TALES FROM THE WA­TER COOLER: GET­TING THROUGH BACK PAIN

TALES FROM THE WA­TER COOLER

Guru Magazine - - CONTENTS - MATT LINS­DELL FIT­NESS GURU

To look at him, you’d con­sider Fit­ness Guru and per­sonal trainer Matt Lins­dell to be the pin­na­cle of health, with a physique peo­ple would pay good money for. Yet a hid­den pain ham­pers his joie de vivre. He shares his hurt in the hope that we can avoid such pain our­selves.

Chronic pain can be a ter­ri­ble, dis­tress­ing af­flic­tion. Is there ever a time when you need to es­chew ev­i­dence­based treat­ments in favour of al­ter­na­tive re­lief, or rely on the adage that time is a great healer? Fit­ness Guru Matt Lins­dell re­flects on his own ag­o­nis­ing lessons.

In 2008 I de­vel­oped tremen­dous back pain. The pain trav­elled down my left leg and re­stricted my nor­mal daily ac­tiv­i­ties. Af­ter sev­eral months, it had be­gun to di­min­ish when, one day, I was out run­ning and it ap­peared again. In fact, the pain came on so strongly it felt as if I had been shot with an ar­row. My girl­friend forced me to take a bath with eu­ca­lyp­tus-scented Epsom salts. For the record, there is no sci­en­tific ev­i­dence that Epsom salts do any­thing other than make the bath wa­ter salty. And now I hate the smell of eu­ca­lyp­tus. De­spite my girl­friend’s loving ef­forts, the pain per­sisted and so I fi­nally went to a walk-in clinic. The at­tend­ing doc­tor re­ferred me to an or­thopaedic sur­geon – set­ting the wheels of the Cana­dian health­care sys­tem in mo­tion. Full of jokes, the sur­geon ex­am­ined me thor­oughly. He ex­plained that one of the in­ter-ver­te­bral discs low down in my back had bulged and cracked, and now its juicy cen­tre (known as the ‘nu­cleus’) was com­press­ing the nerve root in my spine – hence the pain down my leg. Not re­ally a laugh­ing mat­ter. I was des­tined for the Van­cou­ver Spine Clinic. How­ever, be­fore the sur­gi­cal con­sul­ta­tion fin­ished, the jovial sur­geon low­ered his voice and his face took on a very se­ri­ous ex­pres­sion: “Matthew, if your symp­toms be­come worse – if you have any loss of con­trol of your blad­der – then you must go to the emer­gency room im­me­di­ately. It is pos­si­ble that the nerve in your back could be­come ir­repara­bly dam­aged. If that hap­pens you will never have con­trol of your bow­els again and you will never have an erec­tion again.” Things got real for me right then. It be­came clear that this in­jury, al­though com­mon, was more than a mere in­con­ve­nience – for me or my girl­friend.

Pain? Wait un­til the sur­geons get hold of you

Sev­eral con­sul­ta­tions and a CT scan later, I was of­fered both surgery and a ‘nerve root block’ – a steroid in­jec­tion into the nerve that is caus­ing the pain. Nei­ther was a prospect I fan­cied: you don’t re­ally want to mess around with sharp ob­jects when the spinal cord is in­volved. I opted for the less risky nerve root block first. To make sure the nee­dle goes into the right spot, the docs use X-ray imag­ing. Which is com­fort­ing to know. It hurt. Only for a few sec­onds – but dur­ing those sec­onds it felt like a fire hose was un­der the skin of my back leg. And the hose was turned on full blast. I en­dured it, but my symp­toms per­sisted.

Back to nor­mal: the long road

Months later I went for the surgery – a pro­ce­dure called a dis­cec­tomy (ba­si­cally cut­ting out a bit of the bro­ken ver­te­bral disc). My re­cov­ery af­ter the op­er­a­tion was slow and I still ex­pe­ri­enced some pain down the back of my left leg – al­though thank­fully less than pre­vi­ously. 18 months had passed from the time of my first symp­toms to the day of the op­er­a­tion – and I learnt that when a nerve is ag­gra­vated con­tin­u­ously for this long it be­comes hy­per–sen­si­tive. So even though the pres­sure on the spinal nerve had been re­lieved, it con­tin­ued to send pain signals. In my case I had low-level on­go­ing pain. I was lucky. For some peo­ple the pain is con­tin­u­ous and ex­treme. My sis­ter’s ex-boyfriend was one of the un­lucky ones. Trag­i­cally, he com­mit­ted sui­cide be­cause he couldn’t bear the agony. What I want to stress is that some in­juries to nerves, if dealt with in a rapid man­ner, can have much bet­ter out­comes. Through my ex­pe­ri­ence as a per­sonal trainer, I know peo­ple who have had the same in­jury as me, with the same sur­gi­cal in­ter­ven­tion, and their re­cov­ery was com­plete. This may have be­cause they only waited weeks, rather than months, be­fore seek­ing help. Maybe they are just the lucky ones.

Avoid the quacks

‘Non-Spe­cific’ Lower Back Pain is a catch-all term used by medics for this very com­mon mal­ady. Doc­tors all over the world see peo­ple with it ev­ery day and of­ten it re­solves nat­u­rally: the pain re­stricts what you can do, you take it easy, and so it goes away. The symp­toms com­monly oc­cur when the pain is from over-stressed mus­cles, rather than nerves. Be­cause th­ese prob­lems are so com­mon, and of­ten get bet­ter over time, they of­fer ripe pick­ings for quack­ery and odd ther­a­pies.

Con­fu­sion arises when mus­cu­lar back pain is ‘treated’ and then gets bet­ter. Most peo­ple will at­tribute their re­cov­ery to their treat­ment – what­ever it was. This leads many vic­tims to the ‘log­i­cal fal­lacy’ Post Hoc Ergo Proc­tor Hoc – trans­lated ‘Af­ter there­fore be­cause of’. (Check out Scep­tic Guru’s (Daryl Il­bury) ex­cel­lent guide to log­i­cal fal­la­cies on page 18). When you are in pain you feel des­per­ate. I know. You are pre­pared to try any­thing – and if you try some­thing and no­tice a less­en­ing of your pain, you sing the praises of the treat­ment and de­clare it to be a cure. Ev­ery­one is sus­cep­ti­ble to this ten­dency be­cause this is a part of hu­man na­ture. All man­ner of quack nos­trums have arisen be­cause of this – with sen­si­ble-sound­ing claims of be­ing able to cure back pain. I’ll stay hum­ble: maybe your treat­ment did help, but maybe it didn’t. Time tends to heal most is­sues. And time is what passes af­ter we swal­low a pill, have a mas­sage, get our backs cracked, stick dozens of lit­tle nee­dles in our skin or rub stinky balms all over our body. All th­ese ‘treat­ments’ have some­thing in com­mon: the pas­sage of time. I was for­tu­nate to make a good re­cov­ery, but my pain lingers like a drill sergeant. If I do ev­ery­thing by the book, it won’t bother me. As soon as I stop fol­low­ing the ad­vice given at the Spine Clinic, the pain flares up like that in-your-face shout-fest pop­u­lar­ized by Amer­i­can war movies. It should be noted that not all shoot­ing lower back (or ‘sci­atic nerve pain’) re­quires surgery. But by shar­ing my story I hope to im­part some knowl­edge to all Guru read­ers about a con­di­tion that is very com­mon. This ar­ti­cle is a rec­ol­lec­tion of ex­pe­ri­ences, not med­i­cal ad­vice. My hope is for you to think crit­i­cally about what­ever course of ac­tion you take. Is your cho­sen rem­edy likely to be a placebo, or is there ev­i­dence to sup­port that it works? Did you get bet­ter be­cause of the treat­ment or did enough time pass that it went away on its own? Is your con­di­tion se­ri­ous enough to merit a trip to an or­thopaedic sur­geon or will a few days of kick­ing back with a TV re­mote fix you up? Let my story ring in your ears next time you feel a sti­fling pain in your back. I sought out ev­i­dence­based med­i­cal science. I didn’t want just to feel bet­ter – I wanted to be fixed. And if I had to do it all over I would do the same again, only sooner. And I’d skip that nerve root block. Damn that hurt.

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