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severe back pain

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Kristina1

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Hi everyone. I recently traveled to visit my brother out of state. Since coming back, I have had severe mid-low back pain. I believe it was caused by the way I was sitting while traveling and my weakness in the muscles that support your posture when you sit. On the day I came home I was in a car for 5 hours, then in an uncomfortable manual wheelchair for 2 hours, then a plane for 2 hours, then a car for 1 hour.

It's been a full week and I still have severe back pain. I don't know what to do to help it get better. Can anyone advise?
 

Nikki J

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Oh so sorry. What have you tried? I have had similar and a combination of ice, stretching, getting up frequently and trying not to sit very much at all ( lying on a supportive surface with pillow under knees to rest). Plus ibuprofen. I don’t know how your capabilities are now. Some people find heat helps I didn’t for this.

Also consider if you have done all this checking with your doctor for something to break the pain cycle
 

Kristina1

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We have tried massage, heat, laying on my back in bed with pillow under knees (my bed is great for back pain). When im in bed I feel relief, but I can't be flat on my back in bed all day.
 

KarenNWendyn

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In addition to massage, stretching, and range of motion, I recommend alternating ice with heat. I also suggest ibuprofen with food, assuming you tolerate antinflammatories.

I also like pain patches that contain capsaicin, such as Tiger Balm patches.

Prescription meds could include Lidocaine patches, muscle relaxers such as Flexeril (Cyclobenzaprine) or Robaxin (Methacarbamol). Opioids such as Hydrocodone would be a last resort.
 

Kristina1

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I have been doing ibuprofen. Thanks for the suggestions!
 

KimT

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Kristina,

I developed back pain in January 2016. At that time I was walking fine and could do most everything. I tried everything. Finally, my neurologist gave me Valium and Oxy to break the pain cycle. I took the Oxy for several months at 1/8 the dose he prescribed. It worked. The other thing that I did at the same time, thanks to Laurie, is bought a lift chair. When sitting in the lift chair I used the heat, massage, and even a heating pad. It finally went away completely until I sprained my ankle about six months later. That threw off my gait and made the back pain come back. Again I took 1/4 of one Oxy every morning with a Valium. It broke the cycle again but I was still hopping around for several more months.

Now I rub tons of THC cream on the parts that hurt. I do this several times a day and at night. The lift chair is my go-to place when I'm in pain. I have an adjustable bed (not a hospital bed but just a regular queen size bed.) I've slept with a pillow under my knees for three years. Sometimes I have to use different size pillows.

I know you know the risks of benzos and opioids, especially if your breathing is compromised. I weighed the risks and my decision was anything was better than relentless, stabbing pain.

One caveat. When my back first started hurting I went to a nurse who was also a massage therapist. He made it worse. Be very careful with massage. I've had massages since and I have to lie on my back when they do my back and they can only do it gently.
 

lgelb

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To help the muscles relax in sleep, I would consider a low-voltage heated mattress pad, if you don't have one. It helps keep the temperature of your back more constant.

As Kim points out, a lift chair gives you another set of supported positions during the day if the priority is not being in bed. But arguably, another day stretching out in bed since you don't have a lift chair is worth a shot, using the bed as a base for stretching exercises as well.

There is an increasing body of evidence (pun intended) that opioids worsen back pain instead of helping. Ultimately, in cases like yours where the muscles were asked to do too much, I believe reducing inflammation of the muscle fibers, which opioids have nothing to do with, is really the key. To that end, I would stay up on your vitamin C, zinc, copper, E from diet, and consider turmeric if you're not taking it already.

When you say you've tried massage, not sure if that was by a real CMT with a neuromuscular specialty, but that would be the ideal. The bed provides traction, as does a lift chair, and a good massage can help reprogram your muscles to be "longer" again. If you can get help with slow stretches like arm and leg lifts, never going past 90 degrees at a time, that is the same concept.
 

chally

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Massage works for me but not to deep or else you might make it worse

Also Bio Freeze. Or tiger balm

Ibuprofen
 

Kristina1

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Thank you all for the replies. I actually did buy a lift chair, and while normally I love sitting in it, it has been making my back worse when I'm in it in a reclined position. But I can't sit in it in the fully sitting-up position for long, I kind of need to be reclined with feet up a bit, I'm not sure why.

My husband was the one doing massage, not a professional. I'll try to be careful with that, I didn't realize he could make it worse.

I do think it is improving slightly or very slowly. As to meds, I do think flexeril might help..shortly before diagnosis I had a similar issue with my abdominal muscles after having a flu virus. Throwing up for a weekend created WEEKS of severe abdominal muscle pain. Looking back, I believe this was another early showing of my ALS. It still happens now that if I cough or vomit I deal with major backlash from stomach muscles that clearly can't handle that level of activity. Anyway at the time my GP was perplexed but prescribed flexeril and it helped immensely. I already take Baclofen, does anyone know if temporarily increasing my dose would similarly help without the need for flexeril?

I also have lorazapam, my anxiety has been lower this week so I haven't taken any. Would it help? I'll email my doctor too but it's a holiday weekend so soonest I can hear back will be Tuesday.
 

KarenNWendyn

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Lorazepam probably would help your back pain but shouldn’t be relied on for long term use of muscle strain or as a primary treatment for it. So consider that as more of a side benefit when you are taking Lorazepam for anxiety.

As far as an interaction between Baclofen and Flexeril — mainly in that they can both be sedating (as is also Lorazepam). So taking two or three of these together will probably make you very sleepy and can increase your risk of falling if you are still walking.

Increasing Baclofen will only help the back if there is a significant spasticity component to the back pain. Before adding Flexeril, you could try increasing the Baclofen for a couple days and see if it makes any difference.
 

notBrad

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Stretch your hamstrings. A friend of mine who was a trainer told me this and I have never had sustained back pain since. The second I start to feel pain I stretch my hammy's and it goes away. She explained that when you spend a lot of time sitting your hamstrings tighten up and your back takes up the slack.

When my dad was coaching he instructed the trainers to go very lightly on taping ankles because if you immobilize the ankle the knees have to take up the slack and that leads to tears in the knee ligaments.

Google hamstring stretches and pick the ones that are best suited to you.

Hth,
Brad
 

ShiftKicker

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Brad brings up a really good point- your back may be painful, but it could be caused by something seemingly unrelated. If you have access to a good physiotherapist or occupational therapist, they can perhaps do a posture/seating assessment to see where there is possible strain and where more support is needed. If you have an imbalance or weakness in one place, everything else is picking up the slack and creating strain that could be mitigated with foam supports, stretching and/or some other form of adjustment to your body when sitting or lying down.

I had shoulder pain on one side that I could not relieve for the longest time. Turns out when I sit, I manage to twist my hips around (weakness+spasticity), which creates a spasm in my intercostal muscles on one side, which in turn pulls down on some mysterious and usually unobtrusive shoulder muscle- which causes pain that won't go away with any amount of stretching or massage. Physio looked at me, stretched my hip out, told me to put a wedge under one side of my hips when sitting, and my shoulder pain went away. Like a reverse Jenga game.

I hope you find a solution soon!
 

Kristina1

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this is an embarrassing question but where are my hamstrings?
 

lgelb

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You can Google seated or standing hamstring stretch and get all kinds of videos.
 
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