I've a question about long-term, recurrent, but not always bad, back pain, and I'm hoping someone can provide me with advice on whether or not it's worth getting checked out.
I'm only 19, but since the start of adolescence, I've struggled with back pain. I always attributed it to the awful bed I had - from the age of about 5 to 16 I had a very flat, thin and very uncomfortable mattress. I've always had good posture, for the record, and do to this day. Before I had that mattress replaced a few years ago, I struggled with very severe and constant back pain, which could sometimes be disabling, but never saw a doctor about it. Since 16, I've had a much more comfortable, proper mattress, with a memory foam topper, and within weeks I found that my back was MUCH less painful on the whole.
But even to this day, I still struggle with a degree of back pain. Most of the time it's quite manageable - it usually isn't enough to get in the way of (cardio) exercise, and in actual fact, I'm actually in quite good physical shape now that I'm not in crippling pain. It's certainly not nearly as disabling as it once was, but it's still causing me problems.
I still experience pain and discomfort throughout the day from my lower back and sometimes my upper back as well, and whilst it isn't usually too much of a problem, I find that if I strain my back even slightly - say through over-doing exercise, lifting even a small amount more than I should or even just bending too far - I can often be left with crippling back pain that takes a while, sometimes even a full day or two, to fully subside. I also still can't stand still for very long periods of time before I start to experience extreme discomfort and increasing pain - I can walk for much longer periods of time than I can stand, but after a few hours, I also start to experience increasing pain and discomfort which can become problematic, given that my current work regularly requires me to walk for long periods of time to make doorstep visits or deliveries. I have found that sometimes walking with my father's spare cane (he also suffers from severe back problems, but as the result of spinal trauma) can help alleviate the strain from standing or walking, though I've only ever tried it at home after my back pain has all ready flared up.
A few people have suggested that maybe it's just intense muscle tension, and I had intensive massage therapy a few times after this was suggested (three sessions in as many fortnights), but it didn't seem to do anything for me - my problems were just as bad and no better afterwards.
Any guidance or advice would be appreciated. Is this worth talking to my doctor about, or should I just keep on grinning and enduring it?
Since you do not have any "tension signs" and the pain is basically located to the muscles of the back, caused by activity, the most likely cause is musculoskeletal.
Tension signs are signs of nerve problems in the spine. These would be pain radiating down the back on the leg, to below the knee, with numbness, tingling, weakness, change in reflexes such as when a nerve root is being compressed. You do not describe any neurological signs or symptoms.
Since your back pain is most likely musculoskeletal, what the physician would prescribe is physical therapy to emphasize core muscle strength and flexibility, doing specific types of exercise. Proper weight management. Proper biomechanics when lifting and performing your occupation. Increased cardiovascular fitness. Massage or chiropractice as needed for comfort. Acetominophen or NSAIDs as needed, if you can take them.
However, if you feel that you have given these measures their proper attention and your back pain is significantly limiting your life, then you may want to see your physician.
I also still can't stand still for very long periods of time before I start to experience extreme discomfort and increasing pain - I can walk for much longer periods of time than I can stand
This could mean either:
1)The ligaments (discs) that hold your bones in place are stretched or torn.
2) You have no motion in your lower back when you stand but things get a little loosened up when you walk.
I would first suggest:
1) "Static extension on elbows" (Do a Google search)
1) "Cats and Dogs exercise" (Do a Google search)
2) "Hand leg opposite glides" (Do a Google search)
- IMPORTANT: let both ankles drop out EQUALLY so your legs turn in FROM THE HIPS and you are pigeon toed.
- Look for the leg that doesn't turn in as much. You will find a reaction in your hips (usually it's the low hip side) and tightness in the abdominal on the OPPOSITE side of the body.
3) "Standing windmill". (DO a Google search - NOT the breakdance move Smile )
- You can trying this on your back at first.
- IMPORTANT: Make sure you lean as much to one side as the other.
- Do ALL 3 positions: feet spread apart narrow / medium / wide.
4) "Knee drops" (Do a Google search - it's the YOUTUBE video).
- As you lift your knees up from the dropped position, use you abdominal muscles (external and internal obliques). Do NOT let your lower back arch more as that is the wrong muscle group for this exercise.
I would bet 100:1 your hip flexors are VERY tight. Some type of lunge stretch (like with the front leg on the stairs is good) or
1) "Progressive groin stretch" (Do a Google search)
Massage will not relax this unless you ask them to "release your psoas" and this could help a little.