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  • Page 4 of 4 FirstFirst ... 234
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    Thread: Back pain

    1. #31
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      great post Thanks brother.

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    3. #32
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      I have bad back pain (arthrosis of the lower back, degenerative disc disease). Doc told me to keep moving. I avoid deadlifts and heavy squats. I do crossfit/combat conditioning and stick to medium weights.

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      A lot of info on the site, yet I will say it goes well with the other sites I have researched for back pain. I have a compressed L5 S1 with severe arthritis. (Thanks Uncle Sam) I have been trying to find a way to overcome the issues. Sometimes these older posts or sticky's contain valuable information.

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      These are some very good exercises that definitely work for most people with back pain. Unfortunately there are some with deliberating back pain that do not respond to these exercises. Note that these exercises mostly strengthen the outer muscles of the lower back and the abdominals. However, they are not the most important muscles for stabilizing the spine. The most important muscles are the multifidus and the deep abdominals that are located directly posteriorly and anteriorly to the spine. Chronic pain because of disc degeneration,herniation,stenosis, facet arthritis tend to weaken these muscles that then start to disfunction. So first you have to strenthen these muscles starting with simple isometric exercises and progress slowly to more dynamic exercises as pain decreases. Of course, it is better to work with a good pt that can reduce your muscle spams with massage, ultrasound, manipulation,heat therapy, etc. and show you the appropriate exercises and the correct form.

      If the pain is so bad that does not respond to anything stated above for many months/years, you can try some non-invasive therapies. For facet joint pain/arthritis you can try prp, prolotherapy, prolozone. These can not only reduce the inlammation so you can continue with your pt exercises but they also may heal your joints to a degree. For disc degeneration, hernation you can try discogel or discseel. I do not really advise cortisone injections since they do more harm than good in the long run but they may be helpful in the case of accute injury by reducing inflammation and pain so you can continue with your pt exercises. However they are not generally helpful in chronic cases.

      If nothing stated above works and you cannot have a normal life even with some limitations then you may be recommended surgery. There are many kind of surgeries for the many different cases so be sure to consult with doctors that have expierence with all kind of surgeries. Many doctors recommend mostly fusion since not only it is the easiest but it is also the most profitable. If you have disc degeneration and your facet joints are good enough and you have no stenosis then disc replacement is your best option and you also retain your motion in that segment. If there is facet hypertrophy that causes stenosis that requires decompression then facetectomy along with fusion is best to stabilize that segment. However if you have stenosis that can be relieved with laminotomy then fusion may not be necessary if minimal lamina is removed since there is not much iatrogenic instability. For disc herniation without degeneration a discectomy is best. However if there is also disc degeneration you can still do a micro discectomy and if it does not work or if there is rehernation you can do a disc replacement given that the doctor did not remove a big portion of lamina during the discectomy. Many people did a discectomy that bought them a few years and when the situation got worse again they did a disc replacement successfully. If there is dic degeneration and facet arthritis then fusion is recommended. Unfortunately there is still not a reliable facet joint replacement. There is the TOPS and Nexux system that are used in Germany but the screws they are anchored with tend to loosen up over time because of the motion they allow. I am sure in the future there will be a future total joint replacement that will replace both the disc and the facet joints just as knee and hip replacement so that there will be no need for fusion. Think of each segment as a three legged chair. One is the disc and the other two are the facet joints. If there is a problem with any of the three there is instability and thus pain. That is why we should follow a good core exercise program. To compensate for the loss of stability caused by any of the three joints. Of course nerve compression goes along with many of the above problems.

      Hopefully some people will find my post helpful. If there is anything you want to ask about feel free to pm me.

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