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Ask HN: Are you an engineer with back pain?

14 points by RohKo ↗ HN
I'm super curious to hear about your experience with dealing with back pain. I have it too and feel we're underserved here.

What did you do to help it, what did your company do? Did anything help in the end?

If you're down to share, I'd love to chat: https://calendly.com/rohkoh/15min

:)

63 comments

[ 3.4 ms ] story [ 123 ms ] thread
stmblast
Not a SWE - I'm a WFH DevRel Eng who is starting to get back pain.

I work on the sofa and my colleagues are urging me to get a proper office chair, but I don't really want to because my living space is tiny and I intend to move out soon (3-4 months ish).

RohKo
Sorry to hear about the pain! I'm actually super curious to hear more your setup etc - you free to chat for 15 mins?
t-3
Not an engineer, but doing a small amount of exercise each morning to limber up and keep my core muscles from atrophying due to my sedentary lifestyle has done wonders.
RohKo
That's awesome! When you say did wonders, how did your symptoms actually change?
t-3
I went from barely being able to get out of bed in the morning and having trouble staying on my feet for long periods to no pain or difficulty. I don't think I left it alone long enough to build up (much) permanent damage, so efficacy is probably less in more severe cases, but it was really shocking to me how much of a difference a little exercise makes.
diegoholiveira
> What did you do to help it, what did your company do? Did anything help in the end?

My company did nothing about it specifically, but no problems because they give me a really good health insurance plan, so I'm not paying anything to go really good doctors or taking exams.

Currently, I'm seeing 3 doctors to take care of it: endocrinologist, gastroenterologist and physiatrist. We're investigating it because it looks like the pain it's being caused an inflammation pinching a nerve.

Also: exercises, it helps a lot.

RohKo
Wow 3 doctors is intense. I hope you're making headway with them! I'm curious to chat more about all this if you have 15 mins to spare? Are you exercises coming from your doctors? How long have you been seeing them and to what avail? I've got quite a few questions haha!
codegeek
I started getting lower back pain last few years (41 now) and in my case, it was just bad habits, lack of exercise, extra fat on abdomen area etc. I started paying attention to it by working out especially the Core including squats and deadlifts (nothing crazy and light weights only). It helped tremendously and I am fortunate not to have back issues because of other reasons and just my own negligence. Hope this helps.
RohKo
I see, that's awesome to here! How did you start uout
RohKo
*oops, redact second half-sentence :D
codegeek
Nothing special. I used to workout in my 20s and just got back to the basics. Eating right is always a challenge for me but if I can stick to a 2-3 day a week workout schedule, it does wonders.

For me again, it was just a very weak Core which I addressed with exercises such as squats. Even if you don't lift anything, just do squats at home for 10-15 mins and focus on Core exercises.

diehunde
If it's awful and doesn't improve over time (I'm talking weeks), try pushing your doctor to get an MRI. I visited three doctors before they ordered one and found two bad herniated and degenerated discs, and at that point, surgery was the recommended option. It's been a year after my surgery, and I'm finally pain-free after almost three painful years.
RohKo
jheeezz, great to hear you're feeling better though!
scrapheap
Make sure you exercise your core muscles - don't go overboard if you're just starting out and make sure you include some good stretches before and after.

Look at how you're sitting, make sure your chair gives you good support for your back.

Look at how you're sleeping, a bad mattress can give you all sorts of problems including back pain.

RohKo
How would you recommend 'looking' at how I sit/sleep?
scrapheap
There will be better sources of how you want to be positioned when you sit and sleep than this - but in general you want to be thinking of the positions of your hips, pelvis and spine. Good positions tend to keep your hips aligned and pelvis level. Viewed from the front/back you want your spine to be straight and viewed from the sides you want that natural S curve (that's the reason that chairs these days have lumbar support).

If you are struggling to visualize how you're sitting then try recording yourself while working.

sborsje
I am not a doctor nor a physical therapist, but what helped me a lot was focusing on fixing anterior pelvic tilt. If your hip flexors are too tight due to prolonged sitting, there are a couple of things you can do that will combat that:

1. strengthening your abs / core muscles (planks, hollow holds, deadbugs, loaded carries, etc) 2. strengthening your glutes (air squats, lunges, glute bridges, etc) 3. stretching your hip flexors (kneeling hip flexor stretch, couch stretch, 90/90 stretch, etc)

RohKo
How did you figure out this was going to help you?
sborsje
Trial and error, with help from coaches at my gym (CrossFit, a few of them have a background in physical therapy).
RohKo
How long did you iterate till you found something working?
[deleted]
(comment deleted)
billythemaniam
Similar experience for me. I found that many of my aches and pains as I get older are resolved by exercise and stretching. For example, I hurt my lower back in my 20s. Not extremely bad, but bad enough that it still gets sore if my back gets too weak after 20 years. I stretch and strengthen it without using weights, and it eventually gets better. I stopped running for a decade then decided to pick it back up. My knees were sore or hurt mildly initially, but eventually they got strong enough that they got better. Running is also great for strengthening the lower back.
RohKo
How did you figure out what worked, exercise wise?
billythemaniam
Trial and error. I recommend looking up non-weighted exercise, stretches, and activities that target the body parts you are interested in, and start trying them.
greenie_beans
are you trying to "talk to potential customers about a problem" for your startup idea, or are you genuinely trying to fix your back pain?
yellow_lead
For me, I found two causes: sitting too long with feet off the ground (either against wall or sitting cross-legged), and glute tightness. The glute tightness is strange because it feels like back pain, but really it's muscle tightness that goes away with foam rolling or dry-needling.
RohKo
How did you figure out these are the culprits?
yellow_lead
I went to a pt and they helped me figure it out. Basically they asked me how I sit, then told me to try sitting with feet on the ground. Surprisingly it helps for me.

Also I'll add that I noticed on my own that squats made my glutes very tight, inducing the back pain (I was doing heavier weights then, approaching 225lbs), so need to roll them after and not do too heavy weight these days.

yellow_lead
Btw I also want to add that I went to a chiro first, before realizing they were kinda scamming me out of $ and that chiropractics has no scientific basis.

It's kinda funny how they operated. This clinic made me watch a short video which praises chiropractics, they gave me an evaluation, then recommended a "treatment plan" over like 1-2 months, coming in 2-3 times a week. It's quite expensive at around a $30 copay.

Not sure you care about this info, but just me ranting a bit :)

polishdude20
Squats and deadlifts 2-3 times a week mean I almost never get back pain.
lgkk
I do a 30s to one min plank for every 30 min I sit.

And every 30 min I get up and look outside anyway to rest my eyes.

RohKo
Why did you start doing this? (may sound like a dumb question but humour me)
lgkk
Because my core gets weaker the more I sit. And it leads to bad posture which makes my back hurt.

Just a little plank every so often offsets the back pain and posture issues.

dansalvato
I work from home and had back pain for maybe a year. It effectively went away after I switched from a crappy budget office chair to a quality ergonomic chair. I opted for the Steelcase Leap.

These chairs are over $1k new, but it seems you can find them used for around $400, maybe even less if you have a local used office furniture store. The downside is that you're giving up a good warranty by purchasing it used, so if this is a 10+ year purchase then it may actually worth be getting new.

RohKo
Wow interesting. Do you work anywhere else but at home?
denvaar
It's funny because I did the opposite - switched from a Herman Miller Aeron to some crappy chair that looks like a couch - and that has cleared up my pain.
RohKo
Wow that's curious!! What prompted that decision?
rajlego
Cannot understate how strongly I recommend reading about mind body syndrome for anyone with chronic pain. Decent summary: https://www.lesswrong.com/posts/BgBJqPv5ogsX4fLka/the-mind-b...

the tl;dr of it is that a lot (probably even the majority of chronic pain) is psychological, not structural. This isn't obvious because the pain is in fact entirely real. What causes it though is that if you think there's something wrong/sense minor pain in your back, brain thinks 'oh no somethings wrong' and sends more pain - this reinforces your sense of something being wrong and makes the pain worse and stay.

This normally doesn't happen that often but if you're stressed, you're much more sensitive to pain making it much easier to trigger.

My story with chronic pain: I had bad RSI for 2-3 weeks. Went away over a weekend after I read a story [0] of how someone treated their RSI. Your thinking about pain influences you're brains perception of it - you can halt the brain pain amplification cognitively.

For more detail on the nitty gritty of how this works neurologically, I recommend Unlearn Your Pain by Dr. Schubiner: https://www.amazon.com/Unlearn-Your-fourth-Howard-Schubiner-...

[0] https://sjbyrnes.com/rsi.html

rajlego
Also, for those that think they have structural back issues based on MRI's, iirc some crazy number of people without pain also have weird MRIs - MRIs suggest the possibility of something structural but in no way guarantee that that's a strong explanation.

The Way Out by Alan Gordon talks about this in more depth - one anecdote he mentions was a football player with REALLY bad back pain, who you'd expect to have all kinds of injuries, was pretty much completely fine after pain reprocessing therapy. This isn't an isolated case - I think the majority of people he tested PRT on in the Boulder Back Pain Study ended up getting significantly better via PRT implying most people didn't actually have structural issues

(note, exercise does still help because it's theorized that the way the body creates pain is by lowering blood flow/oxygen - exercise counters this. When my RSI was fairly bad, I remember that working out or sprinting and getting blood flowing would make me feel more or less ok)

RohKo
I'm super curious about this concept. I watched All The Rage about Dr Sarno, who treats back pain with the same mind-body approach. Its fascinating that the results are so drastic for people who've been healed by the mind-body approach - that they're not cured over months in the gym but over the course of the time they've read the material.
rlawson
Standing desk, stretching, jogging and losing weight

Some pushups/situps/barbells

Have done some yoga classes when things were really bad

RohKo
What did you start with? How did you decide?
rlawson
Standing desk first - since that's quick - just spend money

Then realized also way out of shape

  * Did some yoga to help with back pain
  * Jogged to lose weight
  * Added basic exercise program for overall strengthening
(super simple - got 7 minute workout app and then added pushups/situps and very basic barbell routine)

I think the best thing is keep it very simple and add one thing at a time and give your body some space to adjust

I mean I'm not an athlete by any means but just basic 30-45 min a day of simple exercise does wonders

vitaflo
For me the solution ended up being very simple, going for walks.

This wasn’t easy at first because shortly in I’d have back pain just from walking, but over time this subsided and I was able to walk longer.

Now I go for a walk over lunch and use it to think about my work (which is great for brainstorming). Any time I stop my regular walking routine my back pain starts to creep back in so I know the walking has helped a lot.

RohKo
Nietzsche had that right - "I am walking a lot, through the forest, and having tremendous conversations with myself." Guess he forgot the bit about back pain though...

Awesome to hear you've found that this works! How did you figure this out? What else did you try?

wmurmann
If you workout your back more often it should take care of you back pain(unless you have some type of injury). If your back is used to pulling weight then keeping you upright in you seat shouldn't be an issue. Do some bent over rows, lat pull downs, cable rows, pull-ups, etc. It shouldn't take more that 30 minutes once a week.
RohKo
Did you have back pain before doing any of this?
didip
It used to haunt me to the point where I was worried about the longevity of my career.

It took many many years and several steps to address it.

1. My walking posture was bad with flat feet. So I addressed it with physiotherapy to change the way I walk. It was a success, my legs no longer pulled my hip incorrectly.

2. And then I need to change my home office to standing desk. It helped tremendously, no more pinched nerves.

3. And then my wrists, shoulders, and core are simply too weak. I started lifting weights and do core exercises. It helped tremendously as well. It makes me aware of my anterior pelvic tilt.

RohKo
Great to hear you've found things that work! How was the foot issue diagnosed? Who did you work with for that? How were the pinched nerves diagnosed? Where did you start with your routine? How did/does it fit into your life?
KA01
I have an exercise physiology background (BS & former personal trainer), so I know a bit about this topic. I'm now a SWE and have had my share of back pain. Back pain can be caused by an imbalance of muscle strengths/weaknesses (e.g., strong anterior and weak posterior muscles) or poor stability during movement like walking and squatting.

The commonly-suggested treatment is to perform weight training- squats, deadlifts, lunges, rows, pull-ups, core stability exercises like planks and suitcase carries, anti-rotation core exercises like pallof presses. The idea is to strengthen weak muscles to improve muscle imbalances and stabilize your body when you move.

Exercise alone may or may not work. You need to screen for the root cause. This is a bit more involved, and the best advice I can give is to find a really good physical therapist and/or read "Rebuilding Milo". There's an entire chapter dedicated to back pain- anatomy, how to screen for back pain, classifying the back pain, and treatment. Other chapters are dedicated to hip and ankle. These joints can also be a cause too.

You can step away from your sitting position more often or buy a fancy chair but exercise is the ultimate solution here.

RohKo
Fascinating! I'm curious to pick you brain a little bit more, given your background - got 15 mins to chat briefly?
appplication
I know many skilled weightlifter who eventually fucked their backs doing deadlifts. I know even more unskilled folks who tried to learn, didn’t quite do them right and got the same outcome.

Deadlifts are great if you always do every rep perfectly. But it can be quite easy to let your guard down, or get distracted, or just not really realize your technique is a little off until you hit weights where irreversible damage happens. I think the game theory on deadlifts for the average joe is unequivocally “don’t do them”, especially because side there are so many other alternative and less risky exercises to build similar strength. You’re gonna be fine until the one time you’re not. The rest of those exercises are more than enough.

KA01
I understand. Compared to a common movement like a squat, the average joe rarely performs a hip hinge. If they do, it's likely with poor form. I've personally trained beginners. Most know how to squat but struggle with the hip hinge. The hip hinge needs more attention to learn than, say, the chest press.

There are risks for injury throughout the entire fitness spectrum- from being sedentary to powerlifting. Not exercising has its own set of risks. On the other end, your risks increase when you lift too much weight, move too quickly, push through fatigue, or disregard technique. That goes for any exercise. You can reduce risks by learning from an experienced weightlifter and/or hiring a personal trainer.

I've never heard advice for the average person to avoid deadlifts. The therapy and fitness industry advises the opposite- they should learn how to perform hip hinges. The stimulus placed by deadlifts, RDLs, or any front-loaded hip hinge is unique. Weight distributed anteriorly to the body puts a load on the spine. This exposes weaknesses in spinal stability, but it's also a great solution to improve it. The challenge is figuring out the readiness of the person prior to and during a program. Do they have adequate hip and shoulder mobility to maintain a neutral spine throughout the hinge? Can they maintain this spinal stability when progressing to heavier loads or higher volumes?

I agree there are higher risks of injury for deadlifts compared to squats or lunges. However, I would not remove them entirely from a training program because of their unique stimuli.

avery17
Squats fixed my back so fast it was like magic. Do squats.
d0mine
- the best posture is the next posture. Move. (drinking non-caloric fluids, standing during meetings can help with that too) - firm pillow for the back - resistance training of any kind (barbell is great)