When the Healer Needs Healing

When you're in a chronic back pain flare as a healthcare professional and a mom.

TL/DR: Consistency is key. Do the things you need to do to take care of your body on a daily basis. Seek outside help when it's too much to do alone.

Here we are in the duldrums of January. On the South Shore of Massachusetts, we've had more snow in the last two weeks than we've seen in a years. We got around 20 inches of snow almost 2 weeks ago and it still hasn't melted. It's been below freezing cold. When the temperatures reach freezing, it actually feels balmy.

Here I am, after the post-holiday lull, in this dead of winter, managing family life and work, helping family members navigate the healthcare system, with balls in the air, and I overdid it. What does that mean? It means that I live with back pain and sometimes I ignore my body in the interest of daily life and meeting the needs of those around me and my chronic back pain flares up.

I had a lumbar spinal fusion when I was 15 years old. I always have some level of discomfort in my back and sacroiliac joint (one in particular). At best, it's a tightness or stiffness in my lower back that I can live with. At worst my sacroiliac joint is aching deeply, by mid-afternoon my thoracic spine feels like someone sucker punched me right in the middle and there's a tight band across my shoulder blades, and my neck is constantly sore. On a weekly basis, I do pilates on a mat and reformer lead by my highly trained classical Pilates instructor who also has chronic back stuff (she gets it). After Pilates, I'm usually rebalanced, realigned, feel 5 inches taller, and I feel strong.

How I Overdid It

How did I get to this place of "I overdid it"? Back tracking over the past few weeks, we had snow. I wanted to get outside to help, so I had my husband and then my brother show me how to start the snowblower and I went to town on our 250 foot, hilly driveway. Felt good to be outside, out of the chaos of restless kids and doing something productive to take something off my husband's plate. Then it snowed again, harder. We took turns. I went out again. It was this second time that I realized the snowblower has levers that guide it to turn right and left. I didn't have to muscle it to turn the way I did the first time. (Strike one?).

The day after we got 20 inches of snow, I went outside with my snowshoes and trekked a trail across the yard into the woods with my 3 year old following me in her snowshoes and my husband and 5 year old up ahead. I sunk down into the deep snow and got stuck with my knees flexed and strained to get back up with help from my husband. My knees felt elastic for a moment, but I got up and continued on until my kids were cold and tired.

A few days later, my husband and I took my daughter to family swim time at the pool. I took advantage of having my husband with us and went off on my own to shoulder deep water to do some water walking, leg exercises, and stretching with water resistance. Felt accomplished, proud of myself. Doesn't sound too strenuous, right?

A few days later, I was carrying a light box to my basement when I slipped in my socks on the second to last step and hit my hip and back against the stairs as I fell. One of those embarassing falls that makes a thud. Falling as an adult hurts.

A few days later, I did my pilates routine, started with the usual "this is sore" and "that is sore" and "Oh, by the way I fell". Within 2 days after, the flare had taken full hold, persisting, aching, burning in a way that worries me about living and aging with a "bad back". In a way that tells me, lifting my kids one wrong way could be the last straw. Or helping a patient to stand up without minding my body mechanics could be the last straw. The other day I taught my 5 year old how to hold his elbow on a trigger point in my piriformis. He laughed and did it, but asked when he could be done. He'd prefer to drop an elbow like a W.W.F. wrestler than hold still to wait for tissue to release.

Becoming A Patient Again

So...yesterday I decided it's time for me to be a patient again. I took myself to Urgent Care, waited a couple hours. Spoke to an NP. Got a few x-rays; nothing broken, nothing mal-aligned, definitely with degenerative changes as expected. Got on a steroid taper to calm the inflammation. Spoke to an Orthopedic Physiatrist, who recommends 6-8 weeks of Physical Therapy for this Physical Therapist before considering any additional imaging or pain injections. I just scheduled an appointment with a PT who I saw a few years ago. I know she can help me with manual therapy and accountability (both of which I need).

As I'm writing this, my 3 year old came up behind me with a "skeleton map" and wants to sit on my lap so I can read the words next to all the bones on "The Skeletal System" poster. A brief lesson in anatomy for my girl. Maybe she'll be a PT someday.

Now I find myself on a traditional healthcare model path of taking care of this chronic back pain flare and I have to remind myself (and you my gentle reader) that health is not a one time fix. It's the things I do to take care of my body on a regular basis, consistently. I told the Orthopedic provider that both of my grandmothers are living into their 90s, so I may have 50+ years of living in this body. Tomorrow, I'll see my old PT again and be humbly reminded to do the work.

My Go-To Self-Care Tools

To get some relief in the past few days, I've used:

• CranioCradle - under my sacrum to provide decompression and relief

• The Neck Hammock - gentle traction that lets my neck "unwind" as it needs to

• Sacral Wedgy - also helpful for decompression, but I'm not tolerating it very well at the moment, I prefer the foam CranioCradle presently.

• Foam Roller - my thoracic spine thanks me!

• A myofascial release ball - tucked under me in a spot of muscle tension, added the craniocradle under my sacrum, plus my CPAP, helped me to sleep well.

• Walking pad - I tolerated at 2.6 mph max for 15 minutes, time limited by pain and also toddler interruptions looking for mama.

• Ibuprofen 2x/day - helpful for a time, but pain is persistent, which is why a steroid is helpful to calm the inflammation.

• Seat warmer in my car- feels good, for short car rides <20 minutes.

• Sleeping positions - with a pillow or two under my knees on my back or between my knees for side sleeping to keep my pelvis aligned.

• Sauna or hot tub? I considered if I had time and actively chose not to go in the sauna or the hot tub at the gym (as my husband suggested, which sounds lovely) but I'm trying to decrease the inflammation during this acute flare-up.

• Any Distractions I can: starting and restarting to knit a cowl scarf for my niece, using a stress management app on my phone, teaching others how to use the same stress management tool since I've been reminded of it, playing loud music in the car at the request and direction of my 3 year old, trying to watch a full movie of my choice with my toddlers around.

Thanks for reading. If this resonates with you, let me know.

Dr. Jenn