how can I fix my back pain?

Antbrewer
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Re: how can I fix my back pain?

Postby Antbrewer » 1 Jun 2020, 10:14am

Hi SparkO

You have really opened up a can of worms here.
You are likely to receive lots of opinions on how to solve your problems , some sound perhaps and some less so. It is all very well posting images of the anatomy and saying that your pain is in such and such an area relative to the image you are seeing.
May I assume that you have perhaps little knowledge or understanding on our anatomy? Forgive me if I am wrong on that one.
I am certainly not going to suggest what could be causing this discomfort on this forum. Having spent all my working life in diagnostic radiography mainly in the NHS but also in many national Govt surveys of this very problem ie, back pain it would be a brave man to presume to know the answer(s).
Obviously one can see that your riding position may not look comfortable and to me it doesn't. A number of reasons have been put forward and they are ones most would consider. Bars, saddle height, frame size etc etc.
However without knowing any more about you other than what you have posted there are thoughts......Do you have back ache at other times, in different positions, walking etc etc? A generally held view is that an upright spine is the best position. Not so. This isn't the place to explain that.
The spine is so extremely complex we have to be very careful in how we look after it.
The first thing you might do though not possible at this time ( covid 19 restrictions) is to visit a good bike shop and get advice and help.

I hope this post hasn't come across as dismissive in any way to your problem as it is a subject so many of us suffer from. I suffer myself so I speak with experience.
Hopefully a few adjustments might help but it can be a problem
All the best and good luck. Don't give up as there are very very few downsides to this great activity.
Anthony

diapason
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Re: how can I fix my back pain?

Postby diapason » 1 Jun 2020, 4:57pm

I suffered for years after a lifting accident at work when, eventually, about 20 years ago, a Consultant at the Pain Clinic prescribed Pregabelin which works on nerve ending pain. It did the trick, and It's been tolerable - often much better - since then. It's a Controlled Drug these days, but the GP is happy to continue to prescribe it. Without it, I thinkl I'd have been in a wheelchair years ago,
Advena ego sum in Terra

Jdsk
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Re: how can I fix my back pain?

Postby Jdsk » 1 Jun 2020, 5:32pm

Pregabalin

Cochrane Review: "Pregabalin for chronic neuropathic pain in adults"
https://www.cochrane.org/CD007076/SYMPT_pregabalin-chronic-neuropathic-pain-adults
and blog "Pregabalin for neuropathic pain: balancing benefits and harms"
https://www.evidentlycochrane.net/pregabalin-neuropathic-pain/

NHS: "Pregabalin":
https://www.nhs.uk/medicines/pregabalin/

Jonathan

Antbrewer
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Re: how can I fix my back pain?

Postby Antbrewer » 1 Jun 2020, 6:30pm

With the greatest respect to those with suggestions of pain relief in the form of Pregabalin or other similar drugs. Surely this is not the place for such suggestions. Firstly these are controlled drugs and not OTC medication. Secondly such would be prescribed by a doctor with careful consideration to the patient and their possible other conditions and medications.

Having reread the posts again I notice the sensible post from Peetee ( didn't see it first time around) about having a medical examination .
A physio was mentioned but they are not the best people to diagnose the problem .They endeavour to treat the problem. A proper consultation with your GP and then a possible referral . Quite possibly a long haul certainly in today's climate but to talk of such medication is not good at this stage. We all take analgesics and that is normal but if they are not helping then you should seek professional help. Sorry but that is the way forward.

A I said previously I do have some experience on both sides of the fence in this area. A career in radiography at the highest level and then having two serious ops on my cervical spine in the 90s and a massive lumbar spinal lymphoma tumour a few yrs ago and now on a cocktail of medication I feel I know a little about this 'pain in the back' business. Not much fun at all.
I would urge caution if analgesics and readjustment of obvious bike parts do not work.
Anthony

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Paulatic
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Re: how can I fix my back pain?

Postby Paulatic » 1 Jun 2020, 7:19pm

spark0 wrote:
i will try Paulatic's suggestions and drop my saddle a little, I raised it that high because I was having knee pain but I can drop it a little, I can take a bit of knee pain and keep going,.


That is significant where was the knee pain? Knee pain is more common with the saddle was too high and causing stress on the iliotibial band.

Antbrewer wrote:. We all take analgesics and that is normal but if they are not helping then you should seek professional help.

Not all of us do. Perhaps working in a medical background you might be excused to think it is normal.
I last took, over 30 yrs ago, Paracetamol back in my thirties suffering with back pain. I tried an ibuprofen for, can’t recall the reason, around 20 yrs ago. It set my heart racing and felt worse than whatever I’d taken it for. I never want to experience that again. We have pain for a reason and masking it might not always be a good thing. Getting to the source of it and learn what your body is trying to tell you isn’t easy but often very worthwhile.
Whatever I am, wherever I am, this is me. This is my life

https://stcleve.wordpress.com/category/lejog/

Antbrewer
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Re: how can I fix my back pain?

Postby Antbrewer » 1 Jun 2020, 8:25pm

Paulatic
Clearly what I meant was that analgesics are taken by many people when they feel they have the need. I do not think it is normal to take any medication unless necessary. That was my very point. Surely you could understand my words on that. You agree with me ( from your words) that finding the cause of the problem is the start of the procedure which is exactly what I was saying.

You don't take any tabs and that is great. Good that you have no need of them. I certainly wish that I could reduce all these toxins that I take. However it is a balance between taking a minimum against the relief it offers.

spark0
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Re: how can I fix my back pain?

Postby spark0 » 1 Jun 2020, 8:32pm

Again thank you all for the suggestions. I'm on the phone now so I might not name check you, but I have read everything. Anthony, I appreciate the comments, I have already visited a GP and discussed my situation with him, he is the one who referred me to a physiotherapist. They unfortunately did not help, I have been to them three times over 8 months. No change, the exercises he gave me did nothing to help. They both checked my spine and said there is no issue with alignment or slipped disks or anything serious.

In terms of the bike fit, I have dropped my saddle like was suggested by paulatic with a slight bend in the knee when the pedal is at its lowest. This I'm sad to say did not help my back at all, I am still suffering from the last time I went for a ride so I may just be causing more problems here. I may need to rest it for a few days and try again. (The original knee pain is something I've had since puberty really, it flairs up if I sit for too long or when bending too much hence lifting the saddle. Not much can be done about it and I have seen a few doctors, they said it would go away when I got older but here I am 15 years later and no joy, maybe I'm due a growth spurt)

I may just not be built for exercise I think!

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Re: how can I fix my back pain?

Postby Vorpal » 1 Jun 2020, 9:35pm

531colin has this DIY bike fitting guide https://wheel-easy.org.uk/wp-content/up ... -2017a.pdf

I obviously don't know the source of your problem. I might suggest that a different physio could be more useful, as the first wasn't helpful. Although my pain was of a different nature (sciatica caused by pregnancy), I have also had some success addressing back discomfort with someone who specialises in sports massage.

Antbrewer also asked if you have pain at other times? Are there are other things that affect it?

If so, I would persist with treatment, even if you have to seek alternatives, or go back to the GP and explain that the physio isn't helping.

If not, the answer has to be in the bike setup, and I suggest that you take a look at the DIY bike fitting guide linked above.
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531colin
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Re: how can I fix my back pain?

Postby 531colin » 1 Jun 2020, 10:25pm

Anthony makes a very good point which I feel may be in danger of getting lost...…
Is this back pain only caused by cycling or do you get it from other causes?
If you are in pain, I think you should feel entitled to treatment by the NHS. About a year ago my GP practice referred me to an NHS physio; the whole process was prompt and the results brilliant.

Have a look at my DIY bike fit pages linked below, they are a reasonable starting point for anybody with an unremarkable standard of fitness, flexibility, etc....I was about 70 when the photos were taken, so I was no fit flexible youngster even then.
A couple of points from a glance at that one still photo....that bike is about 2 sizes too small, the saddle is too high as already noted, and the reach is far, far too short.....for a person of "normal" fitness/flexibility.
From looking at the video, you should aim to turn the pedals much faster, say 70 (complete) revolutions per minute, and relax!
Try stretching after exercise for knee aches.
Photo of a 70 year old....
Image_DSC0891 by 531colin, on Flickr

Freddie
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Re: how can I fix my back pain?

Postby Freddie » 1 Jun 2020, 11:07pm

That is an excellent photo, Colin. How was it taken?

spark0
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Re: how can I fix my back pain?

Postby spark0 » 1 Jun 2020, 11:36pm

Antbrewer wrote: May I assume that you have perhaps little knowledge or understanding on our anatomy? Anthony


I have basic knowledge but that is it I'm afraid. I did biochemistry for my first degree, waste of time as it turns out.

Antbrewer wrote: Do you have back ache at other times, in different positions, walking etc etc? A generally held view is that an upright spine is the best position. Not so. Anthony


You are correct, I do indeed have back pain in a similar position while jogging (after 20 mins roughly) or walking for very very long distances (over 25 miles-ish) which is expected given the distance. Should be going in demanding an X-ray in your professional opinion?

531colin wrote: A couple of points from a glance at that one still photo....that bike is about 2 sizes too small, the saddle is too high as already noted, and the reach is far, far too short.....for a person of "normal" fitness/flexibility. 531colin


Thank you for the feedback, also great guide I will be using it. I think it has come down to me simply buying the wrong size bike I think, from everyones general consensus. However just a point about the reach being so short. It was something I did on purpose, I first bought a stem extender and lifted it to the max setting as someone said the stem is too short. That didn't work so I slammed the seat forward because I read something about not leaning and trying to get more upright to fix back issues. The latest modification has been the butterfly handlebars to bring the handle bars even further back towards myself. So I think I may wait till this covid-19 situation is finishd then I will go to a proper bike shop, evans or something of that ilk.


Vorpal wrote:531colin has this DIY bike fitting guide https://wheel-easy.org.uk/wp-content/up ... -2017a.pdf


Thanks Vorpal, that is very helpful.

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Re: how can I fix my back pain?

Postby Vorpal » 2 Jun 2020, 9:53am

spark0 wrote:
Antbrewer wrote: Do you have back ache at other times, in different positions, walking etc etc? A generally held view is that an upright spine is the best position. Not so. Anthony


You are correct, I do indeed have back pain in a similar position while jogging (after 20 mins roughly) or walking for very very long distances (over 25 miles-ish) which is expected given the distance. Should be going in demanding an X-ray in your professional opinion?

I'm not a professional, but I do think that you should pursue this with your GP. It sounds to me as though the problem may be caused by something lower in your back than where the pain manifests.

It also seems strange that physio did not help. It could be that more general back & core strength exercises would help, but again, talk to your GP.
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NATURAL ANKLING
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Re: how can I fix my back pain?

Postby NATURAL ANKLING » 2 Jun 2020, 11:59am

Hi,
GP
I would suggest probably Be referred to a NHS physio do not pay!
A physiotherapist will diagnose the weakness if there is one?
if not you will go back to your GP for further consultation and referral.
I have suffered from chronic back pain for over 20 years and I find riding a bike is therapeutic in this respect.
I came off all pain anti-inflammatory meds daily and I only do physiotherapy exercises every day.
Now and again I do need some help with medication. but this normally would be once every six months and then for a few days.

The bike is probably not too small for you it's just set up wrong.
Leaning forward although it puts your weight on your hands more when you press on the pedals your weight is lifted off your bum and hands anyway.
Your picture is chronic.
Raising the bars only puts more weight on your back in an upright position.
Leaning forwards opens the spine up!

but you need to be diagnosed first.
If you're given exercises you need to do then religiously.
X-rays and scans are rarely given with this tool type of problem.
Like I said I've suffered for over 20 years and I have a weakness which was probably an industrial accident plus moving home, but I've never been referred for an x-ray or a scan.
The fact that your back hurts 20 minutes jogging or even doing walking for a long distance, means that you have an underlying problem with your back.
Keep posting.
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spark0
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Re: how can I fix my back pain?

Postby spark0 » 2 Jun 2020, 1:01pm

Vorpal wrote:It also seems strange that physio did not help. It could be that more general back & core strength exercises would help, but again, talk to your GP


I am quite active in the gym anyways, so I do strength exercises for my shoulders, lats and overall back. I was already doing the exercises he was telling me to do with the bands but with the cables and weights. I still did his recommendations on top of everything else however.

NATURAL ANKLING wrote:Hi,
GP
I would suggest probably Be referred to a NHS physio do not pay!
A physiotherapist will diagnose the weakness if there is one?


Thank you for comments, this referral to the physiotherapist was indeed via my GP. The physio said I didn't have anything wrong with my back, he made me do a range of movements to check my flexibility and where the pain manifests itself. He said he couldn't find anything at all wrong with my back. (I work out in the gym so my core is somewhat strong). The physio was a recent graduate so I feel like I didn't get the most experienced person, not to say he wasn't good at his job but rather I don't think he had come across many niggling problems like this which aren't really mentioned in text books.

in terms of the location of the pain, C7-T1 is the exact location. It feels like the muscle in that area is unable to support the weight of my head, my GP admitted to me he doesn't know much about pain in that area hence the quick referral to a physio on the first visit. He did the check for a slipped disk and misalignment but he didn't find anything and said it was purely muscle.

NATURAL ANKLING wrote: Like I said I've suffered for over 20 years and I have a weakness which was probably an industrial accident plus moving home, but I've never been referred for an x-ray or a scan.
The fact that your back hurts 20 minutes jogging or even doing walking for a long distance, means that you have an underlying problem with your back.


That sounds bad, is your pain in the same area? In terms of a weakness from an industrial accident. I did have quite a bad car accident 5 years ago, I walked away fine from it but the airbags went off and I had back and shoulder pain for a couple of weeks afterwards (some people said that was whiplash, no idea I was at fault so I didn't go to the GP, just waited till it went away).

Hopefully I can get to the bottom of this because I really do love cycling, it is just forcing me to stop!

Freddie
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Re: how can I fix my back pain?

Postby Freddie » 2 Jun 2020, 1:41pm

A physio can't categorically state there is nothing wrong with your back, if he hasn't seen x-ray images of it.