Why do I talk about back pain?
Who am I? I am an Orthopaedic Surgeon near to retirement and I treated a lot of people with back pain throughout my career. But it is not only this that makes me able to talk about back pain. For the last twenty five years I suffer from low back pain. I went through the symptoms that all low back pain sufferers went or go through and I came out winner. I spent my entire life battling it. I have been swallowed by the dark canyon but I fought and came back to light climbing out of it at the opposite side.
I already mentioned briefly what makes me to be an authority on the field. I am one of the people who suffered from chronic low back pain and rarely still having the occasional symptoms, so I know exactly how people feel when they are hit by this. I lived all my working life suffering from this. On top of that due to my professional position I treated for 43 years many who presented to me with back pain symptomatology so I am able to explain and make matters clearer to all.
I am here to offer my service to all, share my experiences and walk with all of you, step by step, the path that can lead all to “freedom”. Freedom of the severe debilitating pain which demoralises all and drops us to the abyss.
But is Freedom the complete elimination of your symptoms from your life? The answer is NO.
According to Pythagoras, the Greek philosopher, “The person who is able to Control self is Free”.
In other words Freedom is the control of the symptoms; it is not the complete elimination. Finding ways of controlling and reducing the frequency and the time of suffering is a win and this is what all can call Freedom.
The story
For me all started one day in the operating theatre. I had to operate an acromegalic (giant in other words) patient. He was taller and longer than the operating table and his weight was more that 150 kilos(kg)-(330 pounds). After he was anaesthetised we had to reposition and turn him to one side, in preparation for the operation.
A team of six people we gathered around the operating table, the anaesthetist on the top to control his head and neck, four people in one side to do the initial lifting and myself on the other side to help the lift, pull, finalise the positioning and finally stabilise him with the supports, in the way it was necessary for him to be. Unfortunately during the final moment of countdown one of the opposite to me team changed position resulting to the whole disorganisation of all of them who only sporadically lifted and I was left alone to pull almost on my own 150kg. My spine “cracked” and felt pain running through the length of it. It took me sometime to straight my body. I was given painkillers by one of the nurses and took about half an hour to be able to come back to the upright position. I had to go ahead perform the surgery, as there was no other surgeon available to help and after I finished the operation I threw myself face down on one of the theatre trolleys. More painkillers were given to me and when I felt better I drove home. That night I could not sleep turning and tossing as I was trying to find a comfortable position. When I informed the Hospital in the morning about my pain and stiff back, I was told that a clinic already was booked for me and they were unable to cancel it as there was nobody available to replace me, so I was called back on duty. This acute pain forced me to move in a tilted position. I went to my doctor who sent me for plain X-rays and gave me painkillers. The results of the radiological investigations came as “there is no congenital deformity or fracture” something that I already knew. Following this, my doctor said that possibly all this was muscular and he only providing me with painkillers and never sent me to physiotherapy or allowed me to stay out of duty.
The pain carried on for months and I was walking in pain and with a twisted back. My doctor was saying to me that I am an Orthopaedic Surgeon so I know how to treat back pains, so I had to ask myself about any treatment. On the subject there was a caveat; I could not self-refer to have any other treatment or investigation due to regulations and only he could offer such service by requesting or suggesting these alternatives.
About 4 or 5 months after that initial episode, another “accident” made things “better”. I was dictating a letter to my secretary after a long day’s work. My back pain was not permitting me to sit on my chair, so instead I placed my one knee on the seat and held the back of the chair to stabilise and rest from standing all day long. The chair was a rotating office seat and as I was talking suddenly lost balance and I twisted my back trying to avoid a fall. A sharp pain went through my spine and this acute pain I had for months was gone. I was so happy but over time I found out that it was replaced by a dull discomfort that became a constant presence since. It was getting worse every morning. I had a stiff back, moving like a robot and with a lot of limitations, unable to bend freely in any direction. The pain had the ups and downs in frequency and intensity throughout the day, but it was present at all times. This resulted to periodically use of painkillers, helping me to cope with the symptoms. Physiotherapists in unofficial discussions, as I had not been referred to them, were not interested now on me and, as I had not presenting any red flags and there was no appetite for any investigations, they thought that no treatment was necessary. My doctor was looking at me as nuisances so I stopped asking help from him.
I chose to do the minimum movement and that resulted to a slow but steady increase of my weight. My mood was wavy following my pain’s frequency wave pattern, matching exactly the waves of the pain’s intensity. When my pain was increasing my mood was decreasing and the opposite. Family life was affected because of my behaviour. Nobody was happy anymore. Everybody was under stress. I was constantly worried and questioning myself if this will be my life from that time onwards and I believe the rest of the family had the same thoughts, but they were not voicing them. I was getting deeper and deeper into depression, driving everybody around me to the same dark place. In addition my general health started to be influenced by the whole condition. I was not able to climb stairs anymore, I had lost stamina, I was getting breathless and my blood pressure went through the roof. I was worrying about me but in the same time I had to look after my patients, adding extra stress on me.
One day my doctor called me and said to me that I may be close to a pre-diabetic status and he only wanted to “feed” me more pills, of all kind, to control my “issues” and this treatment had to be for life. That was the wakeup call. Something kicked in my brain. I was not prepared to keep taking medications for life. When I refused his offer he looked at me and gave me an ultimatum of six months to pull myself out of my misery. I had to change within this given time my body and my attitude. I was in the depth of a dark valley and I had to come out of it. I had to be “resurrected” by becoming free from all these troubles that had crossed my path and threw me into the abyss.
That was it. I started my own research and I studied numerous of papers and books. As nobody was prepared to help me I had to help myself on my own. I went back to be reminded about metabolism at the physiology textbook, endocrinology and finally chronic pain management. Following all this with a lot trial and error I successfully done it.
Initially I started to move. The initial short walks became longer and slowly I could walk miles on miles. I joined the gym, lost weight. Blood pressure and blood sugar went back to normal levels and as the body became stronger my dull back pain was visiting me on rare occasions. My mood swings stopped, I became happier and my family started to smile again. Saying all that I stress to all of you, that I know what chronic back pain is. I went through it and conquered it.
Having this life experience and being able to understand the situation having the professional and scientific knowledge, I am able to serve others to overcome the same problems by sharing the information and support, something that nobody provided to me when I needed it. I am ready to talk about the steps and strategies that helped me to go through this burden.
I look forward to this challenge; I am ready to serve my senior retired folks who are suffering from chronic mechanical back pain to understand their back pain and achieve an improvement of the quality of their life. I want you to be active again, to be able to play with your grandkids and mainly be able to take care of yourselves and do what back pain stopped you doing.
This is my purpose; to help you move forward, to help you to come out of the misery, back pain is forcing you to live. To help you to control your symptoms and as mentioned by controlling them you will become free.
To do this you need to learn about back pain. Education on this subject is necessary and I am here and prepared to help you understand back pain.
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- Back Pain Management During Intimate Moments: Nurturing Connection While Prioritising Comfort and Respect.
Intimate moments are an essential aspect of human relationships, contributing to emotional bonding, stress relief, and overall well-being. However, for individuals suffering from chronic back pain, these moments can become sources of anxiety and discomfort rather than pleasure and connection. This essay explores strategies for managing back pain during intimate activities, emphasising the importance of communication, adaptation, respect and holistic approaches to maintain a fulfilling intimate life.
Communication and Emotional Connection:
Open, honest communication between partners is crucial when dealing with back pain during intimacy. A study found that chronic low back pain significantly impacted sexual function and satisfaction in 81% of patients. Discussing concerns, limitations, and preferences can help alleviate anxiety and foster understanding. This emotional connection can itself be a form of intimacy, potentially reducing the perception of pain through the release of oxytocin, often called the “love hormone”.
Adapting Positions and Techniques:
Experimenting with different positions can help minimize back strain. Sidhu and Haldeman (2017) suggest that positions maintaining the natural curvature of the spine may be more comfortable for individuals with back pain. For example:
1. Side-lying positions can reduce pressure on the lower back.
2. Standing positions may be suitable for those with disc-related pain.
3. Seated positions can provide support and control for individuals with extension-related pain.
It’s important to note that what works best can vary depending on the specific type and location of back pain. Consulting with a physical therapist or sexologist specializing in chronic pain can provide personalized recommendations.
Preparation and Pain Management:
Preparing the body before intimate activities can help minimize pain. Gentle stretching or a warm shower can help relax muscles and increase flexibility. Additionally, timing pain medication to coincide with planned intimate moments may help manage discomfort, though this should be discussed with a healthcare provider to ensure safe and appropriate use.
Use of Supportive Aids:
Pillows, wedges, and other supportive devices can help maintain comfortable positions and reduce strain on the back. A study by Rosenbaum (2007) found that the use of positioning aids can significantly improve comfort and satisfaction during intimate activities for individuals with chronic pain.
Expanding the Definition of Intimacy:
It’s crucial to recognise that intimacy encompasses more than just physical acts. Couples may need to redefine their understanding of intimacy to include activities that are less physically demanding but equally connecting, such as massage, sensual touch, or simply spending quality time together.
Mindfulness and Relaxation Techniques:
Incorporating mindfulness and relaxation techniques can help manage pain and enhance the intimate experience. A study by Brotto et al. (2016) found that mindfulness-based interventions improved sexual function and reduced pain in women with chronic pelvic pain. Similar techniques may be beneficial for individuals with back pain.
Seeking Professional Help:
For persistent issues, seeking help from healthcare professionals is advisable. This may include:
1. Physical therapists who can provide exercises to strengthen core muscles and improve flexibility.
2. Sex therapists or counsellors who can help couples navigate the emotional aspects of intimacy with chronic pain.
3. Pain management specialists who can offer additional treatment options or medications.
Maintaining Overall Health:
General health practices can indirectly benefit intimate life. Regular exercise, within the limits of what’s comfortable, can improve strength and flexibility. Proper sleep hygiene and stress management techniques can also contribute to better pain management and overall well-being.
Conclusion:
Managing back pain during intimate moments requires a multifaceted approach that addresses both physical and emotional aspects. By fostering open communication, adapting techniques, and seeking appropriate support, individuals with back pain can maintain a fulfilling intimate life. It’s important to remember that intimacy is a broad concept, and couples can find numerous ways to connect and express affection that accommodate physical limitations while nurturing their relationship.
