Problem: low back pain, sciatica, due to sitting too much; MRI indicates grade 1, L5-S1, retrolisthesis, 3mm disc bulge
Solution: Physical therapy with core strengthening and stretching (hip openers and hamstring stretches). One year later I can sit again with mild discomfort and also stiffness when waking. Also, tried one epidural but it only helped temporarily.
About Me: Male, 35, 145lb, 5'8, active
My back pain began one year ago. I had my day job and at night, I worked on my startup. So I was sitting a lot. I used to brush it off, swim it out or go to yoga, but the next day, I would return to my usual habit of working many hours at a time, sitting down in front of the computer, with minor awareness for posture and ergonomics. I never thought I would have a serious back incident. At the time I was doing a lot of crossfit and yoga!
One day, as I was working, the pain became unbearable. My visit to the doctor was uneventful. She suggested advil and to come back a week later. But I couldn't bear the pain. So I looked up a chiropractic and remember not being sure if I could sit in my car long enough to drive there. Standing up and sitting down, in and out of my car, were very painful. The chiropractor did not help. He stretched my neck out. That was about it. So I went to a different chiropractor.
This one was better: he pummeled my piriformis, giving some temporary relief. I did that for about a week, driving each time, for a half hour of pummeling and being stretched. My chiropractic suggested X-rays, which weren't revealing, except minor scoliosis. So later, about a month later, we finally did an MRI, which showed the bulge clearly. I wish I had done it sooner. Meanwhile, I was awkwardly lying down at work since standing for long made the inflammation greater and sitting was unbearable. I only managed to drive to work because I lived 5 minutes away. Its amazing how not being able to sit is somewhat socially unacceptable, at meetings and your own workplace!
At this point I think I was taking advil, 3 times a day, maybe 200mg or more at a time, after food, which is important because I learnt that otherwise it does not get absorbed properly. I was also building pillow structures at home, trying to find the best position to lie down. I learnt that different back conditions call for different lying positions. For me, lying on my back was out of the question. Lying on my stomach, with a pillow under my hip to force a pelvic tilt, was nice, but my neck was typically twisted and uncomfortable. I didn't want to cause neck problems, either. Also, I was sinking in my new Tempurpedic bed. So I had to sleep on the floor. Putting my legs 90 degrees on a chair to sleep was difficult since I am a side sleeper. So I slept sideways, on the floor, which was too hard. A pillow between my legs was not enough, though recommended. I needed to get a thick enough pillow, more like a sofa pillow, and long enough too. But that was also not enough. I found that I had to put a pillow somewhere beneath the top of my hip. That helped my alignment, forming a T with my legs and my hips (imagine the top of the letter T being a straight line between your left and right hip), and also giving me some cushion from the carpeted floor. I was also icing my back, maybe 15 min every few hours, which helped with the pain. I worked on my back with my laptop on my stomach, and legs on a chair or 90 degrees to a wall, with one foot on my knee, creating a hip opener.
It was around this time, after the MRI, that I started physical therapy. If I knew what I know now, I would have gone immediately, as I found that all my physical therapists know more than the other institutions of medicine that I visited. Indeed it is confusing when you first research about back pain and how to deal with it. There are so many recommendations from acupuncturists to chiropractors, massages to physical therapy, epidurals to surgery. I did not want to do surgery until all avenues were explored. I found all helped, somewhat, temporarily, except physical therapy.
After one month of physical therapy, I was told that maybe getting an epidural now was a good idea. The epidural was a direct way of reducing the inflammation significantly, and giving my nerve some space, hence a chance to heal. So I did that and it felt better for sure, for about a week or so. So I had to continue with physical therapy.
With physical therapy, in the ensuing 6 months, I learnt: how to maintain a pelvic tilt thus positioning my back in a way that reduced pain; how to strengthen my core, thus strengthening my muscles and distributing the load away from my back muscles; how to use a big ball to sit on, to exercise on, to stretch on (which I found better and more controllable than table inversion), and much more. The stretches that helped were very specific, that is, some stretches helped much more than others. So it is important to find what works for you.
I learnt that my bulge caused less space for a nerve to pass through. This nerve, being squeezed, flared up muscles around it. And those muscles were used to being clenched so my brain had to stop telling them to clench in protection of that nerve, in order to reduce inflammation. Or something like that, I am no doctor. The challenge when I began serious physical therapy was that exercise caused more inflammation initially, but I had to work through that, learning to tilt my pelvis when working out and maintain my core to protect and open the space. Moving created some inflammation, but it was essential to move around and create space. It allows for better circulation to those muscles as well.
When I was getting better, only after a few months, I reduced my advil intake. I also started stretching more. The more I stretched, the better I got. Still, I had pain when I sat and burning due to the inflammation when I stood or exercised a lot. For example, it burned when I did dishes. So doing the pelvic tilt helped me a lot in reducing that sensation. In time, as I got better, the burn become less intense. Now it is only occasional and minor. This took 6-12 months to improve.
Cardio was difficult. The first few months, I wanted to swim. But I didn't know how to deal with the inflammation. I thought swimming was making me worse. Now I am not so sure. I think there was more variability in my movement and some inflammation but I overreacted and stopped swimming. I didn't do cardio for two months after that. And then I started jogging which was difficult since I have a bad knee if I run too much. Jogging, slowly, was great. I could do it multiple times a day and the movement felt great, until two months later, when my knee finally had enough and I had to lay off. So I started biking at the gym. That worked out well and I am still doing that today.
I bought an inflatable pillow from Relax the Back, which was the best support from all the back pillows I tried, since it was a good shape, light, and transportable - which I meant I would use it more. And since it was inflatable I was able to adjust the resistance as needed.
Emotionally, it was a hard battle. I lost 20 pounds, a healthy lifestyle, and a good nights sleep, for many months, which messes with your mood. I lost the ability to escape, since my escapes were quite active. But I gained perspective, how short life is, how quickly we age, and how frail our bodies really are. So I quit my job, and focused on my startup, and I am thankful for the intensity which I was able to pursue it. It is almost all I did during those many months. My physical therapist also tells me that now I will have better knowledge of my body that will serve me well as I get older. I have no choice but to maintain a strong core.
On a side note, I never had massages until I had back pain. But I never had a great massage until I had a Thai massage. On vacation in Thailand - yes, I survived the long flight! - I got multiple Thai massages a day. They stood on my hamstring and my piriformis, which was wonderful, and massaged my legs much more thoroughly, than any other type of massage I ever had.
Forward to this day, I still have soreness and stiffness when I wake up from sleeping. So walking it out in the morning is important. I kneel when I work, over a big ball. I stand. I sit occasionally too. I move positions a lot throughout the day. I believe I can live with this pain. I believe I am still slowly healing. So I think I have avoided surgery, thankfully. I hope my story helps others suffering from back pain. It is a long journey to recovery.