[BHV] back pain

[wlodico at stny.rr.com]

I've been fighting back pain (sometimes with radiating pain into the legs) for forty years, and the best thing for it has been bicycling.  The best way that I've found for knocking down the occasional bad flare is to go out for a shortish (one hour or so) ride at an easy pace, with lots of climbing.  The exertion of climbing seems to heat up the musculature of the low back from the inside, flush it with blood, and reduce the splinting and cramping that produces most of the discomfort.  Downhills and flats sometimes seem to aggravate the situation, but climbing always helps.  I've never found my pain to intensify following this regimen (though yours might, in which case it's probably not the right one for you).  Sometimes the pain before I start bad enough to make it very difficult to make the necessary physical motions to get on the bike (like lifting my leg over the saddle, or clipping a foot into a pedal), but once I'm on and going I start to feel some improvement within a!
  few minutes.

I stay away from any kind of formal stretching.  I've tried many stretching regimens without exception they aggravate the problem.  On the other hand exercises that involve some incidental dynamic stretching, such as the movements of Tai Chi, seem to be helpful.

If the pain has settled down below take-your-breath-away intensity, a conservative program of situps, crunches, Russian twists, and back extensions to strenghten the core seems to accelerate recovery and reduce the probability of a significant recurrence.

It's important to stay on the right side of the pain threshold when doing sit ups, and to assist with the arms, or have someone help you, when doing these.  

The same caveat goes for the cycling as well.  Stay away from anything that seems to make you more uncomfortable.   In these circumstances, significant pain will not yield gain, but a setback instead.  Also you'll condition yourself to be exercise averse.  Do just enough, and do it just hard enough, so it feels good; and don't cross into where it's not feeling good.

Some exercise is infinitely better than none when your back hurts, but too much or too hard may be worse than none.

As far as medications go, my best results have been with ibuprofen:  lots of it, always with food; for my approximately 180 pounds, 4X800mg the first day, then 3X800mg for a day or two, then off.  This seems to get the pain down enough so I can move around and do the above exercises, and eliminates the side effects and tolerance problems associated with long term use.  

I've never had an MRI and don't know how many bulging or herniated discs I've got, or how many bone spurs, or how many possible encroachments on nerve roots, though I expect I've got my share.   I really don't want to know, either, since that information is highly likely to mislead when it comes to considering appropriate treatment options -- and since current, non-surgical options outlined above are working really quite well

Bill Lodico