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Mid Back Pain

Old 05-08-17, 09:05 PM
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Mid Back Pain

Articles I read about back pain on the bicycle tend to talk about neck & shoulder pain and lower back pain ... but that's not where I usually experience back pain. I experience it in the middle of the back, usually on the right side.

If you look at the image, I've circled the area where I experience the pain.


I was doing just fine until about the beginning of March when this pain returned. It's one I've had before and seems to come and go at random. I'm not quite sure of the cause but the muscle(s) is really tight.

At the beginning of March, I started using my large backpack for work and to haul stuff to and from the university ... so perhaps this has nothing to do with my cycling at all. I've switched back to my small backpack.

I have been playing around with the fit on my bicycle, so it could be related to that. I am going to get my main bicycles up on the trainer to check fit.

It is quite possible I need to focus more on core work ... I tend to let that go a bit.

Longer, and especially hillier, rides increase the pain ... but I've also done long hilly rides without pain.

If I am going to experience this pain, as the ride continues, it goes down into my hip first and my right hip area seems to tighten up ... and then it goes up into the shoulder area. But interestingly, I'll be left with a spot about the size of a golf ball right in the middle of the area I circled in the photo that is numb. Pain all around, and this completely numb spot in the middle.



Just wondering if anyone else has experienced this and what they did about it.
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Old 05-08-17, 09:35 PM
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get out the dice, because this is a crapshoot guess.

I suspect that you may have sciatica like issue. i doubt it's sciatica in the classic sense because it's too high, but other than location what you describe is just about identical what I and others with sciatica feel.

So, some nerve leaving the spinal cord higher up is pinched or otherwise inflamed, and causing the symptoms. Possibly a muscle map of what you feel where might allow a good diagnostician localize the likely culprit, and recommend exercises and stretches to relieve the issue.

You might also see an acupunturer, (acupuncturist?) who might get you relief.

BTW - keep in mind that this is a medical diagnosis from a manufacturing engineer, so give it the same credence you might give a doctor when he tells you how to fix your bike. But, one other possible underlying factor may be how you sit, stand, walk, or carry stuff, so take a look at those, and avoid spending long periods in the same position
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Old 05-09-17, 01:20 AM
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The first thing that I would put at the top of the list is kidney pain. Not necessarily for being the most common, but being something that would require a doctor visit. They are supposed to be sensitive to vibration, so you can test by pounding on the back just below the rib cage. If it causes severe pain, get it checked.

What is your typical cadence and climbing method? Low cadence, pulling up, and standing climbing may cause low to mid back pain. I believe some stress may make you stronger, but you may look at your pedalling style.

You've already mentioned a backpack. Are other methods of carrying your gear an option such as a rack and panniers?

Do you get morning back pain/stiffness? If so, look at your sleeping arrangements. Mattress firmness? I've found that sleeping in a chair is less stressful to my back than a bed.

Also, a tight belt or restrictive clothing can cause back pain.

Stretch and shift positions on your bike.
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Old 05-09-17, 02:40 AM
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I do have kidney stones. Just about every time they check, there are several rattling around in each kidney and I had a large one surgically removed a few years ago because it got stuck on the way out. At times, this reaches the pain level where I start to wonder ........... but I do know that the muscle is tight so I'm kind of thinking it's that.

I use the backpack while walking, not cycling. Why I think it might be at fault is that my large one somehow rests against the painful spot. My small one doesn't so much.

No morning stiffness ... no tight belts.

However, the other possibility is that I sit a lot (office job and IT courses in university), so it could be that ... I do try to get up and move relatively frequently, but when I get busy doing something it can be a couple hours. And related to that, it could be my posture ... I think it was improving, but recently my eyesight has deteriorated again, and so I'm kind of hunching over the computer again.
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Old 05-09-17, 08:39 AM
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Just to add to this ... I mentioned that this is not the first time I've experienced this pain.

The first time was when my distances started increasing but I was riding bicycles that were way too big for me. Then I went to bicycles that fit me and the pain went away, so I thought the problem was solved.

It returned when I got up over 400 km on my Giant in 2001, but again I thought that maybe I was a bit too stretched out. Although my Giant fits me for height, the reach is a bit long.

So I got my Marinoni and all was well till the Paris-Brest-Paris in 2003 when it returned ... but it went away soon after and I don't recall that it bothered me again until 2015.

In 2015, I did a climbing ride on my titanium ... and it was back. But then I adjusted handlebars and so on and it seemed to go away ... till now, or rather, early March. I have been riding the titanium again on long rides ... so maybe it is a factor in this equation.

I was also in uni walking decent distances with a heavy backpack in 2015 when it flared up ... so ... who knows ...
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Old 05-09-17, 10:03 AM
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I've had a fair bit of what you describe. Everything you mention is a contributing factor. My experience is that this sort of thing can best be resolved by exercise and stretching. When you have this pain, get Rowan to feel around in your back and see what the painful area feels like. My guess is that he will find muscle spasms there. If so, then what causes them? Certainly nerve pinches can do it, as can tired muscles.

Anyway, core work, like you say. Squats, rows, lat pulls, unsupported dumbbell presses, hyperextensions or back machine, the usual, whatever works that area, hard. Seated floor stretches really help, every day. Roll the area with The Stick after stretching. Next time you have that pain, get off the bike and try putting your knuckles on the road, locked knees, see if that makes it go away. That's diagnostic.
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Old 05-09-17, 10:35 AM
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How big is your "Large" backpack? If you have a large camping backpack, make sure it also has a good frame and a good belt. Adjust the belt so that it puts the weight on the belt and the hips.

I don't bother with belts on the smaller packs, but be careful of the packing so that they don't put awkward stresses on the back, or stuff poking into the back.
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Old 05-09-17, 11:43 AM
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Another sufferer of mysterious aches and pains that come and go, seemingly randomly but more likely due to something that occurred some days in the past. I see a chiropractor regularly and things can be felt popping back into place, usually with immediate relief, during a visit. In my case, vertebrae get out of alignment, probably due to disc wear. In fact, thinned discs can be seen in an X-ray image.

In between chiro visits, I've learned several moves that get misaligned vertebrae back where they belong. Most of these moves have to do with putting the spine in mild traction. For example, simply folding at the hip while maintaining a straight back and placing hands on knees puts the spine in tension. I do this every morning and can feel and hear vertebrae popping into place. I also have discomfort from neck vertebrae. I bit of careful rolling my head around for less than a minute and I can then manipulate neck bones back into proper place. These moves along with daily stretching and some yoga exercises keeps me mobile and mostly pain free.

Your issues may be due to a different cause altogether but if the cause is for similar reasons, you may benefit from some time spent on an inversion table or any other method that causes traction (tension) in the spine. How to Use an Inversion Table for Back Pain: 15 Steps

This can be debilitating and depressing so my best wishes to a good outcome.
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Old 05-09-17, 07:16 PM
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Originally Posted by Carbonfiberboy
Next time you have that pain, get off the bike and try putting your knuckles on the road, locked knees, see if that makes it go away. That's diagnostic.
Never in my life have I ever come close to being able to do that!!! I'm lucky if I can reach mid-shin!! Even when I was doing yoga and my flexibility did improve a little bit I still couldn't reach my feet.


That said, one thing that does help is leaning forward, then over to the left and kind of making some attempt to wrap myself around my left knee. That seems to stretch out the right side of the back and right hip a bit.

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Old 05-09-17, 08:18 PM
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Originally Posted by Machka

That said, one thing that does help is leaning forward, then over to the left and kind of making some attempt to wrap myself around my left knee. That seems to stretch out the right side of the back and right hip a bit.
That is exactly what I used to do to relieve back and hip pain.
I went to a good neurologist. It turns out that I have nerves that get pinched by muscles in the lower back. My hip pain was/is from a pinched nerve. When it gets out of hand I go to the neurologist, he gives me shots in the lower back that are a muscle relaxer. It get better usually in a day or so. They sent electric pulses through the nerve to analyze how bad the nerve was. It all starts when I pick up something too heavy or push or pull something wrong.
Maybe this is part of the problem. Maybe you have pinched nerves higher up. That would possibly explain the numbness? I have pinched nerves in my neck that cause numbness in other places, occasionally.

Tell Rowan he needs to proof read this post.
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Old 05-09-17, 09:24 PM
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Originally Posted by Machka
Never in my life have I ever come close to being able to do that!!! I'm lucky if I can reach mid-shin!! Even when I was doing yoga and my flexibility did improve a little bit I still couldn't reach my feet.


That said, one thing that does help is leaning forward, then over to the left and kind of making some attempt to wrap myself around my left knee. That seems to stretch out the right side of the back and right hip a bit.
Yeah, exactly. Go to your limit and hold for 20 seconds. I'll bet you could get a lot more bend if your worked on it every day. I do these every day - since I developed back pain! https://www.bikeforums.net/road-cycli...l#post15372967

Oh yeah, and also since I developed bursitis in my knees.
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Old 05-09-17, 09:53 PM
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Another thing to consider is your floating ribs and the effect that greater exertion has on them.

They attach at the spine near where you indicate and do not normally move much with moderate exercise but can expand when breathing deeply into the lower lobes or working for extended periods. That irregular effort may cause DOMS for the next day or so.

Looks a little high for sciatica which usually radiates down from the butt into the leg.
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Old 05-09-17, 10:50 PM
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Originally Posted by Carbonfiberboy
Yeah, exactly. Go to your limit and hold for 20 seconds. I'll bet you could get a lot more bend if your worked on it every day. I do these every day - since I developed back pain! https://www.bikeforums.net/road-cycli...l#post15372967

Oh yeah, and also since I developed bursitis in my knees.
I wasn't even able to touch my toes as a child. I remember being 6 or 7 years old and marvelling that anyone could touch their toes ... and they used to get us to try to do it just about every day back then.
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Old 05-09-17, 10:53 PM
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Originally Posted by Happy Feet
Another thing to consider is your floating ribs and the effect that greater exertion has on them.

They attach at the spine near where you indicate and do not normally move much with moderate exercise but can expand when breathing deeply into the lower lobes or working for extended periods. That irregular effort may cause DOMS for the next day or so.

Looks a little high for sciatica which usually radiates down from the butt into the leg.
Don't think it is DOMS as it goes on for a month or two at a time. This flared up in March and is still going. We cycled 1000 km in each of March and April, and did a lot of long rides in both months so I would have thought if it were just DOMs I would be over that by now.
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Old 05-10-17, 02:51 AM
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I can touch my toes, and more often than not, put my palms on the floor. Makes Machka very envious.

We have both discussed this, obviously. Her numbness is reminiscent of something similar I had after finishing PBP 2003. I couldn't work out what caused it. Psychosomatic? Perhaps, because the body does play tricks when the mind is determined. Constant position on the bike? Maybe. 88+ hours of riding with a few breaks might have encouraged it. Band on my bike shorts? Perhaps, but the band was a couple of inches below the numb point.

We've also been doing quite a bit more climbing than Machka has been used to since stating back on the randonnee journey several years ago. Maybe we need to fiddle just a tad with handlebar height.

Happy Feet... the floating rib thing is interesting. I cracked several ribs about a year ago in workplace accident, and it's only just recently that that area of my lower right back has felt OK. But even before the incident, I would have an ache-type pain in that region.

And 2manybikes... 10/10 for your post.

Last edited by Rowan; 05-10-17 at 03:53 AM. Reason: 5/10 for me... wrong year for PBP :)
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Old 05-10-17, 05:38 AM
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My brother had symptoms similar to yours and was diagnosed on the weekend with a pulmonary embolism. Given your history with blood clots it might be something to consider, particularly if the pain seems related to breathing hard.
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Old 05-10-17, 09:46 AM
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Originally Posted by Rowan

And 2manybikes... 10/10 for your post.
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Old 05-11-17, 06:57 AM
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Your story brings up a painful memory for me. My ex-wife's mother, may she rest in peace, had a midback pain for a long time, and she left it unchecked for a long time. It turned out to be ovarian cancer, and it killed her. It seems unlikely that this is what you have, but please be sure you figure out what you have and what a good treatment is. Don't let anything bother you for too long.
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Old 05-11-17, 08:16 PM
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Originally Posted by noglider
Your story brings up a painful memory for me. My ex-wife's mother, may she rest in peace, had a midback pain for a long time, and she left it unchecked for a long time. It turned out to be ovarian cancer, and it killed her. It seems unlikely that this is what you have, but please be sure you figure out what you have and what a good treatment is. Don't let anything bother you for too long.
My gynaecological oncologist has been keeping a pretty close eye on things for the past 2.5 years, and I am going in for surgery again for cancer-related issues of two parts of the female anatomy in that general region next week ... but I'd be surprised if these things are the cause of my back pain. However, I suppose you never know ... referred pain perhaps.


But it really does seem to be the muscle.
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Old 05-12-17, 11:50 AM
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OK, glad to hear you're taking care of things.
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Old 05-17-17, 02:29 AM
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I read something yesterday that I found relatively mind-blowing, which said that a tight/dysfunctional diaphragm can be the root cause of just about anything, including back pain. Ya know, ya read all the usual stuff about injuries a million times, then something different comes out of the blue.


"The iliopsoas is better seen as part of the diaphragm. Where one ends the other nearly seamlessly begins.

Diaphragmatic disorders
can most commonly result in sacroiliac joint disfunction, thoracic outlet syndrome, piriformis syndrome, IT band dysfunction, pain throughout the hips, low back, spine, and ribcage. The reasoning behind why the diaphragm should be considered part of a whole body system of its own, instead of a piece of the muscular system, takes an entire paper to explain, but that concept is very important. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731110/

I saw many times repeated by folks here, "It's like you're missing the problem", "the work I'm doing in my glutes, quads, etc... ...only last for a little while before everything tightens back up", "my foot tracks to the outside", "my hips are rotating laterally and anteriorly", "try to do the exercises in a way that does not activate your hip flexor", "I do tend to slouch when sitting".

The psoas connects on the lesser trochanter where some of the adductors attach. Tightness in the psoas will result in tipping the bowl of the pelvis forward to the trochanter, straining hamstrings, glutes, and rotating the femur so that the lesser trochanter presents forward and your toes point outward, which allows tightening in all of the deep hip rotators and glutes. Your upper chest will droop/slouch forward as it is pulled down by the psoas/diaphragm tightness.

Your psoas will tighten if you are chest breathing instead of breathing into the belly, stretching the transverse abdominis, and using the transverse ab. to compress the abdomen. The nerves which innervate the diaphragm will only activate and tell it to reset to its umbrella-like position if breathing is done correctly. Babies naturally belly breathe only. We learn to chest breathe in response to our need for fight or flight. The chest space opens to allow for more air, but if we do not return to the diaphragmatic breath (thanks to modern anxiety, stress, and sitting for too long), the transverse abdominis weakens, the diaphragm tips upward, cascading a shortness into the psoas which will in turn rotate and shorten the leg (usually left side, since the right side of the diaphragm has a 3lb liver holding it in place).'



The rest of the comment is on here, about 1/4 of the way down the page, posted by cmillerCMT. Some quick Googling tells me that she could be masseur Sally C. Miller, in Trinidad, Colorado.

https://www.mobilitywod.com/forum/di...for-6-years/p6

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