Lower back pain

diy

markhewitt1978 wrote:

I've tried quite a few of the exercises on youtube - particularly those on GCN, hard to tell but it feels like it's making it worse

Which ones? Some are quite complex and there are often simpler versions. IMO you start with stretching and you do strength once the pain has reduced. If you've actually got an injury, you have to rest it.

There is always voltarol

markhewitt1978

https://www.youtube.com/watch?v=KmHqBYFYwmc

Mostly this one as they are easy to do as you can do them standing up, no rolling around the floor!

diy

Far too static and stressful IMO. Start with flexibility, mobility and release exercises. Those exercises wont do anything for tight muscles, but will make a difference once you've got range.

kajjal

For peace of mind you are better off seeing a medical professional as an injury I had to my shoulder went on for months of incorrectly targeted physio. After scans I had the correct treatment and was pain free within a week and back mountain biking after several weeks. Rebuilding my fitness took a while.

ai_1

While we're on anecdotes....I got a relatively minor back injury in my mid twenties that was sore for a couple of weeks but I decided to wait and see if it took care of itself before seeing anyone about it. It gradually seemed to improve and although I had the occasional twinge over the following years it was minor and not enough to persuade me it needed looking at.
Eventually about 5 years later I hurt my neck in an unrelated accident and since my back had also been bothering me more recently I got both checked out. The physio refered me to a neuro surgeon who got some scans done. It turned out the original minor back problem had caused me to modify my posture a little to protect it but as a result I was putting more load on parts of my lower spine. This causes the bone to thicken slightly to accomodate the extra stress and resulted in slightly restricted space at the facet joints for the nerves to exit the spinal column. This was causing the pain. It's not a big problem. I went back to the physio and with some guidance (maybe 3 visits worth!) I corrected my posture over the following few months with some core strengthening and the like. Now I rarely have any discomfort but if I do, a little stretching to loosen up the joints is normally enough to deal with it.
If I'd seen a physio soon after the original accident problem I wouldn't have this now permanent, though thankfully very minor, problem. Back injuries in particular, are best dealt with quickly rather than waiting to see what happens. The consequences are too big to take a chance and, in my experience, the fix is often relatively easy for minor issues.

diy

I think it goes without saying that people should always go to a pro, and preferably one who can take X-rays etc, not just a sports physio.

ai_1

diy wrote:

I think it goes without saying that people should always go to a pro, and preferably one who can take X-rays etc, not just a sports physio.

Generally a half decent physio will refer you for scans if needed. It's not like GPs, or specialists generally have X-ray or MRI equipment sitting in their surgeries either. I usually consider the physio the best first point of contact for musculo-skeletal issues rather than a GP. Would you disagree?

diy

I don't have any personal experience, but the anecdotes of people with serious damage being manipulated when they need surgery are pretty common. I wonder how a pro can diagnose without a decent X-ray?

Also some core strength exercises will cause you a lot of damage if you have spine issues as they can push the damaged segment into the ground. But also things like leg raises with Lordosis will make it worse.

I'm quite lucky in that I have a fair few PTs as friends and they seem to be good at diagnosing common muscle issues that I get as a result of being an old bloke who is trying keep his body as good as it was in his 20s

jimwalsh

sorry diy but the evidence doesnt back up your view.

In the main when looked at in retrospective analysis of outcomes of cases of back pain. folk who have xrays/mri scans do worse than those who have conservative treatment (physio etc). these studies were done looking at matched cases (two similar people presenting with the same issue) retrospectively that went down the surgery or physio routes.

the reason being is that surgery for back pain is almost never warranted except for in medical emergencies (cauda equina syndrome and the like). However we all walk around with what are refered to as incidentalomas in the spine (an estimated 40% of us have discs bulges which dont seem to cause problems). these become false positives and the patient ends up in surgery and becomes a VOMIT victim of medical imaging technology.

ai_1

I must be getting lucky with the people I've seen!
Some physios do seem manipulation happy and intent on keeping you coming back for ever. Several friends have experienced this. However those I've seen have always done a pretty in-depth analysis first and only done any manipulation when sure they new the issue and could help with it. On another occasion as mentioned earlier, the physio referred me for an MRI after the initial analysis without ever doing any manipulation. A neurosurgeon reviewed the scans and said surgery could be done but was way over the top and likely to cause more problems than it would solve. He referred me back to the physio and a few months later with strengthening and stretching exercises (which if I'm honest I didn't adhere to all that strictly) I was back to normal with no problems. I was surprised the surgeon even mentioned surgery but it seemed like he expected to be asked about it. Probably like GPs expecting people to ask for antibiotics.
I've never attended a physio on any issue more than 3 times and generally twice. Not that I go all the time! That's from maybe 6 experiences in 20 years.