Wednesday, June 18, 2014

Back Pain: The Follow Up

I couldn't work out. At the time, I was working in a fitness center, unable to exercise. I compared this to being a recovering alcoholic, tending bar. Physically painful. Mentally challenging. Emotionally, close to impossible. There were several times the pain was so severe and the frustration so extensive that I broke down in tears--at home, and in public. I did feel a sense of ease when I read online that this was normal. Being able to identify with others brought upon the slightest bit of "comfort"--a word I wasn't very familiar with back then. Tying my shoes required a chair, at least 3 or 4 minutes, and infinite patience. I had learned that many people with severe back pain (in my case, a herniation at L5/S1) are prescribed anti-depressants because not only is the physical pain excruciating, but not being able to do what you enjoy and having to rearrange your life takes an emotional toll as well.

In my original post about back pain, I spoke of the experience leading up to my surgery. This follow-up entry takes a different stand point, covering the experience itself along with the two year recovery. I have known people with similar problems who have reached out to me for suggestions and input and I have the desire to help more people. My back went out in October 2010 as a result of too much activity, not enough rest and stretching. Prior to that, I had the occasional flare up which can be common among many people. However, when I wasn't able to stand up one Sunday afternoon, I knew something more serious had happened. My surgery took place in February 2012. It is my intention to provide insight, resources, and a connection with others (so important!) who are having a similar experience. This is based strictly on my personal story and I highly recommend consulting a doctor for more information.

When to See a Doctor
Any time you have persistent, physical pain that is keeping you from completing your daily activities--see a doctor. The longer you wait to be evaluated, the more likely you are to worsen the injury which may lead to permanent damage. Pain is a red flag! It signals that something is wrong and while it may not interfere too much at the time, you are likely compensating in other areas of your body. Your gait will change as you walk. Your posture will change, even the way you sleep and sit will change. Over time, this can also lead to muscle imbalances.

What Does a Herniated Disc Feel Like?
Some people who have MRIs will feel perfectly fine, yet their scans will show herniated disc. Others who are in pain will have scans that indicate a perfectly healthy spine. It is important to keep in mind that each person's problem and perception of the problem will vary. With a herniated disc, there tends to be nerve compression. I had a severely compressed sciatic nerve which resulted in an excruciatingly painful sensation down the back/side of my entire right leg (the herniation was on my right side of the spine). It felt like a string was tied from my hip to my ankle with a 50lb weight at the bottom. Other times, there was a burning sensation. Sometimes my leg tingled, like there were fire ants crawling along it. The outer side of my right foot went slightly numb--and it still is. One of the doctors said that is the last area I will (if ever) feel improvement because the sciatic nerve heals very slowly and the foot is the last place you will notice improvement.

Conservative Approaches

I recall the exact moment I contemplated getting on the ground for the exercises I was supposed to do, unsure of whether or not I'd be able to get back up. It hurt to lie down, it hurt even more to stand up. There are several methods of conservative treatments that include steroid injections, medication, physical therapy, massage, and chiropractic treatment. Acupuncture is also very common--one that I did not try, as I had all of the others mentioned. There are also a lot of natural remedies to keep the body healthy including eating a variety of fruits, vegetables, and spices...along with incorporating collagen supplements, which I began doing in the spring of 2013.

Surgery Considerations
People will tell you stories about how surgery saved their lives. Others will tell you how surgery ruined their lives. Take their stories with a grain of salt. As Bruce Lee said, "Absorb what is useful, discard what is not, add what is uniquely your own." It was about 1 year and 4 months after the initial pain that I was with my primary care doctor for a routine visit. Explaining to her that yes, I still had pain and, yes I was (a rock star for) dealing with it...she asked why I wasn't doing anything about it. Although I had tried nearly all possible conservative treatments, I had come to terms with the fact that "this is just how it is." And while the pain was as noticeable as an untied shoelace, I ignored it. However there comes a time when you have to ask yourself how much the problem is affecting your daily life. Are you unable to complete usual tasks and have you cut out activities you used to enjoy? Based on my symptoms and the MRI scan, I had two surgeons say I did not need surgery. Two other surgeons said they would operate. A short while later, I realized that the two surgeons who did not want to operate were both neuro surgeons. The other two, and one which I had my procedure with, were both orthopedic surgeons. In February 2012 I had a microdiscectomy and laminectomy at L5/S1.

As I laid in the hospital bed, I insisted that my mom take a photo of me with the current issue of Oxygen Magazine, my favorite source of fitness ideas and inspiration. I wanted to "save" the photo in case the day ever came that my story was published. I actually established this blog when I returned home to recover! Last November, during my first NPC Bikini Competition, I had the pleasure of meeting the cover model, Alicia Harris. She even tied my bikini top for me. It doesn't take a miracle to make things happen, it takes persistence and commitment. I hope to be an example of the possibility you can uncover when you stay focused and patient, despite the pain you are experiencing. Physical or otherwise.

Prevention and Recovery
Following surgery, I anticipated leaving my mom's house and spending the next couple of weeks, off from work, at my apartment. However, when I realized I couldn't put my shoes on or even bend over to pick up the toilet seat, I came to terms with the fact that I wasn't in a hurry to leave. The area of the incision was very painful in the days that followed. It took about five days before I was able to bend over enough to put my shoes on. From what I recall, I went back to work for half shifts after two weeks off. Over time, the flare ups have become less severe and less frequent. Upon completing physical therapy, I was very eager to get back in the gym. However, I knew it would take a great deal of time before I was able to do what I used to do (if ever). Considering it was all of the high impact, repetitive movements that brought my life to a hault, I was evaluating a new approach. One of the first things I did after therapy was attend a class at Barre Bee Fit. The small movements and high repetition methods of the barre methodology were exactly what I needed to strengthen my core and learn how to be gentle with my body while still feeling challenged. I appreciated the mind/muscle connection that the class emphasized and wanted to learn more about it. That summer I completed the instructor training and I currently teach 2 classes a week. For the most part, I am able to do everything I used to with the exception of running. My body doesn't like it. The right leg is still weaker than the left because of atrophy which resulted from nerve compression. If I do run, it's for 30-40 minutes max and only to get outdoors and enjoy the weather. I have spent a great deal of time researching various ways to reduce the pain, prevent pain and have come up with the following list of considerations.

-Heal with food. When your body is under stress, it becomes inflamed. Consider your current habits and see how they compare with the chart below.

-Be gentle with yourself. When it comes to exercise, "more" is not always a good thing. I typically do HIIT circuits twice a week, maximum. The quick movements, big range of motion resulting from burpees and mountain climbers should not be done in excess. Formats such as barre, yoga, and Pilates are a great compliment to those routines along with strength training. Remember, your muscles grow and you become stronger when you rest.

-Supplement with collagen. The changes I have made to my diet and exercise routine this past year have increased my strength. I have mentioned how much better I feel and how my back pain has decreased. No doubt, exercise is a significant part of this because of I have more muscle to carry my "load," which is also 15lbs lighter. However, it recently occurred to me that along with the benefits collagen provides for hair, skin and nails--which is why I began taking it last spring--it is also known for it's ability to support bone and joint health. In this article, we learn that collagen is the most abundant protein in the body that comprises the foundation of all connective tissue, bones, skin, and most other tissues. The NeoCell brand can be purchased here. 

-Evaluate. How old is your mattress? Are your shoes providing the support you need? Is your work station set up poorly, causing you to twist and turn to answer the phone? Do you spend too much time sitting down? All of these factors, including how your office chair is set up, can contribute to pain.

-Listen to your body. Years ago, my playlist and inner critique drowned out the voice of my common sense. I ignored the red flags of physical pain. It took this experience to realize the importance of moderation. This lesson in patience has given me the knowledge to educate others and give peace of mind that improvement IS possible. Because when tying your shoes without any pain is an accomplishment, it's one to be celebrated and shared. Find something in your own life that you can celebrate. Focus on the positive. Focus on the progress.

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  1. Just hang in there. I think you're doing great by acknowledging those straints and the temporary set of limits they bring you, and that you are coming to terms with it. Healing is a gradual process, and not only that is a constant one, it entails a sense of will to keep on, press on and complement the therapeutic treatments to ensure invigoration of your overall health. Thanks for sharing that update! All the best to you!

    Jacqueline Hodges @ Dr. Koziol

    1. Thank you Jacqueline, I appreciate the kind words and thoughtfulness. :)

  2. Excellent topic and very helpful for me.due toi working long time ,Recently feeling severe back pain and already get suggestions from a friend who is back pain physiotherapist and he told me to do Yoga or physical exercise regularly and to meet with a remedial massage specialist.Some time taking pain killer though ,I know it is not a solution.I will definitely follow your instructions and hopefully it will work .Thanks

    1. Thanks for sharing your story and I'm glad this was helpful. Wishing you a continued recovery!!

  3. That’s true; when one feels pain, it’s best to visit a doctor immediately. Pain is an indication that something is wrong in one’s body. So the faster you seek medical help, the faster they can determine the root of the problem, and apply the necessary treatment for it. Anyway, thanks for the advice! I hope you recovered soon after your surgery.

    Madalyn Oconnell @ SHC-Denver

    1. So true! Thanks for the comment Madayln. I certainly wish I hadn't waited so long to treat the problem (beyond the chiro care and massages). With the extend of the pain, it definitely was a red flag that the injury was severe. Glad you were able to get something out of this article, I hope. :)

  4. I can only imagine the pain you’ve been through. But it’s very nice to know that you’ve stayed positive throughout this encounter. Anyway, thank you for sharing your story and all that information. I hope it can help a lot of people who are in the same situation as you are. But of course, consulting with a professional would be the best recourse.

    Agnes Lawson @ Pain Relief Experts