Severe pain, what would you do if single handing?

[Scubaseas]

Originally Posted by Franziska

So,

I'm in my bunk with severe lower back pain. Thankfully at anchor and not single handing & with some potent painkillers.
Even more thankfully we have a well protected anchor spot while it's blowing a force 7.

Still, the situation could be different.

Say you are on a solo transatlantic or similar, far away from doctors, but not necessarily from hard places to hit.

Sails are fully up but weather will change.

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 know that exercise is tge best way to train your muscles, still, what would you do in the acute situation?

Sent from my MHA-L29 using Cruisers Sailing Forum mobile app

So very sorry to hear you are suffering. I'm not a Doctor but I do have some experience with back pain so will share what works for me. Might or might not work for you. See a qualified Doctor. Or two. I got more benefit by seeing neurologists and neuro surgeons than I did from Orthopedists. If your pain doesn't resolve seek out a pain management specialist after you've had an MRI and consult with a back specialist.

Some good advice here. Some not so much. Depends really on if you have a stenosis issue like a herniated disc that is crushing the nerve or a muscle spasm that is causing your spine to be out of line. Or a stenosis issue or kyphosis or retrolisthesis. I have a very, very bad back. The worst my surgeons and pain management MDs have seen. 4 major back surgeries to date with bolts, screws, rods, cages and a 5 level fusion, 4 level full laminectomy, yada, yada, yada. I have been told I need another 6 levels fused due to yet more canal stenosis and disc issues. I feel your pain. If it goes on long enough you learn to deal with it. It's hard. Agonizingly hard sometimes but I worked as an auto mechanic when I had a fully compressed left L5-S1 nerve root where I could hardly walk and lost ankle reflex and have permanent nerve damage in that leg. I worked when my spinal cord which is usually 19 to 21mm was crushed down to 5mm and everyone thought I should not have been able to walk. There are many things you can try. Some might help. Some will do nothing for you. You need to find what works for you and your particular situation.

I keep a supply of Medrol (prednisone) on the boat to use in emergencies. Ketorolac works well also. Both are strong anti inflammatory drugs but for temporary use only. After that course (5 to 7 days) take NSAIDS. find one that works for you. Take Omeprazole so they don't burn a hole in your stomach. I use Diclofenac Sodium (Voltaren) to good effect. High doses of Ibuprofen or Aleve do not work that well for me but might work fine for you.

For muscle spasms try Skelaxin or similar might be of benefit. Booze works too.

I also keep onboard Neurolitics like Lyrica or Gabapentin which work for nerve pain (tingling, numbness) Lyrica is much faster acting. Gabapentin takes a couple of weeks to kick in.

Topical pads like Salonpas or Lidoderm patches can be very effective sometimes.

CDB oil can work for some people.

Take analgesics. Paracetamol (Tylenol aka acetaminophen) at doses 4000 to 5000 mg/day will help.

Opioids as a last resort. They can be addictive but they do work for 16 to 30% of chronic pain sufferers. Some work better than others for different people.

Cognitive Behavioral Therapy can be helpful. Try it. Stretching/yoga can also help. Combine CBT and Yoga and you have more, non drug tools in your medicine chest. It's good to know what causes the pain and what mitigates it.

A GOOD back brace can be very helpful if you have disc issues. Mine were custom made by a prosthetics shop. A rolled towel or stiff foam mat and some elastic bandage can do in a emergency. A padded board works too.

Try laying flat on your back on a firm surface with both knees elevated. This may get you some temporary relief.

Your instant problem is tough. You don't want to hear it but grin and bear it maybe all you can do if you can't try any or all of the above.

I'd rest it for a day or so being very still and knees elevated. This may help calm it down enough to be able to start moving around again. Throw NSAIDs and analgesics at it. Seek medical help. Keep an emergency supply of strong anti inflammatory and analgesic drugs on board. Get an MRI so you know what you are actually dealing with.

After resting it a bit, try to keep moving. Laying in bed being miserable is the worst thing you can do. If it hurts when you do that...don't do that. But do try to keep mobile.

To the person who said never go on long passages or stop sailing. well, bite me. You do you. I'm not going to stop sailing just because there can be level 8 or higher pain at times. Life goes on.

Best wishes for a speedy recovery. Hope you find some relief.

[Trimaran Ken]

Originally Posted by Franziska

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've had severe (debilitating) back pain and have ongoing non-severe back pain.

90% of the time Naproxen Sodium will get me through it. 10% of the time, I use Codeine. Codeine makes me drowsy, so I try to only take it at night. A few times in my life, I had to take two 30mg Codeine pills to get past the pain. My doctor gives me an Rx for 25 pills, once a year. I never use them up.

Based on my experience with debilitating pain, if my life depended on it, I believe I could push through debilitating pain, but we never really know until it actually happens.

[JAFO]

Originally Posted by Franziska

Say you are on a solo transatlantic or similar, far away from doctors, but not necessarily from hard places to hit.

Sails are fully up but weather will change.

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?

That's easy.. I get out my portable Omron HV-F128 T.E.N.S. machine (it's about the size of a TV remote), put the pads on the affected area, turn it on, and in 15-30 minutes, the pain is gone!



I've suffered from lower back pain for many years, and I never go anywhere without my T.E.N.S. machine. Absolutely the best money I've ever spent on anything.

[Lodesman]

Originally Posted by Shaneesprit

Look for lower back exercises but make sure these are not from people in any sort of Gym because they workwon't help.

I assume that's what you meant to write?
It's cr@p advice. If you're going to judge back exercises, it should be based on the qualifications of the people giving the advice, not the location where the advice is given. Physiotherapists, physical therapists, strength conditioning therapists, etc. all basically live in the gym.

Wasn't really the OP's ask, but assuming this is a new problem, then when she can, she should probably see a doctor to rule out anything more serious, and follow-up with physiotherapy to learn how to stave off the next one. If this is a recurrent issue, then she probably already knows what needs to be done, and has just been neglectful in doing her back exercises.

[skkeith]

When I get to that point I do what I do on the land which is a McKenzie stretch



https://www.healthline.com/health/mckenzie-exercises


I think the 'prone press up' is the one you want. I would recommend getting the short book by Dr. McKenzie 'Treating you own back'.



Also I recommend getting an "McKenzie original Nite Roll Lumbar Support". Tie it on and just wear it all day. If you can manage sleep with it as well.

[Greg K]

This has worked wonders for me since it was first recommended to me by our local pharmacist. Works quickly and last for hours.... massage it in.

Available in Spain and, possibly, the rest of the EU at pharmacies over the counter.

[AA3JY]

Originally Posted by JAFO

That's easy.. I get out my portable Omron HV-F128 T.E.N.S. machine (it's about the size of a TV remote), put the pads on the affected area, turn it on, and in 15-30 minutes, the pain is gone!



I've suffered from lower back pain for many years, and I never go anywhere without my T.E.N.S. machine. Absolutely the best money I've ever spent on anything.

Where are you placing your pads? Left and right of your spine? Above and below your hip?

[dannc]

Originally Posted by AA3JY

Where are you placing your pads? Left and right of your spine? Above and below your hip?

We place the pads around the area in pain. Usually diagonally if that makes sense. One pad up and say to the right of the pain and the other down and to the left. Sometimes, you just put the pad where the pad will go but they need to be on different sides of the place of pain.

The pads will loose their ability to stick after a number of uses and there is a spray that will restore the stickiness.

The TENS units we have are the size of a deck of cards, can be clipped onto a waist band or belt and do not look like the one posted. Our TENS units can be worn for quite some time though I don't think we usually used them for more than 15 minutes, maybe 30. The only issue we have with ours is the dial that changes the power setting. If one moves that dial to high it will make you JUMP and it is not pleasant. Slow and gradual adjustment is good. Sudden adjustment is bad.

The TENS unit in the photo looks like it would be difficult to just pump up the power by mistake, but one would not be able to wear the unit, which may not matter depending on the user.

Later,
Dan

[dannc]

I mentioned earlier about using ice or cold packs to decrease pain.

My wife has had numerous shoulder surgeries, unfortunately, and after each surgery we are given an ice machine. People with knee surgeries get an ice machine as well.

The ice machine is a cube about 15 inches to a side that one fills with ice and water. There is a hose that goes to a pad that fits around the shoulder or knee and a pump moves the ice cold water from the cube to the pad. The ice water minimizes the pain. One only uses the ice machine for a week or two. For a few days one is on heavy duty pain medication and the ice machine is to lower inflammation which lower pains. After the pain ball is used up, it is over the counter medicine time and ice machine.

Ice/cold packs do an amazing job on many painful injuries. For a boat, crossing an ocean, having ice or a cold back maybe impossible but putting a wet towel on the area in pain and letting it evaporate might help a bit. Tis not ice but it might help cool down the area.

Later,
Dan

[AA3JY]

Originally Posted by dannc

We place the pads around the area in pain. Usually diagonally if that makes sense. One pad up and say to the right of the pain and the other down and to the left. Sometimes, you just put the pad where the pad will go but they need to be on different sides of the place of pain.

The TENS units we have are the size of a deck of cards, can be clipped onto a waist band or belt and do not look like the one posted. Our TENS units can be worn for quite some time though I don't think we usually used them for more than 15 minutes, maybe 30. The only issue we have with ours is the dial that changes the power setting. If one moves that dial to high it will make you JUMP and it is not pleasant. Slow and gradual adjustment is good. Sudden adjustment is bad.

The TENS unit in the photo looks like it would be difficult to just pump up the power by mistake, but one would not be able to wear the unit, which may not matter depending on the user.

Later,
Dan

Tnx for the info...borrowing my wife’s Empi t.e.n.s.

[dannc]

Originally Posted by AA3JY

Tnx for the info...borrowing my wife’s Empi t.e.n.s.

You are welcome. Your TENS and the one posted about earlier, are very fancy compared to ours. Our units just have a simple dial to increase power.

Hopefully, we never need a TENS unit again, but if we do, I will check out the unit and the other posted showed.

Thanks,
Dan