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Old 01-13-14, 11:58 AM   #1
David Bierbaum
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I evidently took the right course with my back pain according to NPR's latest piece.

There were some interesting finds in this article on NPR, such as the fact that back pain really has very little to do with the actual backbone's condition, and has more to do with nerves developing hyper-sensitivity with age...

All I know for myself is that taking up bicycling has just about totally eliminated the back pain problems I was having, while my sister has had repeated surgeries on her back, and has only had things go from bad to worse.
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Old 01-13-14, 12:18 PM   #2
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Most people these days would agree that surgery is the last option, but the "ignore the pain" sounds unfounded and dangerous. I've successfully used, and recommended the course of spinal support exercises offered in the book Foundation, by Goodman and Park.
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Old 01-13-14, 12:22 PM   #3
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There were some interesting finds in this article on NPR, such as the fact that back pain really has very little to do with the actual backbone's condition, and has more to do with nerves developing hyper-sensitivity with age...

All I know for myself is that taking up bicycling has just about totally eliminated the back pain problems I was having, while my sister has had repeated surgeries on her back, and has only had things go from bad to worse.
I agree totally! About 2 years ago after a visit with the back surgeon, I decided to cycle more. He was actually honest and said I was aging and the disks were thinning. Not a candidate for surgery, but they could inject. I told him I did get some relief through biking, especially when I was in the drops. He showed me my x-ray pic and how the bent over position on the bike would logically provide that relief by increasing that space between the two culprit vertebrae. Then he told me to stick with the cycling, use the meds and ice as needed. Best advice ever! Winter is a b***h around here, but I get what I can. When I can get days on end of 50+ miles/day, I feel my best. Last fall on a 3 week tour, I took only one round of advil the whole trip. And nothing stronger. And I do think that the exercise produced endorphines have a lot to do with it also. At least it works for me. Bike on!!
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Old 01-13-14, 01:14 PM   #4
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I have pain in my lower back, sometimes severe (caused me to DNF on two double centuries, both at about the 165 mi. mark) but my (GP) doctor says it's just arthritis and there's nothing I can do about it. And he's probably right, as far as that goes.

My chiropractor tells me to roll on a foam roll (about 6" in diameter) both aligned with my spine and perpendicular to my spine, which takes maybe 15 minutes. I find that works rather well, but YMMV obviously.

She advises once a day but I rarely roll that often. Twice a week is more like it, but yes, it really helps eliminate the pain. Also she advises against using a Camelback because she doesn't want that extra weight on my back. Also interesting (and unlike the OP) she doesn't want me using aero bars either.

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Old 01-13-14, 01:49 PM   #5
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Don't necessarily believe unconditionally what the doctor says. You have to own the whole process. MRI's showed I have a serious herniation. A surgeon told me I needed surgery. A chiropractor told me I needed manipulation. Yada Yada Yada. My worst pain was local to the back, not down the leg (but I had some sciatica). I opted for spinal injections partly for the immediate pain relief but mainly for their diagnostic value. If you inject position A and the pain doesn't go away, try position B, etc, until you know exactly where the pain comes from. I had a dozen injections over a few years with dwindling relief. Another surgeon insisted I needed surgery immediately. All those years I was also doing my own research. I finally suggested we needed to do a facet joint injection to see if that was the source. The PA rolled his eyes and mumbled vaguely how I couldn't possibly know anything, and again said surgery was the obvious solution. I insisted on speaking to the lead doctor. I told him my theory and suggestion and he liked it. The subsequent facet injection gave me total relief for a month. Two more injections confirmed the location and he did a rhizomoty. I've been pain free for years now and I frequently walk and carry for 36 holes of golf. Your issue may be different but I recommend you own the process yourself.
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Old 01-13-14, 02:26 PM   #6
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I started to use inversion table few years ago due to back pain issue . I am on it twice a day , 10 minutes each time . No back pain so far .
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Old 01-13-14, 03:21 PM   #7
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Been dealing with bulging disks in l3, 4, 5 for well over 20 years. 4 simple yoga positions, riding as much as possible, and keeping my weight in check have been the best medicine.
Have really bad arthritis in the mid and upper spine. For that I have found little relief.

Recommend the book BACK Rx. Simple, effective and requires minimal time to get the process of recovery started and maintained.
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Old 01-13-14, 04:22 PM   #8
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The one thing we have in common is that we're all different.

I know many people who have had dramatic benefit from back surgery. I would never be dismissive of it.

But the only time I would have it is if I were losing function.

I have back pain, both upper and lower, that comes and goes. My physical therapist is a bud of mine. I see him all the time. Usually just when I'm ready to schedule an MRI, the pain goes away for awhile. I know what it would show. I'm saving a copayment by not getting it.

One thing, and I risk excommunication from the fraternity of benders: whereas the bent makes a dramatic difference with neck and shoulder pain, my SWB bent does not help low back pain. Sometimes I think it makes it worse.
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Old 01-13-14, 04:44 PM   #9
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I agree with all the comments. I would avoid surgery in any way possible. I used to find double centuries with 12,000 to 18,000 feet of climbing controlled my sciatica pain. But I reached a point 7 years ago where exercise, stretching and riding no longer helped so underwent a microdiskectomy where they shave off the extruded disc which impinged on the nerves. That worked until a year or so ago when I underwent a multilevel Lumbar fusion due to Stenosis and degenerative disc disease. Unfortunately the nerves were being severely damaged to a point where the sciatic nerves went numb on standing. By all means avoid surgery but definitely add an orthopedic surgeon who has a good reputation and who specializes in backs to your contact list.
I am 1 1/2 years post surgery and only starting to return to pre-surgery fitness. Was it worth it? YES! Do what it takes to remain on the bike!
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Old 01-13-14, 05:56 PM   #10
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At times surgery is the most effective, sometimes the only, means of relief. I had a herniated L4/L5 disc that could only be "fixed" with surgery. I've been on the bike for a while with stretching, but I've still have bouts of sciatica that are best addressed with steroid injections now.
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Old 01-13-14, 07:45 PM   #11
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I listened to that also. I thought they way underplayed the role of exercise. Like the OP, the bike has been my best doctor.

I picked Alpine skiing back up a few years ago, and one of the first times I was out, I did something to my back. I heard and felt something go rip. Serious pain and sciatica. So I went to the doctor. He was a good guy and ordered an MRI. The MRI reader just looked for what they usually find, and found it: arthritic facets, lumber stenosis, thinning discs, and an old collapsed lumber vertebra. None of those things were the problem this time, though my back has given me a little trouble for years, probably a combination of those factors.

My treatment was exercise: bike, weight room focusing on back work, etc. I'd work out until it hurt really bad, then I'd let it recover over a day or so and then make it hurt really bad again. Fixed it up in about 6 months. Today it hardly ever hurts. I'm using Core Advantage this season with good results. Highly recommended. And almost free compared to the alternatives. Stoker and I are hoping to ride the one-day STP and RAMROD this year. We're getting some good training in. We'll see.
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Old 01-13-14, 08:12 PM   #12
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Originally Posted by Rick@OCRR View Post
I have pain in my lower back, sometimes severe (caused me to DNF on two double centuries, both at about the 165 mi. mark) but my (GP) doctor says it's just arthritis and there's nothing I can do about it. And he's probably right, as far as that goes.

My chiropractor tells me to roll on a foam roll (about 6" in diameter) both aligned with my spine and perpendicular to my spine, which takes maybe 15 minutes. I find that works rather well, but YMMV obviously.

She advises once a day but I rarely roll that often. Twice a week is more like it, but yes, it really helps eliminate the pain. Also she advises against using a Camelback because she doesn't want that extra weight on my back. Also interesting (and unlike the OP) she doesn't want me using aero bars either.

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Aw, what does she know?

So far, I've been lucky. As long as I ride, I have no back pain whatsoever. I honestly think that all the climbing is great for strengthening the lower back.
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Old 01-13-14, 08:49 PM   #13
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Aw, what does she know?
So far, I've been lucky. As long as I ride, I have no back pain whatsoever. I honestly think that all the climbing is great for strengthening the lower back.
I hope you're right Victor! Last year I climbed 592,683 feet and sometimes my back still hurts. Maybe not as much as it would hurt if I hadn't done so much climbing, and yes (as you know!) she knows a lot.

I plan in riding Devil Mountain for the first time this year so you (and she) could probably teach me a lot about that too!

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Old 01-13-14, 09:50 PM   #14
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I occasionally have some back pain. Yet when I get on my recumbent and ride, it goes away. Then after a while when I get back home it will start up again.
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Old 01-14-14, 11:13 AM   #15
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I hope you're right Victor! Last year I climbed 592,683 feet and sometimes my back still hurts. Maybe not as much as it would hurt if I hadn't done so much climbing, and yes (as you know!) she knows a lot.

I plan in riding Devil Mountain for the first time this year so you (and she) could probably teach me a lot about that too!

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Oy ... I want to do Devil Mountain again this year. That is truly an EPIC double, and you truly can't beat the Quacks for support.

Almost 600,000 feet of climb for the year. That's great! I get a lot of miles in every year 'cause of the commute, but not a lot of climbing. I probably got only about 400K or so.
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Old 01-15-14, 04:28 PM   #16
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At times surgery is the most effective, sometimes the only, means of relief. I had a herniated L4/L5 disc that could only be "fixed" with surgery. I've been on the bike for a while with stretching, but I've still have bouts of sciatica that are best addressed with steroid injections now.
This statement, in bold, that I wrote was the only solution for me. I had to have the surgery. 12+ years later I occasionally have sciatica and when it's bad enough and stays around for a couple of weeks +, I have to get a steroid injection.
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Old 01-15-14, 07:45 PM   #17
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The discussion/suggestions in this thread along with the article has provided some interesting and timely food for thought for me. A couple of days ago I decided that it was probably time for me to make an appointment with the back doc, so I will see him in about 10 days. Iím 52 and over the last year or so, my back issues have seemed to get progressively worse. Not horrible, but noticeable. I have scoliosis that was diagnosed in childhood, not enough for surgery during my younger years, but I suspect that is the root cause of the degeneration I have been experiencing during the last few years. I have been very active my entire life and my back issues really havenít impacted me much but things seem to have changed recently. Like many of you, the bike seems to provide relief. Last summer I did several relatively long rides including one of about 10 hour, 150+ miles, with lots of climbing and had virtually no issues except a little stiffness. In contrast, I can take a short walk with my wife and find my left leg going numb very quickly. Sometimes I canít stand still for more than about 15 minutes before I start to feel numbness down my leg. Do a deep knee bend and it will fade away. The back pain is something that I can and have dealt with, but the numbness and accompanying weakness is something that is concerning. I pretty much know what to expect from the doc that I am going to see Ö MRI first, recommendation for injections/surgery next. The guy is an excellent surgeon but before I do anything radical, I plan on continuing to work hard on improving core strength and flexibility, and maybe get a hold of an inversion table and try some simple spinal decompression. I have never spent a day in the hospital my entire life so I am very reluctant to undergo anything major but I am thinking the MRI might be a good idea since it might better identify what is going on. I guess we will see. Despite the issues, I feel fortunate that I can still do what I enjoy doing and ride without major problems.
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Old 01-15-14, 08:44 PM   #18
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The discussion/suggestions in this thread along with the article has provided some interesting and timely food for thought for me.

A couple of days ago I decided that it was probably time for me to make an appointment with the back doc, so I will see him in about 10 days.

I’m 52 and over the last year or so, my back issues have seemed to get progressively worse. Not horrible, but noticeable. I have scoliosis that was diagnosed in childhood, not enough for surgery during my younger years, but I suspect that is the root cause of the degeneration I have been experiencing during the last few years. I have been very active my entire life and my back issues really haven’t impacted me much but things seem to have changed recently. Like many of you, the bike seems to provide relief.

Last summer I did several relatively long rides including one of about 10 hour, 150+ miles, with lots of climbing and had virtually no issues except a little stiffness. In contrast, I can take a short walk with my wife and find my left leg going numb very quickly. Sometimes I can’t stand still for more than about 15 minutes before I start to feel numbness down my leg. Do a deep knee bend and it will fade away.

The back pain is something that I can and have dealt with, but the numbness and accompanying weakness is something that is concerning.

I pretty much know what to expect from the doc that I am going to see … MRI first, recommendation for injections/surgery next. The guy is an excellent surgeon but before I do anything radical, I plan on continuing to work hard on improving core strength and flexibility, and maybe get a hold of an inversion table and try some simple spinal decompression.

I have never spent a day in the hospital my entire life so I am very reluctant to undergo anything major but I am thinking the MRI might be a good idea since it might better identify what is going on. I guess we will see.

Despite the issues, I feel fortunate that I can still do what I enjoy doing and ride without major problems.
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Old 01-19-14, 12:45 AM   #19
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Yoga!

Local 'go to' spinal specialist, although a surgeon, conservatively favored yoga. Local instructor has a back specific program which has done wonders for me. Been at it about 18 mos.
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Old 01-19-14, 08:52 AM   #20
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Local 'go to' spinal specialist, although a surgeon, conservatively favored yoga. Local instructor has a back specific program which has done wonders for me. Been at it about 18 mos.
I've heard the same from several friends. For some of them, yoga was the only thing that helped.
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