Your Lower Back, and You

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mooser

Trad climber
seattle
Topic Author's Original Post - May 9, 2013 - 12:31pm PT
OK, mostly I'm thinking about "MY lower back, and ME."

I've had lower back "issues" since I was in my early 20s. I'm now 55, and not diggin' the prospects of how it's gonna feel 10 years down the line. I'm not debilitated, or out of commission, or anything, and could embark on a rigorous program if it was worth exploring.

I was a distance runner (not competitively) for years, and I imagine that took some toll on it. I've been climbing regularly since '75, and was told by a physical therapist that if my core weren't being regularly worked out from climbing, my back would probably be in a lot worse shape.

I know that everyone's back is different, and different people respond differently to different therapeutic approaches. I also know that the medical community seems to be pretty hit and miss on how to be helpful about back stuff.

For those of you who have had chronic lower back pain, what has worked best for you? I'd love to hear about "Your Lower Back, and You!"
GhoulweJ

Trad climber
El Dorado Hills, CA
May 9, 2013 - 12:48pm PT
You HAVE to get your hamstrings and calves stretched and strong.

This saved my life. I was in chronic pain. Docs handed me vitamin V and said u did it to yourself, tough luck.

Painful sessions early on of weighted squats and constant daily arching of the lower back now has me pain/pill free. Not even IB.

If I think ur hams are loose..... They're not. Make them looser and stronger.

U can buy a beer once your doing hurdles again.

Cheers
ydpl8s

Trad climber
Santa Monica, California
May 9, 2013 - 12:48pm PT
Had problems most my life, it most probably started when I broke my left leg skiing at 15 during a growth spurt and consequently have a shorter leg (I do wear a lift, but it doesn't take up all the missing height). I exacerbated it through crazy bump skiing in my 20's, and then running 5 k's and jumping off of tall boulder problems before pads.

I'm not as good at stretching as I should be (in fact I'm downright lazy about it). When it's bad, the lumbar muscles on either side of my lower spine stand out like two railroad tracks. The best thing I've found is knowing my body and taking the appropriate precautions, such as:

When I feel I've "tweaked" it, lay low for a couple of days, don't do sh*t!

Never, never, never, carry anything over about 10 lbs in front of you (this is a hard one if you've got kids, or you don't want to bruise your ego by letting your petite, short backed wife out do you when it comes to moving stuff).

Make sure that all of your seating arrangements, work chair, car seat, home seating, have firm lumbar support.

In short, don't be afraid to baby it when you first feel it coming on. I've tried all of the build the stomach exercises and push your back to the floor exercises that were given to me by my physical therapist. I think those things probably work for someone that doesn't have the problem and doesn't want to get it. They never seemed to really "fix" my back.

Good luck! A good supportive chair and a couple of Old Rasputin's work about the best for me.
gonzo chemist

climber
Fort Collins, CO
May 9, 2013 - 12:52pm PT
Swimming. Anytime anything in my body starts rebelling, I hit the pool for a couple weeks. Always makes me feel like a million bucks...

Ghost

climber
A long way from where I started
May 9, 2013 - 12:52pm PT
Jeeze Tom, I tried to end your misery. I really did try. But oh, no, you had to duck out of the way and let the rock miss your head. If you'd just taken that shot like a real man, you'd be dead now and we wouldn't have to listen to you whine about your back.

But since you are still alive and hurting, here's a couple of quick thoughts...

First, there are a lot of different things that can cause lower back pain, and here on the internet you're going to hear about every one of them, and how if you just do what I did (Yoga? Cut out gluten? Dancersize?) it will surely fix you up.

Second, I'm not a back doctor, nor do I play one on TV. But I do know one of the best back doctors in the Seattle area (she's a climber) and can put you in touch if you like.

Cheers

David
Mungeclimber

Trad climber
the crowd MUST BE MOCKED...Mocked I tell you.
May 9, 2013 - 12:55pm PT
I did notice some back popping (not really pop, as much as settling) when laying down flat on soft mattresses. it's not really pain in this case. sublax?

the more I climb, the less it happens. when I get lazy and start losing the very little core I have, it returns some. I don't image it is anything near what most folks have. Just one experience.

usually my neck is what get's jacked up. muscles and cold temps and all that.
Snowmassguy

Trad climber
Calirado
May 9, 2013 - 12:56pm PT
Flexibility in your glutes, hammys and hip flexors is key. Also a good strong core. If I can maintain good strength and flexibility from my knee caps to my nips, all is good! Also,the MRI is a necessity to see what is really going on back there.
Reilly

Mountain climber
The Other Monrovia- CA
May 9, 2013 - 01:00pm PT
Sounds like you need some Kris Solem:

Kris will straighten you out!
Wayno

Big Wall climber
Seattle, WA
May 9, 2013 - 01:02pm PT
It was those three large boxes of climbing mags that you put in my trunk. I screwed up my back getting them out and back in then back out again. And now I gave them to someone with a real serious back situation: Big Mike. What is wrong with us?
ydpl8s

Trad climber
Santa Monica, California
May 9, 2013 - 01:10pm PT
Boxes of magazines and books, those are the worst! The next day you'll be bending over the sink to brush your teeth, and you won't be able to stand back up.
Cragman

Trad climber
June Lake, California....via the Damascus Road
May 9, 2013 - 01:19pm PT
Tom, I am absolutely convinced that the key to a good lower back, is VERY fit abs.

I work out every day, and the only muscle group that NEVER gets a break...are my abs....tight abs, no back issues.
mooser

Trad climber
seattle
Topic Author's Reply - May 9, 2013 - 01:20pm PT
coz: once you got your MRI, what did you do beyond the diagnosis? And thanks for the suggestion!

Ghost: better luck next time, and work on your aim!

Wayno: you might be on to something there...

Dean: thanks. I am on a regular schedule of 4 days of cardio, and 3 days on the home woodie now.

Thanks, all, for your great input! I'll be continuing to watch this thread with interest.
WBraun

climber
May 9, 2013 - 01:26pm PT
When my back hurts I go to the Cookie and do laps.

Then back hurts more.

Then day later back hurt goes away.

This is just sarcastic humor.

Almost 99% of my post are like this so do not disrepair ..... :-)
Dingus Milktoast

Gym climber
And every fool knows, a dog needs a home, and...
May 9, 2013 - 01:30pm PT
Mooser aren't you a skinny phuc? Wtf with the lower back probs, dude?

Ok, our stories may be similar so I will type....

Hurt my lower back bad at 17, lifting, twisting and tossing bags of sweet feed for horses. I have had recurring lower lack issues ever since (53 now).

Chronic? Yes, at times. For a time I climbed with a medical back brace on, it was that bad. Over time I self-discovered the things that caused my back to hurt and how to avoid it. The number one issue for me is weight control.

Its this simple - when fat? CHRONIC LOWER BACK PAIN IS A FACT OF LIFE. Only rarely will a lard ass avoid lower back pain. Americans have chronic lower back pains because Americans are obese or just fat.

When my weight is under control, like right now, I have far fewer symptoms and little to no pain. Miracle cure! Nope, but nevertheless, I can track my pain to weight ratio over time, I know its true.

In terms of 'treatment'?

I have a chiro who can crack my back free when I pinch a nerve and get the thing going across my hips and down my legs (sciatic nerve or some such?). I do not let him 'put me on a program.' He cracks back for a living, let's not assign miracle cures to that. Does it help me?

YES! When I throw my back out, say clearing brush for a trail or even yard work (lower back bending and twisting that I don't normally do day to day)? I get an adjustment. If it still hurts bad a day or two later I get one more adjustment. End of chiro involvement.

I have had the same chriro now for 10 years. I can go a year or more in-between visits, so infrequent am I they have retired my file to 'former patient' more than once :-)

A day or two after the back cracking, I am usually good to go. Disk swelling subsides, realignment settles in and the pain (constant burning sensation) subsides.

I have to watch how I sleep - I am a side-sleeper not a back sleeper. I have to be very careful I don't let my hips twist too much. I will wake up with a screamer if I do, like someone sticking a knife in my back; sharp pain. So I don't sleep that way.

I have to have lumbar support for long drives and airplane rides.

That's it. Very simple for me and no extensive exercises necessary:

1. Control the weight. I'm size 33 waist right now, 190 lbs, 53 years old. I'm kinda proud of that. :-)
2. See a chiro when my back acts up, sooner, not later. But do not over do manipulation, impo it is destructive to do so. One or two back crackings, that's it!
3. Sleep position is important.
4. Watch how I sit. I have a lumbar pillow for my office chair, as I type. its just a little throw-pillow, nothing fancy. A scrunched up jacket will do in a pinch, as will a towel.

I am OFF anti-inflammatories pretty much... SUCCESS. Taking that sh#t for chronic pain is not good for the rest of the body, imo.

YMMV.


DMT
John M

climber
May 9, 2013 - 01:31pm PT
Don't listen to Ghost. He don't know jack about internet doctoring. I'm sure you can find just the right answer if you will just get that fecal transplant. Oh wait.. thats moosedrool with that problem. you are mooser.. never mind



What works for me has been learning to let go of stress, plus Finding a really good physical therapist and learning the right exercises and stretches for m. Finding a good physical therapist is really tricky because its hard to know if they are good or not. I didn't find out the difference until I found one. He helped me more in 6 weeks then years or therapy had before. He figured out which muscles and ligaments and tendons were too tight, and just where they were contributing to the pain, and then he tied me up into all sorts of weird psycho movie positions, and it helped a ton.

Dingus Milktoast

Gym climber
And every fool knows, a dog needs a home, and...
May 9, 2013 - 01:34pm PT
Oh and don't wear your pants or underwear too tight. Seriously.

DMT
wbw

Trad climber
'cross the great divide
May 9, 2013 - 01:44pm PT
I'm 52, have been climbing consistently since I was about 22, and have been a distance runner (not competitive) since 15. The main thing that I do that makes my back sore is running. I stretch lower back, hip flexors and hamstrings religiously after every run. I stopped running on hard surfaces several years ago, and this makes a big difference. Fortunately, we have excellent trails to run on around Boulder: just as good as the climbing.

I have tweaked my back badly three or so times in the last 4 years, while attempting to strengthen my abs through specific exercises. I have decided that I can't do any intense abs specific exercise anymore without putting my lower back at risk. At my age, I'm not willing to take that risk anymore.

When my back gets sore, but before it goes into spasms, I rest, do very gentle stretches (talking about lying on my side with my knees pulled a little toward my chest) and apply a heat pad.

Climbing generally helps with potential back issues. I don't seem to stretch after climbing the way that I do after running, and my back is mostly okay with that.
Elcapinyoazz

Social climber
Joshua Tree
May 9, 2013 - 01:48pm PT
I've got about 12 degrees lumbar scoliosis, since childhood, and have had lower back pain since about 17yo. It comes and goes.

Luckily, I am skinny and have a very strong core. Unluckily, I work a job that keeps me at a desk 90% of the time. Keeping my hip flexors, hammys, quads, and lumbar stretched is vital.

Like DMT, I'm also a side sleeper. Switching to a memory foam mattress about 5 years ago made a big difference for me. Seems to keep me in decent alignment without twisting. The rare time I migrate from side sleeping, I end up on my stomach with head turned to one side...this tends to cause neck pain which sometimes migrates all the way down.

Manage your stress levels too. Holding a lot of tension in your body (which you often don't notice) due to the stress can exacerbate the issue.

My dad has it much worse. Aside from a terrible diet and smoking a pack of marlboro reds a day, he never stretches, and ended up with multiple ruptured discs and DDD after what should have been a minor muscle tear type injury on the job (steel worker), which eventually ended with fusion of 3 or 4 vertebrae and a lot of hardware in his back..rods and screws and stuff....which meant he was on Oxy, lortabs, somas, percs and similar for about 3 years. Being the irresponsible dipshit he is, he'd hoard them for a while then get ripped on a big dose sharing them with his GF.

I'd focus on addressing these: stretch, stengthen, diet, sleep, stress mgmt. And if it is chronic, Coz is right, see a doc and get the MRI.
10b4me

Ice climber
Soon 2B Arizona
May 9, 2013 - 01:56pm PT
Tom, I am absolutely convinced that the key to a good lower back, is VERY fit abs.

I agree 100%
Ksolem

Trad climber
Monrovia, California
May 9, 2013 - 02:07pm PT
Tom, I am absolutely convinced that the key to a good lower back, is VERY fit abs.

No disagreement there, but sometimes it's not that simple. As has been said, many folks with back problems exacerbate their problems by doing ab work. Sit ups are often the worst culprit.

Pilates is a great way to develop the core, and balance all those quads, hammys and hip flexors which have been mentioned. But if someone with serious back issues comes to me I'll ask them to see a Doctor (who will want an MRI) and a physical therapist first. Then I can have a chat with the PT and we'll be able to proceed safely. Baby steps at first.

FWIW a lot of back injuries happen after sitting for a while (a lot of spinal stabilizers which are active standing take a nap) and then getting up and and lifting something with rotation.

I am currently building a standing workstation here at home. If I have to spend several hours a day at the computer (yes, I do,) then I'll darn well do it standing.

Is-Your-Chair-Killing-You
Heyzeus

climber
Hollywood,Ca
May 9, 2013 - 02:40pm PT
Your post is timely for me- it took me 13 minutes to get out of bed this morning.

I won't bore you with my specifics here, but if interested feel free to PM. All us back suffers appear slightly different and have different things that work, don't work etc. That said, the last two years have been a different phase for me, and I'll throw a few ideas on to the pile.

Pilates, helped at first, but I was not one on one and got very adept at cheating- using other muscles to do the work than the ones I should have been using.

PT had worked great in the past, but could only bring me so far recently.

Swimming helped vastly.But again reached a plateau.

Trigger Points have been amazing in other parts of my body, but limited success with my back, but it has all been self treatment. I have not had someone else work on me using this method.

Chiro- Basically a big no- I need to be able to work on myself and like to do the work. Same w/ acupuncture

Egoscue Method- am doing this now in a clinic and the jury is out.

Network Spinal Analysis- looks at the problem from a whole different angle and very trippy. I can talk more about if you're interested. Jury is out.

For driving : http://www.yogaback.com/The_YogaBack_for_Driving/new_YogaBackDriving_BU.html

I just heard of a MD here in LA that has great non-surgical success. I can let you know.

Every practitioner of each modality are not equal. So you have to not only find the right path (for you) but the right healer practising that path. We have similarities but are all different.

mooser

Trad climber
seattle
Topic Author's Reply - May 9, 2013 - 02:50pm PT
When my back hurts I go to the Cookie and do laps.

Then back hurts more.

Then day later back hurt goes away.

This is just sarcastic humor.

Almost 99% of my post are like this so do not disrepair ..... :-)

Thanks, Werner! This confirms that this is a legit thread.

Dingus: No weight issues with me, but lots of time flinging 95lb sacks of Red-e-crete in my safe installation days. Countless pallets with no way to lift with legs, etc., and lots of time with digging bar, jack hammer, and sub-floor work putting in floor safes. Forgot about all that time in my original post.

Thanks again for y'all's input! I'm fascinated by what has worked and not worked for you.
fluffy

Mountain climber
May 9, 2013 - 02:59pm PT
good thread. I am missing half the disc between L5/S1 from years of gravity sports (falls,wrecks) and hardcore manual labor...mainly stonework and chainsaw work.. narcotics barely touch the pain, ganja helps though.

ditto on running I just can't do it anymore, the back pain outweighs the pleasure :-(

got a inversion table for $200 at costco and it really helps

yoga helps a lot too

tried trigger point dry needling for awhile but that didn't do much

actually had the nerves in my L5 S1 facets cauterized but that didn't really work either

looking into throwing some serious money down on a latex bed since sleeping hurts it worse than anything active I do.
FRUMY

Trad climber
SHERMAN OAKS,CA
May 9, 2013 - 03:03pm PT
Listen to Coz & Ksolem, they are right on.

MRI first --- then build the core.

Give yourself a fighting chance to heal & recover.
FrankZappa

Trad climber
Hankster's crew
May 9, 2013 - 03:09pm PT
My lower back issues are purely muscular (according to doc's x-ray and separate PT opinion), but it has been debilitating at times and forced me to change my career.

Two largest things that help.
1) Holding Plank pose, elbows on floor. I usually do 3 sets of 1-minute holds (use a stopwatch).
2)Stretching the hamstrings.
Big Mike

Trad climber
BC
May 9, 2013 - 10:14pm PT
Being that i burst l2 and dislocated l1 not long ago, (plus some spinal cord damage..) i can say that lower back is definetly and issue. Truth is it's always been ever since i was a kid. I have learned a few things tho in my last 11 weeks.

1. Get a mri, to make sure you don't have a herniated disk or worse.

2. Stretching is mucho importante senior!! Mucho! Your leg muscles are pulling on those glutes which are connected to the lower back muscles.

3. Posture, posture, posture! Pull your chin back with your spinus erector muscles (the muscles which line either side of your spine) relax your chest and shoulders while doing it. Look regal. Don't worry.. It's hard.

4. Use your transverse abdominus, this is basically your lower abs, it's the one you use to suck in your guts.

5. Build those abs. I can't even do a sit up yet. I can however do four point ok. Four point is kneeling on your hands and knees and engaging your abs, then lift a hand off and remain completly still. Your knee opposite your hand should feel weightless. DO NOT SHIFT. If you're doing it right you'll start shaking eventually ;) otherwise you are cheating. Make sure your shoulders are fully extended before you take that hand off. It should be hard. If not, lift the unwieghted knee also.

6. Get a good physio to help you make sure you're not cheating!!
Norton

Social climber
the Wastelands
May 9, 2013 - 10:36pm PT
mooser,

I sent an email to our Supertopo listed profile email

I just had major spine surgery 32 days ago, check out my email

john
mooser

Trad climber
seattle
Topic Author's Reply - May 9, 2013 - 10:49pm PT
Thanks, guys! You both clearly know of which you speak!
Big Mike

Trad climber
BC
May 9, 2013 - 11:42pm PT
Thanks for the mags btw. Can't wait to start digging into them.
mooser

Trad climber
seattle
Topic Author's Reply - May 10, 2013 - 12:59am PT
Glad Wayno is a generous guy, and willing to pass them on! Probably about 30 years worth there. Hope you are healing up well, Big Mike! My back issues pale in comparison.

Looking forward to my next trip to Squamish!
Ksolem

Trad climber
Monrovia, California
May 10, 2013 - 01:27pm PT
Pull your chin back with your spinus erector muscles (the muscles which line either side of your spine) relax your chest and shoulders while doing it. Look regal.

I love that!

My wife has some cervical issues exacerbated by years with a "head forward" posture (always on a mission.) I've worked on it with her, but I think that "look regal" cue will really resonate. Anyone who's met "The Barbara" will know what I mean.
saa

climber
not much of a
May 10, 2013 - 01:54pm PT
Make love to a woman 5 times a day.

Hiiihiiiihiiii. This one was way too tempting.
steveA

Trad climber
bedford,massachusetts
May 10, 2013 - 01:56pm PT
The doctors are amazed at my activity level, considering the fact that my l3,4 and 5 lower vertebrae are fused due to no disc space and arthritis.

I did them in from excessive heavy lifting for over 30 years.

I plan to do the RNWF of HalfDome next month, with my son. That will be a pain-fest for me, but not for my son, who does not abuse his back.
pud

climber
Sportbikeville & Yucca brevifolia
May 10, 2013 - 02:00pm PT
My 30's and 40's were filled with lower back pain.

In my 50's I am pain free thanks to yoga.
mooser

Trad climber
seattle
Topic Author's Reply - May 11, 2013 - 11:25am PT
Been looking into local Pilates offerings. A bit spendy, but doable. For those of you who do Pilates (I have no experience with them), is it best done in a "studio" with a drill instructor, or is a DVD sufficient?

SteveA: Have a blast on Half Dome with your son!
Srbphoto

climber
Kennewick wa
May 11, 2013 - 11:34am PT
BOOBS - They solve everything!
darkmagus

Mountain climber
San Diego, CA
May 11, 2013 - 12:31pm PT
I'm a chiropractor. I cringe when I read "anti-chiro" statements on here because I know that they are most likely based on a lack of understanding. And that lack of understanding could be the basis for advice, which would be wrong, because there's a mountain of evidence supporting the management of low back pain (acute or chronic) with chiropractic care. And your fellow climbers on here will be misled and perhaps not get the right kind of help when they need it. Save the detailed speculative analyses and critiques for purveyors of the medical literature.

Chiropractic is superior to PT for episodes of LBP. Doesn't mean that PT won't help, but that's not what the evidence says nowadays. It says you should try conservative management, and that you should try spinal manipulation performed by someone that is really good at it (a chiropractor).

But really, don't listen to any advice on this thread, seek the counsel of the health care professional of your choosing.
Big Mike

Trad climber
BC
May 11, 2013 - 12:39pm PT
Go to the studio mooser. Until you know what you are doing. It's too easy to cheat to get the result you are looking for, but not actually do the excersise. Chiro rules too. If you find a good one. Some of them are like bad mechanics, they only do half the job so you have to come back.

Ksolem- that's my physio assistant Derek's saying. I agree it works quite well. When my back starts hurting, i straighten up and it stops until i slump again... Pain is a good cue i guess.. It's so hard to have good posture. You have to do it all the time!

But really, don't listen to any advice on this thread, seek the counsel of the health care professional of your choosing.

I take exception to that. That was my first statement!!
Ksolem

Trad climber
Monrovia, California
May 11, 2013 - 01:11pm PT
Here's a beautiful example of the Pilates "series of five."

http://Alissa Wyatt

The only thing she does not make perfectly clear, although she does it perfectly, is that when you roll up through your head, neck and shoulders you want to find that magic spot where the bottom of your shoulder blades are just touching the mat, no higher and no lower.

Mooser, a good way to go is to pony up for a few privates to get your fundamentals, then do regular group classes, which cost much less. By "group," I mean ideally four people, no more than five. A good teacher can handle a group that size and still give individual attention.

The exception is when a master teacher has a large group of experienced people who do not need individual attention.
Sierra Ledge Rat

Mountain climber
Old and Broken Down in Appalachia
May 11, 2013 - 01:19pm PT
What works for chronic low back pain? Assuming serious pathology has been ruled out....

-Maintain a normal body weight
-Core exercises
-Good abdominal tone
-Proper lifting techniques

I found that squirt boating (a discipline of whitewater kayaking) has been really good for my back, since it's a serious abdominal and core workout. If you ever wanta serious core workout come paddle with me in West Virginia...

Squirt Boating at the Halls of Karma, New River
My favorite little playground

Heyzeus

climber
Hollywood,Ca
May 12, 2013 - 01:10pm PT
http://www.guardian.co.uk/society/2013/may/07/back-pain-breakthrough-major-operations

Back pain breakthrough could eliminate need for major operations

Discovery could transform treatment of chronic lower back pain and save health services millions of pounds


Ian Sample, science correspondent
guardian.co.uk, Tuesday 7 May 2013 04.30 EDT

When patients have no other options, surgeons can fuse damaged vertebrae, or transplant artificial discs into their spines, but both of these operations might largely be replaced with courses of antibiotics. Photograph: Christopher Furlong/Getty Images

The figures make for grim reading. When all costs are considered, the NHS spends more than 1bn each year on back pain. More than half goes on hospital costs. But 140m covers GP consultations, with even more spent on physiotherapy sessions. On any given day, 1% of the national workforce is on leave with a back problem.

Most people recover from acute back pain within six weeks but for a fair portion, around 8%, the problem becomes long-term. In the past, doctors prescribed bed rest for back pain. They now accept that only makes the pain worse, and instead recommend physical exercise, or at least staying active.

In more than 80% of cases, there is no clear cause of back pain. But to the long list of factors, from lifting and posture, to stress and anxiety, scientists in Denmark have now added bacteria.

Microbes should not be lurking in the spine, but Hanne Albert and her team at the University of Southern Denmark found a common bug called Propionibacterium acnes inside the slipped discs of patients who had operations for the problem. The bacteria normally live without oxygen, in hair follicles, or at the bottom of crevices in teeth, but brushing teeth can sweep them into the bloodstream.

The bacteria should pose no threat as they circulate around the body, but when a person has a slipped disc, the body grows fresh blood vessels that reach into the soft disc to repair the tissue. This gives the bacteria a route in, where they can thrive, scientists believe. As the bacteria grow, they cause inflammation around the disc, and release propionic acid, which irritates nerves, and may even cause the painful microfractures seen in vertebrae around the disc.

The Danish researchers found that a long course of common antibiotics, lasting three months, killed off the bacteria, and alleviated pain in most patients who took part in their trial. All had been in pain for more than six months and showed signs of vertebrae damage in MRI scans. They took six to eight weeks to feel better.

The drugs must be taken for so long because the blood supply to spinal discs is very poor. Once the disc is free from infection, the inflammation dies down, and the vertebrae begin to heal.

The discovery could transform the treatment of chronic lower back pain and save health services millions of pounds by doing away with unnecessary operations. When patients have no other options, surgeons can fuse damaged vertebrae, or transplant artificial discs into their spines, but both of these operations might largely be replaced with courses of antibiotics.

The treatment is controversial because greater use of the drugs can lead to more antibiotic resistance, already a major problem in hospitals around the world. The scientists have joined forces with a small team of experts to make educational material and guidelines for doctors and surgeons, to help them target the right patients.
Bruce Morris

Social climber
Belmont, California
May 12, 2013 - 03:23pm PT
A big question this "discovery" brings up: Why in the heck are the rates for chronic back pain so high in the developed world and virtually non-existent in undeveloped countries? Also, the ratios of chronic pain vary considerably from one developed country to another: 1 in 3 in the US, 1 in 4 in Europe, and 1 in 5 in Australia. A native-born Kenyan almost never has a so-called "bad back". However, if you transplant an American or a European or a Japanese to Nairobi, they will have lower back problems at the same rate as in their point of origin. How is this so, if a bacteria is solely responsible for lower-back complaints? There just have to be some psycho-social variables that have to be factored in to the different rates of infection from country to country and culture to culture. You'll notice too in the article that the bacteria only seems to account for back pain in 20-40%. What about all the other cases of lower back pain? What's causing it in the other 60-80% that don't have the bacteria in their systems?

And how about CTS, RSI, TMJ and frozen shoulder? Are there different bacteria associated with these conditions? It's interesting in this context to observe the history of stomach ulcers, which used to be blamed solely on stress. That is, until a bacteria was discovered in the stomachs of some (but no all) people with ulcers. Now there are drugs that target that bacteria and the rates of stomach ulcers have gone down considerably. Ulcers are no longer what is called a "preferred symptom" that develops under psychological stress. Now there are new "preferred" symptoms like back pain, knee pain, and more recently the foot. Of course, almost no one has classical hysterical symptoms like the ones that Charcot and Freud observed anymore either. I would suggest that the recently discovered bacteria can start growing in the soft tissues of patients who have been under a great deal of psychological stress, either external or self-imposed due to personality traits. So, despite out mechanist, dualist bias, it's still a bit premature to exclude psychological causes as reasons for the development of lower-back pain.
Norton

Social climber
the Wastelands
May 12, 2013 - 04:19pm PT
A big question this "discovery" brings up: Why in the heck are the rates for chronic back pain so high in the developed world and virtually non-existent in undeveloped countries?

good question

my guess is because the data behind the question may be seriously challenged?

people in third word (undeveloped) countries simply live, suffer, and die

record keeping is virtually nonexistent and there really is no medical care to speak of

outside of that, I suppose one could also put forth that people in the third world are much more physically active, constantly trying to secure food and shelter and as such move more blood and oxygen through their cardiovascular systems, promoting an overall less abusive


nah, on second thought I will go with live, suffer without reporting, and die
mooser

Trad climber
seattle
Topic Author's Reply - May 13, 2013 - 04:19pm PT
Bruce: I suspect that one of the big reasons there are differences between the US and other in lesser developed countries is that while we may have jobs that require lots of motion and exercise, we also have (generally speaking) the luxury of hanging out after work and being couch potatoes. Most of those in lesser developed countries don't have that luxury at all, and are regularly in motion. In addition, they don't pack on the pounds the way more and more USAmericans do. Pretty broad brush strokes, I know, but my hunch is that there's something to that.
mooser

Trad climber
seattle
Topic Author's Reply - May 13, 2013 - 04:20pm PT
ksolem: I just went through that Pilates video, and that was actually pretty cool! Thanks for that.
Ksolem

Trad climber
Monrovia, California
Jun 7, 2013 - 04:08pm PT
Been looking into local Pilates offerings. A bit spendy, but doable. For those of you who do Pilates (I have no experience with them), is it best done in a "studio" with a drill instructor, or is a DVD sufficient?

The DVDs out there are pretty variable. Alisa Wyatt has some good ones. Peter Fiasca's Complete Classical Pilates series provides an excellent demonstration/documentation of the work, but offers little instruction.

There is no real substitute for working with a good teacher. One good way to do it without having to sell all your gear is to take a few privates to get a foundation, and then do weekly group classes, with a private thrown in once in a while. Create a regular home practice using what you learn from your teachers. Make sure your teacher knows this is your plan when you start.

A lot of good studios require this (some amount of privates before joining a group) and often you'll get a lower rate on the privates if you commit to a series of group sessions up front. Any good studio will let you come in and observe a class so you can see if you like the idea before you commit. Buying a series of 10 classes at a time should substantially reduce the rate.

In the places where I have worked, the class sizes are limited officially to four but they'll let in a fifth if the teacher okays it. Unless you are very experienced at Pilates, a class of more than five is a waste. Occasionally I attend workshops where a master teacher will lead a large group, but this is different as everyone's technique is already well formed.

mooser

Trad climber
seattle
Topic Author's Reply - Jun 7, 2013 - 06:19pm PT
Thanks, Ksolem. I've been doing some of the stuff your initial link demonstrated, and it's easier now that I've been doing a couple of them a bit more.

I know the real hardmen and women are into this: http://www.youtube.com/watch?v=o-50GjySwew, but I know that's a bit ambitious for me at this point in the game.

I've appreciated all the suggestions, and the PMs! Thanks, folks!
kennyt

climber
Woodfords,California
Jun 7, 2013 - 06:27pm PT
I'm sure that the lower back has a mind of it's own
Snowmassguy

Trad climber
Calirado
Jun 7, 2013 - 06:35pm PT
Genetics play a pretty significant role in many conditions that cause lower back pain.
Ksolem

Trad climber
Monrovia, California
Jun 7, 2013 - 07:08pm PT
The spinal cord proper, as a distinct anatomical unit, ends somewhere around L1-2, as it divides into a large array of nerves forming the Cauda Equina (Horses Tail.) These nerves, among them the notorious sciatic nerve, find their way out of the lumbar vertebrae and sacrum through a series of Foramen (holes or openings) in the skeletal structures.

The specific layout of the Cauda Equina, the routing of these various strands of nerves as they reach out to the rectal and genital areas, and down the legs, varies in different individuals.

So, yes it can be said that the lower back has a mind of it's own, and there is certainly a genetic role in lower back issues as well.

Actually the idea that other parts of our nervous system than just the brain are involved in our feelings and emotions, our movement and what we call "muscle memory," is an exciting area of study in neurology today. I have been kind of buddies with the neurologists who have been studying my own somewhat unusual situation, and in conversations with them it has become clear to me that the brain is no longer thought to be exclusively in control of our bodies, nor is it the exclusive repository of memories or emotions. It appears we are more like a network, than a machine controlled by a cpu.
phylp

Trad climber
Millbrae, CA
Jun 7, 2013 - 07:15pm PT
My lower back was horrible in my late 30s and early 40s. Constant pain and sciatica. Now it's quite good - not perfect but very functional and I'm mostly pain free.

Here are what I think were the key changes:

Leaving a job where I had to commute for 2 hours a day and then sit all day. I probably don't sit in a regular chair for more than 2 - 3 hours a day now.

Stretch my hamstrings and hip flexors every day, religiously.

Ice my low back every night after a day that included exercise (ice works for me as well as nsaids).

See a chiropractor about once a month. I used to be a skeptic about chiropractic - before I had ever tried it, but it makes a big difference for me.

Good luck! Phyl
Ksolem

Trad climber
Monrovia, California
Jun 7, 2013 - 10:04pm PT
I mentioned up-thread that i was putting in a standing workstation. So now it's up and running, and it's great!

Credit: Ksolem

Yeah I know all you finish carpenters out there will raise an eyebrow to the cheap closet world furniture. And I still have some wiring to properly dress, pictures to hang (they'll distract you from the furniture,) and I'll find a nicer way to get the monitors at the right level than a couple old drawers upside down.

It sure is nice to be on my feet, rid of the chair. I was slightly concerned at first, but now I have logged enough hours standing here to know it's right for me.

And the Gel-Pro floor mat rules.

edit: The counter-top is 38" off the floor.
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