Severe pain, what would you do if single handing?

[Bill O]

Unless you have damaged discs/vertebra it is typically muscle cramping/spasms (butt and upper legs) causing lower back pain.

Not a big fan of heavy drug usage (unless you need to keep going/power through it) when the underlying problem is still there/not addressed.
A couple of replies (Chotu & Sailorboy) gave excellent advice of physical therapy (yoga stretching/core strengthening) followed by heating pads/TENS units (to help loosen muscles quicker).

It is very important to exercise on the boat, but can be challenging in limited space. Yoga, TRX and others exercises are very good for stretching/core strength which can be done with limited equipment.

Even w/the stretching exercises, once back pain occurs it does take a bit to loosen the muscles. The heating pad and TENS units help relax the muscles for quicker relief.

Oral supplemental of magnesium gluconate (not oxide) is a natural muscle relaxant. Also using epsom salts in a hot bath is a way to get magnesium into the body.

[rslifkin]

Originally Posted by Chotu

I do notice my problems typically come from too much sitting around doing office work. Not from physical activity (in my case).

I've found this as well. You can over-do it and hurt yourself doing things, but sitting around too much lets certain muscles get weak, and then it becomes easy to hurt yourself as various parts aren't as well supported.

[roryboy]

Ice lower back pain. Lot's of ice, make it numb to the touch. Apply as close to the skin as possible as often as possible. Maybe just a thin layer of fabric between you and the ice. I know ice can be hard to find at anchorage, but it works wonders if you can get it.

Know your pain killers. Ibuprofen works really good for some of us and an adult can take up to 800 mg for a short period of time. Tens units do work if applied correctly and are very compact and inexpensive today. Don't be afraid to try new things, I myself had very bad nerve pain from shingles for many months. Delta-8 provided instant relief. Was cheap and easily/legally available in USA.

[jordanbigel]

Originally Posted by Time2Go

Lots of back pain is caused by swelling of tissue around the affected area
and muscle spasm as the body tries to immobilize the area.
I have suffered the same from time to time and always travel with a
Mederol 5 day pack. ( Prendisone steroids, 5 tablets day one , 4 day two
and so on) Muscle relaxants also.
These are prescription meds. Not for long term management
but work great for short term intervention.
Once you get swelling and spasms under control you will feel much better.
Advil for pain control
Cheers
Neil

THIS ^^^

When everything else failed, including narcotics, a course of Prednisone saved me. You can only take them once every 6 months, but in my case at least, laid up in bed for a month (history of disc issues) after the course of steroids described above I was up and about.

Agree with everything else suggested here, but, those things like stretching, walking, exercises, strengthening, can only be done if you can get out of bed and move around.

[thinwater]

Originally Posted by Chotu

Thomm:

Try these. I only had back pain (sciatica) once. It put me on the floor for 2 weeks because I didn't know these. Any time I have even the smallest back pain I do these now and no longer have problems. I have to do the stretches maybe once a month. Because they have worked so well.

I do notice my problems typically come from too much sitting around doing office work. Not from physical activity (in my case).

These are stretches that specifically relive sciatica.









there is one more that I could not find a picture of. On a bed or something comfortable, lie down on your stomach, face down.

Bring your head up and rest your chin in the palm of both hands, supporting yourself on your elbows.

Hang your head over the edge of the bed in this position so you are comfortable.

Using your elbows as a lever, you can gently feel your way to stretching out your spine. If you pull in different ways, you can stretch the neck or mid back or even the stuff compressing your siatic nerve.

It doesn’t take very long at all for these exercises to fix everything. Just a couple of days. Any time the pain is really getting at you, just start doing the exercises and soon enough it will be gone.

Combining this with the muscle relaxers is even more powerful. But not even necessary all the time. Often these exercises will take care of it without any drugs.

Lastly, find any knots in your lower back and massage them out. Either at a massage place or DIY if cheap like me. Lol. There are often a lot of knots people miss where the back and the butt meet going into the top of the butt. there is this whole set of tiny muscles there at the top of the pelvc bone. Where it meets your back. These have small knots that can add a lot to back pain and go unnoticed.

also, it’s best not to stop. Crazy as it sounds. I was down for two weeks because I stopped. If I had done the stretches and took walks and just dealt with the pain, it would have been gone faster. I wouldn’t say you should go running like you usually do, but a nice slow walk is often helpful.

Good stuff. I had big problems ~ 20 years ago but have moved on with the help of regular self-PT. The above, plus this, which is the most effective single exercise for me. Go slow. Like all stretches, you only do 1-2 reps, but you go slow easing into it and taking 30 seconds.




Also, magnesium is a great anti-spasmodic, with no side effects other than moving the mail if you are taking too much. Possibly your diet is low.


Ice is generally better than heat during the acute phase (when it really hurts). Heat feels better but just increases swelling. Even with backs, I tried both.


Once it starts getting better, add core exercises to prevent the return. Planks are good, and lower abdomen crunches. Sweeps, but NOT sit-ups.


I once spent several days on my back, instructing my 14 year old to sail the boat (my wife was with us but is somewhat disabled with bad knees and not the sailor my daughter was) through a hatch conveniently located to the cockpit (aft cabins). I would crawl on deck to steer when docking (some tough tidal situations) but let her do everything else. Good crew.

[Shrew]

Originally Posted by Franziska

How would you deal with it? How have you dealt with it?

Honestly, you're given two options. Lie down and die, or do what you have to do. I know this sounds like a cavalier 'Monday morning quarterback' response, but if there is no third option, then what you do is simply (LOL) everything you can.

Two short semi-related stories.

As a younger man I was riding a dirtbike (motorcycle) deep in the Northern New England woods. My brother and I were several miles from the closest road and many miles from our trucks. I got into a bad accident. I went over the handlebars and landed on my head. I did have helmet, however I had compression fractures of T6 and T8 and 3 broken ribs.

I didn't have much choice. My brother picked-up my bike and got it started. I then spent the next several hours idling out of the woods in blinding pain. If you've never been in northern New England woods, it is rough, rocky, with many hills.

On another occasion I was back country skiing in Tuckerman's Ravine on Mt Washington in New Hampshire. I fell and blew out my left knee. There is no lift service here. It is hike 4+ miles into the mountains and ski, then either ski or hike out. I had a full pack because I had hiked in and was camping there while I skied. I had to load my full backpack and skis and hike the 4+ miles out. Again, ridiculously slow and in blinding pain. It took me many ours to hike out.

I was a mix of lucky and stupid in both cases, however you will be amazed at what your body can do given time and lacking options.

[dannc]

Even with a spine/back bone related injury, much of the pain is from inflammation. After numerous back, shoulder, and neck injuries, I have learned a few things.

• Ice is your friend.
  • Course, having ice or cold packs on a boat might not be possible but if you can cool down the area in pain, this shrinks the inflammation and lowers the pain. This is one of the first things we do with injuries.
• TENS units help as well.
  • Since the TENS unit uses a 9 volt battery this might help those without the ability to have cold packs or ice.
  • Carry extra batteries or be able to recharge.
  • Have extra pads and the glue to hold them to skin.
• Exercise and stretching.
  • Many pain events are from sitting in a chair "working" vs accidents.
• After shoulder surgeries, the wife was told to interleave Ibuprofen and Acetaminophen, but these are not benign drugs even though they are over the counter, so one has to read the instructions.
• Curcumin supplements, heck maybe plain old curcumin would work. This is one brand I use but I take others, https://www.amazon.com/gp/product/B0...?ie=UTF8&psc=1
  • I use this supplement instead of Ibuprofen or Acetaminophen to reduce pain and it works. I use it for head aches as well as body pains.
  • Years ago we made a trip overseas and I hurt my shoulder moving through immigration due to repetitive motion of picking up heavy bags while wearing a heavy back pack. I think the back pack restricted movement and was part of the problem. A good six months after the trip I was still in pain so I went to the doctor and did an X-Ray. No damage to the shoulder but I had inflammation. The doctor said I could go home and take 800mg of Ibuprofen for a month or I could get a steroid shot. Figure I was at the office already so give me the shot and if that did not work I could take the Ibuprofen. I really did not want to take 800mg of Ibuprofen for a month.
  • The steroid worked in that it lowered the pain but the pain was still there. Decided to take the Curcumin as linked above instead of the Ibuprofen and the pain reduction was pretty quick. It took a month or so for the pain/inflammation to go away but it did.
  • I take one of these supplements each day and more if I have some sort of body or head ache.

After my first injury, I went the traditional medicine route of heavy pain killers, Ibuprofen, and muscle relaxers. Never again unless there is no other choice. The drugs left me a zombie on the couch or in bed for a week. The next injury, I listened to my wife and went to a Chiropractor who minimized the pain with treatment, ice, and Ibuprofen. I could function, though in pain at that start of treatment, but I could function. I thought he was nuts when he told me to use ice every hour for seven minutes for as many hours a I could a day. I knew I would be in the emergency room in bad pain the way the pain was increasing but the ice prevented an ER visit AND I did not have to use serious drugs.

Certainly, one needs to be able to use heavy pain medicine but I try to avoid it and the above has worked for me.

Using heat, either a hot shower or heating pads, increases the inflammation and thus the pain. Learned that one the hard way and ended up in the ER. One doctor had me use heating pads well into the treatment cycle but I would use ice packs, then heat and then ice again to cool down the area.

Later,
Dan

[thomm225]

Originally Posted by Chotu

Thomm:

Try these. I only had back pain (sciatica) once. It put me on the floor for 2 weeks because I didn't know these. Any time I have even the smallest back pain I do these now and no longer have problems. I have to do the stretches maybe once a month. Because they have worked so well.

I do notice my problems typically come from too much sitting around doing office work. Not from physical activity (in my case).

These are stretches that specifically relive sciatica.









there is one more that I could not find a picture of. On a bed or something comfortable, lie down on your stomach, face down.

Bring your head up and rest your chin in the palm of both hands, supporting yourself on your elbows.

Hang your head over the edge of the bed in this position so you are comfortable.

Using your elbows as a lever, you can gently feel your way to stretching out your spine. If you pull in different ways, you can stretch the neck or mid back or even the stuff compressing your siatic nerve.

It doesn’t take very long at all for these exercises to fix everything. Just a couple of days. Any time the pain is really getting at you, just start doing the exercises and soon enough it will be gone.

Combining this with the muscle relaxers is even more powerful. But not even necessary all the time. Often these exercises will take care of it without any drugs.

Lastly, find any knots in your lower back and massage them out. Either at a massage place or DIY if cheap like me. Lol. There are often a lot of knots people miss where the back and the butt meet going into the top of the butt. there is this whole set of tiny muscles there at the top of the pelvc bone. Where it meets your back. These have small knots that can add a lot to back pain and go unnoticed.

also, it’s best not to stop. Crazy as it sounds. I was down for two weeks because I stopped. If I had done the stretches and took walks and just dealt with the pain, it would have been gone faster. I wouldn’t say you should go running like you usually do, but a nice slow walk is often helpful.

I’ll give those exercises a try. Thanks

[AKA-None]

Originally Posted by sailorboy1

I get the low back thing a few times a year. Have normal over the counter drugs. Plus have heating pads and a TENS unit. The Tens does the most for the pain itself.

Yes to this

Also a back brace like we used when heavy lifting it moves the effort from your lower back to your shoulders while holding tight to your torso

[Madehn]

Talk to a dr. An Rx for tramadol which is a painkiller and a string anti inflammatory such as meloxicam worked for me. I didn’t take the tramadol more than once but an Rx for meloxicam has worked many times. If I start to feel back pain I take the meloxicam immediately. If I try to tough it out then the muscles start to tighten up which makes the pain worse which makes the muscles tighten etc. I also have a mild muscle relaxant that I will take if I am too far down the cycle. Those bottles travel with me and have saved the day. I have had to refill the anti infkamatory twice in 15 years. High doses of ibuprofen will perform as well but be careful of liver damage. Consult a dr for what is appropriate for your physical circumstances.

[JPA Cate]

Originally Posted by Shrew

Honestly, you're given two options. Lie down and die, or do what you have to do. I know this sounds like a cavalier 'Monday morning quarterback' response, but if there is no third option, then what you do is simply (LOL) everything you can.

Two short semi-related stories.

As a younger man I was riding a dirtbike (motorcycle) deep in the Northern New England woods. My brother and I were several miles from the closest road and many miles from our trucks. I got into a bad accident. I went over the handlebars and landed on my head. I did have helmet, however I had compression fractures of T6 and T8 and 3 broken ribs.

I didn't have much choice. My brother picked-up my bike and got it started. I then spent the next several hours idling out of the woods in blinding pain. If you've never been in northern New England woods, it is rough, rocky, with many hills.

On another occasion I was back country skiing in Tuckerman's Ravine on Mt Washington in New Hampshire. I fell and blew out my left knee. There is no lift service here. It is hike 4+ miles into the mountains and ski, then either ski or hike out. I had a full pack because I had hiked in and was camping there while I skied. I had to load my full backpack and skis and hike the 4+ miles out. Again, ridiculously slow and in blinding pain. It took me many ours to hike out.

I was a mix of lucky and stupid in both cases, however you will be amazed at what your body can do given time and lacking options.

Imo, Shrew's got the right of this. You do it all through huge pain that you can, because it's that or die. Once your hypothetical singlehander has the main down, then attention to the headsail, and maintaining a slow safe course, and think what to do. It is harder to make pain go away than to prevent it.

But, bensolomon's post is also right. His solution will give a great deal of relief. The good thing about pain is that when it goes away, it's gone. The bad thing about back problems is that if you don't self-treat (like doing the stretches above regularly), they can lead to chronic back problems. I've had back problems since I was in my early 20's, and have had 2 spinal fusions; and now I also have scoliosis. What I have for muscle spasms, prescribed in the States, are carisoprodol (Soma), which has a reputation for being addictive, but has less side effects for me than cyclobenziprine (Flexeril), which has the side effect of dry mouth. Both Soma and Flexeril are skeletal muscle relaxants. Neither is available in Australia.

Imo, I think having the green whistle would be a great idea. An important tool for the medicine kit. But, preventive exercise is the best way to go.

About magnesium, I know someone who had it prescribed for hand cramps, and so far, it hasn't helped so you'd notice. No idea why, wish I knew.

Ann

[Zanshin]

Originally Posted by Franziska

So,
...
You suddenly have severe lower back pain and can not move without enormous pain.
How would you deal with it? How have you dealt with it?
...

I was singlehanding from the USA to the Caribbean when I had a tumble 3 days off of Cape Hatteras. Weather was really bad, going back to the USA east coast wasn't going to be easy. SAR in the Turks & Caicos would take me, but would have scuttled my boat.

The pain was intense, I couldn't stand and could barely crawl without risking syncope.

I have SSB and a Pactor and at least had comms. The only real option was to continue for about 5 days and go to an ER in the BVI or St. Martin. All I had were normal analgesics, but I did have a doctor friend give me an optimal cocktail from what I had aboard - enough to deaden the pain but not too much to prevent me from functioning.

It was quite painful. I've had kidney stones, broken bones and ribs, been shot. None of those came close. Upon arrival in the BVI the doctor, who didn't have a functioning X-Ray, gave me a small elastic back brace and a Voltaren injection. I then flew to Europe, because it was too painful for a sprain.

The doctors in Europe X-Rayed me and found I had 3 broken vertebrae and wanted to put me in traction! They said there might a hairline fracture on a fourth, but it was out of the X-Ray negative's range.

So, my lesson that I learned earlier in training was "never give up".
When it happened I couldn't move for over 10 minutes and could see my EPIRB up there but knew I couldn't reach it. It took all my will just to stay conscious at that time. Then I thought "That EPIRB isn't going to help me, I have to help me!". There really was no choice, either give up and die, or suck it up and deal with it.

And that's what kept me going. The lesson in past training was that pain, once it is gone, is just a memory. Don't let it overwhelm you. I had my mantra "pain, pain go away. Come again another day" that I kept on repeating to myself. Sometimes I think I might have shouted it; but there was nobody there to hear me...

That was 3 years ago. I've had to stop my martial arts after 40 years - being slammed onto a mat is just too risky for me now. I hurt in the morning. But I'm glad to be alive and that pain is now just a fading memory!

[rounder]

Re pain. Been there done that. Blew out acl off Antarctica after putting a few stickers got in an axcendental jibe driving my face into a lexan dodger. Woke up delt with it a few butterflies fixed the face. Now the knee was wrapped and lifted into and out of cockpit. Crawled mostly for another 30 days to get a brace.

Paul. BOC Around Alone 90- 91 boat VOLCANO

[Shanachie]

It sounds callous, but in situations such as this, you find out how tough you really are.


People who survive difficult situations don't give up, no matter how much pain and how challenging things are. You find a way, or you don't.


I remember a story about a famous sailor -- I won't mention his name -- who had a bad break-up and decided to commit suicide. He jumped overboard many miles off Fort Lauderdale -- and then changed his mind.


He was found treading water many hours later, long after he should have been dead. But he was just a stubborn son of a bitch. And he lived on to do other notable sailing.

[GordMay]

Originally Posted by roryboy

Ice lower back pain. Lot's of ice, make it numb to the touch...

Icing definitely works to numb something.
And The National Athletic Trainers’ Association, and the National Institutes of Health both recommend icing for sports injuries.

But, FWIW:
Icing a Muscle Injury May Not Help, and Could Slow Recovery

By trying to reduce inflammation, you could also be interfering with the process of repair.
Inflammation is an indication of recovery, and icing, and other cold-based “cryotherapy”, may only delay it.
In other words, by using ice to try to lessen inflammation, which is the immune system response to injury, you could also be reducing the activity of the cells, that are promoting repair.

Icing, it turns out, is an ingrained practice, that seems practical, but is not strongly supported by clinical evidence.

The oldest justifications for icing, dating to the 1970s, have melted under scientific scrutiny, some cryotherapy researchers say [1, 2, & 3], and most scientific studies on icing haven’t provided the solid results, that would justify its popularity.
This is true, they say, both for icing for daily recovery, and for an injury.

For example, a 2008 meta-analysis published in the Journal of Emergency Medicine [1], which looked at multiple studies on cold therapy’s effect on acute soft tissue injuries, concluded there is “insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.”

Similarly, a 2012 paper published in the Journal of Athletic Training [2], which reviewed multiple, peer-reviewed studies, noted that the practice of using ice to treat sprained ankles “is based largely on anecdotal evidence” and that “evidence from [randomized controlled trials] to support the use of ice in the treatment of acute ankle sprains is limited.” “Insufficient evidence is available from randomized controlled trials to determine the relative effectiveness of RICE therapy for acute ankle sprains in adults.”

Even the Dr. [Gabe Mirkin] who coined the term “RICE” (Rest, Ice, Compression, Elevation), no longer endorses it. [3] “It’s perfectly fine to ice if you want, but realize it’s delaying healing,” Gabe Mirkin says, “[Icing] is not going to change anything in the long term.”


[1] “Is ice right? Does cryotherapy improve outcome for acute soft tissue injury?” ~ by N C Collins
“There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.”
➥ https://emj.bmj.com/content/25/2/65.full

[2] “What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?” ~ by Michel P.J van den Bekerom, MD, et al
➥ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/

[3]“Why Ice Delays Recovery” ~ by Dr. Gabe Mirkin
➥ https://www.drmirkin.com/fitness/why...-recovery.html


“I have yet to see any problem, however complicated, which, when looked at in the right way, did not become still more complicated.” ~ Poul Anderson