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  • Opiates and training

    Guys,

    I've recently tweaked my back causing what feels like intense muscle spasm in response to leaning forward on left lower lumbar region, non_radiating, sharp with some throbbing.
    No red flags, I just did a few rows with 60kg as a warm up to 80kg (75% is probably not a great choice for initial warm up set!).
    I have been deadlifting three times a week and squatting the same, as well as rowing. I think this was too much too soon and I was not yet adapted to this volume and frequency, and tightness was high in the lower back for a couple of weeks, followed by a sudden decrease in pulling performance.

    I think the outstripping of recovery resources due to fatigue build up had something to do with it.
    This is something that occurs from time to time, on rows (memory, expectations?). It is very severe when it happens, and even walking causes pain.
    I usually try to ignore it.

    I've made huge progress over the last year, through Austin's pain management stuff and other sources, to the point I felt back pain was a thing of the past. But I know I'm not injured per se, so its all good.
    I also know it is my brain freaking out due to my long hx of same and all the psycho-social issues around that.

    I am aware of the protocol for pain management while training.
    I unfortunately did not persist with rows that day, since it was just really pissed off so didn't want to reinforce that pain pathway, and did weighted pull ups instead.
    I went in yesterday to work with light deadlifts to get back into pulling asap. It was not that great a result with me having to stop at around 25% loading for that movement (1RM 195kg).
    counterintuitively, it was worse with a belt, so I had to take it off.

    My question is, do short term opiates (a day or so) have a legitimate role in desensitizing the pain pathway to the antagonizing positions or movements when moving forward to full training load again?
    That is to say, taking opiates prior to training in that first day or so after the initial occurrence to essentially limit the chance of pissing it off.
    It seems that they are not recommended and I was wondering why, specifically? Is it just the potential dependence in the context of unsupervised use or are there other considerations?
    Potential for too much load too soon? I'm just thinking if there is no real injury present, what is the risk in returning to full loading again?

    Thanks for any response.


  • #2
    Opioids are not recommended for the treatment of acute back pain. This is likely because 1) they do not significantly alter the trajectory of recovery, and 2) they are associated with increasing risks with each additional day of prescription -- in other words, the risks outweigh the benefits.
    IG / YT

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