I have had back pain and associated sciatica for over nine years and have seen specialists that include chiropractors; orthopedic, osteopathic, and naturopathic specialists; physical and massage therapists; acupuncturists; pain management doctors and neurosurgeons with their therapies and advice sometimes conflicting. Before resorting to surgery, I made a decision to do everything possible to treat the problem.
NOTE: Before reading this article, please understand that I have no medical background, but want to share what I have learned along the way to hopefully help others who are experiencing similar issues.
MRI and X-rays confirm that I have a spondylolysis with spondylolisthesis, which is a stress fracture in the spinal column vertebrae that weakens the bone so much that it is unable to maintain its proper position sometimes causing vertebra to shift out of place. If too much slippage occurs, the bones may begin to press on nerves. Doctors are unsure if there was a specific spinal injury that occurred or if I was born with a weakness or deficiency (more likely). The internet provides a wide array of information on this condition, including a few Facebook groups for those with Spondylolisthesis and others who have had spinal fusions. It is common to find those in the severe stages of “Spondy” to be on narcotic pain medications and on disability because the pain is so great that they can no longer work. Some of those people have had spinal fusions with little or no improvement. What I have a difficult time finding though is how athletes deal with spinal disorders and if they can successfully rehabilitate themselves without having surgery. Could I strengthen and stabilize my core enough to prevent further spinal damage? How can I at least manage the pain?
When I began physical therapy the first time, I stopped a lot of my physical activities—canoe paddling, weight lifting, bicycling. I thought maybe those were causing more pain or even damage. I sat and laid down more and began experiencing more pain when I walked or stood. In turn, I spent more time in a sitting position and could no longer stand or walk without feeling pain within five minutes. I simply thought I was getting worse. I also began to notice that my spine was becoming more unstable; every time I rotated my upper body for something as simple as looking behind me as I was backing out of a parking space, I could hear and feel my vertebrae shifting. I began to seriously consider the recommendation of two neurosurgeons’: a spinal fusion surgery called Transforaminal Lumbar Interbody Fusion or “TLIF”. TLF would hopefully stabilize my spine and stop my excruciating back pain and sciatica that was constantly shooting down my left side all the way to my ankle.
Over the course of six years, I have had reconstructive ACL knee surgery and surgical repair of the rotator cuff in my left shoulder, both with excellent results but spinal surgery is something I just can not bring myself to do yet…without a fight.
How I Helped Myself
Only recently have I noticed an improvement in my condition. I can’t say for sure if it is one thing or a combination of things that I am doing, but I am happy to say that I finally see a ray of hopeful sunshine!
Key things that helped me:
- SEE A DOCTOR. See an orthopedic doctor if your back pain has gone longer than a month. If the pain persists, see a neurosurgeon. Having X-rays AND an MRI will confirm a spinal condition.
- PRACTICE PATIENCE. Two specialists told me that my type of condition would take longer than 6 months to rehabilitate. Now I believe it! I have to do my exercises every day, twice a day…forever. The exercises that seem to make the most difference are Side Bridge (Beginner version if your back is highly unstable), the “Bug” (lying flat on your back, bring your right hand to your left knee and then alternate with your left hand to right knee), side-lying ankle circles forward and back, and bicycling (either a road bike set up on a fluid trainer (rather than a gym-type exercise bike) or riding on the road worked better than a gym-type stationary bike). Two of the most important things for me: avoid is sitting too long and to go for at least one long walk every day. If I had to choose one exercise, cycling on my trainer seems to help me the most.
- MOVE LIKE A LOG. When I get out of bed, when I paddle a standup paddleboard, when I move a box or unload the dishwasher, I move my whole body without rotating or bending at my waist. Instead of bending down, I go down on one knee.
- SHAKE THEM HIPS. I recently found a chiropractor who only adjusts my sacroiliac (SI) joint (located at the bottom of your back on both sides of your spine). He said that I had protected my hips and back for so long, that my SI joint was locked up. The adjustments make a world of difference, as well as walking while shaking or swaying my hips as I walk, almost in a hula fashion. You have to keep those joints lubricated.
- WEAR A CORSET. I ignored my therapist for a long time with this one. I refused to wear a bulky, ugly corset…until my pain started to affect me 24 hours a day. When I started wearing the corset, my pain and the sciatica decreased substantially. Sometimes it took up to 30 minutes or more, but it would eventually go away. I have stabilized my spine enough now that I only wear it when I go for a walk or if I have overdone it that day.
- ICE for inflammation and after work-outs (I ice my back up to 3X a day) and an anti-inflammatory medication when I can’t take the pain. I take Naproxen, which I am grateful that it works every time.
- EAT RIGHT. No processed stuff; limit your sugar (remember that fruit contains sugar). I eat oatmeal and boiled eggs for breakfast; beef, lamb, turkey, fish, and lots of green vegetables for lunch and dinner supplemented with krill oil, CoQ10, coral Calcium, protein, joint support, and “green” powders. I consider everything that I put on and in my body, making sure that everything will benefit or repair the damage done to my body. Even down to my moisturizers and sunscreen, everything is beneficial in some way. No matter how much exercise you do, if you’re putting bad stuff in your body, your body simply cannot repair itself.
- KNOW YOUR LIMITS. If you know you are going to be in pain if you paddle or bicycle for 2 hours, cut it down to 1 ½ hours (or whatever it takes), and commit to stopping. Don’t be a hero…Know when to say when.
- LISTEN TO YOUR BODY. Learn what triggers the pain. Keep a “pain journal” to try to figure out what is causing your pain and what helps relieve your pain.
- NO BACK EXTENSIONS, TWISTING, OR EXTREME FLEXION!!! This one surprised me. When I first started my quest, several specialists told me to do lots of stretching and back extension exercises like “Superman” poses. This is a horrible thing to do for those with spinal disorders. I’m already highly flexible with an unstable spine. I could severely damage myself by doing any type of back extension, flexion exercises or twisting at the waist. Focus instead on “neutral spine” exercises.
- SUP! I began standup paddleboarding (SUP) over three years ago, but only in the last two years switched from outrigger canoe paddling and have been SUPing at least twice a week. I have only recently noticed a huge difference in my back and can honestly say that I am pain-free at least 60% of my day whereas I used to be in pain 24 hours a day. I notice that I do not feel any pain while I am standup paddling. For a while, the pain occurred AFTER SUPing, so I would ice my lower back and take an anti-inflammatory medication. I now typically feel mild or no pain after SUPing, but continue to ice my back. I must add though that I paddle in an upright position. Many of the racers lean over at a 90 degree angle, which sent my physical therapist through the roof when I first told her that I was SUPing. For those with degenerative spine conditions, I recommend paddling in an upright position in the “move like a log” fashion that I described in #2.
- READ. The best book I have read on preventing and rehabilitating troubled backs is “Low Back Disorders” by Stuart McGill. He has another excellent book titled “Ultimate Back Fitness and Performance” with designed exercise programs for injured people all the way up to elite athletes.
Degenerative back pain is an everyday battle, but I am grateful that I have found ways to cope with the pain to at least delay the need for surgery. Do you have a success story for coping with pain or injuries?