Lower Back Pain

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    Jun 29, 2007 7:50 PM GMT
    I've been working for the past couple of years at FedEx (unloading boxes from containers as they come off the planes at 22 boxes a minute for 2 to 3 hours a night), and last week my lower back said "Enough all ready!".... It wasn't even while picking up a box, but as I turned to pick it up a pain shot thru my lower back. I stepped off line to stretch for about 5 minutes, but then went right back to work, and was barely able to get out of bed the next morning. My doctor told me I was having muscle spasms this morning, and he gave me a couple of shots. Meanwhile, I'm taking a few days off, in hopes of getting better. Question: Are there any exercises I can do in the gym to keep this from happening again? Also, while I'm still having trouble moving around (my back is much more stiff, and it's difficult to move, rather than being in actual pain) should I stay away from the gym altogether? Or just take it slow, and perhaps focus on exercises that don't involve the back? Thanks in advance for any advice you're able to give....
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    Jun 29, 2007 8:02 PM GMT
    When you feel comfortable going back to the gym, focus energy on core strength and stability (think planks, side bridges, etc.), rotation (wood chops, lunge with rotation) and glute strength (bridge, squats and lunges). Focus first on your form before adding any external resistance. I'd also suggest finding someone in your community who is well versed in biomechanics and human movement. S/He can provide you with "corrective exercises" to help balance and align your body's structures.
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    Jun 30, 2007 11:44 AM GMT
    As someone who used to had frquent lower back pain, I found (based on Dr.s recommendation) that ab excersizes including the obliques did wonders for improving it. It seemed counterintuitive at the time but it had and has been pointed out that the abdominals support the lower back.
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    Jun 30, 2007 5:27 PM GMT
    Thanks... Concentrating on the abs actually makes sense to me. What about running? I started running again a couple of months ago, should I find another cardio exercise that isn't as jarring?
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    Jun 30, 2007 6:35 PM GMT
    Yeah , you think its back but really its the whole core. Traing methods like pilates fixes..balances abs and back muscles.
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    Jun 30, 2007 8:10 PM GMT
    Yeah, I'd skip the running until you've developed a strong core. Researchers estimate that, during 1 hour of rigorous exercise (such as running) the feet absorb 1 million pounds of pressure. That pressure is then distributed throughout the rest of the body. I'd suggest another activity such as swimming for now.
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    Jul 02, 2007 2:24 PM GMT
    A few comments..

    Physiatrists really do not know how to treat lower back pain except with medications and Depo medrol cortisone shots (facet joint shots or epidural shots.) Yes, if done correctlu, it will take the inflammation down immdeately, but it is not addressing the PRIMARY cause of the inflammation..

    As I have posted in other threads here, muscle spams are a 2ndacry and REACTIONARY response to other primary causes. Muscles do not just spontaneously spasm by themselves. Spasms are either from the actual soft tissue over use, injures, or a protective spasm as a result of pain from other structures such as the faet joints, nerve roots, discs, ligaments, etc, etc. When a cliinician tells you that your muscles are in spasm and stops right there, he or she does NOT know what is causing your lower back pain. A good clinician will take the exam further, and find out if the muscle spasm is caused but over used from poor posture/body mechanics (palpation and mechanical exam), muscle injury from a traumatic injury (palpation and mechanical exam, and for very advanced practices, utra sound imaging), disc issues (MRI), facet issues (x rays), etc, etc.... If he or she just prescribes medication either orally or by a shot and end there, your lower back pain likely will come back inthe future because the primary cause of the musclle spasm has not yet be identified. Muscle spasm is not a specific diagnosis, it is a description of a sympton.

    As far as exercises, one member above mentioned "abs" and "obliques." Most people do not realize that there are 2 layers of the abdominals: outter and inner. The trunk/spine stabilization muscles are mostly the multifdus and the abdominal transverse, the inner layer of the abdomial muscle group. The outter layer of the abdominal do not stabilize the spine, but raher performs trunk flexion and rotation. These are the rectus and obliques. These muscles actually will increase your intra-abdominal pressure when they are engaged. This is HORRIBLE for your torn discs! That is why when you ahve a disc problem, any activities that contract these outter layers of abdominals such as sneezing, coughing, or straining on a bowle movement will "throw your back out." This is one of the standard questions we ask our patients with lower back pain (if your MD or PPT is not asking this questions, that is not a really good sign.) So, performing exercises taht recruit outter layers of abdominals are actually VERY BAD for an acute diac problem. After the discs are healed (yes, discs heal, facet DJD do not), then you can perform these eercies that involve the outter layers of abominial muscles.

    Also, running is BAD for acute discogenic impairments, but OK if your core is strong and your discs healed. It puts a lof of axial presure on the lumbar and cervical spines due to the curvatures in these 2 areas (L4-L5 and C5-C6), which are actually designed as areas of shock absorbers. If you sitll have any signs of back or neck pain, running is not a good thing to do...
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    Jul 02, 2007 2:42 PM GMT
    Also wanted to add to your "stiff" back..

    Go see a GOOD PT (with today's health care climate, there are more bad ones than good ones out there) and have your "stiff bacK' evaluated. Is this a soft tissue "stiffness" or a joint "stiffness"? If it is soft tissue, is it because the muscles are over used into spasm, or there were previous injuries that caused some fibrous build up (scar formation)? Or you back facet joints are not moving wellanymore because of a tight joint capsules or locked because of prolonged muscle guarding?

    After your back is prperly evaluted, you can ues whatever that works for you.. Pilates, ART, chiropractic care, massage, etc, etc..

    Again, get to know what is causing a general sympton such as "stiffness" first. Once you know the spficics, then you can start treating it/them...
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    Jul 03, 2007 12:51 AM GMT
    I must also add that cortical steroid injection of the back (facet or epidural) does has it purpose and it is greatly needed in some cases.

    Sometimes, the primary cause of the back spasm and lower back pain has already healed, or is chronic, or cannot respond to therapy effectively because of the pain, BUT the pain stays because sometimes once the pain cycle starts, it becomes a vicious negative loop feedback mechanism and it perpetuates itself. So a shot to calm down the area is sometimes all you need to let the body heal itself...

    However, one should still investigate what exactly the primary cause of the back pain is in the fist place... If you know what has happend, you can do something not only to treat it, but also to prevent it from occuring again...
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    Jul 04, 2007 6:56 AM GMT
    Thank you NYCMusc4Musc for your insight. I have a feeling what "happened" was the result of over 2 years of moving boxes that weigh anywhere from a few ounces to 150+ pounds at a very fast pace, and not always with the best of form (and, more than likely, my futile attempts to not only keep up with, but be BETTER than guys who are half my age). The tightness my doctor felt was definitely the soft tissue, and not so much the joints, which is why the shots helped. The nurse at FedEx actually did a much more thorough job of examining me than my doctor did.... still, I feel confident I should be able to go back to work on Thursday, and pay more attention to how I lift (so as not to injure myself again). I actually went back to the gym for the first time since it went out yesterday... I took it slow, but I still felt good. Running is now off the agenda (probably for good... we'll see). Thanks again for your help.
  • UStriathlete

    Posts: 320

    Jul 04, 2007 1:33 PM GMT
    www.chirunning.com
    running it's self doesn't hurt you, it's how you run that hurts you.
    find a good pilates mat instructor. Abs are not what helps lower backs. It's your core, deep muscles like NYC mentioned. your core is like a cylinder, there is a top, bottom, and all the way around. good luck!