My struggle with intense back pain led me through a variety of different therapies, some that worked better than others, but all worth sharing with the hope that one may help you too.
Back pain is one of those ailments that unless you experience it yourself, you don’t fully understand how debilitating it is and how much it permeates throughout your daily routine. It quite literally affects your entire life not to mention your mood (constantly being in pain can lead to constantly being pissed off). You’ve heard of ‘hangry’ - the mood you get when you haven’t eaten in a long time? Someone needs to come up with a term for those of us with back pain. It makes ‘hangry’ look like a trip to Disney World. Some people have back pain and it goes away over time. Some people have it and it never goes away; it’s a constant part of their life that they just have to cope with and manage. I don’t yet know which category I'll fall into but it's been ever present for several years now.
Flash back to 5 years ago in Montauk, NY, where we spent summers in our Hither Hills house. On the second day we arrived, I took my bike out of the garage, pumped the tires and decided to go for an early morning workout at Gurney’s. Halfway there I was going down a hill and my brakes failed; my guess is they got brittle over the winter. I flipped over my bike and crashed in a violent and serious manner. Luckily I fell in front of someone’s driveway. I use the word ‘luckily’ in a very liberal sense, there was very little that was lucky about this crash. The houses are scattered but I was fortunate to be right in front of someone’s driveway and they ran out and saw me. Had I not crashed in front of someone’s house, had they not run out and seen me, I could have been there for hours unheard and unable to move. Full disclosure: I wasn't wearing a helmet, and luckily one of the few body parts that was left unharmed was my head.
An ambulance came to my rescue, but my injuries were far too serious for them to take me to the nearest hospital. Southampton hospital couldn’t deal with the severity of the trauma so the paramedics decided to helicopter me to Stony Brook University Hospital, which is an hour and a half drive away. The prognosis? A broken clavicle, all my right ribs broken, a punctured lung, a bruised pelvis and all of this other crazy stuff. I was about 37 years old at the time and I spent a week in the hospital with a chest tube reinflating my lungs. During that time, all of the pain from the broken bones overshadowed any back pain I had. I was in excruciating body pain, it didn't matter whether it was my back, arm, lungs, ribs, or head. It all hurt. I needed to sleep in a special hospital bed brought into my bedroom at home for the next month followed by six months in rehab fixing my body. I couldn't even raise my arm because I had stretched the brachial plexus nerve that brings function to my arm. It felt as if I was mechanically starting all over again except unlike a toddler learning motility and movement, I had to do it with a broken body engulfed in pain.
Over time, and after intense rehab, life went on and I got better. I suffered from back pain sporadically but it wasn’t too bad. Fast forward to a few years later, when I just turned over 40 and adapted a healthier, and more physically active, lifestyle. That’s when the back pain started to come in full-throttle: not just with signs of soreness and stiffness, but excruciating sciatic and lower back pain. Sciatic pain travels all the way down your leg, even numbing your toes. Initially I tried to ignore it by resting and truly believing it would go away. My first line of defense was rotating hot blankets and heating pads with a cold press or ice. I was loading up on ibuprofen and Aleve which didn’t help. When it comes to severe non-muscular back pain, those methods simply don't work. Then I tried stretching, special stretching, and more stretching. I tried Pilates and the reformer machine, because everyone told me to ‘Work on your core!’ and that my back would feel so much better once my core was strengthened. People love playing doctor when it comes to back pain. Pilates is amazing for core strengthening and I did 6 months of reformer training 4-5 times a week. My abs and core were rock hard but I was literally in agony the whole time. The kind of agony where you have to stop after having walked a few feet, then stop again a few feet later, and so forth until basically you realize you can’t walk anywhere. So while my abs looked great, my back pain was ever present and creating an ugliness inside of me.
The next suggestion from the peanut gallery was to get massages. And so I did, and they felt great! Throughout the massage I felt total relief. But as they say, all good things must come to an end, my massage ended and so did my pain relief.
A few weeks later during Yom Kippur, halfway into my short two block walk to synagogue I had to stop and sit at the bus stop because my pain was too intolerable to continue walking. I called my wife to pick me up and went straight to the doctor for an emergency cortisone shot. This was my first interaction with cortisone shots, which are essentially injections of steroids directly into the affected area (in this case, my sciatic nerve). My entire leg went numb and I had to sit at the doctor’s office for a few hours until I could walk again and feel the ground with my foot. A lot of pro athletes get these types of shots before a game to get rid of their pain so they can perform through an injury. Sometimes the pain relief lasts for a long time, sometimes only until the next game. I had relief for about three days.
Next up: I went to get an MRI. I had been avoiding going to a specialist, assuming I could just fix it with ibuprofen, yoga, pilates, stretching, massage, and heating pads. But I was starting to realize that perhaps these therapies weren’t working because my diagnosis wasn’t complete. And to truly understand which therapy will work, you need to get all the proper testing completed to pinpoint the exact problem. Seems obvious, but with back pains it's just not as clear cut and unfortunately misdiagnosis combined with inefficient testing is all too common. It turns out I had a bulging disk between my L4-L5 vertebrae. This is the area where the sciatic nerve comes out of your spine and goes down through your leg. The bulge, which the doctor told me is most likely a result from my accident, was now pressing down on my nerve.
This diagnosis led me to try “spinal traction,” a form of decompression therapy that relieves pressure on the spine. The space created through traction takes the pressure off the nerve, hence relieving the pain. Some people hang upside down from their legs for about 30 minutes on inversion tables. But I chose to put on ankle weights and let my feet hang while holding myself up on my elbows on a roman chair - it has the same effect.
Everyone in Miami told me that “Dr. Matthew Cooper was the best” and I had to go see him for my back issues . He’s with USA Sports Therapy and treats a lot of pro-athletes. So I went to see Matt, who does an acupuncture electrical stimulation combined with his own type of traction, where he puts you on a table, contorts you, and achieves the pain-relieving space between your vertebrae. Three months into the therapy with Dr. Cooper, I was 95% better and it seemed like I had finally figured it out. At that point I felt mostly healed and decided to end my therapy sessions. The treatments were pretty expensive (if your insurance doesn't cover it) and entailed a significant time commitment of 3-4 times a week with an hour for each visit, all of which just wasn’t sustainable for me (and doctors are never available at convenient times like lunchtime). Within a month of stopping I was not only back to square one, but even worse. I went back to him and this time the same therapy didn't work. Was it because I stopped? It’s anyone’s guess, but apparently it’s pretty common that back pain returns even after you fix it.
Electro Acupuncture Therapy on both my lower back and neck
Faced with limited options, I then started looking at alternative therapies. Rolfing was the latest suggestion and looked pretty interesting. Over time your body's fascia (the band of connective tissue just under your skin that envelops, binds and separates all the muscles, organs, etc from each other) gets misaligned forcing your body into an unbalanced state. Rolfing is a super deep “massage” that feels like someone is taking a tenderizer to your body. The Rolfer attempts to realign your fascia. It’s a very visceral, intense, painful massage, to say the least. The goal is to try to loosen the fascia deep within your muscle, around your organs, spine, and pelvis. In a desperate attempt to try anything that would help ease my pain, I signed up for a 10 session therapy that works your entire body. It really hurt, and unfortunately so did my back even after the sessions. Meanwhile, throughout this time I was continuing to work out, looking like a superstar athlete on social media. But the reality was that I was doing very specific exercises that didn't require me to bend over and most of the time I was still in agony and barely able to walk. Looks can be deceiving: What was showing on my outside was absolutely not reflecting what was going on with me on the inside.
Foam Roller and Ball Massager I use everyday
My Rolfing Session with Ivette Pineal in Ft Lauderdale, FL
Next I tried Eldoa, which was developed by a spine surgeon and involves a series of exercises and stretches targeting specific vertebrae pinpointing where your pain is. You repeat these over and over again and essentially achieve the same traction that Dr. Cooper had done, but through natural stretch methods. Many golfers use Eldoa, especially when they have back problems because it also helps with range of motion and stroke. Simultaneously I was trying some other methods at home such as a ball massager and foam rollers. I even bought a plastic makeshift cold plunge tub to put on my balcony that I’d fill with ice, which works well because it numbs your entire body (but only for that day). Each of these things helped a little with temporary relief, but none actually got rid of the back pain - with the exception of those initial three months of therapy with Dr. Matt Cooper.
Eldoa Movements with Ryan Degale Part 1
Eldoa Movements with Ryan Degale Part 2
Finally, Dr. Cooper, my trusted advisor at this point, suggested I try PRP (Platelet-Rich-Plasma Therapy) which is an injection of a patient's own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. PRP injections use your own healing system to improve musculoskeletal problems. It was a fairly new special new technique that I was assured was more effective than all my previous treatments. Once your blood is drawn (in the same way as when you get blood taken for a standard blood test via arm vein), it is then vacuum sealed and put into a centrifuge that separates plasma from red blood cells. The plasma is then injected into your joints or wherever you’re feeling pain (for me it was the SI joint and L4-L5) under a special X-Ray machine.
First I was injected with Lidocaine deep into my joint to numb the pain from where the plasma was going to be injected. I won’t sugar coat it - both the lidocaine and the plasma injections are uncomfortable and hurt, despite whatever they tell you! The good news is, it was totally worth it. Because the lidocaine numbed my nerves, I felt immediate relief (which is a good sign because that means they injected the right spot!). Still numb from the Lidocaine, I didn't feel much of anything that evening and was told the overall pain relief will be a gradual process. I felt a little bit better every day and after the first week, I was about 80% better. It’s been a month now and so far it’s thankfully lasted with the exception of a few bad days.
PRP Injection Being Administered under X-Ray to Me
Another option that has an even better success rate than the Plasma Injections is Stem Cell treatment, which many athletes do as well. Stem cells are taken from the bone marrow in your femur with a syringe and then injected into your injured problem areas. Since the process of retrieving cells from your bone marrow is significantly more invasive (and painful!) rather than simply drawing blood, I opted to first try PRP with the hopes it would help before resorting to more extreme treatments.
I’m still a work in progress and while the PRP made a huge difference for now, I’ve been warned it’s likely temporary and people usually have to repeat them several times a year. There are certain things I categorically can’t do any more such as running or specific weight lifting exercises like free weight squats. I’ve come to terms with the fact that my condition is chronic and I may never completely get rid of it, although I’m hopeful and open to try anything!
People have all different types of back pain be it muscular or derived from their nerves/joints, but luckily there are so many different treatments and options out there. And what works for one person may be totally different for another but the best road to relief is by knowing your options and then trying everything out there until you find what works for you!
Follow Me On Social Media