# Lower Back Pain



## JaeBeam (Aug 23, 2004)

I've had chronic back pain for a long time. I went to a chiropractor for a year, with no results.

So last year I biked a lot, lost some weight, did RAGBRAI. Then I transitioned to running for an October 1/2 marathon. By the time I did the run, my pain was very managable.

Enter November and hockey season. No cycling, no running. Skating 5 times a week. Back pain comes back over christmas, worse than ever. Now I have spasms, and the occasional locking.

So I figure I better start running and cycling again... but now I can't really do much more than an hour of light riding/running. I rode 20 miles on Saturday, and spent Sunday being a PITA to my wife, instead of going for a run.

So my question, after all that preamble; is there a simple test for me to do that would let me know if my legs muscles are imbalanced? I suspect my hammies are now weak from working only my quads by playing hockey.

Tomorrow, I go to a back rehab specialist. So I will be getting professional help, but I want to see what others have for experiences and advice.


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## lookrider (Dec 3, 2006)

Try this exercise, it worked wonders for me and comes from the Multifidus Back Pain Solution book.

Get down on hands and knees,

Extend right arm forward, and left leg back, hold for a couple of seconds,

extend left arm forward and right leg back

repeat, alternating right arm left leg and left arm right leg.

When performing this exercise you should make a straight line from you right hand to you left foot along the back and vice versa.

It sounds simple but helped me tremendously...


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## kike_gavilan (Jan 2, 2003)

Work on your lower abs and lower back strength and your overall core flexibility. I have chronic back pain and ended up at the ER a couple of times with the worst pain of my life. After the second time, I started being really disciplined about my lower abs and lower back strength exercises and I stretch my core EVERY DAY. No pack pain whatsoever. Regardless of the diagnosis and recommended treatment, it just can't hurt to work on your core strength. 

An added benefit: I climb much faster as a result of the core strength work and now my hip flexors don't complain after long rides.


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## oily666 (Apr 7, 2007)

They're three really good workouts for your lower back and you only need a stability ball from WalMart. The first is an abdominal / low back crunch. Start with your lower back slightly down from the top of the ball with your knees bent at 90 degress and feet on the floor at standing width. Do 12-15 ab crunches while focussing on driving your butt into the ball. Try not to use your legs to create the force, just your core. For the second routine start facing down with the ball pulled tight against your abs and upper legs. Place your hands behind your head and do reverse crunches while keeping tha ball stable. The last is to lay over the ball with the ball at your mid section and, while supporting your upper body with your hands, lift both legs from the floor together while pointing your toes forward. Keep your head up, looking forward. This one will hurt at first as you're raising your legs with your lower back and glute muscles. Keep the toes pointing forward. 12-15 of each of these per day will provide improvement quickly. Obviously, if you encounter any suspicious pain, stop or go to every other day for the first couple of weeks. Be sure to stretch out your back when finished. My core strength was next to nothing six weeks ago. It's much better now and I think my wife is shorter too. Could be posture. Yeah, probably. Pants are a bit loose too.


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## JaeBeam (Aug 23, 2004)

Thanks for the suggestions!

I went to the DR. and PT on Tuesday. Diagnosis is Arthritis in either my L3 or L4. Prescribed some Muscle relaxants, but I haven't used them yet.

I was told to keep on exercising if I can, so that is a relief.

I have a balance ball, and she is a harsh mistress, but I'll keep at it. The reverse situp (back extension) on the Balance ball is wierd. I'm probably going to buy a roman chair off of craigs list to do this exercise. The PT folks actually want their clients to own this piece of equipment, I guess its the best way to strengthen your lower back.

Lookrider: how many repeats, and how long/slow do I hold the posture? right now I just go slow and do about 20 (10 each side), and add them at the end of the PT routine I was given.


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## lookrider (Dec 3, 2006)

JaeBeam said:


> Thanks for the suggestions!
> 
> I went to the DR. and PT on Tuesday. Diagnosis is Arthritis in either my L3 or L4. Prescribed some Muscle relaxants, but I haven't used them yet.
> 
> ...


I raise the arm and opposing leg to a count of five for one rep. I hold that for one second then lower slowly, one or two seconds.

I don't do this to anywhere near exhaustion but do about 10 to 20 reps with each arm/leg combo.

For me this exercise seemed semi miraculous. I felt immediate alignment/ relief. 

How does it work for you?

Regarding the balance ball. I think the awkwardness is part of what makes it effective. It brings a lot of the stabilizing muscles into play that you're not consciously contracting, like you would be when you are using a roman chair. Muscles like the transverse abdominals and multifidus.


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## toonraid (Sep 19, 2006)

I too have been suffering from back pain which dates back to an injury (sciatica) I picked up hyper extending during a game of squash (similar to racket ball). Long or steep uphills as well as long rides seems to aggrivate it and this is what I have so far found out.

Main culprit seems to be 

1 - core strength - you need strong core muscles to stay bent over on a bike specially if like me you are 6'4 with a longish torso. Cure seems to be Pilates and lots of ball work.

2 - Hip flexibility - To avoid putting undue pressure on your back you need to have flexible hips so as to rotate them forward. Cure seems to be yoga work

3 - Hip flexor muscles - these tighten up in cycling and will cause back-ache as well as pain down your leg, similar to sciatica as they get inflammed and push on to your sciatic nerve. Also when they tense up they cause movement problems to your hips and this imbalance also creates lower back pain. Cure is deep tissue sports massage and routine specific stretches after cycling.

4 - Bike geometry - If your saddle is too high you will rotate your hips as you pedal so check that, perhaps have your seat positioned so that at max extension your fimur is 25 deg bent (or less). Check your kops - if you maintain the kops position you will put less strain on your back.

5 - Cleat position - make sure your cleats are at the right position, a little fore or aft and it will through out your balance while pedalling.

Of course once a problem has been aggrevated it can transfer itself to other sports due to sensitivity.


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## skiierx (Feb 20, 2008)

Glad to see all the help on this topic.

I too have had major back problems since I was 18 and won't go into all the treatment I have been through but will say that all the stretching that people have spoken about is right on target with what has to be done. Once the pain comes it is very rare that you can stop the stretching regiment or the pain will come back, some are lucky but ones with arthritus and herniated discs need to do these stretches for the rest of their lives.

One really interesting thing I learned about my issue is that my hip flexors were firing improperly and my PT and I had to retrain them. To this day I still get treatments (radio frequency and cortisone) but am now down to twice a year with the stretching and am also back to doing normal activities, although I will never run/jog or play basketball again.

Once I find all my exercise pages I can scan them and email them to anyone that would like them. Just pm your email and I will get them to you as soon as I scan them.

Jamie


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## JaeBeam (Aug 23, 2004)

Radio frequency treatments were discussed if the PT doesn't give me the appropriate relief.

Can you PM me the process that radio frequency treatments entail?


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## skiierx (Feb 20, 2008)

pm sent!

Good luck getting rid of the pain. This procedure works well for me!


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## prschatt (Aug 19, 2007)

Has anyone actually given you an accurate diagnosis? My problem with chiropractic is "manipulation" to align a spine can do more harm then good particularly if there i disc disease or compresion of vertebrae. Any Radiographs/MRI or other advanced diagnostics done?. Don't mess around with your back until you know the origin of pain..


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## JaeBeam (Aug 23, 2004)

Well, initial diagnosis is Arthritis. I'm going to do the PT thing. In the mean time, I was prescribed a muscle relaxant (forget the name) that I can take 2 times a day. I take it on a "as needed" basis right now, once a day. 

IE, if I'm going exercise, I may take it after or before depending on how I feel.

I'll avoid the chiropractor for the time being, mostly because he had a year to fix me up and nothing changed. Now I'll go the PT route, and ultimately try radio frequency treatment if PT doesn't do the trick.

In a week the PT does seem to have given me a bit more motion in the mornings than what I've had in quite a while, so I'm optimistic.

Thanks for all the responses. A lot to chew on.


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## lookrider (Dec 3, 2006)

Have they done an MRI? MIne was pretty screwy. Two herniations, osteoarthritis and the radiologist and two different spinal surgeons don't agree on whether I have spondylolisthesis (slipped disc). My pt thought it was crazy when I showed him the radiologist's report. Everybody thought I was faking it. I could tell that the orthopedic who referred me to the first spine guy thought I was bs ing him.

My lawyer friend tells me that most MRI's turn up some kind of "damage" but you might not even be symptomatic. If you look at your back the same way you look at your riding or your car from a maintenance perspective, you can probably keep the back trouble at bay. Good luck.


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## Angelracer (Dec 12, 2004)

*Lucky...*

Lucky duck, I fractured my L3 and L4 and its been nothing but hell since I did it. Lucky there isn't nerve damage, but I get numbness if I sit funny. I have reduced my pedaling intensity, doing high cadence now. If I try to crank too hard, after 3-4 hours the pain radiates so much I just can't take it. PT helped greatly, but its just has not been the same since.


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## El Caballito (Oct 31, 2004)

kike_gavilan said:


> Work on your lower abs and lower back strength and your overall core flexibility. I have chronic back pain and ended up at the ER a couple of times with the worst pain of my life. After the second time, I started being really disciplined about my lower abs and lower back strength exercises and I stretch my core EVERY DAY. No pack pain whatsoever. Regardless of the diagnosis and recommended treatment, it just can't hurt to work on your core strength.
> 
> An added benefit: I climb much faster as a result of the core strength work and now my hip flexors don't complain after long rides.


Ditto on the core movements. I too am a member of the bad back club, currently trying to get over a stiff back. Stretching is good, but it has to be consistent. That's my problem, I'm not consistent so this is the result. I guess, just making it a part of everyday things you do. Good Luck!

Before this current back episode, I had gone almost a year without any pain.


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## JaeBeam (Aug 23, 2004)

No MRI has been done. I've been good about doing core stretches and strengthening exercises, just hasn't really done me much good, hence the trip to the DR.

Tomorrow is my second PT session. See how that goes.

I've basically cut my workouts down to 3 times a week to keep my back from flaring up big time. Now it seems to only lock up on me in the mornings, so thats progress. I'll give PT a few more weeks before pursuing radiotherapy.

The prescribed muscle relaxants help too, but I ration them out as I have "episodes" rather than take em' daily. I'm also sucking weight... ich.

And yes, I am very glad I don't have a bulging/fractured/degraded disk problem!


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## Sashana (Dec 19, 2007)

JaeBeam said:


> The prescribed muscle relaxants help too, but I ration them out as I have "episodes" rather than take em' daily. I'm also sucking weight... ich.


I have a chronic pain problem(unrelated to biking)and I've found that it's much better to take the muscle relaxants/pain pills regularly. Once the pain or muscle spasms get to the point where it's a 7 on the 1 to 10 pain scale(10 being most pain)I'm going to be playing a game of catchup and it's a losing battle. If you are having pain every morning you need to take the pills regularly. Chances are after a few days of doing so you will feel a lot better, maybe even in the a.m. You aren't going to become a drug addict if you have a real problem and take pills as prescribed. When I had back spasms it took about a week of taking the pills, PT, and stretching to get real relief. IMO.

Good luck, pain is a real beotch.

Sashana


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## Doggity (Mar 10, 2006)

Good advice, all. I would add, if there are no contraindications, a tilt table/inversion boots combo can really help relieve low back issues, because you're using your body weight and gravity to work for you, rather than working against them. Aaah, it can feel so good to feel those muscles around the L/S area relax, and stretch, assisted by gravity. Plus it's highly amusing to watch your face turn purple. For this reason, especially if you have high BP and/or sinus infection do NOT use. Check with your doc.


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## I-Ride (Jan 18, 2008)

What is the "kops" position?


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## RJHarary (Nov 8, 2007)

Read Dr John Sarno's book called Mind over Back Pain. It is a quick read and its not "all in your head" the way some people who haven't read the book think it is. 

RJ


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## cbags101 (May 23, 2008)

Its surprising that the pain shows up when you are skating alot. I get back pain alot when I run and dont stretch. Biking, I never get back pain.

To me it sounds like your problem is pinpointed to skating, given the desctiption. If you must play hockey, make sure you STRETCH before and after. 

Sounds simple, but you would be surprised how many people I have heard complain about back problems and they never stretch.

Pills and medical dependancies = bad advice. If you ask me its more of a blanket solution, not actually solving the underlying problem.

Recap: STRETCH


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## Triman52 (Jun 8, 2008)

I am not a physician, and my experience may not be yours, but I had back spasms for 37 years, 3-6 per year. I did all the leg exercizes I read about and that were recommended to me. Then one day I was in a hot shower and simply leaned over gently as if doing toe touches, but I didn't force it. Then I stood up crossed my arms across my chest and gently twisted back to the left so that I was looking backwards. Then twisted to the right. I repeated this twice in the hot shower.

I started these exercises over a year ago. I have not had ONE back spasm since. I am convinced it is due to these simple exercises. 

I feel your pain and wish you well.


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## bubba biker (Mar 1, 2008)

I had a very similar situation as yours hernated disc L4 L5. You really need to keep flexible and strong in your core. Palates and yoga are great just take it easy. I to did some skating and played some hockey but found that this aggravated my back a great deal and had to give it up believe me this wasn't easy but I was afraid it was going to cripple me in the end. You have to learn to live your life around your injury or you can really screw yourself up. Good luck and if you don't already have one buy a bike that is super comfy Ti works for me.


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