Advice to people who suffer long-term back pain

This is for active people, it may not be good advice for sedentary people.

I’ve had disc-related back pain on and off for the last 10 years. During that time there have been month-long periods when I couldn’t walk more than 100 metres without needing to sit down in order to stop the breath-taking nerve pain. I’ve had long periods of bad sciatica down to the foot in both legs (thankfully not at the same time). There have been many flare ups after doing something that was too much for my back. I’m currently experiencing a flare-up which has been going on for four months so far. It took me a long time to fully understand that my pain is a mechanical issue, with some mind-trickery thrown in as well.

My advice is stay as active as possible. That might sounds obvious but when I say active I mean really active, to the point that it’s border-line whether you’re going to do it more damage. I’m currently bolting dry-tooling routes across roofs inside some slate mines. This involves the sort of hard labour that would trouble many people with healthy backs. I start the day hurting and finish the day feeling amazing. The most important thing is to build up your all-over body strength so that when flare-ups do hit, as they inevitably will, they knock you down to a level which is still respectable for a normal standard of living.

As any self-help snake-oil salesman will tell you, it’s important to listen to your body and ease off at times. But this can be counter-intuitive – I’ve had many days when I felt I probably shouldn’t be doing what I’ve been doing but afterwards I’ve felt amazing. That may sound trite but I think these are the times when you make progress from inability to ability. Keep the gain made by knocking back some heavy dosage of ibuprofen to avoid sliding back again through muscles over-tightening or nerve fibres becoming too irritated from activity.

A surgeon once drew me a sketch which showed the body’s decline into ill health that we’re all destined for eventually. He illustrated how his surgical procedure would put a little halt on the path of the slide by drawing a little right angle like a step. Everyone’s bodies will have different inherent rates of decline (I figure). You can put yourself in a position where you can slow, but never halt, that rate. That’s what I mean by building up as much all over strength and being as active as pain allows.

Learn and practice good posture, read books on body mechanics and imagery, and do core strengthening/stamina workouts every day for the rest of your life. You probably know that. If you decide pain-killers are needed, go large dosage and combine with caffeine for increased punch. Otherwise do without. I generally use pain-killers after hard physical work to give the irritated nerves around the disc a little breathing space and hopefully not slide back into pain. Lastly, don’t hang on one person’s opinion, especially physio’s/chiro’s/whateverio’s.

Understand it’s a mechanical fault, it’s not all in your head. But also notice how emotions do affect pain levels. If you’re grumpy the pain is often worse. Beware of the potential for a downward spiral – the pain can make you grumpy, the emotion can enhance the pain level.

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