Sam Bauman: Back pain all goes back to standing
Over 50 years of skiing and teaching the sport, I’ve taken many falls and nose plants.
So with over 50-plus years on the slopes, I’ve suffered plenty of back pain. I’ve tried therapy, acupuncture, hot and cold pads and chiropractic help and perhaps best, Tai Chi, but the pain is still with me, support the most of the times in modulated measure.
So when I saw the cover of Consumer Report magazine headlined with “Back Pain … Real Relief,” I quickly read the report. Edifying, to say the least. I’ll pass along some of what I learned, but if you have back pain you might want to read the whole report, Consumer Reports, June 2017.
Standing upright requires supporting the weight of the upper body while remaining flexible enough to bend in all directions. This puts a lot of stress on the network of bones, muscle and ligaments. They can be stretched and the gel-like discs cushioning the spinal bones can bulge and slip, pressing painfully on the spinal nerves.
That’s much of the source of back pain. There are basically five causes of back pain:
Muscle injuries, overstretched or injured muscles, tendons or ligaments can result in strains, sprains or spasms. Prolonged sitting, poor posture and repetitious movements such as throwing a ball may stretch the soft muscles on your back, the most common site of back pain, affecting one-third of subjects in a test.
Degenerative changes; as you age the gel-like discs that cushion the bones of the spine wear and allow bones to rub against one another, causing osteoarthritis. Such degeneration is unavoidable and that almost all of us over 60 have signs of wear and tear. (In my case it was the thin layer of meniscus that wore away and forced the replacement of my knee joint.)
A third cause of back pain is herniated or slipped discs. Many activities such as pulling, bending or twisting puts pressure on the discs causing them to bulge or slip. When a bulging disc in the lower spine hits the sciatic nerve, sharp pain (called sciatica) shoots down the leg. Slouching from the waist can worsen the pain.
No. 4 is spinal stenosis where the spine grows new bones and thickens ligaments. These narrow the space around the spine.
No. 5 is spinal instability. When discs or joints wear they weaken, and they don’t do a satisfactory job of supporting the spine. Pain comes and goes from one side of the body to the other. Weakness is felt on both sides of the body when standing or walking.
So you’ve had a bad back attack, what do you do?
Call your doctor if the attack is joined by symptoms that suggest a serious problem— hard fall or an accident; loss of bladder or bowl controls, fever, chills or an infection, sudden weight loss, a history of cancer.
If none apply, use heat or a warm shower, hot water bottle or a heating pad. Use a towel between heat source and skin and do it for 20 minutes or less.
Get comfortable. Lay on your back with legs up on a chair or on your side with a pillow between your bent knees, sitting with a pillow behind your back or standing on one foot on a stool. (This sounds like part of my therapy for improving balance, only I stand on one leg for 30 seconds without using my hands.)
Also, stretch. Use slow gentle moves like pulling your knees to your chest while lying down or standing slightly backward while standing. Don’t stay down, walk around every hour or two.
While non-drug is best, consider such as anti-inflammatories such as ibuprofen (Advil or generic), or naproxen (Aleve or generic) for no more than a week. These work better than acetaminophen (Tylenol and generic).
After a week and you’re still in pain, see a doctor. Plan out how you’re going to work on getting better. If you’ve been inactive, get referral to a physical therapist. Acupuncture and massage and spinal manipulation can help.
We’ll look at other treatment plans next week, but I’d like to add personal note on back pain. I’ve said that I’ve had bad back pain for years and the only thing that works for me is a palliative — hanging from my horizontal bar in a door frame. I’ve done it for years and while pain relief is temporary it gets me through the day. I’ve given up on total pain relief, but I still get through the time. I sometimes wear a lumbar back belt, which eases my pain, but it’s awkward.
I figure I just have to live with the pain as the cost of all those wonderful skiing days.
Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.