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My aching back! (and what might help yours)

Hangliding fool.jpg (13556 bytes)

How it began... Me hang gliding off Mount Seven, Golden B.C. circa 1975.

No parachute, no helmet, no fear.

 

I remember my back aching frequently after snowmobiling when I was a teenager. Lots of unsupported flexing and bouncing. My first actual back injury, though, was a few years later,  trying out a hang glider I built from a kit.. A rough landing knocked the wind out of me. A few years later, skydiving really knocked the wind out of me again, and gave me a headache too, but in 2 hours I felt better so I jumped again. Then I hurt more.

Luckily I wasn't hurt as bad as Mike at www.deadmike.com! Anyway, a few days later, when bending over, I was hit with a sharp pain in my lower back, in the right sacroiliac joint area (just below the belt,slightly to the right). For several years I periodically visited chiropractors who were generally able to provide relief by manipulation and I was fully able to hike in the mountains.  I later took up mountain climbing; My back still gave minimal trouble.

Eighteen years after the original injury, one day I again felt  a sudden sharp pain in the sacroiliac. Repeated visits to chiropractors helped for only a day or three, but this time I found that my passion, hiking, aggravated it. Physiotherapists helped very little either. It wasn't a disk problem or a hip problem, and they attributed the problem simply to aging (at 36!). I was then doing a variety of stretching exercises and also lower back and abdominal strengthening exercises. I felt stronger and was more flexible, but  I still couldn't hike or climb due to lower back pain.

I waited six months to see an orthopedic surgeon, who quickly proclaimed that he couldn't fix it with surgery  and ordered blood tests to check for a painful, progressive arthritic disease called "Ankylosing spondilitis" which eventually fuses your spinal vertebrae. I didn't (thankfully) have it. He could only suggest frequent use of anti-inflammatories like Ibuprofen or Advil, to reduce the pain. Some consolation...

I tried Yoga for many months and got even more flexible, but my back still hurt.

Finally, a friend told me of a treatment she had heard of for loose and stretched ligaments. Ligaments are what hold joints together, and if they get stretched too much (like a sprained ankle), they can't stabilize the joint properly. If stretched excessively, ligaments don't tighten up or heal well on their own, unlike a muscle. Stretched ligaments cause pain.  Ouch!  Imagine a sprained ankle: It is easier to re-sprain it once you've sprained it seriously: The ligaments holding it together are over-stretched and loose, "lax". They need tightening.

A treatment called "Prolotherapy" described in a book called Pain Pain Go Away by Drs Faber and Walker sounded promising. This prolotherapy procedure involves repeated injections of a proliferating agent (usually a solution of dextrose and local anesthetic) into the loose ligaments, wherever they may be. The lower back is a common location. The solution mildly irritates the ligament and promotes additional cell growth (scar tissue) on the ligament, making it stronger over a period of weeks and months. A series of injections are done in a doctor's office. Many pro sports athletes have had this done. There are no dangerous side effects to worry about.

I suspected that from the impact of hitting feet first in both my skydiving and hang-gliding accidents years before, certain lower back ligaments were possibly weakened. Now, with age, or poor posture (or abuse from carrying a pack), these ligaments had weakened further and were causing me pain. Fortunately, I found a doctor that did proliferation injections (prolotherapy) along with spinal manipulation nearby. Over a period of several months,  I had 5 sessions (about 10 injections along the sacroiliac and lower spine S1/L5 and facet joint area each time). It took about six months to a year to fully benefit from these, but they did help a lot and once again I could climb mountains. I found it necessary to have them repeated about 18 months later, but they did not seem as effective that time. 

Someone suggested I visit a SPORTS physiotherapist, rather than a regular physiotherapist. Skeptical, I did, and he diagnosed me as not properly activating the gluteus muscles (butt muscles) properly when walking. Maybe it was because I was trying to chew gum and walk at the same time! He noted that I was instead using my hamstring muscles, causing additional torsion and stress on the sacroiliac joints. He then showed me specific exercises (more exercises!) to "teach" some of the smaller muscles to enervate (do some work). 

A lazy ass! Exercises to strengthen small lower abdominal muscles were prescribed, to help stabilize the spine, and also some "thinking" exercises so as to activate these smaller but lazy, unused butt muscles. These muscles apparently wrap around the butt across the sacroiliac joints and attach to the sacrum (just above the tailbone) and when tensed, help to stabilize the sacroiliac joint. He also suggested a special back support belt called a Sacroiliac belt,  $40 Cdn (about 29 cents American) at medical supply stores. These are about 2.5" wide, fasten with Velcro and also have two elastic straps to wrap around that are attached to the center of the belt at the back. This is not the same as weightlifters and stockboys wear. You wear this just below your normal belt (inside clothes), stretch the elastic straps snug and stick'em down to the Velcro. This causes an inward pull across the sacroiliac joints for stability, yet it can still stretch to allow leg movement. Good invention.

It took time, but between the sacroiliac belt and the stabilization/muscle enervation exercises, I was once again able to climb mountains, like many years ago. Many of the peaks (Robson, Whitney, Rainier, Tsar, Borah, Clemenceau) on these pages I have climbed since that time. Perhaps someone else out there has a similar back problem (sacroiliac instability) and might benefit from one of these various procedures. 

Although 12 years have passed since my back problem returned, despite all my efforts so far, it is not cured.  Perhaps this is asking too much, but I find cycling, rollerblading or carrying a pack brings back the problem quickly.  Next thing I know, I'm out of commission again, maybe for months. Physiotherapists and chiropractors say that my spine is slightly twisted and the sacrum and pelvis are rotated too. This is apparently not a unique condition, but unless you wanted to walk in a circle all the time this is hardly an ideal situation.

In an effort to try something that might bring about a more permanent cure I spent 11 months seeing a different type of chiropractor; an upper cervical chiropractor. The field of C-1 (as its called)  is highly specialized field of chiropractic. These people only adjust the position of your skull on the ATLAS, which is the upper vertebra (C-1) in your neck. They decide on doing it only after several measurements and specialized x-rays are taken that determine whether or not your skull is sitting straight on the atlas. They work under the belief that if the head is sitting crooked, it may interfere with spinal nerves, cause spasm of spinal muscles and as a result change your center of gravity too, because the rest of your spine and lower back will be crooked. It has helped 2 friends a great deal.

So why would your head be on crooked?   Well, in my case, the whiplash effects of crashing a hang-glider and   sky-diving could do it. So could a car accident or a rough tackle, wrestling, etc.   My problem 25 yrs ago started more as a neck/headache problem; the lower back problem came a bit later, maybe as a result of my head sitting crooked. Your head weighs 12 lbs and if not balanced properly on your atlas, it can cause the entire spine to develop an unnatural curve to compensate. This is the premise they work under. Similarly, if the head is repositioned to its proper position, (verified through additional X-rays and measurements), in time, your spine will straighten and align, with a little help extra through stretching. 

After my first "head" adjustment, my lower back pain quickly reduced. I feel straighter when I stand or walk. Only time will tell if this is the cure I've been searching for. So far, it seems promising. Besides, who wants to go through life all bent out of shape? ;-)

UPDATE: Well, after 11 months, my back really hadn't made any gains, and in fact, I could not do any hiking at all 11 months later. Not much walking either. I figured if it hasn't helped after that long ( and I had actually regressed during the numerous visits and adjustments of my head) then it probably wasn't going to help. My spine would apparently be straight when I left after an adjustment, but a few days later would be crooked again, and painful. It wouldn't stay in place, same as ever, basically. So all in all, I spent money, but little changed.

Rolfing is something else I am currently trying. Rolfing is somewhat like deep tissue massage. This treatment   is to release and loosen up the fascia, a sheath that covers all the muscles in the body. If the fascia is tight, then no amount of normal stretching by the individual will allow muscles to equalize or lengthen. Tight fascia can cause poor posture which can cause or exacerbate back problems (among other body structural problems). The sessions are usually 1 hour at a time, for several visits. I do feel "looser"   after a session, and with less low back pain. I am also back to getting some prolotherapy injections, one of the few things that has in itself provided anything more than temporary relief for me.  (A month long drunken stupor might work too, but I can't afford the time!) And I have a couple of new exercises to do for "core stability". 

Core stability is a current buzzword (okay, buzzwords) in the sports medicine/rehab field. It means doing exercises to strengthen muscles that support the spine and low back.  And guess what? Normal sit-ups/Ab crunches aren't the right ones! No. After they all told us for years that they were the right ones.  AB-ball exercises are encouraged now...that and sucking your stomach in.

A search on the web will turn up much more info about things like prolotherapy; and this procedure could help you. Note: Many or even most family physicians and General Practitioners are totally ignorant of prolotherapy, or that SI joints can slip out of place but don't fault them; prolotherapy does work. For me, the benefits last about 18 months, then I get need injections.  Maybe I won't need them in future: I wish. Right now I worry more about the day they stop helping...

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