October 8, 2008
A SHORT HISTORY OF AN OSTEOPATH’S BAD BACK
Irony is quite difficult to define, but there is a form called situational irony and I think I have just become a victim of it.
I am now spending my third day recovering from acute low back pain. As an osteopath of 20-odd years, (and a back pain sufferer of over 30 years), I am aware that while my patient patients are expressing their sympathy to my face, what they are really thinking is ‘physician heal thyself’. If only life were like that, eh!
At work, on a daily basis, I hear the comment,
“But I just bend over to…….and my back went”.
So, I tilt my head, put on my best professional, but slightly patronising, voice and say,
“Well, it’s never actually that simple. What have you really been doing? How about a couple of days ago, for example? It always takes a day or so for things to swell up enough to cause problems.”
7:45 AM As it happens, that’s exactly what happened to me! I was ‘just’ walking to work and, out of the blue, my left lower back was suddenly sharply painful.
7:50 AM By the time I actually got to work, the pain was sufficient to make me bend forward at the waist, because if I didn’t, it made me catch my breath.
10:45 AM By coffee time, I was finding it difficult to feel my sympathy for my patients, let alone any empathy. Surely, my pain was much worse than theirs? I had started to tilt over to the right by then and maintaining a professional composure and osteopathically correct posture was starting to look comical.
All I wanted to do was get the weight off my feet. A vague but worrying ache had developed over the side of my left leg and into my groin. How am I going to work? What about my desperate patients? What about the credit crunch?
12:45 PM Time to cancel the afternoon list. Pass that task on to the staff and let them take the flack.
Now I can now hardly stand or put weight through my left leg.
Walk home very slowly, with backside stuck out slightly, flare feet outwards to widen the base and swivel the hips, shoulders held back to compensate, take shallow breaths and hope to goodness that nobody I know notices the peculiar gait. (If you don’t recognise this walk, you have never had a properly bad back).
1:15PM Now I’m lying on the floor, propped up with pillows, knees bent and with a subtle twist of the left hip that just takes the sting out of things. I don’t know why that helped, it just did.
I’ve taken an anti-inflammatory and am trying to decide whether I should use hot or cold therapy. Decide not to bother with either because I can’t get up that easily.
I start to plan what I have to do and what can wait. Do I get a drink, go to the toilet and take a turn round the garden and then slump gratefully back on to the pillows?
Make sure the ‘phone is within reach. Don’t sit or stand still for too long. Move regularly, even if it’s only to turn over. Isn’t that what I say?
Do my patients asking the same questions when they are bad? I’m sure that they are and, in a bizarre way, this has started to feel like a useful experience or experiment. It doesn’t harm to be reminded how our patients feel from time to time.
Feeling a bit easier today. Still too touchy to consider any vigorous treatment. I do usually advise against treatment in the first 3 days unless really necessary and this attack just reinforces this advice in my mind. (If I had true sciatica, I would consider acupuncture for pain relief and muscle relaxation).
After all, I’m the professional and that is what I advise. But does it really work?
It has been quite a few years since I had an episode this painful.
Last time I ‘bravely’ struggled on so as not to let anyone down and it took ages to get better. Stupid!
This time, I have quickly decided to take a few days off work, get some treatment on the third day and I should be back in circulation on the fourth day.
Memories have come flooding back however. This is how my back used to be a lot of the time in the late 1970′s and throughout the 80′s, before I had found a good osteopath and relied on him to keep me out of trouble.
My first osteopath was very good, one of the best, and he rescued me so many times that I have much to thank him for.
Indeed, he impressed me so much that I became an osteopath. Not exactly a Remington moment, but he and osteopathy did change my life, quite literally.
That may sound over the top, but it is true. However, good as he was, relying on fire fighting rescue wasn’t really a good thing. His generation of osteopaths did do a lot more rescue work and not very much in the way of exercise advice and how to change lifestyle.
Although he was always very fit himself and ran daily, I don’t recall any advice on prevention. Looking back, there was a sense that perhaps this would be intrusive on his part and was my responsibility anyway.
I couldn’t agree more, but it does need to be said. Nowadays I think that as an osteopath I and my colleagues are more prepared to say it how it is. As a result I believe that the profession has improved for the better.
It really is up to you to take control. The osteopath is there to advise and assist, but can only hold your hand so far.
The main reason that I haven’t had a severe attack for years is that I have generally taken my own advice, the advice of the profession and have listened to experienced colleagues.
I know that sounds smug and it is, but it also works!
Exercise the core; take up something regular like cycling, swimming or walking. Do the type of exercise you want, not necessarily what your therapist tells you. However, do let the osteopath know your plans and agree a safe course of action. Try and keep your weight within reasonable bounds.
I can’t be bothered with swimming, but do love mountain biking. Not something I’d necessarily advise someone with my back history, but it generally works for me.
Over the years I have done regular core strengthening exercises that include pelvic floor and abdominal crunches. Using Ultrasound Imaging helped me to determine just which exercises needed extra work.
They are incredibly boring, but believe me they are worth it, especially as you age. We all feel invincible when we are younger, but, shocking as this may sound, we are not!
What lessons have I learned? Well, nothing particularly new to be honest, but I have been reminded just how incapacitating a bad back can be and this cannot do anything but make me more empathetic with my patients and to reinforce the exercise message.
I hate taking time off work but as I am self-employed I don’t have to ask permission. For many this isn’t true and so it is all the more important that those people get the right treatment at the right time.
Most importantly, however, is that prevention is better than cure and that good advice from someone who knows is by far the best strategy.
You may also be itching to ask, “So why did your back go, Andrew?”
If I’m being honest, the underlying problem is that I haven’t really been doing my core exercises as regularly as I should for the last month or so.
Then, in addition, I spent last Sunday, squatting and crouching having a much needed clear out of paperwork prior to decorating my office.
Now, if there is one thing that I do know, it is that this squatting position is always bad for my back.
Embarrassingly, I have known this since at least 1980, so I should know much better, shouldn’t I……………………………..?
- PLEASE, DO YOUR EXERCISES WHEN YOU ARE WELL AND STOP WHEN YOU ARE UNWELL.
- STARTING EXERCISE WHEN IN PAIN MAKES NO SENSE WHATSOEVER.
- GET ADVICE FROM THE PROFESSIONALS, BUT USE YOUR COMMON SENSE.
Andrew Bellamy is Senior Associate at the Adur Osteopathic Clinic.