Chronic Pain Rehab concepts/back pain

When I was about 26 years old I worked 2 summers as a roofer. I was lifting way too much weight up and down a ladder. I then went to Physical therapy graduate school for 2 and 1/2 years.  I was sitting about 12 hours a day in class or studying on my own. My back started to hurt significantly with sitting and bending forward.  I considered surgery, injections, physical therapy, and a whole array of treatments.  I ended up doing physical therapy 2 x a week, taking anti-inflammatories, ultrasound, massage, joint mobilization, lumbar traction, electrical stimulation, heat,  and ice.  The Doctor I saw performed an X-ray of my back and said it was a muscle strain. Nothing was helping the pain. My back hurt profoundly with trying to surf while I was sitting trying to catch waves, with sitting in Church, bending over to pick something up, and standing for a prolonged period.

The pain was becoming unbearable.  One time I lifted a patient from their bed during a clinical and my back just gave out.There was a sharp pain in my left low back area.  My back was killing me. I consulted with Doctors, physical therapists, and nurse practicioners.  I could not get a clear diagnosis and I could not get any relief from my back pain. Also I was starting to get symptoms of numbness down my left lateral leg. In hindsight, it is pretty easy to see the diagnosis was a herniated disc at L4/5 in the lumbar /low back region.

My condition became chronic and it lasted for about 3 years.  Over the years I have had some similar patients where they saw a lot of different health care professionals and their pain just was not getting better. With some (not all) of these patients and with myself I found some secrets of sorts to overcome or reduce the pain. Here they are:

  1. Find the correct diagnoses as best you can with your Doctor, your physical therapist/occupational therapist, your own research on credible websites like emedicine.com/mayoclinic.com/webmd.com, experience, biomechanics, (finding an exact diagnosis can be important but in some cases you may not find it so you have to move forward and try something different for treatment like I am suggesting)
  2. Remodel the muscles with building over the tissue that is injured
  3. Work through the pain in some cases to re-wire the nervous system’s memory of pain
  4. Stop the activity that is creating biomechanical excess force
  5. Be careful is some cases – for example in the low back region if you have spondylolisthesis you should not do lumbar extension/really hyperextension because it can injure your back ( I will help you understand some of the major cases to be careful with

For back pain and my herniated disc I applied the secrets and my back is 90% better. It is not 100% better but it is so much more bearable and easy to deal with that I am thrilled about it. This is how I applied the secrets.

  1. I worked assiduously with many Doctors, nurse practicioners, physical therapists, researched a lot on my own, worked as a physical therapist for a while until I found the correct diagnosis.  It was an L4/5 herniated disc causing numbness down the lateral left leg. (An MRI is 30% inaccurate for herniated discs according to studies by Boden)
  2. Lumbar extension on a roman chair for strengthening the multifidus and erector spinae muscles. Overload of the back muscles against gravity helps to build muscle. This process  creates micro tears in the muscle and it changes its composition. The micro tears  signal satellite cells to fuse to muscle cells. These satellite cells can also divide themselves. The overall effect is for the muscle fibers to increase in size. It is like building a protective shield over the injured area.
  3. Same as above
  4. For my herniated disc I literally stopped sitting during the day in class, at Church, at work (at work I used a stand up desk), in the car I leaned my seat back about to 135 degrees as safely as I could (BBC article showed research that with leaning back 135 degrees it reduced the lumbar disc pressure). The reason I stopped sitting up straight in a chair puts excess pressure on the discs according to the research.
  5. I did not have spondylolysthesis so I was ok to do this exercise

Chronic Pain Rehab concepts/back pain