I haven’t found a funny meme about the physical therapy costs that come with back pain. It’s probably because it’s not funny to lose money in a fight that you feel you can’t possibly win but are forced to continue fighting.
Lower back pain is a common reason people visit the doctor. It’s also a major reason why they miss work. Yet, treatment options can be disappointing. Even after years of endless appointments, exercises and no days off, my back still hurt. People told me that back pain comes with age, but I just couldn’t give up. There had to be a way for me to feel better again, right?
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Since I turned 30, I’ve been experiencing the usual back problems of someone who spends a lot of time hunching at a desk. The real problem started just before the pandemic when I injured my back while dancing. I’m a terrible ballroom dancer and this added to my embarrassment. After my first bout of stabbing lower back pain, I struggled to stand straight for the next few days. I knew that back pain usually resolves itself within four to six week so I decided to wait it out. I self-administered the recommended salves and stayed active.
My back began to heal over the next few weeks, as the pandemic spread. Then came the delta wave lockdown, which left us housebound for a solid five months. The lockdown was necessary to stop the virus but my back pain returned due to the fear of the pandemic, and the inactivity. My back seemed to be saying all the selfish things that my rational mind was afraid to say: “Yes, yes, I am one of the privileged few in this situation, and yes, it’s making me miserable, and I’m losing the plot.”
I didn’t realize that my back pain was causing this misery at the time. Tawny Kross DPT, physical therapist with Kross Centered Care, North Carolina, says that when pain becomes chronic, looking at muscles and joint may not be enough to solve the problem.
“The cumulative effects of emotional and psychological pressures, not just physical demands, can show over time,” says Kross. He cites things like work issues, relationship problems, trauma, depressions, bad sleeps, bad weather, a cough. Stress can manifest in the body when it builds up. Dr. Kross says that pain, fatigue or panic attacks can be a sign to reduce the stress on your nervous system.
My back pain did, however, not end with the long lockdown. I was willing to spend money on the problem and made an appointment with an osteopathic physician. He had a friendly, open demeanor. I liked him immediately. He told me that I had a slightly shorter leg than the other and a slightly misshaped spine. Apparently, the imbalance had built up over time. This was what caused my current problems. He also told me that I was probably hypermobile, which can cause aches and discomforts to come and go. He gave me an exercise routine that I could do in the morning and at night. “Do it even after you’ve drunk,” he told me, making me feel understood.
The brilliant, expensive osteopath did not take insurance. After seeing him, my back felt great. But after a while, I started feeling resentful. Am I supposed to spend so much money just to be functional?
I felt almost stupid when I went to another doctor. (One that I didn’t need to pay an entire paycheck to see). This feeling was justified when she told me that back pain happens to everyone as we age. She asked me if I had pins and numbness in my legs. (I didn’t.) “Do you have bowel regulation?” Sexual dysfunction? (All good.). In a tone that was a bit too cheery for me, she said it was “one of those” things and told me to go to Pilates.
Lauren Lobert Frison DPT of APEX Physical Therapy, Michigan, explained that discs in the back do shrink and thin, which can cause irritation and pain. This is especially true if your muscles are weak. “But just because your back has degenerative changes or arthritis, doesn’t mean that you will have pain,” she says. “Aging is normal. What’s not normal is if it becomes debilitating.”
“Aging is normal. What’s not normal is if it becomes debilitating.” –Lauren Lobert Frison, DPT
Dr. Lobert Frison suggests finding a doctor who won’t make you hopeless. “Using words that make people feel that their body is fragile and that there are things they can’t do […] promotes disability mindset. The research shows that this only makes things worse.
This is because the body may become overly sensitive to pain after an injury. Your body may sound the alarm if you injure yourself while bending down to the floor. This is even if the injury has healed. Dr. Lobert Frison says that this doesn’t mean that you don’t feel pain, but rather the pain is lying to you. The good news is that by moving slowly and carefully you can teach a body that’s afraid to move to feel safe again.
I was on my way out when I got a referral for physical therapy. I figured it wouldn’t hurt to look around. This guy was not like my charming osteopath. He had the energy of a CrossFit trainer mixed with a school nurse. After testing my reflexes using a small hammer he spent the following 20 minutes forcing me to do exercises straight from gym glass. I still have stress nightmares about gym class, which is why I was having this dream in real life.
The exercises were effective, but I began to feel that my back was living a life of it’s own. The pain would come and then go in a manner that seemed unrelated to the things I was doing.
I became increasingly frustrated by my inability to find my way in the dark. I felt petulant until one morning I woke up without having done any of my exercises. The day turned into a whole week, then two and three. I felt increasingly angry at my body because it wasn’t functioning properly. Stopping would be a break from pain, if not failure.
Dr. Kross says, “If you want to make your body do something and it doesn’t behave the way you would like, you can see it as betraying you.” She explains how overachievers might feel the need “to push through” while their bodies are screaming for them to slow down. Dr. Kross warns against blaming the body: “It is less that it betrays you and more that it is trying to love you.”
It’s more likely that the body is trying to love you. Tawny Cross, DPT
Unsurprisingly, I was in a worse condition than ever as a result of feeling at war with my spine. Desperate, a friend recommended I see another physical therapist. She spent an hour examining both my hips and back, asking me to bend, balance and move my toes. She determined that my L5 vertebrae was the likely culprit. She used her hands and elbows to dig into my hips. Then she gave me a small ball and showed how to massage myself. I told her I was frustrated, and she understood that I wanted to feel in control. I left her office with a simple directive: “Move yourself.” Any movement.”
Agency! Self-reliance! What a concept. For the first time since years, I didn’t need to do any exercises. This freed me up to think about what it was I wanted. I’ve always been a fan of yoga, but I was told that it would not give me the strength I need. But it was what I wanted to!
So I did. It felt great. The weeks that followed brought me a wonderful surprise: my back started to improve.
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My original back injury occurred over three years ago. It should be healed. My body may be holding on to the pain because of fear or stress. Or it could be a slip disc.
Dr. Lobert Frison warns against MRIs when it comes to non-specific lower-back pain: “There are many people with terrible MRIs who don’t even have back pain.” She says that there are also many people with MRIs which look good but have terrible back pain. The cause and effect of this is not always clear. New research shows that the treatment path is not always obvious, either. It’s good to know that no matter what your MRI shows, you are not doomed to a lifetime of pain.
I do yoga every day now because my body loves it. I use a therapy ball to work my muscles and sometimes I do the exercise the osteopath prescribed. I use a backpack rather than a handbag and I do not work in bed. I walk to places. I began swimming outside last summer and continued to do so through the winter. The cold water soothes my back, as well as everything else. The quality of life is much better. I still carry Ibuprofen, but I use it less.
It’s not perfect, but now that we are on the same team, it’s a different story. I listen to my back instead of thinking it’s trying to kill me. It will tell me to rest sometimes, and it will tell me to move other times. Instead of sighing, I ask, “What kind movement would feel good now?” and then I do it.
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