Lower Back help needed

Guys I know the best option is go to a doctor and get an Xray etc.. but I can't do that right now. So I am looking for home remedies and routines you guys use to treat a sore back.

I was rolling about 3 weeks ago and I tried to bum really hard while I was mounted. I felt something on my lower back but it did not hurt. It was sore at home and stayed sore for the next 2 weeks. I did not stop training and kept on rolling with the help of Aleve. This week it got pretty bad and I thought to my self I should stop. So I did not grapple at all over the last 5 days but my back still hurts pretty bad. It feels like my spine is ok, but the left and right lower back muscles hurt like a bitch if I try to get out of my seat or try to get in my car.

So far I am using heat packs, bengay and ibuprofen.
I have a foam roller that I use to stretch the area. It does feel better after the stretching but I am not sure if it is the best thing to do to injured tissue.

Anything else I can do?

flotation tank. seems like that would take all the pressure off to help healing

there's a number of things it could be, if it's a sprain or a pulled muscle it shoudl right itself sooner or later. there's the possibility that you've done something more serious, my biggest concern would be that you've herniated one of your discs. there's a number of preconditions which increase the likelihood of this being the case: posture (while sitting and lifting), hamstring flexibility, excess weight and poor lower-abdominal strength. if any of those sound like you, that could be the problem. other symptoms include pain radiating down one side of your body, starting from the back pain (this will be through the hip and down the back/side of the leg).

on the flipside, you might have just pulled something and keep on aggravating the injury because you're not resting it. do you eat enough protein/vitamins? that has an enormous effect on your healing time.

like you say, going to a dr is the best bet, but do some reading and the answer might crop up.

I am eating pretty good, and thank you for the reply. I wonder if the herniated disk pain is similar to sprained muscle pain.
Mine does not radiate down to my leg, but goes to more like my kidney area.

When my back went out I actually went to the doctor because I was worried that I had a kidney stone.

I asked the same question here and took Louis Ho's advice only working lockdown to my top game and avoiding the closed guard and RG. Not only did it allow me to train through the injury but it drastically improved my top game.

Personally (and I can't speak for your situation) my back injury was related to poor hamstring flexibility. I now have a general routine of parallel squats (flat footed), solo omoplata drills, gramby rolls, and butterfly stretches. I actually don't even stretch my lower back, just every single other muscle that surrounds it. I modified all of my core exercises to not require lower back mobility.

Essentially, I trained around my injury and did not power through it. I was lucky, because I didn't have an MRI and had no real idea of what was going on. It was only the "kidney" like symptom that correlated with my doctor's advice, to be a muscle related issue and not a spinal issue. Oh, and ice and heat it like crazy, i used ibuprofin to help reduce inflammation and kava kava for pain management.

Put I am not posting this as a course of action for you. Just relating what I did. For the most part, if you can't afford an MRI and a doctor then just be diligent as hell in doing your online research.

Hey Andy,

I can definitely help you or direct you where you can receive help. Just answer a few questions and I'll see what I can do for you. I know you may have answered some of these questions already, but I'll ask some of them again. I can aid you in determining if you have a disc herniation, skeletal-muscular, and/or vicerosomatic injury.

Have you seen any type of doctor yet?
If so, what medications have they prescribed?
If not, what home remedies have you tried?
Have you ever had this happen in the past?
Is your pain the same today as it was when the injury first occurred?
Where is the exact area of pain at present?
Is the pain currently sharp (piercing) or dull (aching)?
Is the pain in one location or is it traveling down your leg?
If the pain is traveling, where is it traveling to?
Have you lost any functions, e.g. strength, walking, sitting, standing, breathing, urination, defecation, sensations in your legs or feet...etc?
Is there anything that you're doing that is causing your pain to increase?
Anything, if at all, that makes it feel better?


Answer these few questions and feel free to add any additional information that you feel may be of importance. This is my field of expertise and I truly care about my fellow human beings' health. Oh, and I'm a licensed and board certified doctor in two states. Again, I'll help you in any way I can.

First Al, thank you for the insight, I appreciate it.
Dcdoctr, here are the answers.
1- No doctor yet.
2- No medications
3- I am going in the chronological order.
a) Streching + Aleve
b) +Icy hot patches
c) dropped the icyhot patches for lots of bengay
d) dropped aleve and switched to ibuprofen, stopped rolling ( about 2 weeks in now)
e) dropped pain medications alltogether to determine what hurts how much and started using a dense foam roll to strech my lower back.
4- I always had very minor back pain when I woke up in the morning or sat in a chari studying for long periods of time, but nothing really stayed for this long
5- The pain is exactly the same as it was the first day. The severity of the pain changes depending on the time of the day. When I wake up my back is sore, but then the pain goes away during the day as the blood flow increases to the area. Also I am pretty pain free for about couple hours after using the foam roller stretcher. It felt like it was healing but one night it got really bad, I had trouble getting out of my chair and my back start to spasm. I went to bed, woke up in the morning and it was back to its original state and the intense pain was gone.
6- It is hard to say where they pain exactly is because i can't really point to it. If I turn my body left, my right lumbar muscle next to the spine hurts. If I turn the other way, nothing hurts. When I am standing or sitting with good posture nothing hurts. If I sit and pull my knees to my chest a thin flat horizontal strech of area that is about 12 inches higher than my butt crack hurts.
7-The pain is a mixture of both. It is sharp when I do something that my back does not like, but sometimes there is the dull ache. Overall, I do not have any pain that stays in spot constantly. It moves around with its severity changing depending on the position of my body.
8+9-The pain does not travel down my leg, but it does move to my lower kidney area sometimes.
10- No lost sensations or strength as far as I can tell.
11- A cat strech which you are on all fours and extend your lower back up, increases the pain if I have any at the time.
12- Foam roller makes it better, resting for a week doesn't look like it helped at all. Heat helps a lot, cold does not, bengay is bullshit.

I would appreciate all help, so tnx doc :)

Quote:

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Originally Posted by DCdoctr

Hey Andy,

I can definitely help you or direct you where you can receive help. Just answer a few questions and I'll see what I can do for you. I know you may have answered some of these questions already, but I'll ask some of them again. I can aid you in determining if you have a disc herniation, skeletal-muscular, and/or vicerosomatic injury.

Have you seen any type of doctor yet?
If so, what medications have they prescribed?
If not, what home remedies have you tried?
Have you ever had this happen in the past?
Is your pain the same today as it was when the injury first occurred?
Where is the exact area of pain at present?
Is the pain currently sharp (piercing) or dull (aching)?
Is the pain in one location or is it traveling down your leg?
If the pain is traveling, where is it traveling to?
Have you lost any functions, e.g. strength, walking, sitting, standing, breathing, urination, defecation, sensations in your legs or feet...etc?
Is there anything that you're doing that is causing your pain to increase?
Anything, if at all, that makes it feel better?


Answer these few questions and feel free to add any additional information that you feel may be of importance. This is my field of expertise and I truly care about my fellow human beings' health. Oh, and I'm a licensed and board certified doctor in two states. Again, I'll help you in any way I can.

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Okay. Sounds like you may have a severe sprain/strain injury of the lumbar region and possible compensatory or secondary dysfunction of the ilium/sacroiliac region. The strain aspect of the muscles will heal rather quickly due to the nature of the blood supply. However, where the muscles insert into the bone they become tendons and thus where the sprain is. Also in the area are supporting ligaments and cartilage that are also sprained. The major problem is that cartilage, ligaments, and tendons by protective design don't have the same quantity of blood supply that muscles and bones do, which lends itself to longer time required for healing.

Now the time for using ice was in your acute/onset of injury phase. Now is the time for moist heat. No dry heat! Dry heat will cause more problems than help. Now if you want to use a heating pad, layer two wet and wrung out hand towels over the area and then place the heating pad over that making sure the towels stay moist and not dry out during the process. Do this for 30 min. Also a hot bath or shower is beneficial. This is simply treatment for the soft tissue.

You can take all the pain pills and anti-inflammatory meds you want [sarcasm intended], but it's only treating the symptoms. A lack of symptoms doesn't equate to health. Symptoms are the last to show up and the first to leave in an injury. This means that before you showed symptoms you had a problem and after you begin to feel better the problem may still be present in a smaller form. Long story long, we need to treat the problem which is causing the symptoms.

Though you have significant soft tissue injuries most likely the primary problem is due to a combo of thoracic(upper, mid, and mid-lower back), lumbar (lower back) and sacroiliac (pelvic) segmental dysfunctions. This decrease the natural range of motion in these areas which severely aggravates proprioceptive nerves in the joints of these regions. That is part of the reason you hurt when you perform certain movements or postures. If this is allowed to go on too long, it can become a chronic, ongoing, yet to a lesser extent, problem.

Nerves aren't in their healthiest state when stressed. Some stressors are beneficial, however constant stress on nerves can cause significant deficiencies. Every organ in the body is controlled and maintained via the nervous system (visceral, sympathetic, and parasympathetic). Too much stress on these nerves can cause problems such as: sensory for sensations, motor for muscle strength and movement, deep tendon reflexes for speed and proper unconscious responses, metabolic pathways in organs that aid in immune response-process of nutrients and waste production-hormone balance just to name a few. This can inevitably allow for disease to set in where it wouldn't have otherwise.

During this healing time you don't want to perform strength exercises as this can exacerbate your injury. The soft tissue massage is great, but performing this solo may require some form of contortion which isn't too helpful.

What you need to restore your body's health and function is to find a good Osteopathic or old fashioned/non-screwy/non-quacky Doctor of Chiropractic. I know this may sound a bit off, but I can't stress how important it would be for you to find one of these practitioners. If this is an option let me know as I may be able to assist you in finding professional help. I wouldn't mind telling another colleague that you're a family member without insurance and see if they wouldn't do me a favor and cut you an affordable deal. If this is out of the question we can figure out something else.

Without being able to physically examine and assess you this is the best diagnosis I can render. Do you live in the states? If so, where generally?

Sorry for the long drawn out explanation, but we'll get you figured it out and get you some help.

Quote:

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Originally Posted by AndyK5

First Al, thank you for the insight, I appreciate it.
Dcdoctr, here are the answers.
1- No doctor yet.
2- No medications
3- I am going in the chronological order.
a) Streching + Aleve
b) +Icy hot patches
c) dropped the icyhot patches for lots of bengay
d) dropped aleve and switched to ibuprofen, stopped rolling ( about 2 weeks in now)
e) dropped pain medications alltogether to determine what hurts how much and started using a dense foam roll to strech my lower back.
4- I always had very minor back pain when I woke up in the morning or sat in a chari studying for long periods of time, but nothing really stayed for this long
5- The pain is exactly the same as it was the first day. The severity of the pain changes depending on the time of the day. When I wake up my back is sore, but then the pain goes away during the day as the blood flow increases to the area. Also I am pretty pain free for about couple hours after using the foam roller stretcher. It felt like it was healing but one night it got really bad, I had trouble getting out of my chair and my back start to spasm. I went to bed, woke up in the morning and it was back to its original state and the intense pain was gone.
6- It is hard to say where they pain exactly is because i can't really point to it. If I turn my body left, my right lumbar muscle next to the spine hurts. If I turn the other way, nothing hurts. When I am standing or sitting with good posture nothing hurts. If I sit and pull my knees to my chest a thin flat horizontal strech of area that is about 12 inches higher than my butt crack hurts.
7-The pain is a mixture of both. It is sharp when I do something that my back does not like, but sometimes there is the dull ache. Overall, I do not have any pain that stays in spot constantly. It moves around with its severity changing depending on the position of my body.
8+9-The pain does not travel down my leg, but it does move to my lower kidney area sometimes.
10- No lost sensations or strength as far as I can tell.
11- A cat strech which you are on all fours and extend your lower back up, increases the pain if I have any at the time.
12- Foam roller makes it better, resting for a week doesn't look like it helped at all. Heat helps a lot, cold does not, bengay is bullshit.

I would appreciate all help, so tnx doc :)

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Doc, I am not gonna quote your whole post because it is very long but I'd like to say, damn..
You are good, if you got all of that from a forum post.
Well I agree with you on the pain pill part which is why I stopped taking them. I felt like the artificial loss of pain could lead me to more injury or may have prevent me from finding what is hurt how bad.
Now I am going to use the moist heat with the heating pad as you suggested, but out of curiosity, how does dry heat differ from moist heat. I am wondering how one is better or worse than the other.

As far as the chiropractor situation, I can not afford to go see a chiropractor but if you know someone who could figure something out for me, I could spare some money to pay him. I am a poor college student lol :)

I live and train in Los Angeles by the way.

Dry heat draws out moisture leaving the area dehydrated. This is not as conducive to healing as moist heat. Moist heat penetrates deeper into the soft tissue than dry heat. Also, with dry heat you're more at risk of superficial soft tissue damage, e.g. mild burns. Lastly, water conducts heat better than air. I should add that there are some contraindications to heat treatment. If you have: diabetes, problems with clotting, open wounds, or some other vascular defects then one might want to abstain from heat treatment.

Again, you can utilize this therapy anywhere between 30 minutes to an hour 3-4 times a day for the remainder of the week with an hour rest in between treatments. Just be careful not to burn yourself and maintain the moisture. I'll see what I can do as far as finding you a doctor who will treat you and not break the bank. I may be able to find you a quality Chiropractor in L.A. and see if I can talk them down to a reasonable price per treatment.

In the meanwhile, ask around and see if anyone knows of any good, local Chiropractors in the area. Word of mouth is more of a good sign of quality than those that advertise like crazy. I'll see what I can find and if you hear of anything get their info and let me know so I can contact them. Also, I'll prepare some home treatments that will aid in improving your function.

Quote:

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Originally Posted by AndyK5

Doc, I am not gonna quote your whole post because it is very long but I'd like to say, damn..
You are good, if you got all of that from a forum post.
Well I agree with you on the pain pill part which is why I stopped taking them. I felt like the artificial loss of pain could lead me to more injury or may have prevent me from finding what is hurt how bad.
Now I am going to use the moist heat with the heating pad as you suggested, but out of curiosity, how does dry heat differ from moist heat. I am wondering how one is better or worse than the other.

As far as the chiropractor situation, I can not afford to go see a chiropractor but if you know someone who could figure something out for me, I could spare some money to pay him. I am a poor college student lol :)

I live and train in Los Angeles by the way.

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It is very nice to see a doctor that truly cares. I mean I know most doctors do care, but what you are doing right now is going above and beyond and I thank you for that.

This thread has SKETCHY wrote all over it!

Quick, a mod might want to throw up some kind of disclaimer here!

Quote:

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Originally Posted by Jonathan Wylie

This thread has SKETCHY wrote all over it!

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I'm not following you. Please extrapolate. If it's my credentials you question I'd be happy to provide state licensure numbers, which by law I have to make observable in my clinic. Secondly, you can take these numbers and verify them on said state board websites. Thirdly, don't be so toxic. Surely you have better use of your time than to post glib replies to someone's thread who is seeking advice.

It's no problem at all. I'll contact my Alma mater's clinic capstone this week and see who is in your area. I'm sure there are a lot to choose from in L.A. The trick is finding someone who knows there stuff and is willing to help. Also, if you end up not wanting to go this route then there are other options.

Quote:

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Originally Posted by AndyK5

It is very nice to see a doctor that truly cares. I mean I know most doctors do care, but what you are doing right now is going above and beyond and I thank you for that.

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Well Andy I would take the doc's advice with a grain of salt. There's no way he can tell if there is a chronic injury from inferring such from long term back pain without a physical examination. He does not know your range or motion, and long term back pain =/= chronic muscle / joint problem necessarily (it could well be something to do with your vertibrae, spine, etc.). And no doctor in their right mind would prescribe any sort of heat treatment if he/she thinks a sprain or tear is involved. Ice is for swelling, and if you're constantly irritating your lower back, then it will almost definitely swell. NO HEAT! While you probably do have some sort of strain or pull, that does not necessarily make it severe. Louis Ho had a very bad problem, and it was clear from what he posted that it was indeed bad. It sure doesn't sound like you're prohibited from exorcise too much. In fact, it just sounds like a little tweak. If you have always had some back pain, then THAT is something a chiropractor can help with, but that is not necessarily related to your current injury (as this "doctor" seems to think). I happen to think that it is NOT a major injury, from what you've posted. I would start with rest ice and elevation. Ice as much as you can, lay down with an ice pack and a couple pillows under your back as often as you can. If that does not help after 3 or 4 days, go see a real doctor.

BTW I really am a registered nurse for the Mayo Clinic in Rochester, Minnesota.
http://www.mayoclinic.org/saintmaryshospital/ <-- Here is where I work.

Listen to Pete. I'm not qualified but my sarcasm alarm went off on DCdoctr and his 5 posts.

Quote:

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Originally Posted by Pete Daly

Well Andy I would take the doc's advice with a grain of salt. There's no way he can tell if there is a chronic injury from inferring such from long term back pain without a physical examination. He does not know your range or motion, and long term back pain =/= chronic muscle / joint problem necessarily (it could well be something to do with your vertibrae, spine, etc.).

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The most important step in diagnosis is the case history. It's obvious that this gentleman has a global range of motion issue/hypomobility. What do you think that a soft tissue injury doesn't affect the joint?

Quote:

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Originally Posted by Pete Daly

And no doctor in their right mind would prescribe any sort of heat treatment if he/she thinks a sprain or tear is involved. Ice is for swelling, and if you're constantly irritating your lower back, then it will almost definitely swell. NO HEAT!

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Incorrect. Cryotherapy is only useful in the chief complete that is in its acute phase. Two weeks has passed. You really think he should utilize ice? If he was suffering from a tear the history would be different than his current presentation.

Quote:

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Originally Posted by Pete Daly

In fact, it just sounds like a little tweak.

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Tweak? Ugh.

Quote:

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Originally Posted by Pete Daly

If you have always had some back pain, then THAT is something a chiropractor can help with, but that is not necessarily related to your current injury (as this "doctor" seems to think).

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It most definitely could be related. Old injuries are usually the etiology for future injuries.

Quote:

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Originally Posted by Pete Daly

I happen to think that it is NOT a major injury, from what you've posted. I would start with rest ice and elevation. Ice as much as you can, lay down with an ice pack and a couple pillows under your back as often as you can. If that does not help after 3 or 4 days, go see a real doctor.

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Not to be redundant but this is not how to properly treat a skeletal-muscular injury in this current non-acute state. The ice would've been great the day of the injury on in to the following week.

Quote:

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Originally Posted by Pete Daly

BTW I really am a registered nurse for the Mayo Clinic in Rochester, Minnesota.
http://www.mayoclinic.org/saintmaryshospital/ <-- Here is where I work.

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I have the utmost respect for R.N.'s. My mother served under that title for over thirty years. However, her education was not comparable to the 4 years of biology: pre-med and an additional 4 years of college to receive my doctorate.

Please don't misconstrue my intentions here. I'm not looking to get into the proverbial pissing contest here. I see between 30-40 patients/day many with these same complaints. I'm not guessing or shooting in the dark, but am taking the data given and formulating a working diagnosis sans examination. I'm not trying to be Superman here, but rather help someone that can't afford to go and blow $1200 on imaging and another $1-$3000 receiving treatment.

Quote:

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Originally Posted by AJ Camacho

Listen to Pete. I'm not qualified but my sarcasm alarm went off on DCdoctr and his 5 posts.

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I too was concerned about what that would look like. I'm a long time lurker and after reading this thread I felt compelled to finally sign-up. Like I said, I don't want to be thought of as a deceitful person here. Skepticism is normal and healthy when viewing outsiders, but if you guys believe me to be a fraud then I can hyperlink the 2 state board website that lists where I'm listed as a full-time and active practitioner. Also if that's not enough you can contact the state board of examiners and link my name, work address, and work number. After that you can call me and thus ease this state paranoia.

Quote:

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Originally Posted by DCdoctr

The most important step in diagnosis is the case history. It's obvious that this gentleman has a global range of motion issue/hypomobility. What do you think that a soft tissue injury doesn't affect the joint?

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How is that obvious? And of course soft tissue affects the joint, but there's no way you can know if it is indeed a soft tissue injury without physical examination. You need to feel "where the muscles insert into the bone they become tendons and thus where the sprain is." There's simply no way you can know that without physical examination. If you think this "If I sit and pull my knees to my chest a thin flat horizontal strech of area that is about 12 inches higher than my butt crack hurts." will suffice as positive identification to injury location, you are completely lost.

Quote:

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Originally Posted by DCdoctr

Incorrect. Cryotherapy is only useful in the chief complete that is in its acute phase. Two weeks has passed. You really think he should utilize ice? If he was suffering from a tear the history would be different than his current presentation.

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That's not even true. Ice helps swelling regardless of phase, so yes, I think he should continue to ice and elevate his back.

If you don't know what you're talking about, then you should NOT be giving someone advice

I'm done andy, believe who you want.

Quote:

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Originally Posted by DCdoctr

I too was concerned about what that would look like. I'm a long time lurker and after reading this thread I felt compelled to finally sign-up. Like I said, I don't want to be thought of as a deceitful person here. Skepticism is normal and healthy when viewing outsiders, but if you guys believe me to be a fraud then I can hyperlink the 2 state board website that lists where I'm listed as a full-time and active practitioner. Also if that's not enough you can contact the state board of examiners and link my name, work address, and work number. After that you can call me and thus ease this state paranoia.

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If we were discussing arm bars, and you posted a technique video wearing a black belt, it would be standard protocol to ask for verification of your lineage and proof of your belt certificates.

When discussing back/spinal injuries I would imagine that the standards for validation would be quite a bit higher. I think it's awesome that you are offering your assistance but you gave some fairly presumptive remedies from an online diagnosis. I've never seen a doctor act so decisively from an online diagnosis before.

What is nice is though that there are people like you guys who care in these forums and hop on to intervene when you detect some kind of wrong doing or misguided advice. So AJ and Pete, Thank you.
However I personally don't see any wrong doing here yet. All he did tell me is that moist heat may help, which I was doing anyways and may be able to hook me up with a some cheap chiropractor sessions. I see what you are saying Pete also and I will try to see a doctor if I can, but I have not seen him say anything that would jeopardize my back even worse than it already is. This may be due to my lack of knowledge on the subject so I am not sure.

Quoting Pete: I would start with rest ice and elevation. Ice as much as you can, lay down with an ice pack and a couple pillows under your back as often as you can.

Is this Ice therapy going to help even though the I got injured like 2-3 weeks or maybe even way before than? I thought it was good if you applied it on the injured area right away.

Quote:

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Originally Posted by Pete Daly

How is that obvious? And of course soft tissue affects the joint, but there's no way you can know if it is indeed a soft tissue injury without physical examination. You need to feel "where the muscles insert into the bone they become tendons and thus where the sprain is." There's simply no way you can know that without physical examination.

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That was me giving an example of what a sprain is, not diagnosis. Nice analysis

Quote:

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Originally Posted by Pete Daly

That's not even true. Ice helps swelling regardless of phase, so yes, I think he should continue to ice and elevate his back.

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And that's it? That is why you do what you do and I do what I do. Advising a treatment, ill-advising I might add, and not giving treatment times is negligent at best. You don't even give the guy the benefit of mentioning contraindications. He could have Raynaud's phenomenon, impaired circulation cold urticaria, cold allergic conditions, anemia. I could go on. That's a good way to cause tissue damage...permanent tissue damage.

Quote:

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Originally Posted by Pete Daly

If you don't know what you're talking about, then you should NOT be giving someone advice

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It's obvious that no matter what is said you're gonna be that know-it-all guy, but you actually know enough to be dangerous. Sure ice can help in certain chronic conditions, but only post exercise to limit inflammation from said exercises. He hasn't been exercising genius, thus why it's okay to use the moist heat. Now if he were in a state where he could exercise I would recommend him not to use it because it would increase inflammation post workout.

Totally irrelevant but I have Raynaud's. I just thought it was funny that it was mentioned. I had to take out the trash in the snow tonight without gloves.... that sucked.

I just know what it means to help those that have zero options. I don't believe this to be a coincidence. I've been here and the previous 10th planet site thousands of times. This one thread compelled me to just go ahead and sign up. I may never post on here again, but I saw someone in need and decided to take action. I'm confident in my skills and have connections through my Alma Mater to some Osteopaths and other Chiropractors that may be able to help Andy without leaching his pocketbook. Believe you me, I know that's not the norm. If it sounds too good to be true then...I know. I stand to gain nothing by this, monetary or otherwise. I'm fine with that. That's part of the great blessing of my profession.

I apologize if I have offended anyone, but am only looking to assist Andy; no strings attached.

Quote:

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Originally Posted by AJ Camacho

If we were discussing arm bars, and you posted a technique video wearing a black belt, it would be standard protocol to ask for verification of your lineage and proof of your belt certificates.

When discussing back/spinal injuries I would imagine that the standards for validation would be quite a bit higher. I think it's awesome that you are offering your assistance but you gave some fairly presumptive remedies from an online diagnosis. I've never seen a doctor act so decisively from an online diagnosis before.

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Quote:

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Originally Posted by AJ Camacho

Totally irrelevant but I have Raynaud's. I just thought it was funny that it was mentioned. I had to take out the trash in the snow tonight without gloves.... that sucked.

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Yeah that does suck, but what is irrelevant?

What I should have said was by you saying that you have Raynaud's is not irrelevant as you can testify what cold can do you.

Quote:

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Originally Posted by AJ Camacho

If we were discussing arm bars, and you posted a technique video wearing a black belt, it would be standard protocol to ask for verification of your lineage and proof of your belt certificates.

When discussing back/spinal injuries I would imagine that the standards for validation would be quite a bit higher. I think it's awesome that you are offering your assistance but you gave some fairly presumptive remedies from an online diagnosis. I've never seen a doctor act so decisively from an online diagnosis before.

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That's what I'm saying. You can give someone a range of things that might be wrong with them. Sometimes it is narrow, depending on the area of discussion and information provided, and sometimes it is vague. But to be 100% sure about exactly what is wrong with said person is physically impossible, which is what is being implied. Especially when it comes to the back, because it could be a problem with a muscle, ligament, tendon OR SPINE/VERTEBRAE FFS! And there is 0 chance he can know which it is for sure, especially considering the circumstances. Maybe his chronic pain is due to a slipped disc that andy unwittingly suffered earlier, and it recently slipped further out of place. Or the doc may actually be right, but he couldn't possibly know that. Backs are such a common human pain because it is difficult to diagnose, precisely because without x-rays and MRIs, it's simply difficult to tell what is causing the pain.

I gotta say guys, I'm with the doc on this one. While I'm no osteopath or chiropractor, my 16 years as a paramedic and another 10 as a respiratory therapist have at least enabled me to spot bullshit when it comes to medicine. Everything I've read from him is consistent with the chronic-phase treatment I've seen in HUNDREDS (maybe thousands) of orthopedic patients (and in the treatment my own chiropractor uses for me.). The fact that he asked EXACTLY the right questions was my first clue. The history is an immensely important part of the diagnostic process; in some cases even more so than the physical exam. There is a reason medical students spend a ridiculous amount of time learning to take a history properly. Physical symptoms are often vague and/or applicable to a wide range of problems. The history narrows the differential considerably. He's limited by the inability to perform the physical exam and said as much. I can't diagnose lung disease from a history alone but I can narrow it WAAAAY down -- much more so than someone without the education and clinical experience I have. I can also dispel a lot of misinformation about your lung disease and its treatment just by listening and talking to you. That's all he did. He also offered to work with Andy to find a chiropractor who CAN perform a physical exam and who is also going to ask those same questions (for the same reasons).

My second clue to him being legit was the consideration of contraindications to treatment. Bullshitters rarely if ever acknowledge that their advice or treatment have limitations. Every therapy has indications, contraindications, methods/techniques, and treatment goals. You have to use the right method, for the right reason, to achieve the right outcome.

- He considered the indications for heat vs cold therapy (acute phase vs chronic-phase -- incidentally, the pain that comes on top of an existing injury that you get after training is called acute-on-chronic. The acute inflammation caused by AGGRAVATING the injury responds to ice and anti-inflammatories. The chronic condition does not. That has to do with the cellular process of disease and the way the body repairs damage.).
- He considered the contraindications to therapy (diabetes, clotting disorders, etc.).
- He described the method in detail (wet vs dry, time of application, etc).
- He considered the goal of treatment (optimize circulation to the area to relax muscle spasms and speed healing).
- And he considered the limitations of therapy by noting that he could not offer a more complete diagnosis without an exam but, again, offered to find someone near Andy who could.

Additionally, his plan of care did not stop at "slap a hot pack on there and stretch"; he offered to help Andy find a practitioner near him that can help him establish a more precise diagnosis and provide a long-term treatment plan and do so within his means. That's what the profession of medicine is SUPPOSED to be about! Sorry fellas, but the doc is right.

Sidebar: Our obsession with imaging studies has caused two very serious problems in medicine:

1) The belief that imaging studies are definitive. This is a problem for both patients and students. Students fail to spend enough time thinking anatomically and developmentally when examining a patient because "we'll just get a CT." They don't spend enough time developing their history and exam skills because they use imaging as a crutch. Every surgeon I have worked with has lambasted more than one student or resident for missing a diagnosis because they relied too heavily on the imaging. You wanna know how to diagnose an abdomen? Read "Copes Early Diagnosis of the Acute Abdomen", not a compendium of CT scans. I learned that lesson years ago and have spent a LONG time developing my pulmonary assessment skills for that very reason. It's a problem for patients because they refuse to believe that a history and physical can be MORE helpful in diagnosis than $10,000 worth of imaging. Imaging is good. It is useful. But it is not the sole method of definitive diagnosis. Worse, it can cause a diagnosis to be missed when either the patient or young physician fail to trust the signs and symptoms and rely falsely on flawed imaging.

2) The expense. Because of the belief that imaging IS definitive, patients insist on it when it is neither necessary nor warranted. Fearful physicians order needless studies "to protect themselves in court" from patients who won't trust a diagnosis without a CT or MRI. Because patients don't understand the limitations of the technology but insist on it anyway and because docs aren't going to fight with you in the very limited amount of time they have, the tests get done. They don't come cheap either. In a fee-for-service system radiology is the hot field to be in right now. Sit down and read a few studies and collect THOUSANDS of dollars. Whose money is that? Everyone's. No one pays for a CT out-of-pocket unless they have enough money to not need it in the first place. Everyone who pays insurance premiums is paying for the glut of imaging studies we don't need to be doing. Imaging technology is the fastest-rising cause of the increase in the cost of health care. Meaning not only is it not getting cheaper to perform the studies, we're spending MORE, on MORE expensive technology, that we actually DON'T NEED IN THE FIRST PLACE!

As it pertains to this discussion, that means that no, you don't need an MRI of someone's back to diagnose the problem. What you need is a competent, conscientious practitioner who will spend the time asking the right questions to narrow the differential diagnosis, follow it with a precise and well-thought-out physical exam, and apply their full and complete understanding of the mechanisms of disease and injury to a treatment plan. That is the practice of medicine.

Thank you for your detailed post Jason. Now though the pain moved to about 5 inches above my right hip, right under my right kidney. You guys asked me if the pain was moving and I said no, but now it did. I thought I would just throw that out there.
Also for some weird reason ibuprofen makes things worse. I know it makes no sense but, Aleve reliefs about %90 of the pain where as generic ibuprofen ( both at 400mg's twice a day) increases the severity of the pain. Maybe it's not ibuprofen's fault that the pain is intensifying in that case, it is not doing shit.

I wanna know Don Blankenship's plan of treatment... I bet it includes lots of fried chicken!

Just to update you Andy, I contacted the Capstone yesterday early afternoon and they're compiling a list of Chiropractic Physicians in your area. Once that is completed then they'll email that list to me. I'll go through them and call each one until I find a doctor that is willing to help you out at a reasonable, discounted rate. If I don't hear from them by tomorrow then I will contact them and see if I can get them to speed things up.

Not to alarm you, but just logical advice while we wait for this list, if you ever feel like your condition raises to an alarming level don't try and be a hero. Go to the emergency room. By law they have to treat you, insurance or none. Yes they will charge you an arm and a leg, but your health and life is worth more than any debt. Common problems happen commonly and rare one's happen rarely, therefore this issue most likely, at present, is minor to moderate. I say this to cover all basis so you aren't unprepared for any possible issues, major or minor.

On a side note: Ibuprofen is known to be rough on the kidneys. How is your output of urine? Color? Difficulty? Pain? What is your water intake like compared to your output?

My condition is not severe enough to require a visit to the ER. It did not worsen, it just changed, like it is in a different area with a different type of pain. I am not taking ibuprofen anymore, only 400mg Aleve per day. Urine output is good, clear free of smell. I drink lots of fluids by habit anyways. I am trying to compile some of the information in this thread and I think years of bending improperly over a desk ( a mandatory task for physics students) and sleeping on an improper bed that consists of 1 hard 1 soft layer of foam, did the ground work for this. Since my back was weakened ( hence the small amount of pain in lower back here and there), it got exposed during rolling. That is the only reasonable self-diagnosis i can make. When I was younger, my mom bought an orthopedic mattress for me. It's actually very hard compared to what I lay every night now. Last time I visited home, I slept on that mattress and woke up like a champion. Screw the memory foam, water, air and pillow top. First chance I get, I am buying another orthopedic mattress.