First off- thank you all so much for your heartfelt and concerned emails about my back. It’s been a trying week, to say the least. I have felt all sorts of emotions- from very low and discouraged, to hopeful and thankful. This week has served to remind me how precious every day is. You realize that fact when you literally can’t move and enjoy any of it. I actually prayed that I might have the physical capability to do the laundry today. Now that’s sayin’ something. It’s interesting what kind of perspective on life you can get when not only can you not enjoy a fall drive through the canyon, but you can’t even enjoy doing the mundane tasks like loading the dishwasher.
I have been extremely grateful to my husband this week who has been such a trooper. He’s handled dinner every night, emptied the liter box, massaged my aching back, and many other tasks–all with no complaint. On top of it all, he’s been home sick himself a couple of days this week. Poor guy has been coughing and sniffling and sounding miserable for several days now. I think we are both ready to get back to normal.
During the course of this week I was surprised that several of you revealed that you’ve been suffering from a similar back pain and wanted to know about my progress. So if you’re interested, here’s a run down.
I first experienced this pain exactly a year ago at the end of September 2011. It came on gradually throughout the course of a day and then when I woke up the next morning, I was in excruciating pain. Andy had to lift me out of bed and I cried big crocodile tears. I took some time off work, visited the campus doctor and took pain meds and muscle relaxers. After about 5 days it went away as gradually as it came on. The pain was in the left side of my back, mid way up around my shoulder blade, close to my spine. I had no idea what brought it on—in hindsight, I think I have an idea. The muscle relaxers helped me sleep at night. I slept with an ergonomic pillow only to be told later that that was a big mistake, as it actually tweaked my neck in the wrong direction.
I consider myself a fairly active person. I’m strong and healthy and young. So when I first had this happen, I assumed I’d done something to injure my back and that it would heal, and that would be that. I didn’t think I could have this kind of severe pain when I took good care of my body. I was shocked when it happened again.
The second time I experienced this was in June of 2012. It was bad enough this time that I did some research online about my symptoms and ended up making an appointment at a spine, sports and rehabilitation center. I really didn’t know what kind of doctor to go to or who could help me, but their website told me that they specialized in the kind of pain I thought I was experiencing.
My doctor did some physical tests on me and felt the muscles in my back. He noted that I probably had trigger points that periodically flared up. Trigger points are “classified as potential, active/latent and also as key/satellites and primary/secondary. There are a few more than 620 potential trigger points possible in human muscles.” In my research I have found that this is in connection with myofascial pain syndrome. “Myofascial pain is associated with muscle tenderness that arises from trigger points.” This pain is not initially caused by trauma or injury and often there is no explanation for the pain. However, stress and repetitive motion that irritates these spots can make them much worse.
I was sent to physical therapy for a few weeks. I learned some at home stretched and exercises I could do which helped a little. The physical therapist told me that the muscles in my back were too stretched out. This can be caused by sitting at a computer or desk either in an awkward position or with my arms stretched out in front of me at the keyboard and my shoulders hunched. I often sat like this when working at the library digitizing collections. Also, my scanner was placed in a difficult to reach place and I’d stretch awkwardly over and over again when scanning large collections of photographs or other documents.
This last time, the pain has been on the left side of my back and has radiated tightness and pain throughout my upper back, shoulders, and neck. It is much, much worse than any of the two previous times. I’ve had some time to think about what might have caused the trigger points to flare up and then what may have aggravated them even further.
The first time the trigger points in my back acted up was last fall. I was taking 20 credit hours, teaching dance, working full time, and getting ready to organize the annual book sale at the library, To say I was tense and stressed is an understatement. I was stretched very thin and very, very busy. Hence, back pain appeared which was made worse by the repetitive motion of lifting hundreds of boxes of books for the sale.
The second time the trigger points acted up was in June. My job environment had become unbearable, my boss was going out of town and everything rested on me- in a time when I wasn’t really enjoying what I was doing in the first place. I was stressing myself out with questions of where to go next and what to do. I took full charge of Gift in Kind donations at the library and single handedly picked up over 20 donations in a 4 week period, amounting to over 1000 boxes of books. I picked these books up at people’s homes all over northern Utah, transported them by van and then hauled them in to the library where I sorted, counted and moved them all again to a holding room. As you can see, all this is a major reason why I no longer work there.
This last flare up has come on in a time when I’m a little worried about the lack of decent jobs out there, the decision to take on more debt to get my master’s degree–only to possibly not be able to find a good job afterward, and just other random little things. (I’m a chronic worry wart, what can I say?) But mostly, I think it’s more physical this time. Last Monday I tried a new Pilates class. I’ve complained on here before about people advertising their class as mat Pilates, only to go and find out that it’s nothing more than an aerobics class with very little classical Pilates involved. That’s what this class turned out to be. But I was there- I’d paid my money, so I stuck with it. We did some work that required contracting those sensitive back muscles over and over- way too much. At the time, I didn’t know this would have a major effect on me. I should have stopped, I know. But hindsight is 20/20. Then I taught three hours of dance to hyperactive kids on Thursday night and came home utterly exhausted. It’s only the third week of dance this year and I’ve had the whole summer off- my body wasn’t ready for toe touches and c-jumps. But I’m the teacher and I teach beginners who have absolutely no idea how to do anything without seeing a demonstration- I can’t fake it.
I went to the doctor on Tuesday morning and he gave me some injections to numb the pain. It didn’t help me at all. I still may try acupuncture or dry needle injections as I’ve read that it can help. I would get the injections again just to see if they really don’t help me. He’s ordered an MRI for me as well. He gave me a prescription for muscle relaxers which haven’t dulled the pain either. It just seems that this time around, it’s too severe and the only thing to do is to persist with ice packs, heating pads, soaks in the hot tub, massages from Andy, and the exercises my physical therapist taught me and wait it out. I think these things help to relax me rather than dull the pain. When I’m relaxed I can better endure the pain. When you have this much pain, you end up getting even more tense, which just makes it worse.
In the future I will be much more selective about the Pilates classes I attend. I’ve said before that they are a God send- but only when they’re taught correctly. I need traditional mat Pilates in a serene and quiet environment. Pilates focuses on core and spine strength- it’s very beneficial to me. Also, I’ll rely on my assistant teacher at dance more. Last night she was able to lead the warmups and demonstrate a lot of the skills we were working on so I could let my body rest. She’s a wonderful teacher and I’m going to allow her to step in where I can’t. It’s hard though, to curb my enthusiasm for helping the kids in class. I often get excited and carried away in class just trying to help the kids have a good experience. I’ll have to reevaluate my teaching methods so I can demonstrate enthusiasm but tone it down too.
Also, I’m a naturally tense person. I’m not sure why this is. For instance, I will be sitting at dinner and realize that I’ve got my shoulders tightened up and I will have to remind myself to physically relax them. I’m not sure why I do this. Stress is an interesting problem for me too. I think of stress more in the form of having an extremely overactive mind- it’s always going, thinking, analyzing, wondering, worrying—active. My mind is never at rest. So when I add more to that pot then I liken it to a person being ‘stressed.’ I’m not frantic or anything- there’s just a lot going on up there and sometimes my brain gets overloaded with mental lists, ideas, plans, etc.
The problem is, I don’t often know when my ‘stress’ level is at the point that it might cause a back flare up. This is because I’ve done a very good job my whole life of refusing to recognize when there’s too much going on up in my head. (I plan on giving meditation a try in the hopes that it will quiet my mind for a little bit each day.) I am excellent at ignoring it, pretending I’m fine, and pushing right through- sometimes to the point of really wearing myself down. I usually have to be talked out of taking more on, even though I know I’m already doing too much. Both Andy and my mom have become very good at recognizing when I’m at my limit and telling me so. I need this at times. For example, I have the opportunity to take on one more dance class each week. I know I shouldn’t, but I can so my brain is telling me I should just do it. These are the times when I remind myself that just because I can, doesn’t mean I should.
So the next few months for me are going to be about trying a few different things- muscle relaxation techniques including some deep tissue massages from a specialist, I’ll be getting an MRI just to rule out something more serious, perhaps morning meditation is in order, more self awareness and being okay with not doing everything, and also some extremely light Pilates and weight training to strengthen the weak parts of my back. I’ll be working on getting to a more balanced state in both mind and body.
So that’s where I’m at right now. I’m gradually regaining my mobility and my pain is lessening just a little each day. I am hopeful that, while these active trigger points will never go away, I will be able to manage them with a little daily diligence. I’m good at diligence :)
Here’s some sources that helped me if you want more information: