The first slip

When I was in grade twelve, our school’s concert band participated in yet another band competition. Our conductor liked to compete, so we performed as often as he could manage.

I don’t remember if we performed well or badly, but I remember that our band teacher wasn’t pleased. And when he wasn’t happy, things didn’t go well for us. There would be yelling, and insults, and abuse. And we would take it because children are desperate to please the adults in their lives, and when we did well, he was charming and effusive. The pattern works.

He liked to use intimidating body language to get his message across, so we knew he was angry before the last note finished echoing. The audience sees the conductor’s back, but the band sees his face, and his could be a fearsome thing when he was displeased. He stormed off, and we raced after him for insults and criticisms.

I was wearing white pumps with kitten heels to match the long, white polyester dresses the girls wore – the boys wore black shoes to go with their black pants. I loved those shoes – they had a hot pink satin lining.

But, kitten heels and long dresses aren’t made for running. I slipped, and to save myself from falling, I tightened the muscles in my spine. It was an instinctive and unfortunate choice – the muscles went into spasm, and suddenly, everything was painful, walking included. My arrival at the beratement point was late.

I shuffled up, shedding tears. On the bright side, the discovery of my injury meant the band teacher’s tantrum had to be delayed. I needed medical treatment, so yelling at children would have to wait.

That first back injury was also my first ambulance ride. I didn’t enjoy it. Besides the fact that one is in an ambulance because of injury, illness, or hurt, riding prone and strapped down isn’t something that my need for control embraces.

Torn muscles, stretched ligaments, and angry tendons, oh my. At least I’m not unique. Back pain and the associated problems are increasingly common, a reward for the sedentary lifestyle so many of us live. Our bodies were built to do life a little differently.

On the bright side, once you’ve hurt your back once, it’s much easier to do it again.

Spines

A thrown-out back is the gift that keeps giving. It’s never as good as it was before. The back’s not stronger for the muscular break. It’s more prone to give way instead. You have to be more attentive to the area post-injury: you have to work on your flexibility and strength regularly, so your ‘bad back’ doesn’t flare up and leave you miserable.

Back problems are a mood killer. The pain feels like it’s everywhere and nowhere at the same time. Doing anything is a challenge. We promise our back everything when it’s being grumpy. Too bad we don’t treat it better when it’s silent.

We should. Our spine is important. We need it healthy and functioning well in order to have a good life. Or even a life.

Our spine gives us our shape and our structure. You need something to attach limbs to. It protects our spinal cord, that rather important bundle of fibres that lets the brain talk to the rest of the body. Our spine gives us mobility – we’re able to move, bend, and flex because of it. Without a spine, you’re less person, and more puddle.

We don’t call people ‘spineless’ as a compliment.

The spine is a column of bones (vertebrae) and cartilage discs divided into five sections that encompass the body from the base of the skull to the tailbone. The spinal discs between each vertebra act as cushions; they mitigate structural wear and work as shock absorbers as we move about our business. Gravity takes a toll.

Muscles attach to the spine to motorize movement, and ligaments and tendons keep things positioned correctly as we engage. But it’s a balancing act, no pun intended – a problem in one area of the spine creates issues throughout the system. And getting back to baseline is hard work. It’s like with a car – maintenance is usually easier than repair.

Subsequent sciatica

Sciatica, or ‘lumbar radiculopathy,’ is how medical practitioners describe the “severe pain that radiates from the back into the hip and outer side of the leg caused by compression of the sciatic nerve.” It’s not a good time. The muscles I damaged decades ago now still go into spasms if I’ve been lackadaisical or incautious, upsetting the system and causing pain.

Sciatica is more than muscle pain in the hip and leg area. It also refers to nerve issues. On top of the pain, people suffer from pins and needles, pain, loss of sensation, loss of muscle control, neuralgia, and problems with going to the bathroom. It’s pretty much the opposite of a good time.

One’s ability to live well is impaired when struggling with back issues. They feel so global. Everything sucks when the back hurts. Sitting is hard. Standing is hard. Lying down (sleeping) is hard. The exercising and stretching you must do to move things forward in the direction of recovery – aka physical therapy – is painful. It’s easy to see why abusing medications gets tempting – we don’t make our best choices when we’re desperate, and chronic pain leads to desperation.

The herniated disc

The discs that rest between each vertebra can be injured. When they’re torn or leaking, the condition is referred to as a herniated disc. It’s another condition that can lead to considerable back pain. Cartilage is happiest when it’s not getting ripped.

Herniated discs are most common in the lower spine. The greater the area of pressure, wear, and tear, the greater the risk of injury. Other things that increase the risk of spinal injury are carrying repetitively excessive weights, being overweight, repetitive motion strain, and spending too much time seated. Being male also seems to make one more prone to back injury.

A herniated disc can’t be self-diagnosed. It also can’t be diagnosed by Dr. Google, though you can see if the symptoms match the symptoms you’re having. If they do, then it’s doctor visits and further testing, usually of the imaging kind – CT or MRI to diagnose, others to rule out other possible causes.

In addition to the type of treatments referenced above – meds and physical therapy – injections and surgery may also become indicated depending on how severe the symptoms get. You should definitely see a doctor if you develop unremitting pins and needles, or develop problems with bathroom function.

Chronic conditions

I like pain medication. Entry-level pain meds like Advil and Tylenol. I like the quick fix for the headache. Some things, however, need more. Some problems can’t be fixed with a pill or a weekend of rest. To keep my back problem-free requires certain things of me. It requires maintenance.

Chronic means constant. It means ongoing. I think it also means resentment, though perhaps that’s a ‘me’ thing. But you ignore chronic to your detriment. There are things I have to do to maintain a happy spine, to keep that whole hip-and-spine situation happy and functional.

I can’t spend a lot of time in high heels. I can’t run or jog. I have to spend time stretching out my spinal and leg tendons every day. I have to keep my core strong. If all these things hold true, my back tends to hold strong. If I slack for protracted periods as I have done recently, then I will be forced into painful remedial work to get myself back to a tolerable baseline. Until then, it’s pain, pins, and needles.

All things being equal, keeping up with yoga would’ve been easier and more pleasant. Chronic doesn’t worry about its sufferer’s battle fatigue. Chronic marches on regardless. A better choice is to avoid chronic back situations entirely. Take the included bits of advice and also, one more –

Lift with your legs, not with your back.

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