When Post-Workout Back Pain is a Red Flag

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Kaliq Chang, MD with Atlantic Spine Center provides tips on when post workout back pain is cause for concern

Dr. Kaliq Chang

Delayed-Onset Muscle Soreness (DOMS) usually emerges between 24 and 48 hours after strenuous exercise. During this time, the muscles that worked the hardest will be tight, tender, and fatigued.

Some people love the dull, burning sensation after a tough workout. It’s a feeling that signals that they are working out hard and should reap the benefits of a muscular and ripped body. According to Dr. Kaliq Chang, interventional pain management specialist with Atlantic Spine Center, “Delayed-Onset Muscle Soreness (DOMS) usually emerges between 24 and 48 hours after strenuous exercise. During this time, the muscles that worked the hardest will be tight, tender, and fatigued.”

Dr. Chang offers the example of the lower back after a day of heavy deadlifts. He says, “if done correctly, deadlifts will work everything from the shoulders through the hamstrings. One should leave the gym feeling their glutes, hamstrings, and lower back pleasantly stimulated. DOMS will kick in between 24 and 48 hours and one will begin feeling a dull, consistent ache in their muscles. Paradoxically, fitness gurus find this sensation quite rewarding, as it releases endorphins throughout the body.”

This type of pain is completely normal, and even healthy. However, Dr. Chang clarifies, there is a different type of pain that should raise cause for concern.

“There is a distinct difference between back pain from DOMS and back pain from serious tissue or spinal damage”, says Dr. Chang. “The back pain that we are concerned with is a sharp, jolting pain. This type of pain feels like a stab to your spine, making you gasp and tighten your back. This pain can sometimes render the patient incapacitated.”

What causes this back pain? Dr. Chang offers insight.

“The spine is composed of a stack of bones called vertebra that encase and protect the spinal cord. Between each vertebra is a fluid-filled sack called an intervertebral disc. These discs serve as cushions, providing shock absorption under the stress of daily life.

“There are several things that can go awry to cause that stabbing back pain. One could be a sprain/strain to a supporting ligament or muscle, respectively. In more serious cases, there could be damage to an intervertebral disc. The disc can bulge outside it’s normal area and press against nerves, creating pain and numbness in surrounding areas. The disc could also crack, or herniate, which increases the likelihood of severe pain and numbness. The most serious case could be from cracks to the vertebra themselves, which requires immediate medical attention.”

Numbness in surrounding limbs can also signal serious spinal damage.

“Many patients will experience numbness, tingling, or weakness in their surrounding limbs. If the damage is in the lower back, these sensations will be in the legs and feet. In severe cases, the patient may lose control of their bowel movements. These cases also require immediate medical attention.”

Great, so what can people to do to prevent this spinal damage? Dr. Chang recommends several preventative measures.

“Strengthening the muscles around the spine help keep it aligned correctly. Core exercises, such as ab crunches and planks will help. Yoga and Pilates are always beneficial. If you are going to powerlift, make sure you’re using proper technique and a manageable weight.”

Dr. Chang also recommends stretching the muscles around the pelvis.
“In today’s world, people are often working sedentary jobs, which involves sitting for long periods of time. This can cause strain on the lower back. Hip flexors will shorten and the pelvic girdle will rotate, causing pain in the lumbar spine. It’s important that people stretch their hip flexors, quadriceps, glute muscles, and hamstrings to offset the price of sitting. 3-4 days of stretching per week is sufficient.”

If all else fails, Dr. Chang prescribes a daily dose of walking. “Many people experiencing back pain, particularly the elderly, may benefit from simple walking. Walking every day can do wonders for maintaining a healthy back.”

Kaliq Chang, MD, is a board-certified physician who is fellowship-trained in pain management at Atlantic Spine Center.

Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. http://www.atlanticspinecenter.com, http://www.atlanticspinecenter.nyc

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