For a Fellow Spine Pain Sufferer – And the Benefits of Physical Therapy

I’m so very sorry you ‘discovered’ back pain on that magnitude (bad pun there).  I’ve had issues with this magnificent, hardworking, biological ossification (my spine) since 1993.  A car accident forced disc material out through the branch nerve feeding my left arm, which caused excruciating neck pain and partial loss of function on my left arm.  It showed most conclusively through the atrophy of the left forearm and bicep.  My left arm became visibly smaller in diameter than my right.  Although not as pronounced today, the left forearm remains somewhat smaller.

I had an MRI, an extremely loud instrument back then.  In 1993, the process was only about five years old, and the beast looked like a trolley into a morgue vault, only less space.  I lay on the table inside the clanking and pounding, high pitched metallic, futuristic rhythms wondering when all this would be reduced to a small handheld device that could be waved over shoulders and neck and readout immediately into surgically oriented AI that would use some yet unknown energy source to cure the problem.  In lieu of Star Trek technology, a very skilled micro-neurosurgeon informed me that the location of the spinal breech was such that the risk appeared minimal, the recovery relatively painless and fast, the incision being the worst of it.  Due to this being an anterior procedure, he would need to shift my bronchial tube and voice box, which could affect my vocal quality, but the percentage of long-term damage was relatively low compared to the benefit of surgery.

The micro-neurosurgeon went into my throat in what was to be a 1.5-2-hour procedure which lasted over 3 hours.  Later he reported to my wife that he had used a donut of cadaver bone, bank bone, to cause the C5 & C6 to fuse.  The surgery was the closest I’ve ever come to a physically worked miracle.  In the recovery room, I could tell from the working of my left arm that the nerve impulse had been restored. 

The doctor later told us that the compression of the nerve was greater than indicated by the image on the MRI.  The damage to the spine was more significant that he had initially assumed. The pain would have been akin to what a woman experiences during transition labor, when the nerves in the region of the pelvis are compressed by the head of the child forcing its way through the cervix.  My wife could relate to this, she’d experienced it for part of a day, three and a half days earlier.  I had experienced it for a month and a half, with only extra strength Ibuprofen to take the edge off.  Three large bottles of Ibuprofen were consumed in a month and a half.  The week after surgery, I went out and took a pole saw to cut a seedpod out of the queen palm in front of our house.  A bomb shaped seedpod on a queen palm usually weighs somewhere between sixty and ninety pounds.  After the fact, I realized I had made a mistake to do that sort of labor so soon after surgery.  Plus, my wife and three-year-old daughter (who turned 30 recently) came home from school or errands, I don’t remember which, and thoroughly chewed me out.

The doctor also predicted, nay, prophesied, that ten years from then I might have additional problems with C4 and/or C7, since the additional flexion for the neck would be forced on those levels.  And…, he was right.  We moved to Chattanooga in 2002 and in preparing the old house, in Florida, for sale and the new house for occupancy, I blew out C4 & C5.  The ordeal of catching medical attention when not well connected to health professionals should not be understated.  It took me four months to finally run all the tests, the MRI and to get in front of another good micro-neurosurgeon, a mild mannered, understated, professional.  He looked at the MRI and scheduled surgery for as quickly as he could get a theatre time and space on the hospital’s schedule.  Since the local hospital was a teaching hospital, I had a student anesthetist handling my decent into purgatory.  This was to have been a three-hour surgery.  It lasted five.  It was far more complex than expected.  Because the medication used to put me under was a paralytic, and the length of time required was so long, I was left with short term memory issues that took a year and a half to overcome.  Not a great way to enter the real estate life in Chattanooga, I had been in real estate in Florida, and needed to continue my career.  Also, the pain didn’t resolve in the same miraculous way.  It was greatly lessened, but this disc material had extruded into the spinal column, not out along the branch nerve as in 1993.  The damage was longer lasting and now I had two fused discs, and a titanium ‘plate’ screwed into place to assist in maintaining rigidity.

Before long, osteoarthritis that had been relatively mild in my left knee, in Florida, became inflamed.  When I had been in middle school, back in the dark ages before the medical advances that marched forward through the late seventies and well into the nineties, I had torn the anterior cruciate ligament, ACL, in the left knee.  Because Florida is basically flat, and the weather generally pleasant, the knee was seldom stressed to the point of pain.  The Chattanooga area is known for nothing if not it’s hills, mountains and valleys.  As the pain of the knee wore on, my lower back responded sympathetically.  In late 2004, now only able to walk a quarter mile at a time, and the available tech showing that the bones of the knee were well worn and without a shred of cartilage, the knee was replaced with a prosthetic.  While a total knee replacement at this time is not equal to OEM parts, after about nine months I was thoroughly relieved to have undergone the surgery.  Within another year, the lower back had decided it was time to start screaming for attention.

The lower spine issues that are most on the forefront now are the product of abuse of the body from work related lifting, hauling, heaving in early years. Probably as early as seven or eight, up through adulthood.  There is, I think I’m remembering this correctly, spondylosis of L-4 & 5, bulging discs of L-3 – 5, the physiology that has likely presented to offset the use of spinal strength on the opposite side of the nerve channel (spinal cord, but that low in the spine it’s apparently referred to as nerve, not cord), appears to be some ridged material, like a ligament, but much thicker, that is also narrowing the channel.  The nerve is forced between a resulting structure that appears to be the orifice of an hourglass. 

To boot, there’s osteoarthritis in the hip joints, and a different doctor has said that it looks like my sacrum has ‘auto fused’ and fractured on repeated occasions because an x-ray showed multiple bone regenerations in the region where the sacrum meets the pelvis.  I had not known that the sacrum is essentially a joint that in a working body has a rim of cartilage where mine has none.  Most people have a sacrum that can slip and bend. I crack.  Delightful.

There you have it.  This is the most exhaustive writing on my sorry assed spine I have ever done.

With the benefit of 40 minutes of daily, and I do mean daily, floor exercises that are similar to yoga and Pilates, and a 2-3-mile ambulation, usually a four to five time weekly affair that I look forward to, I manage to retain mobility.  It takes a lot of energy to keep it all up and keep moving.  So, any additional expenditures come at a cost.  It has taken me a lot of years to realize that this is my reality and not simply a whining wimp attempt to sidestep life and its itinerant work to pass from cradle to grave.  Because this disability is not externally visible, dramatic or fantastic; because I appear to be moving easily and well, because I’ve fought the effects of degenerative disc disease, osteoarthritis, and the host of actual, physical deficits that are hidden on my spine and in my body, I don’t appear disabled to the casual observer.  It’s a personal, internal struggle to accept the limitations foist upon me.  And it’s no fun to cower and scrape before the tyrannical pain that occasionally comes over me, either due to my own stupidity or weather or I dunno what.

If you are fortunate to be referred to a GOOD physical therapist, they aren’t all created equally, go and do the niggling exercises you are given.  Do them as often as prescribed, more if allowed.  The progress is slow.  The exercises typically are aimed at small, core muscles that are often overlooked in doing the gross motor work of lawn and house maintenance.  Usually walking is prescribed as a best medicine. Staying in bed is discouraged.  For me, nothing matches physical therapy coupled with self-advocacy.  Look, learn and explore options.  Life with pain is no fun, but it doesn’t have to be a death sentence.

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