Back pain. I
cannot remember when I didn't have back pain. Maybe before an
tobogganing accident at the age of 18. I was hospitalized and told
that I had broken my sacrum. I knew a lot of other people with back pain so it didn't seem to be a big deal.
I
lived the life of taking over-the-counter pills and seeking distraction from pain; two
aspirin sort of coped with pain when distraction didn't work.
When
I was 36 years old, I was diagnosed with arthritis. Both of my knees
had became hot, painful and swollen. I was told that it could be
rheumatoid arthritis; all the symptoms settled on regular enteric coated
aspirin and, given available treatments in 1976, I couldn't see any
reason to investigate further. (Time has not confirmed the
rheumatoid. My hand deformities are osteoarthritic.)
In
1988, my pills and distraction were no longer working. I was taking
what I considered an inordinate amount of antiinflammatories and had progressed to using 292's (aspirin and codeine). I was chronically grouchy because of the pain and the pills. Mainly back pain, but other “hot joints”
were sometimes painful too. The pain was at the level of 3-4/10
where 10 (on my scale) is a broken bone.
A physiotherapist had recommended exercises in 1983 after the birth of my third child and I'd do them for a
few weeks and decide that they “weren't working”. I had never done focussed exercise over a length of time. A masseuse helped loosen up some of the stiff
muscles and I started slowly, adding exercises from a Safeway
check-out booklet called “exercises for your back”. When I sought her advice again in 1991, I could say, “I don't think that the exercises have
altered my pain but I feel better.”
She
examined me. Poked me in the belly and said, “what are you doing
for your abdominals?” She described the layers of muscles and the
exercises that built strength in each layer and left me with
assortment of core strengthening exercises.
Nine
months later, the second week in April 1992, I had a painfree week
without pills. It was awesome.
I
never stopped doing back exercises. The routine included 1 hr/day
5/7 days with back exercises and free weights plus about 12 minutes
of yoga daily. When I could, I attended drop-in exercise and yoga
classes. A few days are painfree, most days are tolerable at 2-3/10
and some days aspirin and naproxen came in handy. Twenty years of
this routine.
November
2011, I slipped on ice and landed on my sit-bones (ischial
tuberosities). My sacrum, the flat place at the bottom of the spine,
propelled by gravity kept going and the SI joint ligaments were
painfully injured; there was pain in my pubic symphsis (the bump
just below the abdomen). I was practically bedridden. It healed like ligamentous injuries, five days
of excruciating pain, five days of severe pain and then four weeks of
slow motion, massage, heat, physio, gentle exercise anti-inflammatories. Two chiropractic treatments at two months
completed recovery.
Then,
four months later, in Mali during a military coup, it was re-injured
and the pain and disability were worse that previously. This time
there was pain radiating into the thigh and across my butt muscles. This
was serious – twice laid up for weeks within the same twelve
months. Time to quit being my own doctor.
When
I got home, appointments were made with a mental health counsellor,
physiotherapist, chiropractor, and a back specialist (xrays). In my
absence, Bill had assembled a ten centimetre pile of reading material
on backs from which two books spoke to my condition.
Two
of the messages was consistent through all practitioners (and the
written material) – 1. healing takes time and the November injury to
ligaments was going to take at least a year to heal and 2. focussed exercise was the mainstay of the healing process.
The
physician. “We should look at that xray together” he said. “Oh
no”, I thought, “this doesn't sound good.” What did we see? A
fully compensated 60 degree scoliosis in the lower thoracic-lumbar
region accompanied by “extensive severe osteoarthritis”;
furthermore the bones appeared osteopenic (thinned).
I
was stunned. All these years, my belief was that I was treating
mechanical back pain, not structural chaos. For the next two weeks,
every twinge bought the image to my inner eye. I felt old and
deformed. I was depressed over the thought that “this is as good
as it gets”. Visions of spontaneous vertebral fractures threatened
my activities. The paraesthesias (sort of a numbness) of the lateral
nerve of the right thigh (I had diagnosed it as idiopathic), the
almost constant discomfort in my lateral quadriceps (I just thought
that I wasn't “conditioned”) - both of these originated from the
back.
Yet,
there was no treatment other that what I was already doing. I was
already taking calcium and vitamin D (in the winter), salmon oil and
the occasional aspirin or naproxen (even with a stomach protector
like omeprazol, my gut eventually hurts so they have to be stopped
intermittently).
More
exercises were recommended, increasing to two hours daily with more
core involvement. I was drinking more than my share of alcohol (good
for pain, bad for osteoporosis) – I stopped that. The
chiropractor recommended glucosamine and increasing my salmon oil
capsules; the physician gave me a prescription for a SI stabilizing
belt for use in severe SI joint pain.
I
could not get that awful xray out of my mind. It haunted me – I woke my housemate in Ottawa screaming in a nightmare! Every
twinge added to my depression. I had proven to myself time and again
that going more than two days without “the routine” was never
worth it – now it was two hours a day!! How was I ever going to
find time to do this?
I needed an attitude change. First, was the importance of exercise. I realized that I had internalized the impression that my exercise routine was
sort of an indulgence, like painting my toenails, when, clearly I had to think of exercises more like
brushing teeth or washing armpits. Absolutely essential to my
health.
Second eureka occurred in
a Yin class of hot yoga (very slow stretches in a heated room). I spontaneously envisioned my back as it was from the outside,
what it could do and how well it had performed all these years in
spite of its deformities. I could and would work on being thankful
for the twenty years of routine – and for my advance planning.
In
1987 when we were building our house, I had the carpenter create a
pair of raised garden boxes at the side of the deck so that I could
garden in the event that I could no longer bend. They stand slightly
higher than waist height, are arm-reach width and deep enough to hold
the roots of most garden plants. Last year we began construction on
a ramp for the entrance. Instead of walk-in closets, the master
bedroom has a dedicated space for back exercises and yoga. My free
weights are part of the living room furniture (if they are handy,
they are more likely going to get used). For years, I have done
exercises in public parks, stairwells in hotels and airports.
Sometimes watching a video makes exercises more interesting.
In
short, I have a crappy back bone but I am a lucky woman! There are
many to whom even getting started is the biggest barrier. I have cleared that hurdle by years!
