If you’ve ever “thrown your back out”, you know what it means to be on the floor, unable to move without making some serious guttural noises—and perhaps uttering words not fit for young ears. It’s so common, we’ve all heard various descriptions: My back is out. I pulled something. Or, if you’re more medically seasoned: I herniated a disc.
In my case, the life-long back issues began in high school, when a hundred-twenty-seven pound kid thought he could play football with young men twice or three times his size. Bad idea. That was disc number one. Fast forward to age forty and WHAM! Two more discs, totally ruptured and pressing on the sciatic nerve so hard I found a new symptom call “drop foot”. Besides the unbearable pain of sciatica, I literally couldn’t lift my left foot to walk. I’ll never forget the first time the neurosurgeon tapped my knee with his rubber hammer and nothing happened. “That’s not good,” was his initial reaction.
To say that a serious back injury is painful is an understatement. You look fine to the rest of the world. Maybe you’re just exaggerating? Maybe your pain tolerance is just too low? Maybe you’re just a wimp? Well—if you’ve ever had that “take-your-breath-away-pain” that is so excruciating that you can barely breathe, you know what sciatica truly is. I’d like to think I’m a pretty tough cookie. And I can clearly remember lying in bed, staring at my knee which I knew was uninjured, wondering why it felt like my kneecap was going to explode off my leg and fly across the room in a giant fireball. You gain a truly new understanding of what pain is when your spine is crushing a nerve. There are a lot of drug addicts out there whose problem started by trying to deal with the agony that is a back injury.
I was lucky. While the two discs will never “grow back or heal”, they did shrink up enough to come off the nerve, and slowly allow me to recover without surgery. And that’s why I’m sharing this story with you. Back surgery is one of the toughest decisions you’ll ever have to face—and you’ll be dealing with that decision at the worst possible time because you’re in such unbelievable pain, you can’t think straight.
When I injured my back—and I wish I had a great story on how it happened, but I don’t—I thought it would get better after a few days of Advil and ice, my usual course of action over the last thirty years since high school. It didn’t. In fact, at the end of a week, I literally couldn’t get out of bed. When I eventually found myself on the floor, unable to move at all, my wife and son did their best to help me to the car, crawling one inch at a time. Truth be told, my wife wanted to call an ambulance, but I found that whole scene too humiliating. So, we made the 45-minute journey to the car—a distance of maybe a hundred feet. I was soaked with sweat from the pain, chewing on my teeth as I tried not to scare them by screaming.
At the ER, the doctor was kind enough to do an x-ray, MRI, and immediately order a morphine drip, valium, and who-knows-what else. It barely took the edge off. At one point, a nurse came in and looked at me and asked in surprise, “You’re still awake? That could have knocked out an elephant.” I was wide awake, and just thankful to have a pain level I could tolerate.
A couple of days later, I was in an orthopedic surgeon’s office discussing a spinal fusion. I was on lots of pain medication, and not thinking very clearly, but the pain was so out of control, at that moment I didn’t care what they did as long as they could stop the torture. When he explained the part about sawing off the back of the vertebra and screwing it back together with rods and titanium screws, he got my undivided attention. I reluctantly said yes, and he had me scheduled for surgery four days out.
For the next couple of days, friends came by to visit and thankfully, two of them insisted that we get a second opinion. Frankly, I was too out of it to have much of a say about anything. My wife had the good sense to listen and found a neurosurgeon for another opinion. This is the part I want you to read more carefully, because just maybe, I can save you from a bad decision.
One small detail of the injury: when the discs ruptured, they blew out the side of the spine instead of the back of the disc, where the “goo” would typically go because there’s more space back there. When I asked the first doctor, who wanted to remove the back of my vertebrae, why he didn’t come in from the side, he said “they don’t do it that way”. What do I know? When I went to the neurosurgeon, as he explained the procedure he would use, it involved making a small incision from my side, and working through a tube to move the disc material off the offended nerve. I was surprised. From the side? I explained that the other doctor said it couldn’t be done that way. Well, it turns out that orthopedic doctors have their way of working with bones, and neurosurgeons have their way of working with nerves. And neurosurgeons who work on brains are used to working in small spaces and touching as little as possible. This was the day before my scheduled spinal fusion. I instantly told this doctor he was hired, and my spinal fusion would be cancelled.
And then there was a second surprise. This amazing neurosurgeon, Dr. Mark McLaughlin of Princeton Brain & Spine said to me, “But wait—let’s not do surgery yet. I’m really good at this, and I like doing it and it’s how I make a living, but you don’t want me doing it to you.” I was shocked. I had prepared myself mentally for spinal surgery—no small undertaking. After almost two weeks of mind-blowing pain, I had resigned myself to the knife, and now I had a surgeon telling me I shouldn’t do it.
This brought us to a long discussion. I had asked the first doctor about epidurals for the pain. It was his opinion that those “pain shots” were temporary relief, and would only delay the inevitable. But, as my new best friend explained, what have you got to lose? “You can always do the surgery. I’m not going anywhere. But why not try the shots, physical therapy, chiropractic, yoga or anything else you can possibly think of first?” A day later I was lying face down on his table while he slid what felt like a ten foot needle into my spine. It wasn’t an enjoyable experience. (I found out much later I could have had general anesthesia, but as he explained, “After what you’ve been through, this is nothing.) The next day, my pain had gone from a solid ten to a seven. Two weeks later, shot number two brought it to maybe a five or six. Shot three didn’t do anything, but by then, I was able to walk and get around again. And that’s when the real work began. As Dr. McLaughlin had warned me, “backs heal in geologic time”. It was true, I healed by the week and month, not by the day. But with the help of physical therapy and a chiropractic technique called A.R.T. (Active Release Technique) I was slowly getting better. It was probably five months before I was finally pain free and able to get back to my normal routine, but I didn’t have rods and screws in my back!
The takeaway from this experience, and what I’d hope to impart to you if you ever injure your back, is that given enough time, you can allow your body to heal itself. You’ll need outside help as that happens, with pain management, physical therapy and chiropractic care, but like that surgeon explained to me, “If you can take the pain and keep working through this, you can heal without surgery.” And that was coming from a surgeon!
It’s now two years later, and I’m pain free ninety-five percent of the time. “Spine School” at the physical therapist taught me some valuable lessons, too. There are certain limitations that have come with being fifty-one and missing a few discs. I can’t run anymore—the pounding is too much these days. And I have to be very careful about lifting heavy objects. (Drop that butt, bend your knees, and use your legs!) I try my best to maintain excellent posture while standing or seated. And lastly, I listen to my body. I try to do my core exercises every day, and if I’m having a bad couple of days, ice and Advil are enough. While I’ll never have the back I had as a kid, I feel good. And I remember that old Clint Eastwood line, “A man’s got to know his limitations.”