A Pain In the Butt-- And Other Places


Jul 8, 2001


The Bottom Line Identify why you hurt. Then treat it. Then get yourself strong and flexible and STAY THAT WAY. That's how to prevent muscle pain!

Oh boy, do I know about muscle pain. I've had it on and off since I was a teenager, and now I'm 40. I just got done with a month-long episode of back pain. That's why I haven't written anything new in so long; I couldn't sit down for long!

It's my own fault: I wore shoes with heels, my muscles were not as strong as they should have been for various reasons, and I had been sitting for many hours at a time on a tech writing contract job. A recipe for disaster for my back. I should have known better!

Most of my muscle pain has been in my back and neck. Over the years, I have learned some strategies for coping with pain, and for relieving it. If you are in pain, I hope my essay helps you.

Is it a muscle or a nerve?

When you are in pain, first you need to ascertain whether it is indeed a muscle causing the problem. Muscle pain feels different from nerve pain. Muscle pain makes you feel stiff, achy, and brittle. Your range of motion is compromised. Things that used to be easy are now difficult, like bending over to brush your teeth, or carrying a load of laundry.

Nerve pain tends to radiate. If the sciatic nerve (in your back) is being pinched, you will feel pain, tingling, weakness, or numbness down your legs, in your butt, or even down to your toes. If a nerve is being pinched in your neck, you may feel pain or tingling in your shoulders or arms, have headaches, or be stiff and uncomfortable.

Nerve pain is harder to treat than muscle pain, because it won't go away as easily.

Ask yourself WHY you hurt. Perhaps you over-did a sports activity. Or you picked up a load that was too heavy. Or you have been sitting or standing improperly for too many hours. Perhaps you were in a car accident that seemed minor, but now you hurt. Before you treat your pain, it is important to try to figure out WHY you hurt in the first place. When did the pain start? Here are some common reasons for pain:

1. You are not sitting or standing in a good position. Maybe your keyboard or monitor are at the wrong height.
2. You are wearing high-heeled shoes. (They are notoriously bad for your back; even small heels).
3. You are not walking properly or you have foot problems.
4. You are lifting or carrying things improperly.
5. Your muscles are out of shape (not strong).
6. Your muscles are not flexible (you have not been stretching).
7. You simply "over did" something and now you're paying for it.
8. You were the victim of an accident.
9. You have fibromyalgia or thyroid problems (both can cause muscle weakness and pain).
10. If you have chronic muscle weakness, you may have gluten intolerance, or it could signal something more serious. See a doctor immediately.



Remedies for Muscle and Nerve Pain

If you suspect that your pain is being caused by a pinched nerve, it is important to go to a doctor immediately (most likely, an orthopedist). A pinched nerve will not necessarily get better by itself. The problem should be properly diagnosed with an x-ray, or MRI. You may need special pain relievers, anti-inflammatory medications, or physical therapy. In severe cases of chronic debilitating pain, surgery may be necessary to correct a structural problem. But surgery should always be a LAST RESORT. Get several opinions, please, before letting anyone cut you!

If you suspect muscle pain, relax, because if you do the right thing, it will get better with time. First of all, try to figure out why you are in pain. Those shoes -- don't wear them! That chair -- adjust it or find a new one! Desk at a bad height? Get it adjusted!

Ruling out the "outside influences" like chairs, shoes, or your overall posture, evaluate your body. Are you in good shape? If not, that could be why you hurt.

If you exercise regularly, chances are that at least some of your muscles are strong and possibly flexible. Believe it or not, the best way to prevent muscle pain is to be strong and flexible.

The problem is, most people don't have a clue how to become strong or flexible without hurting themselves. For me, the answer was found in Physical Therapy. You need to see a doctor and get a prescription for Back School, or for Physical Therapy. Another option is a personal trainer at your gym (get a real fitness expert, not some kid who just works there).

"But I do stretch," you say. Well, most people don't stretch properly. You should hold the stretch for at least 20 to 30 seconds, and do it at least three times; otherwise, it is useless and will not benefit your muscles.


Remedies:

Self-Treatment

If your pain isn't very bad, you can treat it yourself at home. If it doesn't get better in about one week, move on to one of the other remedies listed below.

For new injuries, you must ICE it for the first 24 hours. Apply an ice pack for 15 minutes, on and off for severe injuries. The gel kind are good; you can get them at drugstores. For less severe injuries, ice for 15 minutes once per hour, if possible.

After the first 24 hours, you can move to heat. Use an electric heating pad, or one of those microwave ones available at drugstores. Or, take a long hot bath or shower.

If you don't have liver or stomach problems, take either a pain reliever or an anti-inflammatory. Tylenol is a pain reliever. Ibuprofin (Advil), and Aleve (Naproxin) are non-steroidal anti-inflammatory medications (NSAIDs). Personally, I think NSAIDs are better to take, because they take away the inflammation that is contributing to the pain. Don't take them on an empty stomach! The package says to take one pill of Ibuprofin (200 mg). But if you are in a lot of pain, you can take up to 4 pills (800 mg) every 6 hours (equivalent to a prescription Motrin). (Regarding Aleve, I wouldn't take more than the one pill as directed on the package). Don't do this for more than a few days, however! Also, note that high regular doses of NSAIDs could make you mildly depressed (a fact not widely known).

If you feel that your muscles are loosening up but still not back to normal, a good massage by a qualified massage therapist might help you. You will probably need to go at least twice to derive any real benefit from it.


Physical Therapy

In Back School or Physical Therapy, they will show you various stretches. You should do these religiously. Make them part of your life from now on. They will also show you strengthening exercises. Ditto for those. If you stop doing the exercises when the pain stops, you are setting yourself up for trouble. Believe me, I have made this mistake myself. Make them part of your life and do yourself a favor.

In Physical Therapy, they may do various things. For tight, knotted muscles, they may do massage or ultrasound treatments. It will probably take at least three treatments for you to see significant results. After your muscles have loosened up, they will show you stretches and strengthening exercises.

Acupuncture

When I was 8 months pregnant with my second child, my back started killing me for no particular reason. It was so bad, I couldn't sit. My OB/GYN wanted me to take large doses of Ibuprofin. I hate to take any drugs when I'm pregnant. So I went to an acupuncturist that a friend recommended. After three treatments, the pain completely disappeared. It was like a miracle. I have been back to him from time to time for other muscle or nerve pain. If HE can't relieve the pain, I know I probably must pursue a regular doctor or physical therapy.


Chiropractic

Personally I'm not a big fan of chiropractic, but some of my friends swear by their chiropractors. These doctors do muscle and spinal manipulations to get you back into alignment. But if you're continuing to do something to take you out of alignment, you are not getting to the root of your problem, only putting a band-aid on the situation.

If you want to use a chiropractor, get recommendations from friends and relatives. If you suspect nerve problems, you may be wise to see an orthopedist first for an x-ray or MRI (although, a good chiropractor will want to see an x-ray before he touches you).


Orthopedic

Orthopedists are MDs with special training in bones and muscles of your spine, neck, knees, legs, etc. Many orthopedists are surgeons, so don't be surprised if they mention surgery! However, a good orthopedist will only use surgery as a last resort.

An Orthopedist (or even your GP or Internist) may prescribe pain killers, muscle relaxants, or anti-inflammatory medications. Be sure to tell the doctor if you have liver or stomach problems, because some of these medications can irritate those problems. In some cases where these medications don't work, the doctor may suggest a cortisone shot (this is a steroid which is an anti-inflammatory). Steroids are serious stuff, so be careful with them!

In other cases where medications don't work, your doctor may write you a prescription for physical therapy or back school. These are usually covered under most insurance.


When You're Finally Out of Pain

Please don't make the mistake of getting back to your nasty old habits once your pain goes away. Those shoes, that chair, that desk, your posture...they'll screw you up again. Change yourself! Improve yourself! Keep your muscles strong and flexible! PAY ATTENTION to how you move, stand, sit, and lift. Be good to yourself, and make it priority. If you get sick and can't do your exercise routine, get back to it as soon as you feel better. Be good to yourself and muscle pain will be a memory.










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