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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34683
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My husband has been having some unusual back pain that is preventing

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My husband has been having some unusual back pain that is preventing him from getting a good night's sleep the past few days. It's in the middle of his back and any position when he lies down has been hurting so much, enough to keep him awake, which is really bad since he doesn't get much sleep as it is (for years now, only about 5 hours of sleep during the workweek). Today, he got up out of bed and stood up, and said it doesn't seem to hurt as much, but it was still painful. He was having some sinus problems also during the week. He's 57 years old. Who should he see?

I have heard that some cardiac issues can involve back pain.
Greetings Anna.He can consult any of these specialists;1) Orthopedics2) MD in physical medicine and rehabilitationThis is likely to be myofascial pain syndrome. Muscles of the back can develop myofascial trigger points. These are hyperirritable tender spots in palpable tense bands of skeletal muscle that refer pain. This can be associated with degenerative disc disease in back. Trigger points may develop after an initial injury to muscle fibers. This injury may be a noticeable traumatic event or repetitive microtrauma to the muscles. The trigger point causes pain and stress in the muscle or muscle fiber. As the stress increases, the muscles become fatigued and more susceptible to activation of additional trigger points. The treatment is following; 1) passive stretching of the affected muscle after application of sprayed vapocoolant.2) physical therapy; simple muscle stretch, augmented muscle stretch, post-isometric relaxation.3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation, high voltage galvanic stimulation, biofeedback.4) local analgesic patch / ointment / spray5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)6) ischemic compression therapy; pressure on the points7) massage8) steroid shots9) acupuncture.Please feel free for your follow up questions.Dr. Arun
Customer: replied 4 years ago.
It's only happening when he is lying down...and he's fine now that he's gotten up to start his regular morning routine of going to work. He says it's only been over the last two or three days, a day or two after Sunday when he was pulling out weed trees from our yard...he thinks it's a pulled muscle.

Does it still sound like something related to degenerative disc disease? How long should he wait to see if the pain goes away on its own? Just trying to save doctor costs.

Hello Anna,


This can be pulled muscle; though a pulled usually gets better on lying down and aggravates on standing or sitting and doing some work (especially with the back movements). A degenerative disc disease is more likely to cause pain during lying. Though this too is self limiting and gets better usually in a week or 10 days. So you may wait for this much duration, especially since he is feeling better.


Following measures would be helpful;



1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back
education is one of the most important thing which teaches the basic
body mechanics, like correct posture for standing, standing at a desk or
drawing board, sitting, brushing teeth, washing the face, pushing and
pulling a weight, lifting a weight, getting in and out of bed, sleeping,
getting into and sitting in a car. The training for these routine
activity helps in preventing the spasm of the muscles. One needs to
consult an occupational therapist or physical therapist which can
educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:



a) Avoid activities which increases the pain.


b) Rest intermittently


c) Avoid bending at 90 degrees


d) Pushing and pulling should be avoided till pain subsides


f) Avoid prolonged sitting and standing


g) Avoid sitting or sleeping on floor




2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants




3) Local analgesic gels or sprays / ointment




4) Hot fomentation




5) Electrotherapy like trans cutaneous electrical nerve stimulation:
done by physical therapist. Other thing are ice packs, heating pads,
electrical stimulation, phonophoresis, iontophoresis, relaxation, and



6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back
stretches, seat lifts, mountain and sag exercises, knee-to-elbow
exercises, hamstring stretches, extension exercises, and extension
flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.



7) Lumbosacral corset or support or brace




8) If obese or over weight, reduce weight for long term benefit.



You can start the following exercises;




1) Straight leg raising: Lie on the bed with your back
and remain in a relaxed position. Slowly raise one of your legs upward
and keep it as straight as possible. Count up to ten, and slowly bring
down the leg. Do the same with the other leg. Repeat this exercise ten



2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back,
and curl-up lifting the head and shoulders from the bed / couch. Hold
for ten seconds, then slowly lower to starting position. As strength
builds, aim to complete one sets of ten curls. The exercise should be
done twice a day (both the sets).



This is a slide show for the exercises (he can pick up your own set, which suits him);


It is privilege assisting you.


Dr. Arun

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