Back Problems and Back Pain

February 25, 1996
by Edward H. Newland

We recently came across a Medical Chat channel on the WWW, (http://wbs.net/) which is hosted on Sunday evenings by William K. Main, MD, NYC othopedic surgeon and spinal disorders expert. The following is an exerpt from Dr. Main's answer to a back problem question:

"...when you reach your 30's and 40's, if you are not in good physical condition you are likely to have back problems ...you may have only low back pain, or you may develop what people frequently call "slipped discs" or "herniated discs"...this happens to the majority of people at one point or another, but not always in the same way or with the same consequences....if you are unlucky enough to have a good-sized disc herniation (displacement of a portion of the rubbery disc material outside its normal position), you may have pressure on the spinal nerves ("pinched nerve"), with leg pain ("sciatica") or even weakness of the leg...it is true that plain x-rays usually give very limited information...an MRI (magnetic resonance image) of the spine will show the condition of the discs, and displaced portions, and their impact on the nerves...the treatment will depend on the results of the MRI as well as the symptoms and physical findings (weakness,numbness in the legs) at the time...whatever the specific treatment of the individual case, the root cause is generally poor conditioning... "

It seems to me that the best way to avoid back problems is to be in good physical shape, and not to be overweight. Think of the mid section of the body as a sphere -- any weakness in any section of the sphere will cause problems with the rest of the sphere. The weaker the stomach area is the more pressure one will put on the back area; or the weaker the back the more pressure the stomach will have to deal with. Therefore a strong stomach and obliques will be key to helping the back deal with the pressures of normal moving that the midsection must deal with on a daily basis.

I have had my share of back problems just as most people have or will have; and I have suffered from back pain and sciatica on and off for the last 38 years. Even people who are physically fit and not overweight can and often do experience back problems. As Dr. Main said above, a lot of the pain comes from the slipped disc swelling out and pushing on the spinal nerves causing pain in the back and sometime pain and numbness in the leg. This pain usually starts up high in the buttock area and works down the back of the leg. It is much more common on the right side than the left but it can go to either or both sides.

What can one do to help stop this from happening? -- and if it does hit you what can you do to help stop the pain and heal the problem? Stay as thin as possible particularly in the stomach area. When women get pregnant they often suffer from back pain caused by all that added weight out in front so having a fat stomach will do the same thing to most human beings.

Next, I recommend 20 minutes of stomach strengthening exercises for all human beings; every day is best, or at minimum 3 or 4 times a week. You all should know good stomach exercises, but if you want more info on this let me know.

I have found stretching my back has really cut down the frequency of my back pain. What stretches do I do? The key stretch for me is lying down on my chest and stomach and keeping my hips down, push up with my arms and arch my back and hold the arch as high as possible for about a minute; then roll over on my back and bend one leg at the knee and pull that knee up until it touches your stomach and chest then switch to the other knee; then both knees up, roll up on your shoulders and try to get your knees to touch the floor on either side of your ears. This has often been called the lotus position.

Just these 3 stretches do the job; if you have time, or your back is hurting go through them each 2 or 3 times. This takes about 6 minutes. 6 minutes a day is a cheap price to pay for no pain and increased mobility.

(Note: as in everything else, start these exercises gently, gradually working up over time; do them fairly slowly as nothing will be gained by cranking, forcing or stressing your back here, especially if it is giving you pain in the first place).

What do I do when my back really starts giving me pain? I take 2 Aleve, or Nuprin, or Advil or even aspirin every 4 hours and increase my stretching maybe stretch every 2 or 3 hours. Some times I do easy swimming with fins on and no tumble turns, easy grab turns. I have found this to work very well not only with me but with other people I have had do it.

If your back pain continues and you really are not getting any better go to a good orthopedic doctor who specializes in back problems. Nowadays most orthopedic surgeons specialize in knees, backs, shoulder or elbows. X rays won't show much, as Dr. Main mentioned; and even MRI are not always useful. I read in the Mayo Clinic Newsletter that some people whose MRI's show severely bulging discs have no pain, while others who only have mildly bulging discs have all kinds of pain.

I think the secret is being patient and stretching often and being smart enough to not overdo until it gets well. Not easy for an exercise freak like myself. Stretch and be patient. Don't let them cut you if at all possible because operations are really not always very successful, and are a last resort.

Stay thin, keep your stomach strong, exercise and stretch and be patient. Things will get better. Back pains are like most things we all have to deal with. There are no secrets and no really quick fixes. It takes self discipline and self motivation to change your life style and put in the time necessary each day to deal effectively with you mid section.