Monday, February 4, 2013

Back, Again: The Tyranny of the Bad Back



I started writing this piece sometime in mid-January after being temporarily debilitated by a minor back injury. It’s all better now but I’ve learned a lot from my experience.

I half-sit, half-lie on my right side. My torso is twisted awkwardly, my arms crooked, palms pressing into the sheets on either side of me. The sheets are tangled. The lamp casts its sickly yellow glow over the small room. My hands depress the hopelessly too-soft mattress beneath me. I’m wondering what to do with them next, which part of my body to use to haul my torso up and behind me so that I am sitting on the edge of the bed – the vital position before I can get up from it.

I’ve managed to sustain what is probably an abdominal strain. There are a number of abdominal muscles, and I think I’ve pulled the deepest one on my left side, the transverse abdominal muscle, which is involved in coughing, laughing and sneezing. It’s a strange injury – in my case there’s little pain, apart from soreness, as long as I keep still and sit or stand in the right position. The killer is the accompanying muscle spasms – an involuntary clenching high up in the wall of the chest when I so much as bump into something or move too suddenly (this clip from the IT crowd captures both the feeling itself and the dread of the feeling).

I must have a mild strain because I can breathe without pain (although laughter and coughing present problems) and even the muscle cramping isn’t all that painful. It’s just weird and scary, makes me feel like an invalid, leads to soreness and stiffness, and reminds me that something is awry.

I have an overly soft and comfortable bed, and having to lie in the one position on my back all night since the injury has been disastrous for my lower back, which is probably a map of muscle knots and old strains. I’ve had to stop doing my daily exercises too of course, further weakening my back. The spinal chickens are coming home to roost and I, it seems, am a sitting duck. Since the days after the strain, I’ve gradually lost mobility, and now hobble around like a superannuated courtier in a Shakespeare play. I think of my grandfather, his pot-bellied body stooped and pain-ridden in the weeks before he died of cancer.

Without my back able to propel and support me, my entire body image has changed. I feel fragile, elderly, vulnerable to further injury. I am hopelessly separated from the bulk of humanity, which, on the face of things, appears to take its collective back for granted, while at the same time feeling more bonded with the human race – for who among us hasn’t, at one time or another, had a back strain of some description? Despite the fact that my problems are all muscular, and therefore minor in the scheme of things, I am scared of the future. I want a prognosis. Worse than all of this, I am missing out on precious summer days, the kind so warm they give you the illusion that life will always support you, that you need nothing. Half the time I’m so worried I can't even read.

Frightened to laugh or cough, a thousand giggles and splutters are trapped in my tummy and facial muscles. Ricky Gervais, in a repeat all the way from 2004, causes me pain when he speculates about the attempt to fix Humpty Dumpty. ‘Horses? Why would you use horses – to fix an egg?’ he queries in his slow, droll way, drawing out the absurdity through superb pacing. ‘And all of the king’s horses? What if there was an invasion? Oh, we can’t send the troops because they’re trying to put an egg back together.’

I’m terrified something else will go wrong. I am hanging on to my independence, but last night it was a struggle to do the dishes. Further debilitation would mean a return to the family home, the worst outcome possible for my sanity.

How stubborn this injury is. In the past even the most debilitating back strains (usually lower back) have only been at their worst for a matter of days. Rest has always been the magic, quick cure for any problems. Yet rest doesn’t seem to be having the desired effect this time, or perhaps the progress is just too slow to measure. In fact, the abdominal strain is improving, albeit at a glacial rate, but my back seems to be getting worse.

In desperation, I go to the first physio I can find. Truth to tell, this one is participating in a scheme by which my extras health fund pays the entire fee for the first visit. But we won’t go into that, and I battle to avoid it during the session. He keeps asking how I found the clinic. Who cares? I trust him, he’s excellent at what he does; the clinic is his practice (whatever that means in relation to a group clinic) and he’s been a physio, the receptionist informed me when I made the appointment, for thirty years.

He can see there’s nothing seriously wrong. ‘I want you to feel relaxed and that you can walk around without worrying’, he tells me. By the end of that first session – not more than around twenty-five minutes long – I do walk out normally, if slowly and gingerly. I no longer cringe in fear at the dreaded spasm. That night I have one more of these horrors while walking with my friend Simon in the park. Then they’re gone forever, never to return.

I am watching a blu-ray at his place to see in the New Year, and I masochistically choose This is Spinal Tap, a digitised print that is unbelievably fresh and funny after thirty-odd years. I torture Simon by continually begging him to please turn it off, I’m trying not to laugh. I still feel cheated of this movie: there were so many humorous morsels to savour and I was scared to let them tickle through me for fear of the pain.

Second time at the physio and my back’s back. It’s in good form. He is very paternalistic. ‘Good girl’, he says. I don’t care. I’ll do whatever he says, within reason. I ask for some exercises, he gives me two to do morning and night. ‘I’m very motivated’, I tell him and I mean it. My precious independence is beckoning. At the end of the visit, the physio says he wants to see me one more time.

When he’s giving me treatments I understand why I haven’t been to a physio for 20 years. It’s terrifying. He levers different parts of my spine up and down, up and down, and I am scared I’ll panic. I had contemplated telling him I had an anxiety about being touched in a professional setting and then decided against it. Luckily he seems to think my clear discomfort is about a residual fear of muscle spasm.

Ah, physios. What a worthy profession. I used to have a friend who was a physio and while in training she would occasionally come round and practise on me. At the time I wondered why on earth anyone would do such a long and intensive course in an area that seemed so pedestrian. Now I can’t think of anything more worthwhile than watching someone hobble into a consulting room, and later waving them goodbye as they depart with a spring in their step. Not that this happens every time of course –  clearly in my case I was suffering from nothing but strained muscles, easily assuaged by the treatment  – but improving mobility is a noble pursuit.

After my third and final visit to the physio I’m a new woman for a day or two, but my troubles aren’t over yet. The back strain has been worsened by too many hours spent slaving over a hot computer in the last few weeks. My back is angry and painful, and I can’t seem to get on top of it; I’m doing the exercises the physio has recommended, but am still not back to my old exercise routine. One Friday afternoon after meeting a demanding work deadline my back seizes up to the extent that I can hardly walk.

Determined to get my back back, I start walking laps of the oval at the local park. I buy a cold pack, use a wrapped towel as a lumbar back support when I’m working, consider buying a $200 back rest for watching tele. I religiously leave the computer and curl up on the floor when the strain starts to feel serious.

And then it just ends. It stops. My back is back to normal, in fact probably better than normal because of the physio's intervention. There’s no rhyme or reason, I’m not sitting any better or doing anything different, although I have started my old exercises again, which is probably strengthening it further. Perhaps I had actually strained it quite seriously as a consequence of the original abdominal strain, and it’s only just fully recovered. It’s working so well that I’m happily mildly mistreating it again, twisting and bending and struggling to make the effort to crouch down when I pick something up. The garden’s looking better, the car is clean.

But I will never take my back for granted as I did before, and I’ll continue to build it up with strengthening exercises. I need my back and I’m not going to let it let me down again if I can help it.

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