Wednesday, 2 March 2016

Story of Pain #1; Chronic Back Pain

I broke my sacrum in a freak accident at the age of 18. It took almost three months to heal during which I could not sit comfortably and often rode kneeling facing backwards in the seat to travel. I whined, griped about back pain and took pills and even non-prescription drugs.

Through the years, I also travelled, climbed mountains, Scuba dived, taught school, roller-bladed, skied and had adventures generally allowing the energy of youth to keep me moving. In 1975 using "Be Here Now" by Ram Das, I started doing yoga. Osteoarthritis developed in my knees starting in 1977.

In 1989, now 45 years old and still griping, I decided that I wanted to live longer with less pain. In May 1989, a physiotherapist started me onto an exercise program targeting my back. 

I found exercising to be boring so, in order to do it faithfully, I combined it with watching t-v. I became so accustomed to exercising in the living room that even our guests would be exposed to my routine. When I returned to the physiotherapist in September, 1990, I said “I feel better, I feel stronger, but my back still hurts a lot”. He poked me in my jelly-like soft abdomen. “What are you doing about these muscles?” he said. I replied, “I don’t like sit-ups”. There were a pile of non sit-up exercises for my core. As I faithfully continued adding the new exercises to the other, I experienced a pain-free week in April 1991, six months later.

It didn’t always remain pain free. I learned to change many of the ways that I did things – I changed position a lot, I stopped the car every hour on long trips, I put a foot bar in front of counters and desks, I lost ten pounds of weight, I used heat and saunas. I did not stop exercising – in fact, I added a yoga routine in order to increase both strength and flexibility. Sometimes I took naproxen, a non-steroidal pain and inflammation reliever. 

Osteoarthritis is a progressive disease and exercise didn’t “cure” it. Exercise does, however, make our bodies release endorphins which are natural pain-killers. This seems to be a good thing.

In November 2011, I fell on ice and severely jarred my pelvis and lower back. I struggled back to mobility with the help of my physician, the physiotherapist and a chiropractor. I had to severely modify the exercise program at first but by March 2012 I was well enough to go to Mali with a medical team. Unfortunately, I fell again on uneven pavement while running to avoid tanks during the military coup. When I eventually was able to walk and return to Canada, I made appointments with the physiotherapist, my physician, the back institute specialist, the chiropractor and a mental health counsellor (for PTSD prevention).

In May the back specialist insisted upon a back x-ray, reviewed it with me, emphasizing the deformities. The radiologist had read it as having “osteoporosis, severe osteoarthritis and a 60 degree roto-scoliosis”. In short, a very bad back. At that time, I was using two canes, doing modified exercises and, seeing myself as an invalid. He merely reinforced the importance of acknowledging that I had a severely misshapen back. The view from there was dismal. I was depressed.

A month later, my eldest daughter chided me when i was whining, “so which of these things is acute? Aren’t they all things that you have had for years?”
She was correct – in fact, the scoliosis had probably been present since my teens. 

At yoga in June, the instructor asked that each person “create an intention” for the class. I wanted to “see my back from the outside” and erase the vision of the x-ray. During that session, I was able to have a glimpse of a better back but only a glimpse. I had to consistently and mindfully re-envision my back.

Meanwhile I was learning more about backs. While I was recovering enough to fly home from Mali, my partner was collecting material about backs. A foot high stack of literature was sitting on the living room table. I found new and sometimes non-back exercises that helped backs. Stride – who knew that a long stride was hard on the back? – I modified my walking.  I became stronger and soon there was only one cane and then often none!

The real epiphany – and the reason that I’m writing this – came in the summer of 2015. I returned from seeing my family physician in Saskatoon. He had asked me how much pain I had – I had replied that it was almost always a 2/10, sometimes a 6/10, never 0/10.

Two out of ten all the time? This didn’t make sense. A re-set was in order. If I was always 2/10, then 2/10 was my zero. Using Melzack’s gate theory of pain, I reasoned that a person should be able to simply re-set the “gates”. While I could not change the abnormalities in my back, perhaps I could change my perception of the pain. In a sense that is what distraction, music, movement, and eating does to decrease awareness of pain. In this case, every time I became aware of the pain in my lower back I mentally “closed the gate” just above the painful area. At first this was quite tedious and took quite a bit of effort.  

But in fact, the process took less than six weeks! In mid September I realized that the gate seemed to be permanently closed. Most of the time, I had no pain. It was so hard to believe that I told no one. Today I remain free of that nagging low back pain that I have associated with my broken sacrum.

Not that I have quit exercising, weight control and all of the other good things including moving around – even at meetings, I get up and walk to the back of the room.

On my way through an airport months later, looking for something to read, I picked up Norman Doidge’s “The Brain’s Way of Healing”. Dr. Doidge explains how what I did works, not just for me but others as well! I heartily recommend it.