Back Pain From the Snow & Ice? Get the Facts and Help!
Back pain is the second most common reason for doctor visits in the U.S. Up to 84% of adults have back pain at some time in their lives. Here in Indy last month we had an onset of back pain with so much snow and ice and falls!
Most episodes of back pain are self limited and resolve without specific therapy (these are usually muscle/ligament sprain/strains). If you have severe back pain or do not improve within four weeks of the onset of milder back symptoms, please see your doctor to be evaluated and possible further testing (first plain x-rays, and then may need MRI’s). I discuss below good prevention and treatment of back pain. Treatments range from good common home care, to prescription medicine and procedures for people with significant continuing back pain.
Chronic back pain can significantly interfere with employment and quality of life. Rarely back pain can be from a serious medical illness (infection, cancer, fracture, or systemic disease).
RISK FACTORS OF BACK PAIN ARE – smoking, obesity, older age, female gender, physically strenuous work, sedentary work, low education, anxiety/depression, vibration exposure (even from certain automobiles), and now there is evidence that certain foods may contribute to back pain.
The book “Foods That Fight Pain” by Dr. Neal Barnard gives excellent information on especially dietary treatment for back pain, and other causes of pain and medical problems (and many excellent recipes). His recommendations are included under the Dr. Barnard recommendations below.
Self Care – very important for all to remain active, get proper sleep/rest (at least 7-9 hours/night), maintain good muscle tone/physical fitness, concentrate and work daily to maintain your best posture (especially important when working at a computer to keep your neck and back properly aligned), and drink at least half of your body weight in ounces of plain water daily (so a 200 pound person needs to drink at least 100 ounces/day – I drink 30 ounces at each of 3 meals per day even though I weigh 130 pounds)
–a medium firm back conforming mattress may help, and there is no compelling evidence lumbar supports help
–cool/ice after injury for first 48 hours, then heat or cool (Thermacare wraps are effective), certain OTC creams like Bengay, Tiger Balm, Salonpas, or Vicks Vapor Rub can help
Medicine Options
–pain medicine (Tylenol/acetominophen, non steroidals like Advil/ibuprofen or Aleve/naproxen and available in patches like Flector Patch, and sometimes prescription medicines Ultram (tramedol) or narcotic pain medicines such as Tylenol w Codeine or Vicodin (hydrocodone) or Lidoderm (lidocaine patches)
—-skeletal muscle relaxants (Flexeril/cyclobenzaprine, Skelaxin, Soma/carisoprodol)
–rarely benzodiazepines (Valium/diazepam) or antidepressant/anti-anxiety medicines (Elavil/amitriptyline, trazedone, Prozac/Zoloft/Celexa/Lexapro)
–anti-seizure medicines (Neurontin/gabepentin)
Activity & Physical Treatments – in addition to self care, all people with back pain need regular physical activity
—exercise therapy (stretching exercises, core strengthening, general physical fitness, yoga and Pilate’s)
–physical therapy
–spinal manipulation – usually from a good chiropractor (Dr. Ed Zimmer and Abigail Eaton are excellent chiropractors and nutritionists in our office complex, 813-1998, and I see Dr. Zimmer about monthly to keep from having neck/back pain)
–acupuncture (Amy Yang is excellent here in Indinapolis, 317-876-1054)
–massage (excellent masseuse here in Indianapolis is Josh Neal at 317-872-3380 – I see him for a 1 hour Swedish massage about monthly to keep from having neck/back pain)
Psychological Interventions
–cognitive behavioral therapy, biofeedback – from trained therapists
Physical Modalities – used by some physical therapists or chiropractors or osteopaths
–low laser therapy
–ultrasound
–short wave diathermy
–traction
–trans cutaneous electrical nerve stimulation (TENS)
Medical/Physician Treatments (Commuity Spine Center and Dr. Foley and his associates are great back and spine specialists for consultation, 621-9292)
–epidural steroid injections
–facet joint steroid injections
–trigger point steroid injections
–sacroiliac steroid injections
–surgery – discectomy, fusion surgery, laminectomy
–thermal/laser/radiofrequency treatments
Dr. Barnard recommendations – he feels that back pain starts not in the muscles or spine but in the arteries supplying them/the lumbar arteries – Japanese-American women eating the traditional Japanese diet (rich in the first 4 food groups listed last blog and very low in animal products) have half the risk of back pain as Caucasian women – an optimal diet helps keep arteries open and helps prevent weight problems, arthritis, and osteoporosis which are all linked to back problems
–See your doctor (to make sure not a more serious condition and for help on the things listed here)
–Follow an artery opening diet (low fat mostly vegetarian as in his book and following the first 4 food groups in my previous blog-drawing your nutrition from plant sources helps clear arteries and keep calcium in your bones), regular exercise, no smoking, and manage stress
–No more than 2 cups of coffee/day (or switch to decaf) and limit salt use
–Follow a regular exercise program – exercise reduces pain, strengthens back muscles, helps open arteries, and protects your bones and more!
–Vitamin B6 (50-150mg/day) and powdered Ginger (1/2-1 tsp/day) may help with pain
–Chiropractic adjustments can help
–Be cautious about surgery and get a second opinion
–Simple pain killers (like Tylenol or ibuprofen) can be helpful, but it is best to avoid narcotics to avoid the chance of addiction
Here’s to all our back and spine and body health!
Dr. Lisa
