Tue 22 Feb 2011
Back Story
Posted by anaglyph under Ouch
[34] Comments
The world can be divided easily into two groups of people. Those who have experienced serious back pain, and those who haven’t. As a sufferer from a chronic but (thankfully) episodic problem with my lower spine, these days I can totally pick a person from either of those groups pretty much instantaneously.
The first time I experienced my condition was when I was in my late 20s and I was driving along the highway from Goulburn to Sydney. I don’t actually recall doing anything at all to bring it on – I merely shifted my weight in the seat.
SKRINK! (Each time you see that word, I want you to imagine that it is the Bernard Herrmann knife-stab motif from Psycho – you know, that high-pitched violin screeching sound). It was like someone had taken a marlin spike and rammed it through my back. ((This is colourful imagery, you understand. I don’t really know what it would feel like to have a marlin spike rammed through my back, but I imagine it would not be pleasant.)) I put my foot on the brake. SKRINK! Again. Bad move. But I couldn’t keep driving. I finally got the car to stop on the side of the road. My breath was ragged and I was whimpering involuntarily with the excruciating pain. ((The word ‘excruciating’ comes from the same word roots as crucifixion.)) With every effort of willpower I got out of the car and lay flat on the ground. It was all I could think to do to attempt to stop the agony.
In a minute or two, a car pulled up and a middle-aged woman jumped out and hurried over.
“My God! Are you OK?” she cried.
“It’s my back… I don’t know what I did but it’s terrible.”
“Oh,’ she said. ‘I thought it was something really serious.”
I know now that this woman was in Group B: People Who Have Never Experienced Back Pain.
Now, in mechanical terms, what is wrong with me is very common and something that can happen (to anyone) surprisingly easily. It’s just a muscle weakness in my back that allows my spine to make contact with the nerves that run along it. It tends to be a kind of a feedback loop – the muscle goes into spasm, the nerve gets pinched, I involuntarily ‘overcorrect’ (to avoid the intolerable stabbing pain) which causes the muscle to spasm even worse… and so forth. It doesn’t take much to trigger it – I had a particularly bad episode in 1987 that was instigated by merely bending down to take a power plug from a socket. Thankfully it only happens every two or three years, and usually it’s correctable by my physiotherapist and I’m only out of action for a few days.
But it hit me on Friday night worse than I’ve ever had it before, and, annoyingly, all the local physiotherapists are closed over the weekend, so I’ve been completely bed-ridden for the best part of two days. I don’t really take to that very well. To give you some idea of what it’s like, let me describe what I did just now when I decided to get up and make myself some tea.
Sitting up in bed with computer (while I sit still, I feel COMPLETELY fine). Slide computer off lap and take blanket off knees. SKRINK! Make whimpering noise. Slide legs off side of bed. SKRINK! Jesus! Stand up and walk to kitchen like a ninety-year-old man. Put kettle on and inadvertently knock sharp knife off bench. Instinctively move bare foot out of the way to stop artery being severed. SKRINK! Fuck! Try to pick knife up. SKRINK! SKRINK! SKRINK! Fucking Jesus Cunt Fuck! Whimper. SKRINK! What the fuck? I barely moved that time! Give up on knife. Fill kettle. Mince around in terror that the pain will strike again SKRINK! Thanks. Make tea (Eventually. It takes three times longer than normal thanks to the the additional swearing and the stop-start nature that has now been imposed on the process). Take tea and cup back to bed. Attempt to set teapot down on bedside table. SKRINK! SKRINK! FUCKING SHIT JESUS BLOODY HELL! SKRINK! Scream. SKRINK! Drop teapot on table from six inches above and hope it won’t fall off. Do the same with cup. SKRINK! FUCK. Attempt to get back into bed. SKRINK! SKRINK! SKRINK! SKRINK! SKRINK!.
Every time the pain hits it’s as bad as the first time. When I do finally manage to get back into bed, sitting up straight, the pain is totally absent. The problem with pain like this is that there is no visible sign that there’s something wrong. So what my family sees is me sitting in bed seeming entirely OK (because as long as I don’t actually MOVE, I am) and having a jolly ol’ time on the internet. And, if I have to get up, I seem to suddenly go into Tourette’s-like convulsions of screaming and sobbing for no visible reason. If you’ve never experienced this kind of pain, you simply cannot know what it’s like – I know, because up until it happened to me I used to be part of Group B. And I know, because of this, that those in Group B who see you hobbling about think you’re hamming it up! Well, they might attempt to be sympathetic, but I know that what’s really going on in their minds: ‘Oh come on. It can’t possibly be that bad. You were FINE a second ago.’ Eventually they even lose the sympathetic air and you can almost hear them saying ‘Yeah, yeah, we get the idea – it’s painful. You can stop with the screaming now.’ Only you can’t stop with the screaming because it’s FRIGGIN’ AGONY. ((I have to be truthful here and say that Violet Towne is really one of the few people who can be classified as belonging to neither Group A or Group B. She is a very empathetic person. I think she understood how bad the pain was when she saw me turn white and lose my power of coherent speech the first time I got stabbed in the spine. She has also been good-natured enough to put up with my constant moaning, and has been looking after me very well through this latest episode.))
You know you’ve discovered a Group A person, though, when you tell them what’s wrong and they go a kind of ashen colour. Their brain instantly replays a little bit of the pain for them – it’s an involuntary response reserved for those of us who have been to this special circle of Hell. Usually their sympathetic words are confined to ‘Oh Jesus. Fuck.’, and they sometimes grab reflexively onto a nearby shelf or other stable object. ((The Group A people can be divided into two further groups: Group A1, who know that you’re in for some serious physiotherapy and a few more days off your feet, and Group A2, who offer you some kind of idiotic remedy involving acupuncture, homeopathy or crystals. When I’m in agony and beset by peddlers of woo-woo, I want to grab some of those crystals and shove them right where the sun won’t make rainbows.))
The other shitty thing about this problem is that it makes me so incapacitated. The smallest tasks become almost impossible and even showering or putting on my shoes creates whole new vistas of torment. I’m not really good at sitting doing nothing so I probably do the worst thing I can do under the circumstances and make numerous attempts to get on with my normal life, despite urgings from Violet Towne to take it easy.
It really gives me renewed respect for all those people out there who live with remorseless chronic pain. You brave and courageous souls! I salute you! SKRINK! Aaaaagh. FUCKING HELL!
Group A, baby. Though my pain was more of the constant extreme discomfort variety than the SKRINK! variety. Thankfully, after what seems like thousands of physio visits to scores of physios, I seem to have finally identified the whole complex and ridiculous process that made my lower back rely on the wrong muscles to work, and am slowly making progress teaching the right muscles to take over again.
But Jesus, what a painful, long road it’s been. Like you, I am astounded by those who live with chronic pain, having had a glimpse into that world and the way it affects EVERYTHING in your life. I also have a new appreciation of how many people around me – how many over 40, at any rate – are probably enduring some form of pain or discomfort as they go about their daily lives.
No wonder people get a little grumpier as they age …
I get a combination of the discomfort and the SKRINK!, though they are both episodic. Right now, I have very little pain, but this morning I was almost crying. I have been taking it very easy today, so I’m hoping I’m on the mend. But then I thought that this morning too…
Also, I have to get back on my bike – that definitely helps me.
I have never suffered from back pain, as such, but I do suffer from gout, so I can thoroughly sympathize and claim Group A membership. People in Group B vis-a-vis gout think that gout is HILARIOUS! It’s like a quaint Renaissance Faire thing, isn’t it funny!
No. A bad attack of gout feels much like a rusty hacksaw blade being drawn back and forth through the afflicted joint. It’s an excruciating agony.
I think it’s probably any kind of pain where there isn’t a visible sign of affliction. If you have a broken leg, you have a whopping great piece of plaster on it and everyone sends you cards and wants to help get your groceries. But ‘non-visible’ afflictions have been hijacked by malingerers, so the few bad apples spoil the whole bunch.
So gout can’t be treated these days? I must admit, my knowledge of it’s very scant – it’s an excess of uric acid in the joints? Is that right?
Indomethacin for the symptoms.
Allopurinol daily as a preventive.
There’s a man who knows his gout.
Yes, definitely the Voice of Experience.
Group A, babies!
Also, whisky helps. Not so much for gout, I would think.
I’ve had success with whisky and Allopurinol …
That doesn’t sound like anything you’d see on a doctor’s prescription…
Group A. And I’m in it right now.
Physio, rest and the right strengthening exercises and as many drugs as I can get my hands on.
Also ask your physio about a TENS machine. They only work for a certain percentage of people but I’m one of the lucky ones. You might be too.
Hmm. Is that anything like a Violet Wand?
Nope :-)
Disappointing…
I don’t think I asked my initial question very well. Lemme try again.
What causes the back pain — not what physical activity brings it on (that’s either a mystery or, at any rate, nothing especially significant), but rather the physiological condition — is that a weakness in certain back muscles allows the spine to move in relation to the surrounding nerves. It’s not anything with the spinal discs, right? It’s with the spine’s proximity to nerves in soft tissue, yes?
So, when you go from a period of being laid up and in fear of the next SKRINK to a period of relatively worry-free living, what happens, physiologically? Is it a matter of inflammation that has to be allowed to subside? Or is it a kind of nerve-muscle-nerve-muscle cycle that has to be “broken” (or at least allowed to “wind down”)?
I think what you said is that something like the nerve-muscle cycle is something ON TOP OF the underlying condition; so I guess my question is: What does a “healing” amount to, in relation to the underlying condition? Is it that the weakened muscles actually get strengthened, or that some kind of “damage” gets repaired?
Shit, I probably still didn’t frame that very well.
Oh, I get what you’re saying.
The spinal column, as I’m sure you know, carries a pretty hefty nerve bundle. These nerves run adjacent to a lot of small bones and musculature. Under normal circumstances, the muscles hold the whole thing in a position that allows the bones to be where they should be and the nerves to be where they should be. What is actually happening with me is that one of the small muscles goes into a spasm, or a cramp, which pulls the bones out of alignment, allowing them to touch the nerves (or the nerves to touch each other in a bad way). It’s not really clear exactly what’s going on without substantial tests and xrays, but this problem is common enough that most doctors don’t bother to get it xrayed. If the physiotherapy treatment is successful, then the problem is with the musculature. In my case, this is exactly the scenario.
The remedy is to exercise and strengthen the muscles, which I do, but, as with most body things, as you get older, the ability of your body to deal with them gets diminished. Also, the more often it happens, the more likely it is to get into that ‘groove’ so to speak. It’s a case of trying to avoid improper bending and twisting – difficult as that is…
Also, this problem is not the same as the infamous ‘slipped disc’ that you often hear about, which is when cartilage between the spinal bones gets squeezed out of place. I pray to the Spaghetti Monster that this never happens to me, as it must be totally horrendous!
Group A here I’m afraid too, but let’s not give the Queen more ammo kay?
The only thing that ever helped was Alexander technique, trouble was after that I did Yoga and that really made it all go to hell. Made me very calm in the face of pain though.
Hmmm, swimming next perhaps.
The (ouch) King
Swimming is a definite possibility that I’m going to look into this year. When I was spending time snorkelling at Bondi in the couple of years before I left Sydney, I did notice a marked improvement in my general back health.
I hear pregnancy can be rough on the back.
I hope you’re taking precautions, Rev.
It’s OK – I have the Simple Graphics Man self help guide.
Here’s another tip that helped me, fellow sufferers. I was continually twisting my pelvis by sleeping on my side with my top leg pulled over the bottom leg and resting on the bed.
I taught myself to sleep with both legs resting on each other (or the bottom one pulled up at an angle) and it made a huge difference after my pelvis was repeatedly re-aligned by a physio and I strengthened the muscles around there to hold it in place better.
Proper pelvis alignment + strengthening exercises = back improvement.
All true.
Wife has the same thing, degenative disk, when it flairs up she can’t even get up out of bed. Sometimes I have to get her hospitalized to get ther back on her feet.
I liked the funny bit where you got trapped at the picnic table and couldn’t get out. That was funny, that bit.
(Group B. Goes without saying, really.)
Yessssss…. You only get away with that because you bought me chocolate.
[img]https://www.tetherdcow.com/tetherdcow/cowimage/rum&rais.jpg[/img]
Chocolate good. Is pirate chocolate.
I hope you’re not still spending your days SKRINKing.
Unfortunately.
Not to get too personal, Rev, but I’m wondering how things have progressed, vis-à-vis the back issue.
All well now, thanks for asking. That’s the general patter – I probably won’t have the problem again for another year or so. It did take a lot longer to abate than usual this time though. I sincerely hope that’s not a precursor of things to come…