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Keen to ramp up the self-treatment of my recurring back problems, I hunted about for a good book on personal spinal therapy. I picked up a book a little while ago on pilates but found it next to useless, and although I’ve dabbled with yoga, so far I found the results a little random, and with seemingly little focus in these resources on the kinds of back issues I’ve been getting, I came to the conclusion that non-targetted application of these techniques was a very hit-and-miss affair, with potential to injure as well as assist. What I really needed was a resource that helped me deal with the very specific issues I was getting - and with backs, there seem to be a number of different things that can go wrong.

I found Sarah Keys’ book, The Back Sufferers Bible, through various review sites, and found a large number of people with what sounded like much more serious issues than I have highly recommending it. Sarah specialises in backs above all else, and has written a number of books on the subject over the past couple of decades. This book seemed like the ideal self-treatment text, so I ordered a copy, and it arrived a little under a week ago now.

I’m already quite impressed. The book goes into a large amount of detail about how the spine works, what can go wrong, and how to recover from it - more than any other book I’ve read, and contains much more information than I’ve got out of my various physio/osteotherapists in the past. Even better, I found within its various chapters an exact description of the recent problem I had, something she calls an ‘acute locked back’. Having had physios prod me and tell me my (latest, mid-back) problem was fairly unusual and hard to pin down, it was a great relief to see it described in such accurate detail - right down to how it felt immediately before, after, and longer term. Having seen so many articles that just focus on lumbar pain, I was so glad to find an author who clearly understood exactly what I had, and had exercises laid out specifically to deal with it. The text actually agreed with my most recent physio’s eventual recommendations, but what’s nice is that it has a much greater range of exercises to do, with more detail as to the kind of timescales involved, and when it’s safe to graduate from one type of exercise to another, and focussing on long-term recovery. It’s nice to see someone saying that the spine can get better too, and that it’s not inevitable that I’ll be on a downward slide for the rest of my life, provided I tackle it the right way.

One thing that the book also taught me was that dehydration was a risk issue. I’ve never been one to drink as much water as you’re supposed to in a day - for some reason I just don’t get that thirsty, and when we’re on holiday in a hot country my wife is always telling me to drink more, even though I don’t feel like I need it most of the time. Such a metabolism might be efficient in arid countries, but lack of water is one of the things that over a prolonged period of time can cause disc degeneration. So as well as my exercise I’m trying to remember to stay more hydrated.

So far, I feel quite a bit better. I’d dipped last week, which I now believe was mostly down to some over-enthusiastic drumming, but I’ve done some moderate drumming this week too, I’ve just been a little more sensible and combined it with the book’s exercises (as well as my daily walks), and I find that besides a little soreness, I’m able to cope much better and most of the stiffness, tenderness and most importantly the red-hot knifing pains, are gone. The exercises seem to be targeting my specific injury more effectively than other things I’ve tried in the past, and also allow me to start strengthening up my various trunk muscles again without putting adverse pressure on my spine; one of the problems I’ve had in the past.

It’s early days, but so far, so good. If it carries on like this, this book will have been a great investment.

Apologies in advance for another dull post about my varying spinal health. But, I figure friends, family and some people in my various online communites are interested in contextual stuff like this, so here we go. Hit up some other bookmark now if you’re bored

Since my epiphany 6 weeks ago I’ve been on what I realise is going to be a long road to recovery, and generally each week I’ve been improving, barring the odd minor blip. That was, until the middle of last week when I seemed to go backward a couple of steps, ending up with pain and stiffness in the middle back area which I associate with my most recent problem (as compared to the lower lumbar pain associated with my lingering problem from about 4 years ago). This has persisted all week - better some days, worse others - meaning that I’m having to be extra careful. I’m not sure exactly what triggered the relapse - it might be that Rock Band 2 came out and I did 2 hours of solid drumming one evening, it might have been the time we spent playing Left 4 Dead, it might have been that I’ve been playing my new guitar with a strap (extra weight on the shoulders), it might have been that I took a particularly brisk walk last Tuesday as I was in a rush to get back to work (and at that point my back was feeling great) - or something else.

What is frustrating is that the risk of relapse seems connected to almost anything I do. I sometimes feel trapped - that I can’t work as much as I want, can’t do many things I enjoy, can’t be too active, can’t be too inactive - it’s like I have to be afraid of doing anything because of the risk of setting it off again (except that of course doing nothing also makes it worse). Yesterday this really started to depress me a bit, and I’m generally a pretty hard guy to depress, being as defiantly optimistic as I usually am. I got over it, partly because of my wife, partly because we had a social evening last night which cheered me up, and partly because my ever-reliable sense of logic eventually kicked in and pointed out in no uncertain terms that feeling sorry for myself wasn’t going to help, and I was just wasting time.

So, I’m opting for a more scientific approach. I’m starting to keep a weekly record of how well my back is feeling, and noting down relevant events, and how much work/gaming/exercise I get during each week to try to correlate what’s helping, and what’s making it worse. I went back over my diary & blog to add a bit of history (higher numbers are better):

Obviously too much hunching at the desk was bad, as probably were long-haul flights. The games are mostly on there for interest - with the exception of heavy drumming on Rock Band 2 I don’t think any of them put any particular strain on my back, although Left 4 Dead is at the desk so I should keep that fairly light. Trips to the physio/osteo clearly help short-term but the only real way to conquer this long-term is to keep learning how to rehabilitate myself, and quick-fixes aren’t the way.

The positive note to take from this is that despite the last week, I’m still on an overall up since mid-October. As my wife keeps telling me, I need to resign myself to the fact that this is probably going to take a very long time to put right properly. Frustrating when you have a head full of projects (Ogre & otherwise) wanting to see the light of day, and when you just want to lead a ‘normal’ life without being in pain, or feeling afraid of what you can and can’t do. But, as ever there are plenty of people far worse off than I am in the world, and I have the benefit of a very understanding wife and a flexible working environment (I don’t get sick pay, but I can at least take breaks when I want and set my own workload), so I should stop wingeing and get on with it. I’m going to choose to be grateful that my red line is averaging an upward trend, and work on trying to keep it on that course as best I can.

OK, now I’m getting really pissed off. My back has got slightly better every day over the past week and a half - yesterday I went for my third physio appointment and everything was pretty hunky-dory, just a bit of soreness, but my range of movement was much better and his prodding barely hurt at all. I went more than 24 hours with no painkillers of any sort for the first time in ages, and this morning I felt great.

That is, until despite my being careful I accidentally twisted a very particular way in the shower and had a sudden sharp pain. It was only very fleeting, but now my back feels like it did this time last week - constantly sore and very painful to put any kind of stress on (e.g. bending down, carrying anything). To say I’m annoyed is a very large understatement. I need to be able to carry a rucksack with a laptop in it next week, and up until an hour ago I was feeling really happy that was going to be fine.

I’ve been doing some gentle exercise (walking) and it’s been helping a great deal, but it’s terrifying to know that I can do something so incredibly simple in the space of about 2 seconds to completely reverse my recovery process. It’s frustrating in the extreme.

Just a quick update on the health situation for those that are interested. I’m still in some pain but appear to be getting a little better each day. I’m still very sore most of the time, and mornings are the worst time as I try to slowly free up the swollen joints that have a tendency to seize up overnight, but I’m getting the knifing pain less and less, and I can walk much more normally so progress is being made. I am, however, still on quite a lot of drugs which means I’m a bit phased out at times. I’m also stupidly thirsty all the time, which is odd.

I’m spending some time at the desk, but I have to take a lot of breaks, and I’m certainly not at peak efficiency - I’m spending what productive time I have mostly on existing customer commitments, so Ogre is getting a little less attention than usual. I was in the forum briefly yesterday but I just cherry-picked a few things, and that’s likely to be the case for the next week at least.

I must say Monday’s events were a major wake-up call for me. As might have been apparent, I’ve had a bit of a peak of activity lately, what with OgreSpeedTree, Ogre 1.6 and a few new work projects coming on stream. I’ve also mentioned how Ogre has mostly slipped back into my spare time again. All in all it’s led to me spending more and more evenings and weekends at the desk again, and doing less and less other activity (Rock Band excluded, although even that suffered). I don’t resent this at all, I love my work, I love being self-employed and independent even with the lack of downtime that brings, and I love working on Ogre - and in addition I’m a stubborn git, so when faced with increasing demands I tend to just get my head down and put increasing effort in to meet it. I did have a few back twinges in the past 4 weeks but I generally just gritted my teeth and coped with it, or rested a bit for a day or two until it was better enough for me to resume business as usual. In hindsight, that wasn’t very wise.

I know, I know - people have been telling me for ages that I need to look after myself better (on this blog and otherwise), but I always find that hard when there’s so much to do. Unfortunately, being the stubborn idiot that I am, it really does take something as major as being carted off in an ambulance to finally get it into my thick skull that I might be pushing it a bit too far.

So, message finally received, loud and clear. My initial focus now is to recover enough by the end of the month to be able to travel without injuring myself (since I have a trip already booked), which means initially lots of rest interspersed with very gentle exercises. Then over the next year or two my goal is to gradually get back to the level of fitness I used to have some years ago (or as close as I can get). Believe it or not, I used to be really very fit in my early 20s, doing runs around the steep cliff paths here, regular martial arts training, all sorts. But that was 13-14 years ago now - if I can get even halfway back to that it’ll be a major boost. That means that instead of letting work take precedence all the time, my health will have to jump up to priority #1 (from about 5 or 6 ;)). Once I’m well enough to move about properly again, I think I’ll start with something relatively gentle, like swimming, and work up gradually from there.

As an impatient person I’ll no doubt have an urge to speed things up so I can get back to some project or other, but all I have to do is think back to this Monday if I find myself wanting to do that. Time to be more sensible, dumbass.

I woke up this morning feeling pretty good - sore, but better. Until I tried to move a certain way, at which point it was pain central again. After a couple of hours in which, despite having loaded up on over-the-counter Ibuprofen and Paracetamol it still felt like someone randomly taking a chainsaw to my back, I went to see both a doctor (for ‘pain management’) and a physiotherapist (for longer term help).

The doctor has given me some stronger painkillers and anti-inflammatories which are definitely better, although they do mean I can’t drive or operate machinery because they make you a little dopey, although I do think I’m more qualified to be a patent examiner. The physio after lots of prodding declared my back ‘interesting’ - which is not the first time (I’ve had similar assessments from previous physios and osteopaths) - quite why medical professionals feel the need to infer that my spine is of alien construction I’m not sure. I mean, if by ‘interesting’ they meant it could perform some great superhuman tricks like sprouting barbs (at which point I could find myself a tan brown suit and call myself ‘Hedgehogman’), that would be ok, rather than meaning ‘it’s buggered and we’re not entirely sure why’.

Anyway, his eventual conclusion of why it’s getting worse is that that my posture is actually too straight. That’s right folks, I apparently sit and stand too straight and I’m aggravating an existing injury on my thoracic vertebrae as the various ‘fins’ (technically the ‘processes’) rub against each other, produce swelling and then catch the nerves that are winding their way between. Sitting up straight pushes them together more, and pulling into an upright position from sitting (the ‘demon move’ for me right now) tenses all the muscles around there which also pulls them closer together, which aggravates the nerve, which makes the muscle spasm, which pulls the vertebrae - you can see where this is going. Classic cascade failure

So, his advice? Slouch more. Seriously - to take the pressure off these fins while I’m standing and sitting, I’m to deliberately curve my spine in the very way you’re always told is ‘bad posture’. I’m supposed to find relaxed, slouchy positions and then move as little as possible, except for some hourly exercises. When I’m walking, I’m to do it in a slouchy, hands-deep-in-cargo-pant-pockets kind of way. Essentially, I’m to act like I’m 17 again, just without the bad 80’s hair.

It’s weird, but it actually helps a bit so far. I spent a little time at the keyboard today, but I did it with the chair tilted back, feet on a footrest, and my keyboard on my lap, slightly hunched in a way I haven’t done for years, since I started sorting out the ergonomics of my work area to alleviate RSI. Who woulda thought such a set up was actually ergonomic in its own right?

I hope all this works anyway. I hate being off work, even partially, and these physio appointments are damn expensive! I probably won’t be in the forums much until this is sorted, if something is really urgent (and I mean really urgent), you can reach me on email in the meantime.

I’ve had a long-running back injury (a twisted vertebra in my lower back) which I’ve figured out how to manage through experience - a bit of stretching here, avoid certain types of activity etc. It’s a bit inconvenient but after a while you get used to living with it, and it’s not that painful most of the time provided I don’t go nuts.

However about 2 weeks ago, not long after getting back from LA, I was doing something quite simple (moving a coffee table back after a Rock Band session), when something in a completely different part of my back suddenly hurt really badly.  We had guests at the time, so I quickly took some painkillers and did a quick bit of my usual stretching upstairs, but that didn’t seem to work very well - I ended up just gritting my teeth most of the evening. While I don’t like the existing back injury I have, at least I ‘know it’ and how generally to cope with it, but this time it seemed different - like someone randomly knifing me in the middle of the back, just below the shoulder blades (et tu, Bruté?), rather than just by my right kidney like the old injury always was.

Stubborn git that I am, I gave it a couple of days of fairly frequent hot-poker agony before giving in and making an appointment to see the osteopath. I cancelled it once because it started feeling a lot better before the appointment came up, but then I wrenched it again while doing the grocery shopping of all things (damn you BOGOF offers, you basket-filling temptresses). Luckily I remained on my feet and avoided shouting the foullest obscenities in my repertoire at the top of my voice; no doubt the years of Brit cultural training to avoid making a scene at all costs - stiff upper lip and all that, what? - helped in that regard

Anyway, I finally made it to my second osteo appointment today, although again it had started to recover quite well so I felt a little bit stupid; “that used to hurt like hell” doesn’t have quite the same impact after all. Luckily as a professional he could still tell what I’d damaged even without me yelping, so next came the expected ‘manipulation’ - which basically means ‘beatboxing with your bones’. This time the targets of choice were the Thoracic vertebrae and the attached rib heads, and they can clearly make some quite interesting sounds when properly motivated.

I’ll be sore for a while but with a bunch of new stretching exercises it looks like this one probably won’t be a long-term issue. It’s likely to be linked to the number of hours I spent hunched like a troll in economy class in the last month so hopefully it’ll prove to be a one-off.