Back Attack - Living Pain Free
Due to my recent back surgery and a handful of outside inquiries regarding back pain, I’ve decided to write this post in an effort to tackle some frequently asked questions.
Why Does My Back Hurt?
Ahh, a question we find ourselves asking a bit too often. So often, in fact, many of us have just come to accept our back pain, rather than do anything about it. To treat our backs, we must first understand the causes of pain. Is it a weak core, weak back, tight muscles, or nerve damage? What about disc injury or disease? Maybe it’s our posture and daily habits or strained muscles and ligaments. Could it be related to our spinal fluid or lack thereof? Rather than daunt you, I ask these questions in hopes to shed light on your back pain, educate you, and encourage you to get the help you need.
My Personal Story
About two and a half years ago, I first noticed pain in my back after gardening. It was an achy pain that remained consistent throughout the days following. I backed off my exercise routine for a couple weeks, thinking it was a strained muscle. When things were looking up, I went back to working out as normal. It only took one set of deadlifts to make me realize I was certainly NOT back to normal. Again, I backed off and waited until things felt better. And again, I hurt myself. This time it was enough to knock me off my feet. I was laid up on the couch, unable to move for an entire day before accepting the fact that I needed help.
My physical therapist was great. She attributed the sensations I was feeling to nerve tightness. Over the following weeks, we practiced nerve glides, massage, and stabilizing exercises for the muscles surrounding the affected nerves. Despite weeks of PT and ‘taking it easy,’ my pain remained the same. I was also gearing up to move, so I had to end my PT sessions. The pain lingered and my treatment got swept under the rug.
Fast forward almost two uncomfortable years and I’m in the Emergency Room. I was convinced I had blown out a disc, but was assured by the ER doctors (who had taken X-rays) that it was ‘probably’ a sprained ligament. I was instructed to ‘take it easy’ for a couple weeks, was given medication, and sent on my way. Months went by and my pain remained untouched. I got in to see another doctor who referred me to another physical therapist. Again, this PT was great. But, after sixteen weeks of treatment, no improvement.
Back to the drawing board we went. THIS time, I saw a pain management specialist. We tried medications, nerve blocks, and steroid injections. No relief. She was shocked nobody had ordered an MRI, so she scheduled me for one as soon as possible. The initial reviewer of my MRI diagnosed me with an L4-L5 disc bulge, mild L5-S1 disc herniation, and degenerative disc disease. My pain specialist saw, and showed me, something different. My L4-L5 was bulging but it also had a tear in it, and my L5-S1 was significantly herniated.
Off to the surgeon I went for a consultation. Because none of the conservative treatments provided relief, I was told surgery and chronic pain were about the only two options left. I underwent a diagnostic procedure which determined the source of my pain – my L5-S1 disc. I made the decision to undergo surgery and months later I had the operation. My L5-S1 disc was removed and an artificial disc was put in its place. While I could go on and on about my surgery and recovery, I’ll spare you…for now.
I Have Back Pain Too. Should I Get Surgery?
After a recent post on social media, many people reached out saying they wanted back surgery. They each expressed having back pain and were convinced surgery would fix their pain too. While I am in no way qualified to advise someone for or against surgery, I personally believe it should be a last resort. With this surgery, as well as any, there’s no guaranteed success. It can cause the condition to worsen, the recovery is lengthy, and there’s a possibility of early or increased arthritis. Surgery isn’t a magical cure-all so, rather than rush into it, I advise everyone to exhaust all other options. Get second and third opinions, and weigh the pros and cons.
So If I Shouldn't Get Surgery, What Should I Do?
Treatment doesn’t just happen in a doctor’s office. There are plenty of things you can do, or NOT do, on a daily basis to alleviate your back pain. Regardless of your form during workouts, micro movements throughout your day can add up and potentially outweigh the benefits from exercise. You must be mindful of your movements at home, not just at the gym.
- Pick things up with purpose – Our backs are happiest when our spines are neutral – not over extended or over flexed. We’ve all heard the saying ‘lift with the knees, not the back.’ While this is true for heavy lifting, we typically don’t follow this advice when picking small things up off the floor. Rather than bending or hunching over to pick something up, try reaching down while balancing on one leg. Let your opposite leg naturally kick up in back of you. For those of you familiar with the single leg Romanian deadlift, keep this movement in mind.
- Tying your shoes – Rather than bending over to tie your shoes, bring your feet up towards your torso, one at a time. Propping your foot on an elevated surface such as a chair is a great way to minimize back flexion and maximize back comfort.
- Twist and Shout – A great song, but an even better reminder. The more we twist, the more our backs want to shout. When you open a door, are you pulling across your body? Position yourself in line with door handles so you pull straight back rather than across your body. The same goes for taking things off shelves, washing dishes, vacuuming, etc. Work in front of your body, rather than across. Remember, less work, less torque, happier back.
- Invest in yourself – This is arguably the most important piece of advice. Like most ailments, there is no magic cure to back pain. If you want to get better, you must be willing to put in the time and effort. At the risk of sounding harsh, if you have the tools to make a difference and you choose not to use them, you can’t expect change.
Movement Is Medicine
Ever wonder why you feel ten times your age getting off the couch? There’s no mystery to this one. The facts are simple – our backs don’t love slouching on a non-supportive surface for hours on end. Imagine that! Try to minimize the time you spend on the couch and when you do get up, try this simple exercise I’ve borrowed from Dr. Stuart McGill:
Stand with your arms stretched overhead. Hold for a ten count, remembering to breathe. Reach your arms up a bit higher and back a bit further and hold for another ten count. Finally, take a deep breath in. On your exhale, slowly lower your arms.
If you don’t want to give up your nightly shows from the couch, make an effort to get up at least every 30 to 60 minutes and walk around a bit, allowing for blood flow and mobilization, among other things. Blood flow and a well-positioned spine make for a much happier back. Remember, movement is key!
Additional Help
After two years of being in pain and recovering from a recent surgery, I have done my fair share of research on back pain and solutions. One of my favorite sources of information has become Back Mechanic: The secrets to a healthy spine your doctor isn’t telling you, by Stuart McGill PhD. It includes self-help guides to determine potential sources of your pain as well as at-home treatment and injury prevention. For the record, I am in no way sponsored or obligated to mention Dr. McGill or his book – I am just a happy customer!
Take Away
If you are someone who suffers from back pain, either acute or chronic, don’t give up hope. Get second and third opinions when available, and do all you can to help yourself. Life isn’t as enjoyable with every day spent in pain, so don’t settle for ‘it is what it is.’ The more you practice new habits, the more ingrained they will become. You don’t have to be perfect, but you do have to be better if you want to change.
Book Reference
McGill, Stuart. Back Mechanic: The Secrets to a Healthy Spine Your Doctor Isn’t Telling You. Backfitpro Inc., 2017.