Severe pain, what would you do if single handing?

[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

[HankOnthewater]

That is a hard question.
I recall that one skipper of the Golden Glove Race in 2018 with taken off his boat in such scenario, in the Indian Ocean, and I think boat was abandoned or scuttled; that was Abihlash Tomy.

I think there are 5 thoughts in this order:
1. Firstly, if you have known back problems or other health issues, don't undertake long passages on your own
2. Secondly, when moving around on board, be very vigilant and very careful, as such injury may be expensive healthwise, and boatwise as well
3. In preparation for such events, make things easy:
Make reduction of of sails as easy as possible, or even all the way to all sails being furlers and electric/hydraulic
Also make starting of engine easy, do not have to crawl under the engine to turn the valve for the engine water intake
How easy to drop the anchor? (assuming the water is not too deep)
4. With such event, you can use the 'green whistle' (methoxyflurane) as a painkiller
5. With such event, you could take strong painkillers, (codiene/narcotics), but these may cause drowsiness and quality of decision making will become very poor. For backpain/spasms a muscle relaxants ie diazepam can help but again this is also a sedative.

The problem with the painkillers/medication is to get them prescribed for you in the first place.
Hmmm, all these steps requires preparation, and does not answer your question " what I would do in such case of severe backpain , or any injury for that matter.
Hmmm, on my boat...... I have taken all the steps except for #4
Such situation calls for a "Pan Pan" call on the radio.

[Franziska]

Originally Posted by HankOnthewater

That is a hard question.
I recall that one skipper of the Golden Glove Race in 2018 with taken off his boat in such scenario, in the Indian Ocean, and I think boat was abandoned or scuttled; that was Abihlash Tomy.

I think there are 5 thoughts in this order:
1. Firstly, if you have known back problems or other health issues, don't undertake long passages on your own
2. Secondly, when moving around on board, be very vigilant and very careful, as such injury may be expensive healthwise, and boatwise as well
3. In preparation for such events, make things easy:
Make reduction of of sails as easy as possible, or even all the way to all sails being furlers and electric/hydraulic
Also make starting of engine easy, do not have to crawl under the engine to turn the valve for the engine water intake
How easy to drop the anchor? (assuming the water is not too deep)
4. With such event, you can use the 'green whistle' (methoxyflurane) as a painkiller
5. With such event, you could take strong painkillers, (codiene/narcotics), but these may cause drowsiness and quality of decision making will become very poor. For backpain/spasms a muscle relaxants ie diazepam can help but again this is also a sedative.

The problem with the painkillers/medication is to get them prescribed for you in the first place.
Hmmm, all these steps requires preparation, and does not answer your question " what I would do in such case of severe backpain , or any injury for that matter.
Hmmm, on my boat...... I have taken all the steps except for #4
Such situation calls for a "Pan Pan" call on the radio.

Interesting answer. Agree with all and love to add number four to our medical chest for a worst case scenario. Would give enough time to get the sails down or reduce them and crawl to the radio.
Unfortunately it's not available in Spain afaik.

[GordMay]

Thanks Hank!
I was unaware of the Green Whistle - Methoxyflurane (Penthrox)

Green Whistle - Methoxyflurane (Penthrox):

Medical Developments International [MDI] is an Australian company that manufactures Penthrox, commonly known as the 'green whistle'.

Penthrox is a self-administered [inhaled], rapid acting, analgesic agent, for short-term pain relief, for moderate to severe pain, associated with trauma, in conscious adults.

It has been used as an analgesic in Australia, for the past 30 years, and has
now been approved for sale in 27 European countries. plus the UAE, Hong Kong, Saudi Arabia, Jordan, Taiwan and Mexico. MDI has regulatory approval in Canada. The product approval process is also underway in the USA Iran, Iraq, South Korea and Russia.

The Penthrox inhaler is a green whistle shaped single use device that delivers methoxyflurane in analgesic doses. Patients are able to assess their own level of pain and titrate the amount of Penthrox inhaled for adequate pain control. Continuous inhalation provides analgesic relief for up to 25-30 minutes, or approximately 1 hour when administered intermittently. Patients should be advised to take the lowest possible dose to achieve pain relief.
More about ➥ https://stopioid.com/f/green-whistle...oid-substitute

“The role of inhaled methoxyflurane in acute pain management” ~ by Keith M Porter, et al
➥ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200081/

[bensolomon]

For low back pain presumably related to spine or lumbar disc injuries:

Ibuprofen 800 mg every 6 hours PLUS acetaminophen 1000mg every 6 hours. Get a belt, any belt, place a rolled towel between the belt and your injured area, and tighten the belt as much as you can stand it to lend support to the lower back.

Ben

[thomm225]

Its hard to tell how you would handle that situation since as most know that have had back problems they are all different.

For the last two weeks, I have had sciatica or problems with my sciatic nerve causing pain in my left leg from top to bottom and lower back plus a slightly sprained lower back since.

I think I did it building my backstay. The vice wasn't mounted so I was holding it which held the 1 x 19 wire and then cutting the with a hacksaw in two spots. I'm close to 70 years old but don't seem to understand that at times.

This thing refuses to heal and is very painful at night.

I have been walking every day and on Friday pulled an old jib off the boat to measure. Folding that sail back up was quite painful.

So I sailed on Sunday for the first time in at least two weeks. I was tired when I left the dock.

Wind was gusty so when raising the mainsail while standing by the mast I could feel my back muscles telling me to be careful or else.

I was also balancing myself as the power boats sped by in a great hurry to sit at anchor some place all day to fish.

I was exhausted after a 3 hour day sail but was happy I could still walk.

I did buy a heating pad and have had that on at times below my lower back at night.

As far as getting sails down etc if single handing with severe back pain you would have to plan a strategy based on your pain and get the sails or a sail down.

If possible maybe just drop the main and tie it to the deck then lessen the jib and sail downwind slowly for a few days under autopilot.

As far as pain meds and belts etc the Doc mentioned above, I have been doing 600 to 800 mg Advil (Ibuprofen) several times a day and last night wore a leg warmer on my left leg like cyclists use in cold weather which fit quite tight with the heating pad under my lower back.

This morning pain is mainly in lower back but can be tolerated.

I have also been hanging from a pull up bar for 20-30 seconds several times a day to ease pressure on my spine

[Chotu]

Sorry to hear you had such bad back pain. I hope it’s feeling better or getting there.

I had sciatica before that dropped me on the floor for two weeks. I couldn’t move. So I understand this post.

if I was solo and this happened, I'd scream and do what I had to do to reduce sail area to next to nothing. Maximum reef. Barely making way. Then I'd work on the back issues, feeding myself, using the bathroom, etc.

Unless actually paralyzed, you can do these things, it's just blindly painful and a bit shaky as your legs buckle a lot

[Wotname]

Green whistle works - very well. Someone close to me used it after a severe equestrian accident.

[Chotu]

Originally Posted by thomm225

Its hard to tell how you would handle that situation since as most know that have had back problems they are all different.

For the last two weeks, I have had sciatica or problems with my sciatic nerve causing pain in my left leg from top to bottom and lower back plus a slightly sprained lower back since.

I think I did it building my backstay. The vice wasn't mounted so I was holding it which held the 1 x 19 wire and then cutting the with a hacksaw in two spots. I'm close to 70 years old but don't seem to understand that at times.

This thing refuses to heal and is very painful at night.

I have been walking every day and on Friday pulled an old jib off the boat to measure. Folding that sail back up was quite painful.

So I sailed on Sunday for the first time in at least two weeks. I was tired when I left the dock.

Wind was gusty so when raising the mainsail while standing by the mast I could feel my back muscles telling me to be careful or else.

I was also balancing myself as the power boats sped by in a great hurry to sit at anchor some place all day to fish.

I was exhausted after a 3 hour day sail but was happy I could still walk.

I did buy a heating pad and have had that on at times below my lower back at night.

As far as getting sails down etc if single handing with severe back pain you would have to plan a strategy based on your pain and get the sails or a sail down.

If possible maybe just drop the main and tie it to the deck then lessen the jib and sail downwind slowly for a few days under autopilot.

As far as pain meds and belts etc the Doc mentioned above, I have been doing 600 to 800 mg Advil (Ibuprofen) and last night wore a leg warmer on my left leg like cyclist use in cold weather which fit quite tight with the heating pad inder my lower back

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.

[Franziska]

Originally Posted by Wotname

Green whistle works - very well. Someone close to me used it after a severe equestrian accident.

That's great to hear.

I think it might make the difference in providing a single hander with the critical time span to get the boat into a tolerable status and crawl into a bunk.
Than take another portion close to shore and possibly anchor or shoreside support.

I agree with the other medications above, it's just that they can not help immediately but better when you reached a bunk.

I'm on Diclofenac pills and Voltaren gel now and can slowly start to move around the boat. Much better than yesterday.

[Franziska]

Originally Posted by GordMay

Thanks Hank!
I was unaware of the Green Whistle - Methoxyflurane (Penthrox)

Green Whistle - Methoxyflurane (Penthrox):

Medical Developments International [MDI] is an Australian company that manufactures Penthrox, commonly known as the 'green whistle'.

Penthrox is a self-administered [inhaled], rapid acting, analgesic agent, for short-term pain relief, for moderate to severe pain, associated with trauma, in conscious adults.

It has been used as an analgesic in Australia, for the past 30 years, and has
now been approved for sale in 27 European countries. plus the UAE, Hong Kong, Saudi Arabia, Jordan, Taiwan and Mexico. MDI has regulatory approval in Canada. The product approval process is also underway in the USA Iran, Iraq, South Korea and Russia.

The Penthrox inhaler is a green whistle shaped single use device that delivers methoxyflurane in analgesic doses. Patients are able to assess their own level of pain and titrate the amount of Penthrox inhaled for adequate pain control. Continuous inhalation provides analgesic relief for up to 25-30 minutes, or approximately 1 hour when administered intermittently. Patients should be advised to take the lowest possible dose to achieve pain relief.
More about ➥ https://stopioid.com/f/green-whistle...oid-substitute

“The role of inhaled methoxyflurane in acute pain management” ~ by Keith M Porter, et al
➥ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200081/

Thanks. Especially for the brand name. Will try to get it here.

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

[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

[boatman61]

Something I used to suffer from was popping my Sacroiliac joint which causes intense lower back pain and difficulty switching from a bent over stance to erect without using a wall or other support to brace against while forcing oneself erect.. basically one has the choice of a doubled up hobble or an uncomfortable stiff legged painful gait erect.
Used to go to a therapist to get it popped back in at least once a year till one of them gave me some exercises to keep the muscles toned to keep these 'floaters' from popping out.
Lay on your back on a firm surface, place your arms at the side of your body palms down then bring your knees up till your heels are about 12 inches from your butt.
Do a pelvic thrust and hold while raising your torso using your legs and shoulders till your more or less straight from kees to shoulders, hold for a count of five then lower back down till flat, release thrust.. count to five and repeat.
I do 15 of these twice a week (when I remember) andit keeps my joints in when I do those stupid things like adjusting in/out jib sheets in silly twisted positions rather than stand and do it right..
I manage the pain with Paracetamol when it happens but I have a fairly high pain tolerance.. If you don't mind, it does not matter.
Early training from refusing to say Uncle to boarding school bullies..
At sea I just heave to till recovery..
Hope this helps..

[Simi 60]

Likely not the same level of pain you are going through but interesting response from the Dr I saw several months ago

Had bad shoulder pain, couldn't sleep on that side and went on for weeks before getting in to see anyone.

Was decided by the Dr it was muscle related
Was asked how I managed the pain, answer was a couple of iboprofen and a bottle of red each night.
Does that work he asked? - Yes was my answer
Well keep doing that then was the response.

Gotta say, that response of self medication surprised me but it did work
Muscle pain gone, no iboprofen needed any more

[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.