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Chronic Pain Can Affect Anyone. I'm passionate about helping people avoid it.

My experiences with chronic back pain – Dr. Christopher Aysom.

Being a Chiropractor, I guess it’s somewhat ironic that I have my own history of chronic back pain. As a professional it’s a big part of what drives me now and why I’m passionate about helping others avoid the same mistakes I made. Back pain is complex and it should be treated as such. As you’re about to read, the long-term outcomes can be serious if we treat it as anything less.

My back pain journey started long before I was a Doctor of Chiropractic. I actually had a previous career in Information Technology, where I spent several years in the corporate world. Throughout that time, one of the common variables was a lot of time at a desk and a lot of time sitting. For up to 8-9 hours per day (plus another 2 hours commuting), I was basically sedentary, slouched at a desk.

I was fairly active outside of the workplace and in the later years of my corporate career I’d developed a passion for fitness and spent several years training at a local CrossFit affiliate, often 5-6 days per week. I loved that style of training and the gym itself was outstanding, but I always struggled with niggling injuries. The fitter I got, the more training volume I could handle and my body just got more and more beat-up as I kept pushing harder. Most days of the week, I would sit at my desk working for the day, go straight to the gym and push my body into positions that it just wasn’t prepared for. 

Boc Jumps at the gym

I was constantly over-trained, under-recovered and always carrying some sort of niggling injury because of the stress I was putting on my body. Getting to the gym each day was the fun part that I looked forward to, but the reality was that my range of motion had suffered after years of desk-work and I was continuously asking far too much of my body. 

I found ways to move around my deficiencies and train through the problems.

The constant niggles were annoying, but it was never serious enough to make me slow down. As a patient I felt like I tried everything; adjustments, exercises, massage, acupuncture, muscle stimulators, laser therapy, kinesio tape, stretching, lacrosse balls… it was a long list.

Unfortunately, I didn’t know then what I know now.

As an adult, I’d had two acute episodes of low back pain. Both were associated with weightlifting and both were fairly intense. I remember feeling like I got shot by a sniper – it was a direct hit to the left lower back and it dropped me. I was out of action and couldn’t move for a couple of days. Both times however, I was able to wait it out and the pain eventually went away, so I could get straight back to doing what I wanted to do.

I often wonder what would’ve happened if my problem had been caught then. What might’ve been different if I’d had the information to explain what had happened, why it had happened and what needed to be done about it. But I felt ok, I was able to workout and do what I wanted to do, so I didn’t give it any thought. I went on for several years without thinking too much about my lower back, I didn’t even consider that there could be a problem. There were times that it would get stiff and sore, but I just put it down to being part of the training I was doing. It never got too bad and never put me out of action. I just kept going with the help of a lacrosse ball or a massage.

But then things started to change.

I started having more intense episodes of lower back pain and these ones were different. There was no big incident that set it off – these ones just crept up on me… and they were bad. It wasn’t just going away in a couple of days anymore, it was hanging around much longer and seemed to get stirred up easier. The symptoms were always left-sided, with the primary pain over the PSIS area (the dimples in the lower back) and into the glute but now it was also radiating around the side and into the front of my left hip.

I didn’t pay enough attention to it at the time, but I also noticed that I’d started to limp sometimes when walking, as well as some some tingling and numbness in my left foot which hadn’t been there before.

By this stage my lower back had taken a beating with everything I’d thrown at it – and it was letting me know. I’d been chronically loading my spine while slouched at a chair for years, weightlifting and working out excessively without appropriate rest; and all of this while not having a solid understanding of what was actually going on with my body. I’d driven the wheels off the bus to the point where I was in a lot of pain and now I knew that I was in trouble.

Looking back now, this point in time was probably the last chance where I had a shot at turning it around and possibly getting it under control conservatively. What I needed was a full clinical evaluation that would go over the entire history in detail, conduct a comprehensive physical examination with all necessary neurological testing and then send me for an MRI to understand the depth of the problem. I needed a thorough and accurate diagnosis, to give me the hard truth – that I had a significant disc injury which I was only making worse with excessive activity and load.

I disrespected my body for a long time and was about to pay the price.

Things went downhill quickly. One particular afternoon, for no particular reason, there was intense muscle twitching my left leg followed by a huge electric-like sensation that radiated down through the back of my leg. It was very uncomfortable, so I tried to walk it out, but soon realised that I was limping and dragging my leg. I realised that I couldn’t push off the ground with my left foot. I started to panic and was trying to get home, but after I started up my car I had no strength to push the clutch in and kept stalling when I tried to drive. I was getting worried.

I was already badly injured. I just hadn’t realised until it was too late.

Overnight, the sciatica symptoms in my left leg were so constant that I didn’t notice the back pain anymore. The next morning I still couldn’t walk properly and clearly something was very wrong, so the decision was made to go to hospital. After a long day in emergency and a lot of investigation, I was sent for imaging to see exactly what was going on in my lower back.

L5/S1 disc extrusion

“We recommend that you stay here tonight and have surgery tomorrow”

The MRI came back showing a large extrusion, where the L5/S1 disc was herniated and compressing the left S1 nerve root. The orthopedic team advised that this should be decompressed via surgery as soon as possible to get the best outcome for the nerve tissue.

Nerves are very sensitive and don’t like to be compressed, especially not by a huge fragment of disc material. If that compression is substantial enough, the nerve tissue will start to die.

This problem had been coming for a long time, starting all the way back when I first injured the disc lifting weights in my early 20’s. The issues leading to that problem had never been addressed and only gotten worse over time – now I was faced with someone cutting open my spine just to save the function of my leg.

It needed to happen, but I was nervous.

The surgical procedure opened up my lower back with an incision deep enough to reach the vertebra. But due to the herniated disc material sitting in the spinal canal, the surgeons had to cut away a piece of the vertebra to then remove the disc and decompress the nerve root.

I woke up in recovery and immediately checked that I could move my toes.

Credit to the hospital and the staff, they were great. Waking up in recovery I was told that the procedure had been successful and I just needed to rest and recover while the anesthetic wore off. I was up and walking around the next morning. Everything felt a bit stiff and sore, but the surgeon advised that he was very happy and I should expect to have a good outcome. It was another 2 days before I was discharged from the hospital. 

RNHS after surgery
Disc material removed via laminectomy

The recovery process was slow. Firstly the body had to deal the invasive surgery, so there was dressing changes, stitches and the normal process of wound healing. But there were also the deeper changes where a large part of my disc has been cut away and also some bone removed, so they body had to adjust to that as well.

The surgeon shared a picture of the disc material he removed – and it wasn’t small!

Now that the nerve root compression was gone, the aim was to start getting some strength back into the muscles that had been impacted. I realised that in my left leg had actually shrunk – the hamstrings had gotten smaller and the calf muscles were visibly a lot smaller than the other leg. I also realised that I could not feel any sensation on the skin in certain parts of my leg, which to this day has not improved.

Surgery fixed a big problem, but also introduced new problems.

The disc extrusion had been reduced and the nerve root decompressed, but now as things slowly healed, there would be lots of scar tissue forming. Scar tissue is strong by design, it’s meant to be tough and inflexible to help wounds heal, but once the healing as happened we want things to become soft and flexible, not tough and rigid.

In the months that followed surgery I felt like my back pain was often getting worse. I didn’t have the leg weakness anymore, but I was struggling with ongoing pain and movement restriction. The advice I’d been given was that 3 months after surgery I’d be back to 100%. But the reality was that 3 months after surgery I was still in a lot of pain. I could hardly move when I’d get out of bed in the morning and basic, everyday movements were not easy. I was doing the prescribed rehab and getting adjusted frequently, but my symptoms didn’t improve and sometimes would get worse.

Dr. Chris and Vera

The chronic problems that had led to my disc injuries were still unresolved and now on top of that, I had a bunch of new problems caused by the surgery. It took almost two years to get out of pain and feel relatively normal again. I was fortunate to connect with an experienced practitioner that could treat the many issues that were restricting my movement and preventing my spine from healing.

It was a long journey and it still continues.

My spine will never be the same. The latest MRI showed that most levels are in good shape, except the injured segment which is severely degenerated. Most days are pain-free, but I always know it’s there. I have to be careful and there are a lot of activities that I’ll never do again. My back pain took away a lot, but it gave me a lot too.

I feel fortunate that I’ve been able to learn a lot of important lessons. In my current role as a Doctor of Chiropractic, I get to help patients avoid the pitfalls that caused me so many problems. Perhaps the biggest lesson I’ve learned is that back pain is unique to each individual and it’s not simple. It can be very complex. It requires a detail-oriented mindset from the practitioner, to get the best outcomes for the patient.

One of the challenges that patients face is that not every practitioner they encounter will have the necessary training and experience to thoroughly diagnose and effectively treat chronic back pain. I believe that it is a unique skill-set and requires a dedicated practitioner who is prepared to learn new skills, to think differently and treat differently. My experiences as both patient and practitioner have taught me that we can’t rely on an under-powered diagnosis, adjustments, dry needling and exercises, if we want the best outcomes for chronic back pain. It requires a different set of skills.

I am motivated every day to be the practitioner that I needed myself, when I started out on my back pain journey. I’m passionate about helping people take better care of their bodies and making smart, informed choices for their health.

Dr. Christopher Aysom – Apex Soft Tissue & Spine.

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