Letter Re: Managing Back and Joint Pain

Jim,
I recently “took a bad turn” and re-experienced some back pain. My original injury was in 1979, when I was in the military. After three days I decided to see a chiropractor … like many men, I will see a Doctor only when I have one foot in the grave … (insert visual of wives nodding their heads here). This painful episode got me thinking about survival pain management.

In a previous career, I was the Safety Manager at a poultry processing plant. One of my duties was to manage the in-house Clinic staffed with RNs and LPNs and Paramedics. The jobs at the plant were highly repetitive and strenuous. We saw lots of ergonomic problems that had to be treated, managed and creatively eliminated.

It occurred to me tonight that in a survival situation, even a mild one, we will find ourselves involved in very physical and repetitive tasks that can result in long term pain, swelling and nerve damage if not treated quickly and effectively without having the luxury of using the local physician or pharmacy.

The problem with ergonomic injuries is the swelling, which left untreated, can cause nerve compression damage and long term debilitating pain. Not being able to effectively use your hands after developing carpel tunnel or having severe pain when walking can seriously reduce your ability to engage in needed activities.

Long story short is that, as part of survival preps we should seriously look at pain and injury management and prevention. Powerful pain killers that adversely affect our mental capacity is not a long term or even short term solution. Powerful pain killers should only be used for traumatic injuries and then only for a few days. Extended use can be debilitating, as well as make you live with the side effects.

One of the real problems with pain is that the body muscles overreact causing continual stress and that makes things worse. Managing the pain and swelling is the key.

For my recent pain, the Chiropractor used a Transcutaneous Electrical Nerve Stimulation (TENS) Unit in the office. It worked great. I asked if there were any home versions of the TENS Unit. The answer was yes. I found the one I bought on Amazon.Com. I received the shipment it today and it works great.

I thought I would share some other practical therapy and ergonomic prevention measures that we used for employees:

1. Compression gloves – these are thin elastic gloves that really work to prevent hand pain and cramps. We not only used these at the plant, but my wife used them to elevate her hand pain she experienced while sewing. For some, these gloves can prevent carpel tunnel syndrome from developing. You can find them on line and in sewing supply catalogs.

2. Compression wraps – used post-injury, they can help with swelling and pain management. Be sure they are not too tight.

3. Hot wax soaks – We melted paraffin in a crock pot (not too hot) and used it for those experiencing hand pain. Just dip in the hands and remove. The wax stays on your hands and stays warm. A very effective relaxant and therapeutic treatment. Use 4 to 8 times a day to manage pain. This also gives your hands a rest period.

4. Ibuprofen and vitamin B complex – Double the recommended Ibuprofen dose and four times the daily Vitamin B. This was actually prescribed by our company physician and it works for not only controlling pain and swelling, but speeds recovery and healing for muscular-skeletal disorders. [JWR Adds: Doctors advise that there is no harm in increasing the dosage of water soluble vitamins (which include vitamin B), but beware of over-dosing the fat soluble vitamins, namely vitamins K, A, D, and E. (Use “KADE” as your pneumonic.) These can cause poisoning!]

5. Warm-up – before engaging in repetitive or strenuous activities, warm-up the muscles and joints.

6. Work hardening – All new employees were provided supervises work hardening exercises and the amount of activity from first day to two weeks was strictly managed.

7. Vibration reduction gloves – these are generally for use with powered hand tools that create vibration. Excessive exposure to tool induced vibration can and will cause long term tissue damage. These gloves can also be used to absorb shock from non-powered hand tools.

8. Ergonomic matting – these are used for jobs that require prolonged standing such as meal prep and workbench tasks. These mats will prevent back and leg fatigue, especially when accompanied by the use of a small step to alternately rest one foot/leg at a time. Being able to shift position while working is a basic ergonomic strategy.

20 More Ergonomics Tips

I can drive a nail with a hammer (skill knowledge) but it would be unreasonable for me to expect that I could do it for hours, day after day like a professional framer who has experience in proper tool & body mechanics and has a body conditioned to do this physical work (conditioned experience). In a survival situation, especially those that are long term, we can quickly take ourselves out of the game when we develop, what is called in the industrial and job ergonomics world, Muscular-Skeletal Disorders (MSDs).

Ergonomics is the study of motion, force and stress on a body at work. and in a survival situation, our bodies will be engaged on a lot of that, including use of tools with which we are not proficient . you can’t be everything all at once. But we can use the knowledge gained from industrial ergonomics to lessen the occurrences and effects of MSDs while we ramp up our skills and proficient use of tools in a real world situation.

There are two types of causes of MSDs – Overuse and single event trauma. We have all heard the term “tennis elbow” which is inflammation of the elbow tendon from overuse. A muscle tear would be from a single forceful event. Both are classified as MSDs.

Having had a career in industrial safety, I could go on for hours about ergonomic problems and solutions, but time and space being the limiting factors, I will provide some bullets that may get you thinking about survival ergonomics and do some research on your own. The following list is in no particular order:

1. Job Hardening – Getting the body ready to work includes a ramp-up over time so you can do the hard physical work without injury. Work to strengthen your body core muscles – abdomen, back and sides – to help prevent back injury from repetitive or stressful exertion.

2. Pre-work warm-up – Most gym rats and all professional athletes with do a lot of warm-ups and stretches before starting any strenuous activity. While muscles warm up fast, tendons and ligaments take longer due to the very minute blood flow to and in them. For survival preps, extended, full range of motion exercises with low weight is better than pushing a lot of heavy iron in the gym.

3. Environmental effects – Negative effects, such as high and low light conditions, high and low temperatures, uneven footing, and noise contribute to increase in injuries.

4. Pain & swelling – Tissue swelling causes nerve compression (pain) which can lead to irreversible nerve damage. Muscle and joint pain causes your body to compensate with other muscles, causing strain and more pain and unbalanced effort. Use ice & heat for pain and swelling and medication for reducing inflammation and pain. Once the swelling and pain reduce, get the joint moving again. Don’t stabilize the joint for extended periods. This can lead to loss of range of motion and muscle atrophy. Understand how and when to use hot and cold packs to more quickly recover.

5. Lifting – Proper lifting must include evaluation of the weight, bulk, body position, grip engagement, starting and ending position of the object. The safe lifting zone is between the knees and shoulder. Consider asking for help or using mechanical assist devices

6. Carrying – Flip through some old National Geographic magazines and see how people have carried large, bulky and heavy material on their backs and on their heads. These are not recommended. Breakdown large loads into several smaller ones when rearranging, stocking shelves, etc. Use wheeled helpers such as carts, wagons, bicycles, wheelbarrows, and hand trucks to move heavy material over a distance. Put some bicycle wheels on a child’s wagon and you have a great cart.

7. Backpacking – Experienced backpackers know to keep things light and compact. Heavy items go low in the pack and close to the body to reduce stress from an unbalanced pack. How far can you carry your bug-out-bag?

8. Hands – Rule number one is to keep wrists in a straight and neutral position. The force required to grasp, pinch, or squeeze is multiplied when the wrist is out of neutral position. Working with cold hands is an extreme hazard. Use gloves that are suited for the job. Consider a range of gloves such as sure grip, anti-vibration, compression, warmth, and cut resistance. Make sure the gloves fit well and work with the tool you are using. Improper and extended use of vibrating or impact tools can cause irreversible nerve damage to the hands and wrist

9. Feet – Good non-slip, supportive footwear can prevent injuries. Consider using arch supports and sole inserts for extended comfort and cushioning when moving over flat surfaces, uneven terrain, and climbing ladders. Good work shoes/boots are generally not designed for extended walking or hiking and the reverse also applies. Eye strain – General body fatigue can result from eye strain caused by too much light, too little light or doing fine, close detail work for an extended period. Have good sun glasses and be sure any area in which you work has good lighting. Take eye rests every 15 to 20 minutes when doing close detail work such as sewing.

10. Back – We all know to lift with our legs, not our backs. Lifting and twisting especially in a repetitive motion will cause injury at some point. Our backs are just not designed to do this with even a moderate weight.

11. Repetitive motion – Be sure to stretch and warm-up and take rest breaks. Use fingerless compression gloves for hand work that requires using fingers to repetitively manipulate objects. Use anti-fatigue matting when standing for long periods at a task. Vary your tasks so you don’t fatigue specific muscles. Avoid using your body to create impact force.

12. Tools – Properly designed handles to fit your hands are essential. Handles that are too big or too small with quickly cause hand fatigue. Hand geometry should allow a straight and neural wrist position. Consider the weight and bulk of a tool when selecting your tools. Usage position is important. Off-balanced or twisting or overhead use of tools can cause MSDs.

13. Pushing and Pulling – From a body mechanics standpoint, it’s better to push an object rather than pull it. Make sure you have a good grip and do not flex your wrists if you are doing repetitive work that involves pushing or pulling.

14. Sitting – Extended sitting while working should be done so that there is no stress on the lower back. Knees should be above the hip joint.

15. Standing – While doing work for an extended period at a work bench or counter top, use foot rests, soft anti-fatigue matting and shift your weight periodically. An adjustable work height will be a bonus to keep you from hunching over.

16. Squatting – Watch your body mechanics of moving up or down when squatting. You should generally avoid this position while working.

17. Mechanical advantage – Use levers, block & tackle, hand trucks, pull/push carts, wheel barrows and anything that will minimize the force and exertion you must provide with your body.

18. Temperature – Working in either high and low temperatures can cause rapid overall fatigue that can cause MSDs.

19. Sleep deprivation – Not getting enough sleep creates body fatigue and affects judgment which leads to an injury prone condition.

20. Be prepared to avoid recognize and treat MSDs in a survival situation. Being flat on your back in pain or having lost the effective use of your hands can make it a very bad day for surviving.

I could go on and on about ergonomic solutions that employers (and OSHA) have found effective that could be directly transferred to crisis survival activities, including properly designed tool handles, job rotation, frequent breaks for rest and stretching, etc. Check out the ergonomic sections at the OSHA web site for solutions to problems that you have not yet encountered.

I’m sure there are other non-pain pill pain management and expedited healing techniques, including hot and cold compresses, that are “outside the box” and could be very useful in a SHTF situation.

In keeping with the “if you have two, you have one” dogma, I am ordering another TENS Unit to put in my Faraday cage.

Regards, – Marc N. in Alabama