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My aching back! (and what might help yours)

How it began... Me hang gliding off Mount Seven, Golden B.C. circa 1975.

No parachute, folks.

I remember my back aching frequently after snowmobiling when I was a teenager. My first actual back injury, though, was a few years later,  trying out a home made kit-built hang glider. A rough landing knocked the wind out of me. A few years later, skydiving knocked the wind out of me again, and gave me a headache too, but in 2 hours I felt better so I jumped again. Then I hurt more.

Luckily I wasn't hurt as bad as Mike at www.deadmike.com! Anyway, a few days later, when bending over, I was hit with a sharp pain in my lower back, in the right sacroiliac joint area (just below the belt, to the right). For several years I periodically visited chiropractors who were generally able to provide relief by manipulation and I was fully able to hike in the mountains.  I later took up mountain climbing; My back still gave minimal trouble.

Eighteen years after the original injury, one day I felt  a sharp pain again in the sacroiliac. Repeated visits to chiropractors helped for only a day or three, and I found that hiking aggravated it. Physiotherapists helped very little either. It wasn't a disk problem or a hip problem, and they attributed the problem simply to aging (at 36!). I was then doing a variety of stretching exercises and also lower back and abdominal strengthening exercises. I felt stronger and was more flexible, but  I still couldn't hike or climb due to back pain.

I waited six months to see an orthopedic surgeon, who quickly proclaimed that he "couldn't fix it with surgery"  and ordered blood tests to check for a painful, progressive arthritic disease called "Ankylosing spondilitis" which eventually fuses your spine. I didn't (thankfully) have it. He could only suggest frequent use of anti-inflammatories like Ibuprofen or Advil, to reduce the pain.

I tried Yoga and got even more flexible, but my back still hurt.

Finally, a friend told me of a treatment she had heard of for loose ligaments. Ligaments are what hold joints together, and if they get stretched too much (like a sprained ankle), they can't stabilize the joint properly. If stretched excessively, ligaments don't tighten up well on their own, unlike a muscle. Stretched ligaments cause pain.  Ouch!

A treatment called "Prolotherapy" described in a book called Pain Pain Go Away by Drs Faber and Walker sounded promising. This prolotherapy procedure involves repeated injections of a proliferating agent (usually a solution of dextrose and local anesthetic) into the loose ligaments, wherever they may be. The solution mildly irritates the ligament and promotes additional cell growth (scar tissue) on the ligament, making it stronger. A series of injections are done in a doctors office. Many pro sports athletes have had this done.

I suspected that from the impact of hitting feet first in both my skydiving and hang-gliding accidents years before, certain lower back ligaments were possibly weakened and now with age (or abuse from carrying a pack), had weakened further and were causing me pain. Fortunately, I found a doctor that did proliferation injections (prolotherapy) along with spinal manipulation. Over a period of several months,  I had 5 sessions (about 10 injections along the sacroiliac and lower spine S1/L5 and facet joint area each time). It took about six months to a year to fully benefit from these, but they did help a lot and once again I could climb mountains. I found it necessary to have them repeated about 18 months later, but they did not seem as effective that time. 

Someone suggested I visit a SPORTS physiotherapist, rather than a regular physiotherapist. Skeptical, I did, and he diagnosed me as not properly activating the gluteus muscles (butt muscles) properly when walking. Maybe it was because I was trying to chew gum and walk at the same time! He noted that I was instead using my hamstring muscles, causing additional torsion and stress on the sacroiliac joints. He then showed me specific exercises (more exercises!) to "teach" some of the smaller muscles to enervate (do some work). 

A lazy ass. Exercises to strengthen small lower abdominal muscles were prescribed, to help stabilize the spine, and also some "thinking" exercises so as to activate these smaller but lazy, unused butt muscles. These muscles apparently wrap around the butt across the sacroiliac joints and attach to the sacrum (just above the tailbone) and when tensed, help to stabilize the sacroiliac joint. He also suggested a special back support belt called a Sacroiliac belt,  $40 Cdn (about 29 cents American) at medical supply stores. These are about 2.5" wide, fasten with Velcro and also have two elastic straps to wrap around that are attached to the center of the belt at the back. This is not the same as what weightlifters and stockboys wear. You wear this just below your normal belt (inside clothes), stretch the elastic straps snug and stick'em down to the Velcro. This causes an inward pull across the sacroiliac joints for stability, yet it can still stretch to allow leg movement. Good invention.

It took time, but between the sacroiliac belt and the stabilization/muscle enervation exercises, I was once again able to climb mountains, like many years ago. Many of the peaks (Robson, Whitney, Rainier, Tsar, Borah, Clemenceau) on these pages I have climbed since that time. Perhaps someone else out there has a similar back problem (sacroiliac instability) and might benefit from one of these various procedures. A search on the web will turn up much more info about things like prolotherapy; and this procedure could help you. Note: Many physicians are totally ignorant of this procedure, but don't fault them; it does work even if they have never heard of the procedure. For me, the benefits last about 18 months, then I get more injections.

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