Doc, I have pain.
What should I do? I've been reading the
comments to the ShimSpine YouTube channel, and I realized
many people are looking for some guidance. So, instead of responding to
individual questions, I'm starting a series on how I would
answer the most common question, which is "Doc, I have back
pain. What should I do?" First of all, I'll have
to let you all know that I'm talking about generalities.
So, individual situations may not always result
in the disgust outcomes. As a doctor, I will have to answer your questions
with questions of my own. After all, my first priority is to make
sure I'm considering the most serious and
potentially limb and life-threatening situations.
If you do not have fever, unexplained weight loss,
true weakness of the muscles, loss of the ability to control your bladder or
bowels, or suffer from a traumatic impact or fall, then I can provide you
with some general guidelines on what to do.
If you have any of the mentioned situations I would contact your own
doctor immediately to make sure you don't need attention or
emergency care now. I need to explain what is true weakness
of the muscles. Sometimes you have so much pain that you
do not want to move the muscles, but you can. That is not true weakness of
the muscles. A true weakness is an inability to move
the muscles despite all your efforts. This is a real
problem, and needs attention right away. Loss
of the ability to control your bladder or bowels is even more than just the
reluctance to go to the bathroom because of pain or constipation. It means
you can't control your urination. You may not even feel your bladder
filling up. You may start to store your clothing with both
urine and bowel movements. While it may be embarrassing,
this is a type of condition that along with back or neck pain is an emergency,
and you must get an evaluation right away.
If you do not have these conditions, then you can consider these
general guidelines. I will list these suggestions now,
but I plan on producing more detailed videos of some recommendations in the
future. So, here's my approach for people who do
not have a life or limb threatening episode of
neck pain, back pain, or a pinched spinal nerve.
What do I counsel? Well, statistically eighty percent of people will have an
episode of debilitating neck or back pain in their life. Most episodes
improve without aggressive medical care such as injections
or surgery. I counsel, don't lie in bed for more than two days.
More time at bed rest actually weakens your muscles,
and delays your recovery. Remain active by walking and stretching.
Avoid sitting for long drives or long plane rides. Avoid lifting objects
that are greater than 25 pounds. Avoid repetitive bending at the waist.
If you feel strongly about medications consider either
ibuprofen or acetaminophen, but please be careful.
The medications work differently, and not everyone can take one
or the other. Just because you can buy these medications
does not mean they're completely safe. Avoid the use of narcotic medications.
They really do not help, and can cause harm. Stay socially engaged.
People with pain sometimes withdraw from being with others.
That withdrawal can lead to depression. Which can then
lead to worsening pain. Alternate ice with heat
for the muscles. Track your pain levels with a diary.
Oftentimes, you may not see improvement from day to day,
but a look back a few weeks will allow you to know if you're making
improvements. Sleep on your side, or if you must, sleep
on your back, but make sure to place pillows beneath
your knees to bend them. The vast majority of people
will feel much better by six to eight weeks. If you're not making
improvements, or you're developing any of those
serious findings listed in the beginning of the video,
contact your doctor right away. In my next video, I plan on discussing the
difference between acetaminophen and ibuprofen, and why you
should avoid narcotics. Thanks for watching.