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February 2, 2000
An Alternative to Back Surgery
One patient's power of patience
By Pableaux Johnson

Illustration: Yoga

I was, without a doubt, too young for this to be happening. The first twinges of pain started before my thirtieth birthday. I had often heard my 85-year-old grandfather kvetch about his sciatica and the back pain it caused, but it seemed a distant complaint reserved for my fiftieth high-school reunion.

But as many younger members of the commuter/computer generation are discovering, the common causes of low-back problems -- poor posture, prolonged sitting, and endemic stress -- can cause damage long before your mortgage is paid off. Slouching and stressing in front of your PC puts unusual strain on the lumbar area of your spine and can cause a world of pain in your relatively young years.

My progression of spinal desperation took about two years to run its course. Despite my dismissing those initial twinges as muscle strain, the discomfort spread down the length of my right leg -- sometimes manifesting itself as shooting pain and sometimes as, literally, a pain in the butt. Within months, I developed a limp and couldn't walk for more than a block without severe spasms. I gave in and saw a doctor, who referred me to an orthopedist.

The X rays and MRI scans revealed the cause of my pain. The shock-absorbing disks that separate the vertebrae in my lower back had broken out of their usual territory. These herniated blobs of cartilage were pressing directly on the spinal cord -- the largest clump of nerve tissue outside the brain and the body's "central nervous superhighway." And because the pinch occurred in my lower (lumbar) spinal area, it resulted in a pinching of the sciatic nerve, the leg-length tributary of the spinal cord. I was suffering from sciatica, just like my 85-year-old grandfather.

The pain was constant, chronic, and debilitating for a full year. During that time, I tried anti-inflammatories, spinal steroid injections, and powerful painkillers. These conventional treatments did me little good, but I kept them up in an attempt to avoid the specter of spinal surgery.

The final straw came with the actual disappearance of pain. First, previously pained areas of my foot and shin went numb. Pokes and prods produced only mild sensation -- the outside of my calf felt like meaty Styrofoam. This kind of numbness, I was told, was a classic symptom of advanced nerve damage. So in a quiet and dignified manner, I freaked.

About this same time, the prescription painkillers I took to relieve nighttime pain started to wear off earlier and earlier. Sedatives that used to provide a full night of pain-free sleep stopped working after only two hours. The insomnia made it impossible to function, and for the first time, I seriously considered surgery.

On the one hand ...

The surgical procedure done for my type of back pain is called a laminectomy. It involves opening up the muscles around the spinal cord, exposing the problem area, and then removing bone spurs or disk fragments that are pressing on the spinal column or nerve roots.

The downside of the surgery would have been the necessary (but semi-risky) spinal fusion -- the joining of two or more vertebrae into a single bone to strengthen the spine after the laminectomy. The end result would have been "drastically reduced spinal flexibility," even with extensive post-operation physical therapy -- dashing my childhood dreams of Olympic-level hula competition.

And on the other ...

The conventional side sounded pretty unreasonable to me, and I still had one ace in the sleeve: alternative therapies. Even though the pain seemed greater than what incense and a floor mat could handle, I hadn't tried it all yet. All the doctors I talked to stopped short of calling yoga a cure, but they did recommend it as a good therapeutic regimen. Likewise with acupuncture -- it could provide temporary pain relief couldn't correct the underlying problem of the bulging disks. Taken together, though, there was a chance that these two ancient disciplines could provide the kind of baseline physical conditioning and postural improvement to encourage the disks to realign.

After a few days (and long, painful nights), I decided to take the gamble. After all, what did I have to lose? If yoga didn't cure the problem, then at least my body would be in better shape for the surgery. After a quick visit with my doctor, I tracked down a yoga instructor with experience in chronic pain and an acupuncturist with very gentle hands. My orthopedist wished me luck and scheduled a follow-up appointment in eight weeks.

For the next two months, I gently pushed myself through a beginner's yoga routine, careful to avoid poses and exercises that could worsen my back and leg pain. I could feel my posture gradually improving. (The key here being gradually -- the first real changes appeared about two weeks into the process.) I showed up every day for my hour of quiet stretching; if I was going to avoid the knife, no excuses were allowed.

Slowly and consistently, I rolled into the different poses -- awkwardly at first, but each session brought a little more balance and flexibility. My walking range increased, and pretty soon I could stroll around the block without limping at all. My strengthened back and abdominal muscles straightened my stride. My twice-weekly acupuncture sessions relieved the pain even further -- though I'll never look at sewing supplies quite the same way again. When the orthopedic follow-up rolled around, I had made significant progress.

And a month after that, the stretches had reduced the pain to almost nothing. The stronger muscles in my back and legs adjusted my posture and relieved pressure on the disks, which had realigned into their proper places. No pressure, no pain. It was that simple.

Six months later, I could hike for hours and barely remember the persistent pain that ruled my life for two long years. And all it took was a stretch instead of a scalpel.

I still keep a few of the X-ray films around -- always in plain view on a desk-side bulletin board. Every once in a while, when I'm slouching hard on a stressful deadline, I feel the little bubble of disk pushing its way nerveward and I do the only thing I can do: get up from the computer, stretch myself out, and take a grateful, pain-free walk around the block.

Get back, Pain!

  • Back patients should always consult a doctor before undertaking any exercise plan.
  • Call around and find a yoga teacher who is familiar with low-back pain, and discuss your problem before attending class. The teacher should be able to let you know what poses or stretches to avoid.
  • Be patient and consistent -- you'll experience some initial soreness, but this will pass with subsequent sessions.
  • Don't push yourself through a routine -- yoga works on the premise that you relax into the different poses. As your flexibility increases, the moves will get easier.
  • Develop an at-home alternative for days when you can't make it to an organized class. Many bookstores and alternative health stores carry yoga routines on audiotape and videotape. Ask your teacher for suggestions.