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Learning to Beat Back Pain by Going Back to School

October 29, 1987|LEONARD BERNSTEIN | Times Staff Writer

I didn't ruin my back overnight. It took years of desk work, bad posture and poorly toned muscles--the kind of spinal abuse that ought to be in the penal code--to create the stabbing pain that starts in my lower right back and shoots through my leg to my heel.

But it wasn't until my daughter was born four months ago that I came to know the true meaning of back pain.

People who have never experienced back pain--and that's just 20% of the U.S. population--cannot understand how lifting 8 pounds, 6 ounces of child can be the straw that breaks an adult back. But each time I lifted Julia out of her infant seat in the rear of our two-door car, I paid the price for the next few days.

I went to Dr. Steven Garfin, UCSD Medical Center's spinal specialist, who ruled out tumors and other abnormalities too horrible to mention. Surgery was out of the question. Garfin had one other suggestion: attend the UCSD Back School.

For the Record View Section Photo Captions Incorrect
Los Angeles Times Friday October 30, 1987 San Diego County Edition Part 1 Page 2 Column 6 Metro Desk Type of Material: Correction
The photo captions on a story in the View section of Thursday's Times about a back therapy school at UC San Diego misidentified the woman pictured as Sonja Harlow. On Page 1 and Page 21, the therapist pictured was Sandy Martin. On Page 22, the woman pictured was a patient at the school.

Unlearned Bad Habits

The 6-year-old Back School is a two-day, five-hour instructional course where I unlearned 29 years of back-breaking habits. Like traffic school for speeders or summer school for dropouts, back school is a reform school. I was eager to change my ways. Nothing else has helped so far.

Originated in Sweden about two decades ago, Back Schools have shown a strong record of success. At least four follow-up studies have shown that the lessons taught in the schools reduced back pain for many of the students. In one study by two physicians of 6,418 participants, 69% reported significant improvement; 92% reported that they follow the back care routine; 79% reported that they did their back care exercises and 97% considered back school helpful.

The Back School technique is a simple one, and a common refrain in medicine: preventing back pain is easier, less costly, and less painful than treating back pain. And only the sufferer can do it.

"It's not only much more difficult, it's a longer process (to treat back pain)," said Sonja Harlow, director of the Back School. "You lose money, sometimes, as the employee. The employer loses money. The insurance company loses money."

In Hands of Therapist

If it seems ridiculous to spend so much time learning how your back works, and how to keep it from making your life miserable, then you've probably never had low back pain. After six years of orthotic devices, muscle relaxants, pain relievers, quackery and self-help manuals, it was comforting to be in the hands of a clearly competent physical therapist named Sandy Martin.

Martin said that she had one goal: "to provide you with the ability and knowledge to cope with back pain independently and not seek secondary treatments."

Though most back pain starts at about the age of 35, mine started about seven years ago, when I graduated from college and took a journalism job. Maybe I sat too much and got too little exercise. Maybe it was my uneven desk chair in our cramped office. One of the most maddening things about backs is that you often don't know why they hurt.

"Why backs? Nobody can really put their finger on it," Harlow said. "It's possible that it's a weak area. As you start to get wrinkles on your face and gray hair on your head, the inside of your body starts to get older too. The discs (cushions between vertebrae) start to degenerate. If you're not careful and you don't take care of yourself, by the time you're 35, you start to get some back pain."

No Defects Shown

Since no defects have shown up on X-rays, the best guess I've received from doctors over the years is that one of my discs has pushed out from the stack of bones making up the spinal column and is irritating the thick sciatic nerve that runs from my lower back to my heel. That would account for the pain that radiates down my leg.

All I know is that when the humidity goes up, so does my pain. When I twist or bend or lift the wrong way, I can touch off pain that stays for days. While the pain does go away for weeks at a time, it's more often present than absent.

Over time, I've had to adapt. I wear only soft-soled shoes with orthotic supports in them. I sit only on cushioned chairs, when possible. I cannot keep so much as a pencil in my right back pocket without sending pain rolling from my waist down to my heel.

I also have developed a tendency to lean to the left as a way of taking my weight off my right foot, where the pain is often the worst after a few minutes of standing. Standing or sitting, I'll often find myself tilting slightly to port.

Disc Irritates Nerve

Martin tried to teach our class of eight how we brought this situation on ourselves. Back pain is most often caused when the gel-like interior of a disc bulges through its tough exterior, irritating one of the many nerve roots that begin there, or diminishing the amount of cushion between two vertebrae, Martin said.

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