At the end of my rope with back pain - how do you deal?

[RedHorses]

Back in January my back gave out on me and I was on limited activity and drugs for weeks. By early March I was feeling almost normal, then the pandemic hit, I put in extra time at work and my back quit. I couldn’t stand, sit or walk for more than 10-15min before having to switch to one of the other activities.

I started treatment at the end of March. I am comfortable with the diagnosis and treatment plan, I am aware that it’s something that takes times, and that it’s neither linear nor predictable. My six month assessment in October showed a 60% improvement in the physical markers (and there’s no guarantee of getting to 100%). Apart from the relapses I’ve had some good periods of feeling great and capable of anything.

I’ve been relapsing (for lack of a better word) just before the end of every third month and I am finding it harder to deal with the pain each time. I had a couple of weeks before Christmas where the pain wasn’t acute but felt like I was carrying around an extra hundred pounds on one point in my back. The latest relapse of my back giving out came this week and I’m really struggling with it. I know the additional stress of the season, lack of riding, and lack of regular treatment last week and this week must be part of it - that knowledge isn’t really helping at the moment.

I’m afraid of moving the wrong way. Afraid of that vice of pain that goes from two to ten in a split second. Afraid that it’s not going to get better. Afraid that it’s going to be more than I can deal with.

Back in the spring I could not abandon my team to the pressure of the pandemic and the lockdown. Today is the second day this week I took a sick day. I broke two weeks ago and told myself I just had to make it to Christmas. I made it to Christmas. I’m still broken and I have to go back to work on Sunday.

How do you deal with the pain? Physical and mental?

[2DogsFarm]

I don’t know your diagnosis, but have 2 friends with chronic back pain.

I from an old injury that has morphed into stenosis. She has had 3 surgeries to implant rods in neck & lumbar spine. Last was to correct rods that had loosened.
She is older - 78 - and carries extra weight, both of which affect her comfort.
She takes a daily cocktail of pain meds - tramadol being one, Norco another.
Every 6mos or so she gets an epidural injection of ??? - that gives her relief for the interval.

Other friend is younger - 50 - and back pain is related to chemo. She also takes Prolia, which can affect bones adversely.
A couple years ago she had an implant supposed to control pain (TENS?).
She is not satisfied with the result, but has not had it removed.

Sorry, neither one gets definitive info from doctors that I could specify.

[OverandOnward]

Surgery.

It is one of the best lifetime decisions I’ve ever made. I got my life back.

I had a long-time pain management strategy. Letting go of that was one of the best things ever.

[Sherry99]

I’m so sorry you’re dealing with this. I have congenital spinal stenosis and lets just say many years ago I managed to herniate a couple disks shoveling my car out of the snow. I was 19 and my super shitty doctor wouldn’t order an MRI to get a real diagnosis, because I was “too young for it to be something serious”. After a year a half in excruciating pain I started falling down. Then I got my MRI and diagnosis. I had surgery pretty much right away, my doctor though based on my films I shouldn’t even have been able to stand. I had a laminectomy on 4 of my lumbar vertebrae and while it hasn’t been smooth sailing since, it’s been WAY better. I had an issue a couple of years ago that I think was ultimately related. I was diagnosed with multifidus dysfunction. After a good PT I’m holding together fairly well. I could be better but I’m lazy about my PT at home and have some upper body things that are throwing it a little out of whack, but I’m not really in pain and I’m not scared to move so… I know I’m an idiot. I totally know the, if I move a millimeter the wrong way I’m going to be frozen in pain. Do you have a TENS unit? An external one? You can get them from any pharmacy or amazon for a reasonable amount and for me they work great! Talk to your doctors/PT/ or quite frankly, some of the best I’ve found have been personal trainers who have either a medical background or specialize in rehab. You may be able to find some exercises to help you make it in between treatments. For me right now, it’s stretching my hamstrings (mostly the right one) and my psoas and laying on a foam roller. Not rolling with the roller, but just laying with the roller under my spine. I haven’t been to the chiropractor since February and I totally feel it. If you want to share your diagnosis with me I can see if I can come up with things that I’ve tried. But in a weird turn, riding was the one thing that didn’t hurt me so mentally that helped. I used to wear my TENS device to the office under my clothes.

[RedHorses]

I have had many days where the only pain free moments I had were when I was riding. Right from the beginning riding at the walk really helped to loosen my back and I would go and do “therapy rides” of 15-20min. Any longer and the pain would return. I was free enough to do 25 mile Endurance ride on the Labour Day weekend. For years I’ve gotten back aches if I’m not riding enough. The past nine months have been really interesting in how the treatment has affected my riding. Like which leg was the more or less stable one, my proprioception in regards to where I was on the horse, and a (fortunately) very short lived, significant lean to the right. I rode Tuesday morning and it didn’t help and actually hurt at times.

Fortunately I do not need surgery - there’s nothing for a surgeon to do (please gods keep it that way).

I have had some pain almost every day for the last eleven months, but most of those were quite manageable low levels after April. It’s the relapses that I’m having increasing difficulty dealing with both physically and mentally.

I do think that strength and flexibility training would be helpful and had planned to join a gym, but I’m not doing that during a pandemic. I have signed up for a 12 week online rider strength/fitness/flexibility course that starts in January. When not holding off the pain with sheer determination I am confident that this relapse will have passed by then and I will be capable of doing it.

I’m tired. Tired of carrying the pain around so no one sees it. Tired of checking the clock to see if it’s been long enough since the last pill that I can take another. Tired of bracing myself to do something as simple as get in the car. Tired of asking people to do things for me because I know if I do it I’ll risk another relapse.
Tired enough to cry in private moments. I’m broken.

How do you deal with that?

[Sherry99]

In my case, mostly stubbornness. I REFUSE to let my body dictate my life. I also have an autoimmune disease and same thing. I refuse to not do the things I want just because my body has other ideas. I will take meds, I will ice/heat/stretch/work out/whatever I have to so that I can keep going. A good scream cry in the fetal position about how crappy the universe is and that it owes you big time for this when you’re home alone occasionally helps too. And keeping in the front of your mind that it will get better, because it has to. Because there’s no other choice. Like I said, I’m stubborn. I’m not sure what your “treatments” are, but if they are with a PT or chiro or something like that I’d ask for stuff to do at home to help in between. Ask a lot of questions of them, make sure you understand how to the exercises or stretches correctly, and quite frankly do some of your own research. I diagnosed my multifidus dysfunction before anyone else. It made a world of difference in my treatment. It’s something that came out of some newer research. And if you are getting tight, I recommend if at all possible getting a TENS unit. They are as cheap as $20 on Amazon and I swear, for me, MAGIC. If I’m having a bad day with my back, I’ll slap that thing on and just let it run. It gives me enough relief that I can see the light at the end of the tunnel. A bonus if it works well for you is that its non-chemical so you can use with the drugs or by itself. I used mine a lot about a year ago when I was having sciatica, it was pretty much only when I was driving so drugs weren’t an option.

Pilates with a really good instructor who will make sure that you are doing everything correctly was also really helpful for me. I was at a studio for a few years and some of the instructors were crap! Others were good. Pre-covid I started back up with privates with a friend of mine who’s romana pilates certified and pilates for dressage certified. She’s back to teaching in the studio a little, but she also does online if you’re interested PM me if you want contact info. I have no idea if she has room for new students, but she knows other people, in other parts of the country from her trainings so might be able to recommend someone if you want.

Oh and just because getting to 100% isn’t a guarantee doesn’t mean it won’t happen. My back surgeon told me I’d be good for 10 years, to be fair most of his patients are in their 80’s and 90’s, I was 21. He also looked very nervous when I asked for a note to get back on horse 4 weeks post op. I’m currently 18 years post op! While it hasn’t been all smooth sailing, it sure hasn’t stopped my life! And it never will

[jherold]

It might be time to try something different. Yoga, acupuncture, massage, there are alternatives to western medicine when western medicine fails to produce the desired results. I’ve been fired from western pt twice. But with regular massage, chiropractic and other modalities. I am now serviceably sound. Good luck

[Willesdon]

Age? Employment? Diagnosis and preferred treatment?

A recent documentary I watched had tremendous success with placebos (properly designed double blind etc). What was weird is that when the participants were told they were taking a placebo the good effect continued. Many were in chronic pain and on strong analgesia.

That is leading up to a suggestion that you try something alternative like a good massage, a McTimony chiropractor or up your daily exercise and do it outside where the psychological and physical benefits are being increasingly recognised in research outcomes. From what you say, I suspect you have a stressful and demanding job: that will make any pain worse.

[RedHorses]

Thanks, @Sherry99. I’ve been running on sheer stubbornness for most of the last year. Is TENS the electrical stimulation of muscles through a couple of strategically placed pads? I’ll have to check that out since several people suggested it.

@Willesdon you’re right about the job stress not helping. I write my own schedule and write it around my treatment schedule so I’m not going straight to work afterwards. Christmas (which means December) dials things up to eleven at work. It is physically demanding as well - I’m not spending much time sitting down, and I’m really bad at taking breaks. I’m all over my team to make sure they’re taking their breaks and lunch when they should, but I don’t practice what I preach. Maybe that should be my 2021 goal. 2020’s goal was leaving work on time. I wasn’t doing too badly before the first pandemic lockdown.

The weather this year has curtailed my outdoor activities. It’s icy, frozen, lumpy ground right now. That reduced activity is definitely having an effect. My area is in another lockdown right now so I don’t have indoor options either.

I’m doing better today (had some horse time this morning even though I couldn’t ride on that footing). My ice packs are my best friends right now.

[Willesdon]

If you can recognise a pattern, problems mounting towards the three month mark, is there anything you can do before it gets bad - such as a relaxing massage, days off work to rest?

I also agree that your New Year Resolution should be to apply good management - lunch, rest breaks - to yourself as well as your team. You know you can do it!

[frugalannie]

RedHorses and other posters, I’m sad to learn if your pain and I admire your tenacity and coping skills.

Hereditary back issues in my family have shown a range of treatments and pain levels. It all seems very much hit or miss: what works for one doesn’t for another. But the psychological pressure of constant pain is crushing. I, too, am most comfortable when riding, but there are days when I can’t face getting to that point, if that makes sense. But I get to set my own schedule and build in physically/ mentally quiet time when I need to.

I’m not clear if your job requires you to sit, stand or walk around. If sitting, will a large exercise ball or that special chair that mimics riding help? (I think there’s a posting about it in this forum. Ballimo chair maybe? There’s a version made in Canada as I recall ). For me, standing is most difficult so I avoid it, and move around as much as I can. If you have to walk and that’s painful are there any orthotics that could help?

And don’t be afraid of seeking out psychological support. With the right person you may be able to identify additional techniques that can help you cope with aspects of the pain. You’re clearly tough and disciplined. You may be able to find new pathways in your brain to help you cope even better. Best of luck.

[Sherry99]

@RedHorses yes the TENS unit is the electrical pads thing. If you have it at the PT or a doctors office, they’ll have 4 sticky pads and they’ll try to surround the area they are targeting. The cheap ones like the one I use only have 2 sticky pads but it takes enough of the edge off that I’m good. I also usually take it with me when I’m traveling. I’ve used it on planes, not because I’m in pain on the plane, but I probably would be afterwards if I didn’t. Preventative care is super helpful. I also had some really good muscle relaxers that I would take the first night after I’d been on a plane. It would keep everything from getting so upset that I was locked into one sitting position for so long, but I’ve been good enough that I haven’t needed then in a while. If you get a TENS unit from Amazon or something, just check to make sure you can get new sticky pads that have the right connection for your unit. There are a few different kinds. I have the Omron Max Power Relief unit which has snaps and I got extra pads (that were much sticker) from discount TENS on Amazon.

Can you set a timer on your phone or watch or something? Something that goes off at the top of an hour or something so you know you’re supposed to go sit down for 5 minutes? I have the same but it’s for me to get up.

@frugalannie I got my old boss to buy me a bambauch saddle seat stool. It’s great! It’s shaped like a dressage saddle, as opposed to some of the ones I’ve seen in stores that are more like a jumping saddle. It’s great! Now that I’m at home I bought a ball chair, however since I’m at my coffee table I had to buy the children’s size so that it was the right height! I miss my adjustable sit to stand at my office.

[RedHorses]

That’s a good idea about trying to do some extra care before three months. In September my back gave out on the second morning of my vacation week and I had to cancel a planned camping trip with my horse. I’m going to think about what I can do in March.

I prefer to call it a goal rather than a resolution. Resolutions suggest a cold turkey doing this, while a goal is something to work towards. If I can take one break three out of five days it’s a start instead of a failed resolution. Something to build on towards the goal of taking well timed breaks twice a day, and taking lunch close to the middle of my shift. It’s about the mental game.

[RedHorses]

@Sherry99

Can you set a timer on your phone or watch or something? Something that goes off at the top of an hour or something so you know you’re supposed to go sit down for 5 minutes? I have the same but it’s for me to get up.

Good idea. I’ve been doing something like that for the last two days, using the end of the episode as my cue to get up and move around for a while (binge watching The Rookie). My watch can be set to beep on the hour. I usually turn it off because it annoys me, but if it has a purpose it shouldn’t bother me.

Thanks for the TENS info. I’m definitely going to look into that. It could be something to help head off or reduce the severity of the three month relapse. When you fly are you using it for X minutes at Y intervals, or just when you start to feel stiff, or? I’m wondering if I could wear it at work and turn it on for a few minutes here and there.

@frugalannie I totally understand the not being able to face getting to the point of riding. I’ve had days like that too. Thanks for sharing your family experience with pain management. I get advice from friends on magic bullets all the time and it’s hard when I get nothing from it.

I have to stand, sit and walk in my job. Last spring I couldn’t do any of those for more than 10-15 minutes at a time and the pain was a reminder to do something different that I couldn’t ignore. Sitting is maybe 4-6 hours of my (officially) 40 hour week so I don’t have my own work station. Sitting is usually a relief unless I’ve got to do everything at once.

BTW - if you let Moderator_1 know you still have the 1 on your username they can merge that account with frugalannie and the next time you log in the 1 will be gone (unless the 1 is intentional).

[frugalannie]

Thanks RedHorses. That 1 has been driving me nuts!

[Sherry99]

@RedHorses

Thanks for the TENS info. I’m definitely going to look into that. It could be something to help head off or reduce the severity of the three month relapse. When you fly are you using it for X minutes at Y intervals, or just when you start to feel stiff, or? I’m wondering if I could wear it at work and turn it on for a few minutes here and there.

They should all have a timer to turn themselves off. Mine is a max of 10 or 15 minutes, I can’t remember exactly right now, but you can change it for shorter. To me it feels like a nice massage so I turn it on as I start my movie on the flight (I stick the pads on in the bathroom after going though security and then just keep the wires tucked into my pocket, since they’re white I think most people think they’re headphones). Then I just keep restarting it intermittently. I prefer to use it prior to getting stiff, that way I never really have to experience the “unpleasantness”.

I’ve also used it the way you’re describing at work. Turn it on, let it run it’s cycle, then intermittently repeat throughout the day. Its a real lifesaver for me. Make sure to try changing around the placement of the pads to get different spots. You’ll find some places are more helpful than others.

I don’t use it when riding but only because there is always the possibility of getting launched and I don’t want to land on it. In addition, there’s a lot of dust in the air so it gets on the sticky pads.

[cayuse]

I use a Quell unit which is similar to a TENS. You wear in around your upper calf and it helps with pain everywhere. SalonPas lidocaine patches help when in gets bad and taking Magnesium helps with the associate muscle tension that just makes the pain worse.

[Sherry99]

@cayuse interesting, I just looked that up since I’d heard about units like that one a few years ago, but they weren’t approved by the FDA I think it was something about micro-current whole boy TENS like devices. I just looked up Quell and unfortunately they just settled a $4mil lawsuit with the FTC.

" Under a settlement with the Federal Trade Commission, the marketers of an electrical nerve stimulation device called Quell have agreed to pay at least $4 million and stop making deceptive claims that the device treats pain throughout the body when placed below the knee and is clinically proven and cleared by the Food and Drug Administration (FDA) to do so."

That being said, I’ve heard those types of units are approved in Europe. They just don’t have the FDA approval. Whatever helps right?!

[sheltoneb]

I did physical therapy for about 5 months, a couple of times a week. It was helpful and still use what I learned today. Insurance covered most of the cost. I believe I only paid $25 per visit.

Physical therapy showed me what stretches would help and provided conditioning excercises.

I have also started soaking in the bathtub with epsom salt a couple of times a week when my back is acting up. The moist heat really helps to loosen tight muscles. I soak for 15 to 20 minutes.

I don’t have any bone issues so I am not sure if anything I said is helpful if you have anything like that.

[Kyrabee]

Try the lidocaine patches if you haven’t. I use the Salopas lidocaine patches (when I need to). Costco has them cheap. It won’t make the pain disappear but can allow you to get through the work day with a decreased pain level.

At this point, it might not hurt (sorry ) to get a second opinion. If surgery is not necessary, maybe a physiatrist. I have had back pain on and off since I was in college. You just have to keep trying different things. There is something out there that should give you relief. I have had two herniated discs. The first one I was able to heal with PT and massage although it took awhile. The second one, I had a microdiscectomy which so far (almost 3 years) has worked well. I still have to be careful
…40lbs is about my lifting limit and I try not to do a lot of that if I can help it. It is just a life long management issue. I hope you can find an answer.

Susan