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(Editing to say just seen franksinatra's post which completely makes the main points. Do it his way...)
go to a physio/sports physio. Backs are their bread and butter. Been a while since I've done this but seem to remember it being around £30 a session, for a couple of sessions. You've got to assume they'll pick up and refer on anything possibly serious, but you'll get assessed and taught a few exercises. Turned out I had some tightness possibly related to an old injury on one of my glutes/arse muscles, kind of referred upwards. So a lot of specific hitting it with a little foam ball to to relax it was part of the trick (long road rides at the time hadn't been helping). I'd never have picked this up for myself.
(I also - for prevention - do many of the exercises and stretches listed above most days - deep squat into hamstring stretch into downward dog into cobra, reverse and repeat a few times. Have always had good core and flexibility and thought bad backs were for other people, until you get one...)
I pulled my back quite badly about 18 months ago and a physio concluded it was poor core strength - brought on by not riding for 2 years (due to ankle injury). I had tried to go on a ride after a long period of not doing so and basically sitting in an office chair or sofa had made my core strength like that of a toddlers.
Mattresses - don’t think that a firm one will sort your back out, it depends how you sleep. My wife is small and light but curvy and suffers with back issues and we got a very soft mattress she could sink into and mould to her shape as she slept on her side. It’s a bit too soft for me but I sleep on my side as well so it’s ok in general but I don’t use a pillow!!
Solution to bad lower backs is up there with life's greatest mysteries I think.
Extremely stiff lower back here, worst over the past 18 months and resulted in an immobilising painful injury in July last year (no mechanism of injury). Been to a sports physio every few weeks since and following prescribed programme which has helped, but still nowhere close to normal. Still struggle to put my socks on in the morning level of stiffness/pain. Recent MRI scan showed minor disc bulges but nothing extraordinary. So far spent £700+ on physio and can't afford to continue it.
Started doing pilates classes on Peloton but only a few weeks in so will reserve judgement on that.
Latest stretching and strengthening programme focussing on core strength: deadlifts, 90 deg squats and split-leg Bulgarian squats.
Not seen much improvement since Christmas and really getting me down. Next on list is new mattress. Who knows if that'll work but I need to keep trying solutions.
Mattresses – don’t think that a firm one will sort your back out, it depends how you sleep. My wife is small and light but curvy and suffers with back issues and we got a very soft mattress she could sink into and mould to her shape as she slept on her side.
I did wonder, I used to sleep on our spare bed some nights when I wanted to get up early and sneak out for a ride. I would swear the cheapy soft IKEA mattress was better for my back than our 'good' mattress costing 10x as much.
Shame our three year old has taken over the spare room!
As others have said everyone is different and what works for one may make someone else worse.
- If you can afford it get to a good physio and do any exercises they give you religiously
- if the physio can't help try another one, it was the third one I saw that worked out my back pain was related to issues from an abdominal operation.
- Pilates is great for me but I've had to build up. If your doing it yourself start with the absolute easiest exercises and work up when you know what works. i.e. don't go straight into trying a bridge just lie on your back with the knees up and gently rock the pelvis. Exercises shouldn't hurt!
Finally I hope you find something that works for you as I know back pain is so demoralising but for most people it does get better or at least liveable with eventually.
I have had some bad episodes in the past, not so much in recent years and I think that's because of:
More MTBing, the range of movement involved seems to be good for the back. The static position in road riding, on the contrary, can aggravate things a little.
Strength work at gym - back never felt better, starting to miss it now because I struggle to replicate at home.
Certain exercises like knee rolls, leg stretches, clams, all seem very positive for general niggly pains. When I remember to do them.
Ditch the couch/ armchair and invest in a comfy ottoman.
As others have said really. A good physio is worth the expense. But not all physio's are equal. I've seen and benefited greatly from UK leading physio's, great osteopaths and sports therapists. All are different. My osteopath is brilliant for hands on treatment (i.e near instant relief), a sport therapist (located in a good gym) was best for the mixture of hands on and guided/instructed strength work (at a lower cost) and the best physio's you can find are sometimes better for diagnosis of a complex problem (I've been to see both knee and shoulder specialists for this reason).
I think most people (nearly everyone) are rubbish at listening/feeling what are bodies are doing. It's really quite difficult. This is the key point for me and why yoga (not stretching in front of a TV or whilst listening to music) helps lots. Barefoot shoes also help with awareness and posture. I'm starting to learn to feel when bits of my body start to tighten and inhibit movement before they get to the point of needing professional attention. It costs less and is useful when I'm on holiday.
Physiotherapy in general seems to be more art than science, or perhaps equal parts psychology and physiotherapy!
My physio got obsessed with how stressed I was so spent more time giving me relaxation techniques rather than strength etc. She also said the biggest benefit of yoga and pilates for me was in the breathing techniques and meditative qualities of both, rather than an actual physical benefit.
I do disagree with some of her advice, she was focused on a specific injury at a specific time, so I don't blame her, but I also do think I could have benefited from doing more lower abdominal stuff which she dismissed, in general I don't think she really paid much attention to my postural deficiencies (heavily forward tilted pelvis) but again, her focus was to help my rehab from disc surgery, rather than to delve any deeper.
Now I'd almost rather a good strength coach rather than a physio, I need to learn how to strengthen glutes and abs without also working lower back, in time this will protect and relax my lower back enough that I can actually work on strengthening it (although again, my physio was very dismissive of lower back strengthening, said that they are postural muscles only and don't need to be 'strong' as such).
Im in the knackered back back camp, which i put down to a number of things;
1. Army cadets - carrying silly weight as a 13-17 year old - not good
2. never stretching hams and quads (used to be good)
3. poor core strength (used to be good)
4. joining army and carry excesive weight and then jump out of planes with said weight (this was when stretching and core strenght was better)
5. constant DIY
6. Carrying 2x heavy shiv to save on journeys for said DIY
7. Popping 2 dics doing items 5 and 6
8. crashing bikes
all of these have benefited from
a. New mattress, a firm one - it realy did help sort my back, but i think it's now doing the reverse and not helping with sleeping oddly.
b. My Sister - who's an expert physio/sports science type - who in her sibling love, loves nothing more than making me cry with some of her "moves" - some of the best of these were plank stretches raising things. Im told of constantly for still not stretching after exercise and for not improving my core strength.
on the pain meds thing, i got told in no uncertain terms to not rely on them at all as your body is trying to tell you something not's right. i do agree with this to an extent, and only really went against it if;
a. life depended on moving swiftly (see item 4)
b. had the luxury of not moving and just wanted releif from the pain.
Backs are crap, and why is it blokes suffer the most from/for them..?
There are so many things can can 'go wrong' with your back, what works for you might make it worse for someone else.
Keeping my core strong and stretching- particularly hamstrings, IT band, and the muscles down the side of my core (transverse abdominis?) help me. I get lazy, stop doing core stuff, and within a month or two... puff, my bad back returns!
core strength and the right stretches. These were provided by a sports orthopaedic physio, who spotted stuff the chiropracter failed. All they wanted to do was crack my neck and charge £30 for it over 10 weeks. The physio wanted to actually get me right and keep me right.
Backs are crap, and why is it blokes suffer the most from/for them..?
Apparently we were never designed to walk upright anyway, but I guess men are typically taller and heavier so more stress on the various structures?
@a11y if it's any use, your description kind of resonates with what happened to me. I've gone down the surgery route, but by the by I've had some varied experience with physios and chiropractics that might be useful.
Once I'd had the surgery on L4/L5 I went through some NHS physio, which was poor. Kept having twinges and in the end got re-referred to an NHS back care physio programme which happened to be staffed by a mountain biker. Everyone else in the group was about 70+ so he was quite happy to talk through what was happening to me! Anyway, he talked about cyclists being quite lazy with their core/tummy muscles. So what happens over time is that you become more reliant on your back muscles to stay upright.
So if you think about it, when you're doing anything, instead of working your core, you're using your (very strong) back muscles to do the work. And this is exacerbated by cyclists typically having tight hamstrings. So, when you suffer a "twinge" it's in your back. Chances are there's some underlying weakness/prolapse in there too, so what your brain does is remember the pain and put something in place to stop it happening/stop it getting worse.
The body's solution? Spasm. It locks your back muscles in response to a shock - putting pants on and getting a toe caught? Bit cold and picking something up that's heavy or too few away from your core? That sort of thing. Then you are fighting the symptom, but not the problem. In my case that means ibuprofen and physio to free up the spasm, then stretches and exercises until the body forgets. Then about a year later I'll get lazy and it starts again!
While the underlying condition is there, you'll still suffer from it. That's why preventative measures are so important, but it wasn't till I met that physio that I think I started to understand what my body and brain were doing. I also didn't understand what "core" was at the time. Sounds bizarre, but I just kind of assumed it was "tummy" muscles. Until you're actually shown what it means it is quite hard to grasp.
HTH.
Post surgery (L5/S1 disk tuck and associated vertebrae trim) the following has helped:
-Time
-Stretching - yoga etc
-Core exercise
-Mackenzie stretch
-Hydration (bulging disks are often dried out disks)
-Posture (both sitting and standing)
-Voltarol muscle relaxant for occasional flare ups
-Pedalling from the glute, not just from the quad. helps with the knees as well.
Assuming not a skeletal disorder (and even if so in most cases):
Core strength.
Core strength.
Core strength.
And if you can't work on it yourself - a metric eff-ton of Pilates classes.
What happened to me was, after a year or so of niggling lower back pain I seemed to wrench my back in July starting a petrol strimmer. I had also been doing online Pilates.
I had some physio until he said I really needed to see a specialist. I then went to see a Chiropractor who felt around and said he didn't want to manipulate me until I'd had an MRI.
The NHS booked one of those, but I also had to go to an NHS physio.
The NHS guy took one look at me and diagnosed that my forward lean was all down to poor core strength and gave me a bunch of exercises to do. All leaning back, twists and plank. This was despite having the MRI report on his desk.
Fortunately I had the sense to ignore him and 2 days later had a panicked call from a spinal surgeon who told me to come to the hospital straight away, nothing to eat or drink and come straight to the Major Trauma unit where a surgical team would be waiting for me. The next day I was operated on - 4 hours, he chipped little bits of bone from a vertebra to stop the nerves getting pinched, gently pushed my spinal cord out of the way so he could slice off a bit of the bulging L4/5 disc that was compressing it.
3 hours after waking up I was walking around the ward, upright and pain free for the 1st time in months. Next day, discharged, 10 days later a gentle ride on Cannock Chase. The op was late October, last week 3 good 2-3 hour bike rides (road and Follow the Dog) Online Pilates session and I'm feeling fine.
The surgeon said they whipped me in because he could see that one good sneeze might have me in a nappy for the rest of my life: if I'd have done the exercises I was given, I might struggle with walking.
Moral: everybody will give you advice: some of it isn't always that good. Get a proper diagnosis.
I've had lower back ache since around October 2019, sports massages and the osteopath improve it for a few days. Working from home at the dining room table hasn't helped either.
Trawling YouTube for various stretches and physio advice I found this last Wednesday and its worked a treat - the stretch around the 3 min mark,
I'd say its stetched my lower back /glutes / hamstring, my glutes and hamstrings do get tight from running. I feel like I've got a new lease of life and I don't start the day getting out of bed with the words 'My ****ing back'
Low back pain is like a religion, we all find our own solutions and I think if you just practice them frequently enough and believe in them, you'll probably find some benefit.
I say this as I now firmly believe that for most people, low back stretches not the ideal solution, you're just stretching a muscle which is already stressed and fatigued and just wants to relax!
I really liked this video actually which also (maybe, I'm off to experiment now) explains why all my hip flexor stretches have just contributed to a sore hip flexor instead of back pain relief, I've not been stretching the psoas apparently!
Also check out his 'aeroplane stretch', it's really satisfying to see such a simple move carried out in such a controlled manner, that guy must do a lot of yoga and/or pilates!
I'm generally leaving my low back alone from the point of view of stretching and strengthening, am now prioritising stretching and strengthening all around the low back so as to take the load of the sore muscles.
1-1 sessions with a good pilates instructor.
For me physio - I had unlike some of the above experiences the NHS physio I had was more effective that the private.
I do a lot of yoga now - proper classes where the teacher gives group and individual instruction and pulls you up when you are not doing it right. A mirror to see yourself really helps too - it's amazing how unbalanced you can be without realising it. The yoga really helps in that I materially regress when I'm not doing it. Fortunately my teacher is doing zoom under lockdown.
I also have to remember to do antagonistic exercise. Because my strength work is focused on climbing there is a real risk of overworking certain muscle groups and ignoring others so have to make sure I do oppositional stuff to get a balance.
Finally - good desk and chair set-up. I'm 6'3" so struggled with standard furniture, especially if desks are adjustable height - but I've got a high desk and a really good chair and home and that has helped over the last year
Maureen from Holmfirth,the only yoga class I know was frequented by brickies.
HÅG Capisco chair + sit/stand desk + monitor arm + don't crouch over a latpop keyboard.
Car seat - adjust if you can to have hips higher than knees
and more pilates
Posture, regular movement, not staying in one position too long.
Also a non-obvious tip, be sure to work on stretches on all the large muscles that aren't directly involved, as they'll be taking up the slack a bit when there's pain, getting tighter and contributing.
No magic fix though. Back pain for nearly 17 years here, and I'm not even 40...
The "keep moving" can be completely counter productive..until you know what's causing it you could be worsening it.
If the cause is, for instance, a leg length discrepancy walking could be making your lower back / back worse. However can't go wrong with ice and heat afaik.
See a physio, a good one. That's an important distinction. I went private and had 8-10 sessions some years back. End result lots of dry needling, shoe inserts and Pilates and haven't been near any back issues since. Continuous trigger pointing at home too.
Yoga. 15mins every day. And a bit if core work if the yoga sessions don’t do this.
But do it later on in the day when warmed up not first thing. I have problems at neck/thoracic junction and also in lumbar area. Yoga has improved the pain by about 90%
Also recommend abi carver. Her instructions are utterly clear.
Yoga- superman, cat, dog
Core work, front and back.
Mine was sorted by the musculoskeletal practitioner at our GP surgery (she also used to race XC, so lots of bike chat).
She basically told me never to visit a chiropractor again and that I had an inflamed disc. She gave me some exercises and told me to stand up or lie down for a fortnight.
She was spot on. Sorted me right out and now I have a standing desk at work which I can use when my back gets grumpy. Not had any reason to seek further treatment since 😃
After a brief perusal around IKEA and amazon, it’s got me thinking that maybe there’s a market for decent ottomans that are stable and comfortable enough to spend a few hours sitting on.
37 here.
Nurse for years with no back left from poor handling.
Me:
Bending at my knees when picking stuff up.
Keeping my back straight and not stooping.
Firm mattress.
Sleeping with a pillow between my legs.
Hot tub.
Weight loss (big difference for me)
Stretches.
Know your limits.
All that info they tell you in manual handling training is true. Just need to use it. .
Still suffer and I'm in pain daily but my back hasn't "gone" for a long time now I'm making an effort.
In all honesty, the main things to do with a lot of long term pain issues are to understand how pain works (i.e. pain does not always = harm or damage to the area that hurts), lose weight (if you are over weight), reduce stress, increase physical activity, find something that you feel works for you and that you like doing and keep doing it.
I have a PhD in physio, and have researched back pain for a number of years.
Unless you have neurological signs you don't need a scan (in fact the likelihood is a scan will make your pain worse) or an operation, you may benefit from some pain education programmes ('explain pain' by lorimer mosely and david butler is a go to in the field), you may need to strengthen some muscles and stretch others (although this may or may not influence your pain), i personally believe pilates and yoga are beneficial (although the evidence doesn't support that), you should try to increase your activity levels as able.
Trying to pin pain to something biomechanical if you've had pain for longer than 3 months isn't too useful, as in the majority of cases the tissue injury will have healed, and so other mechanisms are likely to be at play.
Deadlifts, Strengthen those hamstrings & Lower back.
@Rich_s, thanks for writing about your experiences. And to many others here - unsure about the original poster but I'm taking a lot of notes from this for further research and practice.
I'm 6'1-ish and physio suggested part of the issue is simply my deskbound job. I got a raised-height (but not sit-stand) desk at work a couple of years ago and was lucky at the start of lockdown to acquire a basic Ikea manually adjustable sit-stand desk which has been great. Another small step which hopefully helps.
Find my lounge sofa pretty uncomfortable but I'm not one for sitting around much anyway. Still need to address that though.
Mattress - going to start the search but no idea where to start for a decent replacement.
And a biggie for me, sounds a small thing but should make a difference - gardening tools etc. I'm searching for longer/taller tools and/or shafts and handles to make life easier this year. Most stuff seems designed for midgets. I've put my taller snow shovel to great use the past few days with no negative effects on my back pain.
No magic fix though. Back pain for nearly 17 years here, and I’m not even 40…
Am beginning to believe this, I thought I was on top of my back problems and it's just crept up on me again and gradually getting worse.
It's hard not to blame riding (especially the turbo) but I think I've proven to myself in the past that riding really doesn't make it any better or any worse (OK, that one ride in the snow on the singlespeed at 50RPM might have been a bit silly).
Think I'll have a little codeine and Ibuprofen 'holiday' to take the edge off for a couple of days...
By and large my lower back behaves these day but as is often the case, when I get some flu-like lurgy like now, my lower back moans like hell.
Been managing lower back pain for last 20 years or so. Originally put a disc out and since then have had periodic spasms.
Best advice I had was an amalgam of what is above, there's lots of easy day to day life things you can do to mitigate, namely the following:
- Get the right mattress. What this is depends on your weight and what position you sleep in. Very firm mattresses tend to be best for back sleepers. It's all about support in the right places
- Avoid putting your lower back under fairly constant low level stress, as follows
- If you're a side or a side/front sleeper, put a firm pillow between legs so that it is supporting your pelvis and midriff. This is because without it pelvis/midriff is essentially unsupported and is under strain the whole night. Adopting this was the single most beneficial thing that I did, went from not being able to put my socks on to going for a run in days.
- Invest in firm feather cushions for sofa. Always have 2 or 3 of these wedged under/behind your lower back. I tend to wedge into the corner of the sofa
- When driving or at desk make sure that whilst your back is straight from hips up, you're not sat at 90degrees, you want to have an angle more like 80 or 70 degrees. Laid back. When you can't do this (eg dining chairs), have your feet ticked back under the chair, underneath you. Where possible have your hip height above your knees.
- When getting in and out of cars, turn and sit first then swivel your legs
- Stretch your leg muscles every day, twice a day. However, no touching toes. Tight leg muscles exacerbate lower back pain
- If it spasms use ice. Lie flat on sofa/bed with ice pack underneath. A bad spasm might require a couple/few days of this. Failure to do this will mean weeks
- Lose weight, particularly if you're carrying it around the middle
- Do lower torso strengthening exercises, but be aware that these can often put strain on your lower back in the short term
Anything that promotes strength and flexibility (like yoga) is a good idea, as is a good physio. Treat chiros and osteos with caution. In my worst experience they've quacks, best they treat the symptom not the cause.
Best of luck, following those lifestyle hacks should help!
Been suffering for over 10 years with back injuries.
Sometimes I've been laid up for weeks not able to do much. But once the pain eases, the best thing I have found is regular stretching and core exercises. But keep at it.
Once you feel you are better its easy to forget or miss doing your stretching/core exercise for a day, which then turns into a week then a month etc then I'd hurt my back again. So I need to keep doing it often.
Tight hamstrings has always caused me problems, if I have poor flexibility in these and don't do stretching then I know I will be in pain in a few days time with my lower back.
I use to do a lot of heavy lifting, and found wearing a back support helps. This helps in 2 ways, gives a bit of support, but mainly acts as reminder to have good posture when lifting, makes me use knees more than bending my back.
Hope you get better soon
What fixes it? 2 x back ops, 5 fused vertebrae, daily stretching regime and daily dose of 2400mg of Gabapentin 6 x Ibuprofen and 6 x paracetamol (on top of the other 18 pills I take daily for a dodgy ticker - I’m like a friggin marracc