Thursday, March 13, 2014

Back Aches - For What It's Worth

From time to time I encounter people who have back problems of one sort or another. Having such a history myself I am inclined to get into a conversation about what might be done.  A few days ago, after such an encounter, I was inspired to write the following so I could just hand it out and save on talking.

 
I once was very free with advice about back aches, thinking what I had learned from my own experiences would be useful to others.  I’m more modest now in this regard because I now think there are many different sorts of back problems so not all advice is applicable.  That said, what follows is the best wisdom gathered from a 15 to 20 year saga of recurring, incapacitating back spasms.  I hated it when my wife said that I had a bad back meaning a back predisposed to injury.  What I think I had was a perfectly normal back that I mistreated often enough that I would have 2 or 3 episodes a year when for several days I was barely able move off the ground or out of bed.  That was roughly between the ages of 25 to 45.  The incidence of trouble started going down in my early 40’s mostly due to my learning what particular acts or activity put me in jeopardy.  Once I learned what not to do or at least how to be careful, the problem went away.  In my early 50’s, for reasons other than my back, I started getting more exercise which strengthened my back so that now at age 75 I can do much more than I could at 25 without hurting myself.  The following can be read as advice, but as stated above, it ain’t necessarily right.

 

In the case of an acute situation my first goal is to end the pain.  My back aches occurred in my lower back where there are many small cooperative muscles.  If one spasmed the pain would cause the adjacent muscles to grow tense and vulnerable and interfere with the recovery of the sore muscle.  Of course stopping the pain was useful in its own right.  For me step one is to take the strongest pain medicine available.    There may also be some body positions that reduce or eliminate pain.  One such position for me was lying on my back on the floor with my lower legs laid over the seat of a side chair.  My thighs were vertical at the hip and my legs bent at the knees so the calves could rest on the seat of the chair.  Once on a trip to Central America I spent a night like that.  In the morning I was ready to go.  Another tip for comfortable sleeping is to sleep on a slippery surface such a nylon sleeping bag wearing some kind of slippery shorts.  Thus bed friction is minimized.  Before I got onto these friction reducing measures I would from time to time exacerbate an injury in my sleep by trying to drag my hips/pelvis to some new position.  After stopping the pain as much as possible step two is to get the right amount of exercise.  The problem of course is knowing what is the right amount.  I do think exercise is therapeutic.  At the same time it is easy, once one is feeling better, to do too much and suffer a setback.  So move and exercise the injured area, but err on the side of too little.

 

There are two or three things to do that could be thought of as long run strategies.  One is to think very hard about any particular back incident that may occur.  What was the immediate cause and was there any lead up to the immediate cause?  For example I could shovel dirt or snow all day without incident, but then, on the next day, I might easily incur a back spasm by picking up a sock.   The muscles, tired from the shoveling, were vulnerable to the slightest stress.  Eventually I learned to be careful on days following shoveling.  As is well known, improving one’s fitness, especially core strength, can pay off in fewer back problems.  For reasons unrelated to my back, in my fifties I became much more fit.  Now at age 75 I can stress my back much more than I could at age 25 without suffering bad consequences.  And finally recalling my first advice for an acute attack, i.e. stop the pain, I always retain any pain medicine that is prescribed for me, but which I don’t initially need.  It can come in handy.

No comments:

Post a Comment