I’m sitting here with a writhing lump of chronic ache at the base of my spine. It’s a cruel beast that occasionally stabs out with daggers of pain, and it’s capricious in that there are no rules specifying when it will lash out. I’m lying in bed, unmoving: knife up the right side! I’m walking carefully, everything moving smoothly: lance that kidney! I reach out to flush the toilet: oh, don’t do that, here comes the spiked mace. I’m having a tough time finding any motivation to do anything.
There is good news: I’ve got a doctor’s appointment in an hour! Modern medicine will fix me right up, won’t they? Of course modern medicine has to first figure out what’s wrong, and modern medicine hasn’t done the greatest job of that the last few weeks.
In other good news, the first wave of textbooks expelled from my shelves has reached various recipients. If you haven’t got it yet, it’s coming. Meanwhile, there’s a third giveaway waiting for volunteers to accept the burden of knowledge.
Well, modern medicine can’t fix up idiopathic low back pain right away, alas.Typically there is no benefit from imaging — most people have lesions that are not associated with pain and if you do have pain, surgery usually doesn’t help. (There are specific exceptions, but unless there are clear indications, guidelines do not call for imaging.) Long term opioid use, obviously, is dangerous and doesn’t work. Long term NSAID use also has substantial risks. You should do your best to go about your business as normally as you can, do not stay in bed. Physical therapy can be helpful and is the first resort in most cases.It usually resolves in due course. But there is no magic bullet unless something specific is going on.
Best I can do for you. Don’t catastrophize.
steve oberski says
In retrospect that transition from quadruped to biped wasn’t the best idea.
@2 Quadruped, biped: it’s all rubbish. Should’ve stayed in the ocean and avoided the whole leg-thing.
Ray Ceeya says
God that sucks PZ.
@1 Agreed on all accounts. Your Physical Therapist is your best friend in these situations.
Ray Ceeya says
@2, It wasn’t a bad idea, it was just poorly executed. Like most of the things ID folk try to use to prove ID. LOL. If God existed, he did a really half assed job. Maybe he was hungover when humans came along.
One thing to keep in mind if/when you contemplate surgery. About 1/3 of the time it gets better, about 1/3 of the time it stays the same, and about 1/3 of the time it gets worse. That has scared me away from thinking about surgery much more.
Currently, physical therapy with an emphasis on stretching is the route I am on. I’m not as diligent as I ought to be, so cannot really say if it is effective.
One of the ironies (?) of back pain is that walking is recommended for reducing pain. I walk couple of miles a day but I sometimes have a lot of pain when I walk. I have even been unable to walk due to sciatica numbing my leg and sharp pains in my knee.
Low back pain, sciatica, knee issues, etc are absolute proof that the “intelligent design” idea is wrong headed. If there was any design involved in the human body, it was stupid design. Or perhaps cruel design.
And following on what ahcuah says at #6, I have no expertise in the matter but based on my experience working as a “nurses aid” in an orthopedic ward many decades ago, there was no guarantee that surgery would stop the pain…even multiple surgeries.
Marcus Ranum says
Remember: if you are a believer, that is what god wanted you to have; nothing repairable or made of titanium – no he wanted you to suffer with that nightmare of mediocre design. Thanks asshole.
Reginald Selkirk says
You might be better off if you had rectal cancer.
Small Rectal Cancer Study Has Remission in Every Patient
Reginald Selkirk says
Whinging about your back again, and meanwhile there are people in the world who are really suffering.
KFC Australia forced to swap lettuce for cabbage
Isilzha Mir says
I can commiserate, PZ. I have lower back pain from sacroiliitis caused by psoriatic arthritis. I’ve been lucky, I guess, that my rheumatologist got me on an every-other-week shot (Humira) that lessens the inflammation and pain to where it’s manageable most of the time. It’s an immune suppressant, though, so that’s been terrifying during the pandemic.
I hope your doctor can recommend treatment that will help you function at the level you want.
When you mentioned this before, I was feeling a bit smug since I hadn’t had a flare up of my back pain for decades. So naturally about a half week later it decided to give my smugness a reminder for several days. Youch. That was bad enough; I do feel for you.
I suffered from chronic neck and back pain for years. I was so desperate, I tried everything. Yes… even acupuncture… because when it’s that bad, you just give in to irrationality.
Two things practically “curedd” me. One was John Sarno’s book, titled “The Mind Body Prescription.” It sounds very woo-ish and for all I know, it is, but it led me further into the modern research of how contemplating how in pain you are literally makes your nerves more sensitive. It’s a devilish feedback loop, that the more you pay attention and monitor your pain, the worse it can get.
Second… And I’ll probably catch shit for this… but I did lots of weight lifting, with a focus on the deadlift and the squat. As a friend pointed out to me: Would you rather have a weak fucked up back or a strong fucked up back? I chose the latter. Honestly, within about 6-8 weeks of this, everything pretty much went away. Starting Strength is an excellent book depicting the movement patterns, etc., and how to perform them.
I knock on wood am completely pain free and have been for a long time. Again, I expect to be flamed for my comments, but those who haven’t experienced chronic pain, just can’t understand how desperate it makes you. You will literally try anything. And the above worked for me. N = 1, I guess.
Pierce R. Butler says
So – just how would a putative Intelligent Designer produce the central support structure for a biological upright vertebrate?
steve oberski says
@14 First of all, don’t start with a biological non-upright vertebrate.
I understand chronic pain, and the desperation that comes with it.
Unfortunately, I listened to an orthopedic surgeon when he said that lumbar fusion would stop the painful constant contractions in my calf muscles. The fusions didn’t work, because he put the wrong size pins in my back.
After a revision surgery done by a scoliosis expert, who used child-sized pins, my back is better, but will always be weak.
The leg muscle problems never changed. Turns out that it is a neurological problem, most likely stemming from my autoimmune disease, Sjogren’s.
My neurologist most recently tried a botox injection directly into the muscle.
Next, My wonderful Physical Therapist will tackle strengthening it while it’s not as tight. If it works on the right side, we’ll try the left side next.
We are doomed.
George Monbiot has identified serious vulnerabilities in the global food chain.
There’s nothing wrong with the vertebral column, with the legs and pelvis it makes a perfectly serviceable suspension bridge.
Rotating it 90 degrees onto its end? Now that will void the warranty.
I feel for you, low back pain is so debilitating! When the smallest wrong movement sends stabbing pains and makes you gasp, it is impossible to think of anything but stopping the pain.
Stretching out the muscles that are currently in a huge knot of pain is what the physical therapist should do, so the vertebrae stop impinging on the nerves and creating inflammation, which starts the spasms. It’s a vicious circle of pain.
Bending backwards over a curved support to stretch out the sacroiliac was painful, but I heard and felt my hip ‘click’ back into the proper alignment after the second repetition of the stretch. I was still sore, but the stabbing pains and muscle spasms stopped immediately, after ten days of being flat on my back.
Keeping yourself well hydrated is very important, as muscles and nerves can’t function well without adequate levels of electrolytes and water.
The various CBD salve products that are now available are very good at treating muscular spasms, without any narcotic effects. Just remember not to rub your eyes or nose ( or any mucous membranes) with the hand that applied the salve. Ouch!!!
@gsctroop #13 . That why I recommended PZ do yoga a while back . He probably thought I was recommending woo. I’ll be 70 next year and I’m doing basic ballet stuff with no problems other than occasional soreness.
Well, isn’t that how to improve the backbone? The more painfull, the less procreation! Evolution for the win! /s
Flying, self-propelled, either flapping or gliding using one’s own wings… Is what the mildly deranged penguin suggests. Also useful for practicing poo-bombing all those stupid land-based vertebrates (and walruses). Novice fliers may desire her trebuchet-assisted takeoffs, available for a modest fee, cheese not included. (Pro tip: Be sure to agree on a relatively safe / soft landing zone prior to launch.)