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4 in 10 cases of chronic lower back pain might be curable ... with pills.

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praktik

praktik

TRIBE Member
Ya I'm a sufferer and don't fit this profile. I got bulging discs and a CT-scan showed the structural problems that contribute to my constant need for stretching and exercise to stay able to have a normal life.

I would caution back-pain sufferers from thinking there is a quick fix. I am skeptical on the pill angle when I bet the biggest vectors to low-back pain are structural and lifestyle - people have weak cores!

Build your core - protect your back. A pill won't hold you up better, stretching and strengthening will! I can't see there being a realistic substitute to having to devote the time to exercise and stretching/
 
praktik

praktik

TRIBE Member
I would say though - def try the pills over surgery. Back surgery is a bit of an unpredictable route with high risk and low reward.

Recent statistical analyses showed regions in the States with high rates of surgery were areas where there were more back surgeons, and yet no meaningful difference in rate of back pain suffering from regions where people get surgery far less. Its a bit of a money maker with a hard to determine benefit, though there may be exceptional cases where the utility is more obvious. Those back surgeons need a client list, was interesting to see supply of surgeons determining the # of surgeries rather than demonstrated success from surgery getting more people to do it...
 
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acheron

acheron

TRIBE Member
something that's worked for a number of family members and acquaintances of mine is the "Alexander Technique"...

Once you have stabilized your back condition through therapy or drugs or whatever, you will always need to be careful to not throw it out again - so as praktik said you need to strengthen what's there.. but it's very important to learn how to move in such a way that you don't accidentally zing your back again and flare up an old problem.

[YOUTUBE]coVXuDjHrfM[/YOUTUBE]
 
R

R4V4G3D_SKU11S

TRIBE Member
praktik said:
Build your core - protect your back. A pill won't hold you up better, stretching and strengthening will! I can't see there being a realistic substitute to having to devote the time to exercise and stretching/
Click to expand...

I think this pill is meant for people who don't respond to stretching/strengthening. I think it is meant for people who do not have compression/strength issues yet still have chronic low back pain.

But it's also impossible to come to any conclusions whatsoever without seeing the study itself.
 
praktik

praktik

TRIBE Member
acheron said:
something that's worked for a number of family members and acquaintances of mine is the "Alexander Technique"...

Once you have stabilized your back condition through therapy or drugs or whatever, you will always need to be careful to not throw it out again - so as praktik said you need to strengthen what's there.. but it's very important to learn how to move in such a way that you don't accidentally zing your back again and flare up an old problem.

[YOUTUBE]coVXuDjHrfM[/YOUTUBE]
Click to expand...

Yep x1000

An increased sensitivity is important. I relapsed "being a hero" and forcing myself into work when the warning signs were there.

Its really important to sense when you're tightening up so you can engage in more activity and watch what you're doing so you don't "twinge" and kick your back down a few rungs...
 
praktik

praktik

TRIBE Member
R4V4G3D_SKU11S said:
I think this pill is meant for people who don't respond to stretching/strengthening. I think it is meant for people who do not have compression/strength issues yet still have chronic low back pain.

But it's also impossible to come to any conclusions whatsoever without seeing the study itself.
Click to expand...

Yep duly noted I just went through a kaleidescope of not-met expectations and I want to dampen anyone's hopes so they have less of a let-down... I realize now its a life-long commitment.

But I am generalizing from my own experience certainly and maybe there are cases where this will work. Will need to get my hands on the full study!
 
Bass-Invader

Bass-Invader

TRIBE Member
Does nuclear tissue infected with bacteria following disc herniations lead to Modic changes in the adjacent vertebrae? - Springer

Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy - Springer

papers above, subscription walled though.


This stuff about 'quick fixes' is silly. If the cause of the pain is a bacterial infection then kill the infection. Stretches won't kill bacteria, antibiotics will.

Nowhere in the study or the articles is anyone claiming all or even most back pain falls within this. However 4/10 chronic lower back pain (which I understand is a very specific back pain condition and is generally quite severe) is a really substantial proportion. It's interesting for that reason alone.
 
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L

Liability

TRIBE Member
praktik said:
I would say though - def try the pills over surgery. Back surgery is a bit of an unpredictable route with high risk and low reward.

Recent statistical analyses showed regions in the States with high rates of surgery were areas where there were more back surgeons, and yet no meaningful difference in rate of back pain suffering from regions where people get surgery far less. Its a bit of a money maker with a hard to determine benefit, though there may be exceptional cases where the utility is more obvious. Those back surgeons need a client list, was interesting to see supply of surgeons determining the # of surgeries rather than demonstrated success from surgery getting more people to do it...
Click to expand...

I don't know if this is quite true anymore. I had a laminotomy and disctomy (spine surgery) about 1.5 years ago. I was highly resistant to surgery, but didn't have a choice.

I went to 9 months of physio accompanied by intensive stretching. My journey ended in me being competely incapacitated for 1 month on the floor. the surgery was quite successful with a relatively quick recovery time. the technology has changed and Canadian neurosurgeons are known for techniques that are as in-evasive as possible.

I suffered from bulging discs in the L5 S1 region.
 
praktik

praktik

TRIBE Member
Ah nice ya I am L3-L5 inclusive with L5 being the worst.. so similar maybe... you ever have sciatica manifest?

So far my doc has been real lukewarm on surgery... I guess I am at something of an equilibrium so maybe we don't wanna f*ck with that too much... But I am still doing a lot of stretching every day, at least 1.5-2 hours (at beginning and end of day, that total is combined) and trying to strengthen continually...

After surgery I assume there is still some regular maintenance you need to keep your core loose and strong eh?
 
L

Liability

TRIBE Member
praktik said:
Ah nice ya I am L3-L5 inclusive with L5 being the worst.. so similar maybe... you ever have sciatica manifest?

So far my doc has been real lukewarm on surgery... I guess I am at something of an equilibrium so maybe we don't wanna f*ck with that too much... But I am still doing a lot of stretching every day, at least 1.5-2 hours (at beginning and end of day, that total is combined) and trying to strengthen continually...

After surgery I assume there is still some regular maintenance you need to keep your core loose and strong eh?
Click to expand...

Yeah the sciatic was what lead to surgery. I was literally floor bound for a month with unimaginable pain. Sciatic manifested early and I was trying to manage with a combination of physio, intensive stretching, and a topical anti-inflammatory.

According to my neuro consult, surgery has a high success rate/low risk in the appropriate cases. I maintain with a ton of walking, no sitting for periods longer than 1 hours and regular core workouts.

Let me know if you need the name of a good neurosurgeon. He has been around forever and is not known for performing an unnecessary surgeries.

All of my consults pointed to evidence that in some cases the condition can be maintained through stretching and maintenance but mine was not one of those.
 
praktik

praktik

TRIBE Member
Liability said:
Let me know if you need the name of a good neurosurgeon. He has been around forever and is not known for performing an unnecessary surgeries.
Click to expand...

Ya those sciatic periods are just unbelievable! People just don't know how debilitating it is..,.

Back in 2001 it started for me with a bad bout of sciatica, did not have that rematerialize until 2010-2011, when I had a relapse that floored me for a month and took about 6 months to recover from. I was very lucky to be in position where I could work from home, so I was able to feel useful during a really rough time.

Most of the time it is not sciatica for me - thank god - and it is more a dull-ache with intermittent periods of tightness/regression that I just work my way out of by hot/cold stretch/exercise.

Shoot me a PM w/ the dude's name couldn't hurt to have him consider my case - but given I have a mostly ok life maybe he won't want to upset the balance.
 
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praktik

praktik

TRIBE Member
Science-Based Medicine » Antibiotics for Low Back Pain

Ah nice, confirming signal from a trusted source!

Their conclusion:

This study is encouraging but far from definitive. It might justify antibiotics for patients with chronic low back pain and Modic-1 MRI changes following a herniated disc when they have failed to respond to all other treatment options. This was a well-designed study, carefully carried out, with a credible rationale, impressive results, and a cautious interpretation. This is how science should be done.

The authors cautioned:

We rely on our fellow colleagues to use clear evidence-based criteria and to avoid excessive antibiotic use.​

Back pain is a frustrating problem, and patients who learn about these results may ask for a trial of antibiotics even if they don’t fit the criteria of the study. That would not be justified and might be expected to do more harm than good. Chronic low back pain is a mixed bag with various etiologies, and it must be stressed that this study addressed only one very limited sub-group of back pain patients. That said, it is a ray of hope for those patients, and I hope it will be confirmed.​
 
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