starting Strength website/book/training program.

 

[Ross]

My own little tale…like most men we feel some pain we deal, try to work around overcome and then improve…I had a low back issue for over a decade, would come and go, pt could not help they actually recommended a chiro..he helped would only see when had pain couple times a yr..always in shape workout junky maybe to detriment in past….June 2018 little hike I do often small pack 25 pds coming out of hole feel tingling in right leg think hammy….over next couple days about gone but still odd feeling…month later another light pack hike tingling worse and next day can’t sit and worse sciatic pain I learn quickly….things escalate quickly can’t sleep see people mri shows severe l5 s1 extrusion from my fun life tell surgeon get me in quick pain scale off chart…immediate relief after surgery…now always work in progress have strengthened the shit out my ass, learned neutral spine and all other things I did not pay attention to…could this have healed on its own maybe and I could win the lottery…there are times surgery is best option and quick…get opinions what is pain scale mri how long dealing with many variables, but like a recent knee post give it your best pain does not go away make wise decisions and NO One wants sciatic pain…I have plenty of other pain and many surgeries nothing like this electric pain that does not shut off…my MRI and what they cut off That was pinching on the never. I can’t pack 100 plus pounds anymore but 60ish is ok,…good luck to anyone dealing with this or any other issues it sucks but there are options to help ps when I look at my elk racks I cuss everyone of them

 

[Wapiti66]

I’m in the same boat as many of you, 37 and active, fought back pain most my life and it’s gotten worse the last couple years. Finally done the mri to learn the source of pain…a couple herniated disc, degenerative disc, and arthritis. I’ve done some epidural shots when I was 19 and recently done another. It definitely helped numb the pain so I can start strengthening again. Done chiro through out the years with mixed results depending on what’s “out”. started PT with specific stretches and strengthening exercises and am still improving. Gonna use some of the exercises posted here and try to heal these disc without the knife first. As said before get the MRI and learn the source of pain, severity, and any exercises should be specific to injury. Great thread and info considering most guys on here with back issues have similar goals in putting heavy packs on and hiking into or out of the mountains.

Also Ross, of all the pics of back straps ive seen over the years on this forum yours is the first human variety posted so congrats….looks like it’d require some marinade to tenderize

 

[WCB]

NO disc issues for my specifically but borderline severe bone decay in the majority of my back/neck and my neck was curving the wrong direction. Chiro saved me from having to have surgery so far. First question he asked me was "Do you want to fell better or get better. Because I can get you relief from the pain but it wont really help the problem or we can fix you back the best we can"...Being very active in my life and playing high level competitive sports this was nice to hear. I always liked to hear the trainer or PT explain what happened, how it happened, why it happened, how to prevent it from happening again.

The only reason I go back to him now is when I am slacking on my end of exercise and stretching. Whoever says stretching doesn't do anything is fooling themselves. my appointments are kind of like little kicks in the ass.

 

[307]

Unless the research one day reverses that thinking but currently there is nothing to suggest anything of the sort.

Spinal manipulation is certainly no "magic bullet" but to say there's nothing to suggest any support for its use in the literature is a bit beyond the current evidence IMO.

Spinal Manipulation for Subacute and Chronic Lumbar Radiculopathy: A Randomized Controlled Trial - PubMed

Spinal manipulation improves the results of physiotherapy over a period of 3 months for patients with subacute or chronic lumbar radiculopathy.

pubmed.ncbi.nlm.nih.gov

The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis - PubMed

Spinal manipulation may be an effective therapeutic technique to reduce migraine days and pain/intensity. However, given the limitations to studies included in this meta-analysis, we consider these results to be preliminary. Methodologically rigorous, large-scale RCTs are warranted to better...

pubmed.ncbi.nlm.nih.gov

Spinal manipulation and exercise for low back pain in adolescents: a randomized trial - PubMed

Low back pain (LBP) is common in adolescence, but there is a paucity of high-quality research to inform care. We conducted a multicenter randomized trial comparing 12 weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) to ET alone. Participants were 185 adolescents...

pubmed.ncbi.nlm.nih.gov

Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis - PubMed

Among patients with acute low back pain, spinal manipulative therapy was associated with modest improvements in pain and function at up to 6 weeks, with transient minor musculoskeletal harms. However, heterogeneity in study results was large.

pubmed.ncbi.nlm.nih.gov

Spinal manipulation plus laser therapy versus laser therapy alone in the treatment of chronic non-specific low back pain: a randomized controlled study - PubMed

Spinal manipulation is an adjuvant intervention and it can be applied in every day clinical practice.

pubmed.ncbi.nlm.nih.gov

 

[magtech]

7 herniated or bulged discs DD, stenosis, etc. I hurt everyday. Stood too long today and legs started going numb. Drive too long my left arm goes numb and cramps up. Try to wear a helmet my neck cramps up and creates fissure pain in my skull.

Does it suck .. yup
Does any one get why I'm so testy, nope.
Do my kids care and not jump on me when I'm in pain. HA!

Worst part is that working out is a time bomb. It's great until something gets aggravated, then 2-6 more months to convince myself to try and get in shape again.

FYI, tearing a rib from your sternum isn't fun either.

 

[blackdog of vt]

My own little tale…like most men we feel some pain we deal, try to work around overcome and then improve…I had a low back issue for over a decade, would come and go, pt could not help they actually recommended a chiro..he helped would only see when had pain couple times a yr..always in shape workout junky maybe to detriment in past….June 2018 little hike I do often small pack 25 pds coming out of hole feel tingling in right leg think hammy….over next couple days about gone but still odd feeling…month later another light pack hike tingling worse and next day can’t sit and worse sciatic pain I learn quickly….things escalate quickly can’t sleep see people mri shows severe l5 s1 extrusion from my fun life tell surgeon get me in quick pain scale off chart…immediate relief after surgery…now always work in progress have strengthened the shit out my ass, learned neutral spine and all other things I did not pay attention to…could this have healed on its own maybe and I could win the lottery…there are times surgery is best option and quick…get opinions what is pain scale mri how long dealing with many variables, but like a recent knee post give it your best pain does not go away make wise decisions and NO One wants sciatic pain…I have plenty of other pain and many surgeries nothing like this electric pain that does not shut off…my MRI and what they cut off That was pinching on the never. I can’t pack 100 plus pounds anymore but 60ish is ok,…good luck to anyone dealing with this or any other issues it sucks but there are options to help ps when I look at my elk racks I cuss everyone of them

Been there, three at once. Good to hear you are on the mend. Like you my pain was mostly gone right after surgery. Gave me a new(er) life. Like I said before, I will never not take agmatine now, bpc 157 and deca when I do something dumb but otherwise living a much better life. Sucks because at the time I had two small kids and my wife traveled for work. So, there was me crawling on the floor taking care of two toddlers. Couldn't pick them up and could barely walk so it was quite an adventure.

 

[Eyeman]

So a question for you guys that use the inversion table/rack.
How often do you use it and for how long.
I use mine when needed and for about five minutes.
Curious to see if I should use it more?