Dr. Sam Christian

Dr. Sam Christian

Pain in the…

…back. Yep, either you’ve had it, or will have it – no if, ands or buts about it. So now you are about to find out exactly what to expect when back pain gets a hold of you.

For me, it all started one hot Ohio afternoon several years ago. That old tree trunk in the front yard had suddenly lept to the top of my ‘to do list.’ I felt in great shape so I said to myself, “Why not?” I launched a full scale assault swinging a mean pickaxe. However, after an hour with little to show for all my hard work, I was about to call it a day.

Just then my wife appeared on the porch with some refreshing ice-cold juice.

“I’m so glad you’re trying to get rid of that thing, Sam.” She sighed. “I was just thinking about hiring somebody with that kind of machine to dig it out.”

(You see how trouble starts…)

“Nah man!” I countered. “I got it.”

Sure enough, I did. By that time it was approaching midnight. I don’t think I had any gas left in the tank. My hands were all ‘plichay,’ but you better believe I was gloating over that exhumed stump. “Who’s your daddy now?! Eh? Tell me!”

I savoured a satisfying hot shower, downed a hearty dinner and slept like a baby. Yes, you guessed it. Next morning I could barely move. The low back pain was wicked, wicked, wicked, radiating down below my right buttock. It took me five minutes to put on my underwear and at least another 8 minutes to lace my shoes. Days passed. I was crawling around like an invalid. “Oui Bondieu.” I moaned. “I just know it.  I’d wrecked my back for life.”

Part of life

Of course, something like that would never happen to you. You know your limits. But maybe, you took a high fall down the back steps carrying out the rubbish, or was victim in a car accident. Maybe you couldn’t wait for someone to give you a hand moving that loaded cabinet. Maybe someone knocked your legs from under you as you went up to head that football – or oops, you just happened to trip into an open grave. Whatever the cause, you know what backs can give. So what’s next?

Click here for Dr. Christian’s Medical Minute on Back Pain

Fortunately, most cases of back pain arise from para-spinal muscle strain and spasm. That, of course, excludes back pain from hard menstrual periods and other medical conditions like kidney infections which manifest in the back.

Advanced facilities may boast of warm therapeutic pools with special lifts to lower patients with wheelchairs. A sea bath works just as well. Along with the added advantage of invigorating natural salts and minerals, the waves provide just the right range of gentle motion without the weight of gravity. Massage using coconut oil or bay rum is fantastic – if the patient is not too hard-headed to understand one has to slow down and rest. Over-the-counter linaments like Ben Gay or Aspercreme are beneficial, together with Paracetamol, Aspirin and Aleve.

Medical treatment options

Your doctor may prescribe pain medications like Ibuprofen and Diclofenac as well as muscle relaxants for persistent symptoms. Specific yoga exercises and physical therapy is useful in strengthening the core muscles and thus take some strain off the back. If therapy hurts too much, it may actually be making you worse, so listen to your body. If there are occupational or legal concerns, it is wise to get x-rays early to establish the diagnosis. Generally, CT scans or MRI’s are reserved for cases where the pain radiates down the leg (lumbar radiculopathy).

Steroid combined with long-acting local anesthetic injected under x-ray or ultra-sound guidance is the next level of treatment. This gets the potent medicine as close as possible to the inflamed nerve root without damaging it. Repeated treatments are often needed, but no more than a handful of times before reaching the point of diminishing returns. In the few cases where scans demonstrate a slipped or herniated disc pressing on the nerve, surgery is indicated (lumbar laminectomy) after a trial of traction.

Acupuncture

For me, acupuncture worked wonders. This ancient Chinese wisdom dates back to the pyramids before Christ and is still not fully understood today. Even though fully trained in the technique, I still personally had to overcome that innate fear of needles. Actually, since they are not designed to inject any drugs or to draw out any blood like other medical needles, acupuncture needles are as thin as ‘cats’ whiskers.’ I barely felt them. These delicate instruments unlock the flow of natural healing energy (Chi) to help dissipate the pain like a vapour.

With advanced age, the bones weaken (osteoporosis), the spine twists (scoliosis) or humps (kyphosis). Back pain in the elderly therefore is treated supportively with pain medication and massage. The good news is that most cases of back pain in youth and middle-age will get better with time. However, with serious back pain, while valid treatment can still make a difference, one needs to find out the score: an exact physician diagnosis of the problem.

Interest in medical acupuncture is catching on impressively in Dominica. In place of scepticism, my patients cannot wait for their next treatment. For now, me and my back are on the best of terms. However if and when it acts up again, don’t hesitate to hit me with needles. Or, in the words of a song I heard somewhere,Ah turnin’ Chiny tonight!”.

Dr. Sam Christian is a surgeon and health activist. His Urgent Care on 137 Bath Road provides prompt medical treatment, surgery and acupuncture. He is radio host of the Medical Minute, Medical Adviser to the Dominica Cancer Society and author of the faith and fitness nutrition book, ‘Mannafast Miracle.’ Dr. Christian can be reached anytime at 440-9133, 615-8345 or by writing to urgentcare.da@gmail.com.