Indeed, and fascinated by some strange enlightenment , I came to recognize this flare up as a blessing in disguise because by luck this lead me to deep dive my issue a bit more and I ended up discovering something called the biopsychosocial model of pain management. "The biopsychosocial approach describes pain and disability as a multidimensional, dynamic integration among physiological, psychological, and social factors that reciprocally influence one another."
Mostly I've been reading a lot of articles and watching videos and podcast interviews with Greg Lehman and Peter O'Sullivan. This is a pamphlet from Greg titled "Recovery Strategies - Pain Guidebook" https://static1.squarespace.com/static/ ... 202017.pdf . Peter has a podcast and Greg has a really nice set of YouTube videos that dispel all sorts of myths regarding spinal pain and recovering from those injuries. (example: https://youtu.be/tolxdFQ35j8?si=GfvKvFXZ5Gvk2a3e). Also started physical therapy finally - which helps.
Big concepts I've learned regarding herniated discs and recovery strategies in general ...
- Spinal discs do adapt and respond from loads and movement. They're not fragile. Flexion, Extension, and sideways bending should not be avoided.
- Unless you've a spinal tumor or a fracture - back pain is rarely serious even if it feels like it is. In fact, all else being equal, more pain does not necessarily mean more biological tissue damage. Pain is very subjective.
- Indeed many people can have herniated discs and bulging discs show up on an MRI and experience no pain symptoms whatsoever.
- People with back pain do not suffer from spinal instability. In fact, and contrary to popular opinion, people with chronic back pain actually have overactive responsiveness to their injuries and are actually overly stiff and stable and need to loosen up through movement.
- It is okay to experience pain during recovery. In fact, pain is almost necessary for gauging response. "Working into pain" can help desensitize nerves. Some level of pain acceptance goes a long way towards recovery.
- Poking the bear means to slowly adapt to uncomfortable positions and movements through graded exposure (aka progressive overload in the weightlifting world). For example, suppose squatting hurts your right knee. How to recover? Drop the weight and do bodyweight squats. No Pain? Add 5 pounds. Continue on and use pain as a gauge. A little bit of pain is okay. The body responds to stress and loads!
- Flareups are actually normal and part of the recovery process. They happen when you "poke the bear" and accidently get mauled. Practice helps you find the right balance. The worst thing you can do is adopt fear/pain avoidance behaviors and do nothing*.
- Doing Nothing* is only required in very acute stages of an injury. Afterwards, its almost always better to get more active and return to your life's activities - yes even if they hurt a little.
- When dealing with chronic pain, ask yourself what other factors might be at play then just the injury. Are you getting enough sleep? What life stressors are you dealing with? Are you avoiding activities due to fear of pain? Are there different ways you can frame your injury?
- Sleep is underrated and necessary for recovery from a biological and psychological perspective... Drop caffeine sources before noon and get on a stable sleep schedule. Nothing wrong with taking pills if you've absolutely must in the interim (I started taking Unisom and its a godsend). Akin to getting back on track from jetlag.
This is a quote I came across from Nassim Taleb (famous for his love of deadlifting)
Months ago I would've said this was ignorant but I'm finding a lot of wisdom from Taleb's approach to dealing with pain. I've spent many years avoiding sitting too much and avoiding flexion/bending my spine and I've been overly cautious with my back all this time - all sorts of psychological responses that stem from my initial injury in 2011 (that I regrettably had surgery on). Spent years exercising and keeping active but also avoided "aggravaing my back." This added up. Fortunately - I am 100% positive this can be reversed and I can adapt. My body is not fragile.“I once procrastinated and kept delaying a spinal cord operation as a response to a back injury—and was completely cured of the back problem after a hiking vacation in the Alps, followed by weight-lifting sessions. These psychologists and economists want me to kill my naturalistic instinct (the inner b****t detector) that allowed me to delay the elective operation and minimize the risks—an insult to the antifragility of our bodies.” ― Nassim Nicholas Taleb, Antifragile: Things That Gain From Disorder
Pragmatically all this to say fu*k my back problems. A few days ago I started daily cardio sessions on an elliptical and mixed it up with sprints on the machine. I went for a jog yesterday too. It hurt a bit and I hobbled and I had to mix it up with walking. I have not gone for a run in months (since November I believe before my back gave out). Slept like a baby though last night and woke up this morning feeling better and more determined then ever. Will go swimming this weekend. The sciatic pain in my right leg has died down immensely and this flareup is basically almost over in about 10 days where the previous flareup took just over 2 months.
As always a disclaimer that I am not a medical professional. Neither is Taleb.