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Ask Doctor LJ: Back pain - Nathan
November 7th, 2008
02:48 pm
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Ask Doctor LJ: Back pain
Somewhere in August, either while packing for the move or while moving, I hurt my back. I probably lifted something badly. I don't remember noticing it happening at the time; I was probably too busy. After the dust of moving had settled, though, I started noticing this ache on one side, fairly localized. It doesn't spasm, and it's not really at the level of preventing me from doing specific motions - though I have refrained from going to the gym, out of fear of making it worse.

A month or so later and it's not really better. The ache comes and goes, reappearing more if I do much (any) lifting or even just standing/bending for a while (like cooking in the kitchen). Sometimes it's present in the morning when I wake up, too. I still haven't found specific acts that make it hurt right at the moment; it's always something I notice a bit later. OTC painkillers have a mild effect, but Advil does not seem like it should be the breakfast of champions.

I'd sort of like to know what I did to myself. But the real question is this: is it worth seeing a doctor about it? I suspect that going to a doctor will yield no more diagnosis than I have now and some directions to not overdo it and wait, which I'm already trying to do. I also suspect that if I call now, I will get an appointment some time next March, which doesn't exactly inspire me to hit the phones (Darkly, I also suspect this is my body telling me "Welcome to your 30s", and that it's a lifetime of chronic pain from here on in).

What say you, unprofessional back-pain specialists of the Internet?

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From:lindalee
Date:November 7th, 2008 07:58 pm (UTC)
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Speaking as someone who has serious back problems since I fell through the raised floor at the Media Lab back in 1988...

You might try a reputable chiropractor. If you've got something out of alignment, you'll just have ongoing problems until it gets put back into place...and sadly, if this is what's going on, the regular doctor will be of no help at all, and will likely do no more than offer you a prescription for ibuprofen and send you on your way. Ask me how I know. :-(

I see Candace Maddalo in Cambridge, near the corner of Cambridge Street and Third Street. She is really, really good, somewhat gruff, and not at all fluffy-flaky (which some chiropractors are). The phone number there is 617-547-4444, and if you go, tell her I sent you, etc.
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From:alethia_juturna
Date:November 7th, 2008 08:16 pm (UTC)

Welcome to your 30's!

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People swear by chiropractors. They didn't help me AT all. No change in my back.

Yoga.
Yoga.
Yoga.
Posture (suck your belly button into your spine)
Posture (suck your belly button into your spine)
Posture (suck your belly button into your spine)

Not doing stupid stuff like I used to be able to do while lifting.

*hug*
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From:lindalee
Date:November 7th, 2008 08:33 pm (UTC)

Re: Welcome to your 30's!

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Part of the problem with chiropractors, as a larger group, is that some of them believe that chiropractic care can cure all ills, bring about world peace, and cook your breakfast for you. It can't, of course, but it can help certain types of back problems, which might in turn also have a positive impact on certain other peripheral things.

I think that one of the biggest challenges with chiropractors (or any sort of doctor, really) is to find one that's willing to tell you when the problem you have is not among those that they are able to solve. I am so glad that I've ditched the chiropractor who wasn't willing to say that, in favor of one who is.

As for my back problems, I know intellectually that I do better when I alternate chiropractic adjustments with massage. Do I do this? Rarely.
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From:fyfer
Date:November 7th, 2008 08:21 pm (UTC)
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Physical therapy can be surprisingly effective. I hurt my shoulder and it didn't seem to get better on its own. I went to a doctor, worried that I'd torn something serious. He sent me to PT, where they said that it's just all the little muscles that overcompensated for the original problem and were now stuck in a screwed-up state. One PT visit with various painful massage and stretches, and it was mostly better.

Also, for what it's worth, I have fewer chronic joint problems now than when I was 21. I don't think you're doomed to a life of chronic pain just yet, but things do take longer to heal.
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From:foldedfish
Date:November 7th, 2008 08:43 pm (UTC)
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I hurt my back a few years ago due to no specific trauma. My condensed advice:

* yes, this is your body getting older. Welcome to your 30s. That said,
* physical therapy helped. Go see your doctor.
* 'cos really, any time you have two months of pain, you should see your doctor!
* I also saw a chiropractor, which was a waste of money and time. Physical therapy was far, far more helpful.
From:alethia_juturna
Date:November 7th, 2008 08:50 pm (UTC)
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Snap to that - Sally swears by PT for her stuff as well.
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From:awfief
Date:November 7th, 2008 10:24 pm (UTC)
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This question is akin to "What should I do to lose weight?" Different strokes for different folks.

If you have a doctor to whom you can say "I've had this back pain, it's not going away, I don't want to be on painkillers all my life" and think that doctor can help you, so be it.

Everything depends on how good the person you seek help from is, combined with how readily you follow their advice, combined with how readily you can communicate with each other. Given that you're a pretty together kinda guy, I would say what you really need is a clear diagnosis and understanding of what you need to do. Ie, is it muscle strain? Sprain? do you need to strengthen it or leave it alone?

That being said, things people swear by, and how it might help you:

Physical therapy -- basically the right kind of exercise. Stretches, crunches to strengthen the other site, whatever.

Yoga -- see Physical Therapy. ;) Also, yoga can relieve stress, which your body may be storing in the form of "well, this part's already in a knot, let's just add more!"

Chiropractor -- One or more of massage, realignment, heating pads, etc. They might also give you exercises to do at home.

Massage -- Stress reliever, plus might actually help the problem. Might hurt it too, hence the comment that you want to know what's up.

Acupuncture -- don't know why it works, but it seems to for many.

Reiki -- ditto.

So I would pick something on the list, pay attention to what part of that makes your back seem better or worse (and what terms they are -- PT may hurt more immediately but the next day or 2 feel better). If it's not working, try something else.

Given your scientific mind and reasoning abilities, I'd suggest starting with PT. They'll be able to show you pictures of muscles, explain what they believe is wrong, and explain why they believe their suggestion(s) will help. If it's not helping in the way(s) they say....
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From:nathanw
Date:November 7th, 2008 10:56 pm (UTC)
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Yeah, I'm still in an information-collecting phase. I have no doctors, physical therapists, chiropractors, masseuses, or other that I have a relationship with - even my PCP is someone I've seen for a total of ten minutes in the past six years, and those ten when I wasn't having any problems. So anyone I go to is going to be an unknown quantity in terms of my trust in their ability to help.

PT does seem to be the growing consensus here, so I think I should start the wheels of the insurance-industrial complex moving in that direction.
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From:chenoameg
Date:November 8th, 2008 01:05 am (UTC)
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Yeah, you can usually get your doctor to refer you to a physical therapist but sometimes you have to suggest it to them.

I'm another on the physical therapist bandwagon.
From:gmpe
Date:November 8th, 2008 01:08 am (UTC)
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The right therapy can work miracles. A chiropractor or osteopath can help you figure out what the injury or cause of pain is. An osteopath is also able to prescribe medication and physical therapy, not just offer adjustments and massage like a chiropractor. (I just found about about this field of medicine because it's what our babysitter's father does. I don't actually have a recommendation for one, but it does sound like a sensible step for back pain.) We use Medford Chiropractic on Main St. in Medford. We have also both used Spaulding Rehab in Medford for spine/back pain help. The people there are phenomenal and that branch specializes in back care, among other things. You will need a prescription from a doctor for that.

If things are out of whack, the chiropractor will help. PT will help reduce pain by strengthening the supporting muscles, as well as the impacted muscles so that you will be pain free long term.

Back pain sucks. I hope you are able to resolve it soon.
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From:ghudson
Date:November 8th, 2008 03:45 am (UTC)
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I also hurt my back while lifting something (I was helping someone move, and I lifted a box containing a TV out of a car trunk, which is a tough lift to do with one's legs), and have had lower back problems ever since.

My mother sent me a book about exercises for back pain, which I can't find or precisely name at the moment, unfortunately. It said that there are many, many different causes of back pain, some of which are nigh impossible to diagnose, and no form of care can be relied on to work, but that exercises to strength relevant muscle groups can help in many cases. Based on the book, I picked out a set of exercises which I do daily, and I make an effort to walk more often. It keeps the problem to a manageable level--which is to say, my back is often stiff, particularly in the mornings or after an extended walk, and I have to be careful about the kind of chair I sit in or I might have trouble standing up, but I feel fine while I'm sitting, I'm pretty much always capable of walking around, and I rarely have distracting levels of pain.

My doctor also gave me a pamphlet recommending some exercises, so that approach seems to have some validity. "Amateur physical therapy," I guess you could call it.

The best kind of seating for me is a folded-up futon in a frame: not too soft or too firm, high back angled slightly off of vertical, seat angled a little downwards as it goes from front to back. (Imagine an L rotated counterclockwise about ten degrees.)
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