STAY WELL & SPARKLE – Pain In The…

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.

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9 Comments

  1. watching
    March 27, 2014

    thanks Doc for your information, I’m hoping you would answer my question, my concern with back pain is can it affect a woman during pregnancy, i myself have fallen on wet tiles, thank God after doing a x-ray nothing was broken but occasionally the pain comes, I’m 31 and plan on getting pregnant soon, but I’m scared this pain will affect me.

  2. Godswillbedone
    March 26, 2014

    :-D Thanks Doc. Are you sure that you do not want another profession? I recommend: “Stand up comedian”. You get the point across so effortlessly and yet we get all the information. Not too difficult to understand. I do have a post graduate degree, but the reading is easy. I felt exactly what you felt after lifting and carrying too many bags. I was so “capon”: coward to go to the chiropractor. I sent my whole family years before but I never went. I did not want to be told that I had pinched nerves or slip disks, crooked spine, etc., However, I do not like to take pills so I went. It was just sore from carrying the heavy load. I just took some heat therapy and some massages. The doctor said that I was very flexible…I am 50+. Good genes is a blessing, but no more lifting of heavy loads for me.

  3. P.D
    March 23, 2014

    I promised you I would comment on your article. Another great article. Pain in the heel or feet is another article am looking forward to reading from you. Have a great week.

  4. sweety
    March 23, 2014

    Thanks Doc.

  5. LINTON/ MARIGOT
    March 23, 2014

    Thanks for this article I am suffering with my back because of my work I have gone through many different kinds of treatment but never acupuncture. On my next visit with my Dr. this is one I am going to ask for my be this will be my healing procedure.

  6. Francisco Telemaque
    March 22, 2014

    By the time I am through with my input, and opinion which as usually will be factual, someone will get on my case, and say I am repetitive of Dr. Christian; so let me say in advanced what I am about to write I do not know if the doctor already discussed the same thing in his medical minute, since I never enter into that area!

    Backache (back pain) is any pain in the back usually the lower part of the back; that part of the lower back referred to in medical orthopedic terms as the Lumbar, that is from L1 – S5 and including the Coccygeal plexus (S4 to Co 1); the pain is often dull, and continuous, however, sometimes sharp, and throbbing. Back pain is the most common cause of disability and time lost from work in the 18 to 65-year-old age group.

    Statistics indicate that between 50, and 80 percent of individuals will be disabled by backache, even for a shot period of time, at some point and time during our lives. It is common knowledge within the medical profession that more than sixty (60) percent of all back pain is related to non-sciatic muscle strain, and ligament sprain. Approximately 30% of back pain can be attributed to the back component of sciatica, although leg pain is usually a more prominent feature.

    About 10% of backache can be attributed to other causes, such as urinary tract infection, kidney stones, multiple myeloma, metastatic carcinoma, osteoporosis, osteomalacia, abdominal aortic aneurysm, spondylosis, and spondylolisthesis.

    A sudden action, using muscles that are already fatigued, or out of condition is particularly likely to cause acute strain; in such cases rest, and time usually bring recovery. A very sharp, persistent pin following the use of unusual force against something; i. e., when trying to open an hard to open door could indicate an herniated intervertebral dish or sacroiliac strain.

    Note: night pain, or pain that wakes someone from sleep often points to a diagnosis of infection, or tumor.

    Treatment: The initial treatment for back pain is usually nonoperative. Nonsteroidal anti-inflammatory drugs, and postural rest are conservative therapy, and are based on the principles of reducing inflammation about the spinal nerve, or related structures such as the disk, or posterior facet joints, and decreasing at least temporarily the tremendous loads borne by the spine.

    Epidural steroids are helpful in some cases; nevertheless, surgical treatment is usually a last resort, and involves excision of a herniated disk, laminectomy to stabilize the spine, or some other type of orthopedic surgery, depending on the cause of the back pain.

    Chronic backache that does not respond to other modes of treatment sometimes can be relieved by transcutaneous neural stimulation, and other modalities such as antidepressants, muscle-strengthening exercises, and weight-reduction programs.

    A word to the wise, never undergo spinal surgery to relieve back pain especially when the issue is in the region of the Lumbar, unless you find yourself in a situation where you are unable to use your lower extremities; if you are unable to ambulate, it might be time to operate, however remember, bulging and degenerative disk due to aging, and arthritis can cause plenty of back pain.

    I might return with a brief regarding superficial pain receptors, impulses, synapses in the gray matter, transmission and recognition pf pain.

    Francisco Etienne-Dods Telemaque

    • March 24, 2014

      Francisco, no one wants to get on your case, because that case is an ugly case. You are simply asking for attention, so I will give it to you.

      And so, it is not that you repeat Doctor Christian, but you simply write another version of his message–perhaps you think that your version is better than his, since you claim that you are being “factual

      I truly believe that this attitude of yours is insulting to Doctor Christian–for you keep raining on his parade. It would be better if you would give us an example pertaining to what he writes about, don’t you think so?

  7. opinionated
    March 22, 2014

    very intriguing. I find the manner in which you articulated your injury to be hilarious. lol

  8. March 22, 2014

    For me it is not back pain anymore–the trouble was from years ago, when I was working

    But for many years now it has been neck pain. It is amazing that when they were doing what is called a “balance test” to determine the ear of mine which would be implanted for a cochlea–I now have one in my left ear–at the time of the test, the lady asked me if I have pain in my neck–and yes I did.

    What is amazing to me was that a machine could show that I had pain–we need to thank God for technology and to use it for fruitfulness–not the productive corruption that is all over the place because of technology.

    Anyway when the pain in my neck is unbearable I simply take a couple pain relief pills or a rub down with bayrum or Limacol and it will be gone for most of the day.

    I also believe it has to do with sleeping on high pillows, but I cannot sleep with less than two pillows under my head–too bad!.

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