I started experiencing regular (in other words: every day) back pain 11 years ago. Mostly in the neck, shoulders and upper back area. But every once in a while I’ll have a lower back kind of day as well. I remember when it started because there were a lot of changes in my life at the time, all in the span of a few months:
- I started working part time.
- I started going to university.
- I started going to the gym a few times a week.
- I started going out / partying on weekends.
- I lost over 30 kg of weight.
- Because of university, I spent a lot of time in very uncomfortable chairs, namely the train’s and my campus’. At uni they had these shitty foldable wooden chairs who had only a very straight wooden back support. Like this but worse.
So ever since then, until very recently, the pain was a constant in my life, although its intensity varied day to day. Some days it was a serious hinger to my productivity and quality of life (although luckily I never had any accute pains that would prevent me from moving or anything like that), and others (being so used to it) I could easily ignore it while I was focused on something else (having a drink, working, etc). For obvious reasons, sitting for long periods of time in front of a computer made it worse. Since sitting in front of a computer is what I do most of the time, I was screwed.
For almost a decade, I thought the cause of my back pain was physical, obviously. How could it not? Pain means there’s something physically wrong, right? It’s like the body’s alarm system. BEEP! BEEP! Pay attention here!
What I thought was the cause of the pain has been changing over the years. Here’s a list, more or less in chronological order.
1. The Changes in my Body
“Now that I lost so much of weight, I no longer have a nice padding (fat) in my back, and my spine’s bones are a bit exposed. So naturally it’s uncomfortable (it was) for me to sit in all these crappy chairs all day (the train and uni), so I sit all hunched in a bad posture, which over time makes my muscles hurt.” It’s a perfectly reasonable and logical reason (the best kind). The problem with it is that the pain long persisted after I dropped out of university and stopped sitting in shitty chairs. In fact, after that and to this day I’m very picky about the qualify of my chairs, specially whatever I work from. Pro tip: This is the best office chair I’ve ever used.
2. The Spine
“Maybe my spine is all twisted (not straight).” I have a cousin who suffered from this and had to go to rehab for years, so this popped into my mind. I went for an X-Ray and consultation, but there was no problem with my spine.
3. The Muscles
“Maybe I’ve got some kind of contracture or disadjustment that needs fixing.” So I went and did some sessions with any specialist I could think of: masseuse, physiotherapist, chiropractor and osteopathist. I went to a few sessions with each, since I knew just one wouldn’t make much of a difference. After each session I felt great (who doesn’t?), but the relief soon faded and just a few hours later, the next day at the latest, I was back with the same pain as always. Obviously it wasn’t sustainable to go get a massage every day, nor was something I felt was a satisfactory solution. Ironic fact: I remember (this was about 5 years ago) that after doing ten sessions on the chiropractor and (both me and him) realizing I hadn’t improved one bit, he suggested there might be an emotional reason behind it, maybe some kind of suppressed trauma or what not. I laughed and thought to myself “Good try buddy, trying to give me a bullshit excuse for you not being able to deliver on the promised results!“, and left never to return. As I wrote the other day, you need to be ready to embrace change.
4. The Posture
“My eye sight is pretty crap, so while I’m on the computer, I tend to get too close to the screen. Of course the result of my upper back pain is my bad posture all those hours every day!” This is also a very good, logical and compelling explanation. And it’s very much reinforced by society which insists on good posture for office workers (and again, between work and my free time, I spend a lot of time on the computer). This led me to adjust my monitor higher (to eye level) and closer to me (cause I do have terrible eye sight), use a bunch of different chairs until I found The Chosen One, try some of those jelly paddings for your wrists, try feet supports… you name it. I even got LASIK thinking my eye sight would improve, but it didn’t. Well at least I got rid of the classes, so I got that going for me, which is nice.
So after trying all that, my pain didn’t really change at all. And there was something that bothered me about this theory too. At my last job, a lot of people had the worst posture, most of the day, every day, and they never complained about any back pain. And yet, even though I did break “good posture” to try and get closer to the computer every once in a while, in general I’d say I have pretty good posture while on the computer, if we’re being honest. Definitely above average.
But even though focusing on good posture didn’t work either, and despite the fact that it didn’t seem to affect most people, I held on to this belief for many years. Maybe it was a combination of my bad eye sight and shitty back muscles, who knows. But this was it. What else could it be?
5. The Mind
After hearing a couple of times from different sources about a book who had apparently helped several people to get rid of chronic back pain, it peaked my interest and decided to read it. The book is Healing Back Pain: The Mind-Body Connection by Dr. John E. Sarno.
In it, Dr. Sarno explains how after years as a physician and rehabilitation expert, he realized many (most, even) people suffering from back pain these days, do so for emotional reasons. After helping thousands of people get rid of the pain, and experiencing many different cases of people in this situation, he wrote the book to describe his findings in detail. If you’re interested in this you should read the book, but here’s my very short summary of it.
Dr. Sarno calls this problem Tension Myositis Syndrome (TMS), and if you’re suffering from this, what happens is that your brain sends slightly less oxygen to certain areas (those that hurt) so that you feel pain, and thus you focus on that instead of on emotions that your brain decides are more painful for you to focus on. That’s a simplification and I’m sure I missed some details, but I hope you get the general idea. Try to picture this: you have a bad tooth ache. What’s a very effective way of getting rid of the pain (not the source of the pain itself)? Hit your hand very hard with a hammer. Now your hand hurts more and you don’t even feel the pain in your tooth. That’s pretty much TMS in simple terms.
While I would’ve dismissed this years ago as hogwash, there were two things that made me believe it could be the actual reason for my pain. First, I saw myself very much in most of the patient cases Sarno describes in the book (and there are many). Sure, some had to do with the relationship of the patient with his or her kids, or some situation that doesn’t apply to me. And some times the patient’s personality traits or behavior patterns were exaggerated versions of mines (and so were their pain). But overall, it successfully convinced me I was the ideal candidate to suffer from this. I’d describe this archetype as a mix of Type A personality (competitive, perfectionist, impatient…) and the personality type described in the book No More Mr. Nice Guy (a people pleaser). That’s the sweet spot.
The second reason that made me believe this could be it… is that I was desperate. I had tried everything, and nothing worked. Nothing even gave me a definitive answer like “Oh, this is it. But it has no cure. Just live with it.” Nope. I was still in the dark as what was the cause. So maybe this guy, who describes me perfectly in his book, and who has apparently helped thousands of people get rid of a pain just like the one I experience, maybe he has the answer after all, as crazy (by my own beliefs) as it sounds.
Now, the million dollar question, if we accept that premise, is: what are those emotions so powerful and negative that my brain doesn’t want me to focus on? That it much rather have me experience physical pain instead?
At first, since this was a common pattern in a lot of the patient cases described in the book, I thought there was some past trauma that I was suppressing, maybe something from my childhood. I thought about it for weeks, months even. And I really couldn’t come up with anything. Some people said just after reading the book, they were cured. I still felt the same. And in no way closer to finding that hidden trauma that, upon discovering and crying a bit for, would make the pain go away. That’s what I expected to happen based on the book.
One day, researching more about the subject, I stumbled upon this website. It’s created by a guy who believes Dr. Sarno had it right, but the program described in the book is insufficient for a lot of people. So he created a book of his own, with a better process to get rid of the pain. The sales page convinced me enough that I decided to buy it and read it.
It’s a good book overall and helped me a lot, but the key point for me was this (paraphrasing): “You expected emotional fireworks, right? Think again.“. In other words, he says most people don’t experience TMS because of one big, single trauma or reason that once dealt with, makes the pain go away (as a lot of patient cases in the book). But rather, that certain people’s behavior patterns and personality traits continuously repress negative emotions, several times a day, every day. Most of them small enough, no big traumas or anything like that. But they all add up.
Let me give you an analogy. If one day you sweep the dust under the rug, nothing really happens. This is fine, everyone tries to repress negative emotions some time. Everything is OK. But if you keep doing that over years, sweeping both small and big things under it, eventually you’ll have a big bump on your rug from all the stuff you swept under it. TMS is the equivalent of a big stain on the wall that makes you focus away from all the shit you have under the rug. Does that make sense?
So again, what are those negative emotions I used to suppress multiple times a day, every day? Many things. From being frustrated because some piece of equipment (say, a printer) didn’t work as expected (“no point in being annoyed at the printer, it’s just a machine, so let’s put that feeling away”), to being annoyed at myself for not being able to do something I want to do (example: say ‘no’ to something I don’t want to do instead of saying ‘yes’ to please people) (“no point being annoyed at myself, right? let’s put that feeling away”), to feeling annoyed at something someone else did (even something as small as messing up my order at a restaurant) (“only jerks make a scene because your burger came with pickles, right? let’s put that feeling away”)… And it all piles up, slowly but steadily. And it’s no use trying to uncover any hidden trauma because first there isn’t one, but most importantly, as long as I kept behaving like that, the pain would persist to distract me from those emotions.
The Solution
Alright, so how do I change the behavior patterns I’ve had for almost 30 years and that happen so fast and so often I didn’t even know I had them? As you can imagine, it takes an awful long of time and dedication. And I’m still on it, I still get back pain every once in a while on stressful days, but it’s a lot better, and the best thing is I know where it comes from and how to make it go away if one day is specially annoying me.
Since this is getting already long enough for today’s post, I’ll stop here and write some other day about a more detailed process of what it’s taken me to get this far.
But I’ll write a small summary. It involved a few things. Most importantly, you need to believe, in your bones, this is the cause of the pain. If you’re thinking “well I’ll give it a try, but this sounds like bullshit”, it won’t work. You need to truly believe it. For months, it didn’t work for me, because I had one foot on this “theory” and another foot still focused on my posture. I’ll write some other day about the exact moment when that changed, and I realized the true power of my mind over my body. Also, I started to consciously allow myself to feel those negative feelings. For example, if a server brought me the wrong order, instead of saying nothing, feeling anger for a second and then rushing it off and move on to remove the pickles and enjoy my burger, I’d do something like this:
- Ideally, voice out the issue (in this case to whoever made or served you the order). You don’t need to complain or make a scene, but give yourself permission to voice out whatever annoys you, even if it’s in a totally cool, non confrontational manner. “Oh, I ordered no pickles. Well, it’s OK, don’t worry.” If you can’t even voice it out, it’s fine too. But this would help.
- Then stop for a few seconds and focus on what you’re feeling. The annoyance, anger, rage, disappointment, sadness or whatever it is. Go through it all. “I ordered a burger with no pickles, I paid for it, I explained it clearly, and they messed up my order. They brought me something that wasn’t what I wanted. And that annoys me. And it’s OK to be annoyed when thing don’t go my way. And it’s the cook’s fault. Now I’m going to remove the pickles and make the best of the situation, but I’m not happy with it. When I order something, I expect what I ordered and not something different. Next time I’ll ask them to fix the order.” Basically, don’t rush through the bad emotion and try to dismiss it because “there’s nothing you can do” (or whatever), let yourself experience it fully. Spend a full 30 seconds feeling it. If you’re with a friend, feel free to go over the process out loud.
- If you’re like me, you may go through that process several times a day. Many times a day even. It can be a bit tiring and repetitive. But trust me, it’s the only way.
To end, I’ll say another fun thing about TMS. It’s very common that when you start to get rid of your back pain (because it no longer works in its purpose of distracting you from those emotions, your brain will eventually give up and stop sending less oxygen to the area), some other pain or issue will come up in your body. That’s your brain changing its strategy. But the story of how that happened to me is a story for another day.
Let me know if this a topic of special interest to you (if you suffer from a chronic issue, not necessarily back pain actually, you could be suffering from TMS as well) so I write more about this.
