Carl is a 56-year old account manager for a large software company who spends most of his work day at a desk. He lives in New Jersey.
When did you first start having back pain?
I first experienced the pain 6 years ago when I suffered a fall at home. I have had many subsequent flare-ups. My pain also involves my left hip, leg, and knee.
Do you know the cause of your back pain?
I have had several disk problems in my neck and lower back. As it turns out, I also have spinal stenosis. The worst part is that my ability both to walk and to lift are impaired. I am very weak in my left leg and even my balance has been affected.
What treatments have you used?
In the beginning, I needed prescription medications for pain and inflammation. Ice helps me a lot whenever I have flare-ups. Exercises I learned from my physical therapist prevent pain and help my mobility. I've tried spinal manipulation by a chiropractor, but it hasn't done much for my pain.
What treatments have been effective?
Working with a physical therapist in the pool has been particularly helpful for relieving my pain and even improving my strength. Medications definitely help when I need them.
What has not been effective?
Surgery, which I have undergone two times, has never been helpful. It seems that after each operation, I felt better for a short period of time. But, both times my pain came back within a few months.
What makes your back pain worse?
If I sit for extended periods of time without getting up to stretch, I am quite stiff and my back hurts a lot. Basically, I can't lift any heavy objects or climb stairs without pain. Also, if I lose my balance and fall, the pain always comes back. I have to be very careful not to fall.
What makes your back pain better?
Exercising in the water helps. Ice and medications help when I first have recurrent pain.
Have you had to take time off work?
With my initial episode of pain, I actually had to take 4 months off from work. Two other times, I had to take 3 weeks off each time. Mostly, I just need a day off for back pain several times per year.
How much work have you missed altogether?
In 6 years, I have had to take a total of 9 months off.
What do you do at work to make it better?
I don't do any heavy lifting. I also don't climb stairs. I try to avoid any sudden movements and I get up from my desk at least every hour to stretch.
Have your employers been accommodating if your pain affects work and work affects your pain?
I use sick and vacation time whenever I have back pain.
Do you exercise? How often?
Yes. I do 3 good sessions per week and it makes a big difference in preventing my pain.
What types of exercises do you do?
Walking makes my pain worse. So, I ride a stationary bicycle, do certain stretches for my back, neck and legs, and I use a nautilus machine to lift light weights. The physical therapist taught me the proper stretches and strength training.
Does exercise help?
Without regular exercise, I'm afraid that I would get back pain much more often than I do.
What happens with your back if you don't exercise?
When I don't exercise, I feel very down and I have little energy or enthusiasm for much. I'm also less productive and have more back pain as well as problems moving around.
Do you have any advice for other people with back pain?
Chronic back pain is very taxing. You need to address both the physical and the psychological limitations. Also, learning to better tolerate your pain is helpful, as long as you are not trying to deny that you are having pain. Try to listen to and respect your body.
Andrew W. Piasecki, MD, Camden Bone and Joint, LLC, Orthopaedic Surgery/Sports Medicine, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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