Back Pain Sucks!

As you may know, I recently had an acute episode of excruciating back pain with left leg radiculopathy when doing some deadlifts a few weeks ago. As painful and frustrating as this has been I thought it would be a great opportunity to document my rehab and recovery and share my experiences of the ups and downs of an episode of back pain and you can watch this on my Instagram page here.

This journey has been a painful, stressful, and frustrating one, but also an enlightening one that has highlighted some important things for me. The first and most important thing is never to underestimate just how bloody hard it is to endure severe pain for extended periods, nor how easy it is to worry and think the worst about what's causing it, and if it will get better.

Knowledge Without Experience Is Bullshit!

Despite my training, knowledge, and 20+ years of clinical experience managing people with all types of pain, and knowing that the research shows many episodes of back pain and radiculopathy improve favourably over time. There is NOTHING like some first-hand experience of living with severe, searing, unrelenting neuropathic pain to really put things into perspective about how this information doesn’t make things feel any better or stop you from worrying any less.

Despite knowing these injuries heal and recover with time, I didn't care at 3 am in the morning whilst lying on the living room floor trying to find a position that eased my agonizing leg pain. Despite knowing my pain will improve and my prognosis is good I still had doubts and concerns, and often thought of the worst-case scenarios.

These last few weeks of pain, lack of sleep, and bone-deep fatigue have hammered home that if I've struggled to reassure myself at times, just how good am I at reassuring others?

This injury has also reminded me that when pain is severe, constant, and unrelenting it can take control of your thoughts, and no matter how tough, resilient, or double hard you think you are.

Cringe!

I cringe when I think back to times when I have tried to reassure others with similar pains as mine, by explaining how they have no signs or symptoms that indicate they have anything to worry about or need further imaging or invasive treatments.

This recent episode of mine has made me think how effective am I when doing this, and does it actually help anyone?

Well, judging by some of the messages I've received it seems that it does, as many people have told me they have found my own experience and journey helpful. Hearing me express these feelings and emotions publicly and acknowledging and normalising these doubts and concerns it appears to have reassured and helped others understand that it is perfectly normal and natural to have them as well.

I have also been really grateful for all the kind, encouraging, and supportive messages I have received over these last few weeks as these have really helped me stay positive and motivated through some tough times.

These messages have also re-iterated to me just how important and useful some simple, honest, genuine, support, and encouragement can be when you’re in pain, tired, frustrated, and thinking the worst.

Positive and Negative!

However, what I haven’t enjoyed, nor was I expecting when sharing my updates was the number of attacks, accusations, and nasty comments I got from others.

Don’t get me wrong, I’m not naïve enough to think I wouldn’t get any, as I know you can’t put anything on social media these days without some troll posting something hateful, and I’m well aware that I have haters and I’m not everyone’s ‘cup of tea’ rubbing many people up the wrong way with my strong views and opinions on things.

But what I did not anticipate was so many nasty, snide, and snarky comments from so many so-called kind, caring, and compassionate clinicians who are clearly revelling and rejoicing in my current predicament.

Again, don’t get me wrong, I expected some piss-taking and teasing, but never did I think so many would be so excited to see me hurt or use this episode as an opportunity to attack me and my reputation.

During these last few weeks, I have been accused of being unprofessional, inexperienced, and a shit physio and these are just the comments I have seen as I'm also told many more have been said in closed forums and private social media groups.

It seems that some turd juggling wassocks out there think physios should never get back pain or be injured, and if they do it somehow means they are less skilled or knowledgeable than others.

I guess this also means these cock wombles think doctors shouldn’t get sick, surgeons shouldn’t need operations, and professional athletes shouldn’t get injured either.

You Deserve It!

I have also been told by some so-called ‘therapists’ that I deserve my pain and have earned my injury with my reckless approach to training and terrible lifting technique.

Even though there's no evidence that any lifting technique increases or reduces the risk of back pain (ref). Nor any evidence that regular heavy lifting is a common cause of disc herniations (ref). Also this is my first significant lifting-related injury in nearly 30 years of continuous deadlift training whilst doing a near-maximal effort 2.5 x bodyweight lift.

It seems that these arse biscuits think all injuries are avoidable and if you do get injured when exercising it’s your own fault. These ignorant mouth breathers seem to think their so-called perfect form and correct lifting technique they demonstrate with light loads and intensities is the solution to the prevention of all back injuries.

Well, newsflash bell ends, anyone can maintain a pretty-looking posture when they lift light-weights, but trust me it will soon turn ugly when you increase the load or the intensity, which they would know if they did that from time to time. What these comments highlight is just how many ignorant dumb therapists there are completely oblivious to what heavy intense exercise looks and feels like.

When these idiots expect everyone to move the same way lifting heavy-weights as they do lifting light-weights, they are as clueless as someone who thinks a runner should sprint the same way they jog. These clowns fail to recognise that all movement is complex and hugely dictated by the task which includes the loads, speeds, intensities, and complexity and that all injuries are multifactional and never due to a sole factor alone.

Yes ok, maybe higher loads, speeds, and intensities may have higher injury risks, and yes, you may reduce these risks by reducing loads, speeds, and intensities, but don’t kid yourself for one second into thinking this eliminates it.

Fearful Physios

These comments also demonstrate how fearful and risk-averse some therapists are to exercise and training. Don’t get me wrong I’m all for being sensible and I do like to build things up steadily and progressively in most people for most things. But to think you should always move the same, or always avoid high loads, high speeds, high intensities to avoid injury is both ignorant and impractical.

During these last few weeks, I have also been accused of being in denial, stubborn, ignorant, arrogant and some more colourful things ending in ‘T’ for not getting assessed or having a particular type of passive treatment for my pains.

Some of these odious cretins have even tried to accuse me of being dangerous and reckless, and even tried to blame me for making my symptoms worse, despite them improving, as well as causing the growing global back pain epidemic.

It seems that these used dishrags think a physio with 20+ years’ experience who has read widely around pain, pathology, and its treatment cannot make a rational, informed clinical assessment and judgement of their own condition. And it also seems that these douche canoes think that they can assess and manage me across a social media platform from thousands of miles away far better than I can manage myself.

Heal Thy Self!

And to those who think they are being clever by quoting ‘a physician who treats himself has a fool for a patient’ also need to shut the hell up because physicians can and do treat themselves when they have signs and symptoms of simple common illnesses.

And just as a good physician can recognise the signs and symptoms in themselves of a simple common illness that has a favourable natural history, and doesn't need further investigations or interventions, so a good physio should be able to do the same with a common and simple musculoskeletal injury or pain.

What these comments highlight is just how many therapists do not understand normal healing and natural resolution times, and how they do not, or cannot accept that there are many people who do not want treatment straight away, who are happy to wait and see how things go, and who can carry on despite their pain rather than rush to reduce or remove it.

These comments also highlight how arrogant and insecure many therapists are in not wanting to accept or admit that they are not needed as much as they think they are, or the reason why many of those they see and ‘treat’ get better with it often instead just time working in the background.

All these accusations and attacks also highlight how petty and pathetic some can be when they see others saying or doing things they disagree with, and how some have very delicate and fragile egos combined with large inferiority complexes meaning they quickly get jealous, vexed, and bitter towards anyone who questions what they do or achieves more than they have.

Conclusions

Finally, this back issue of mine has confirmed to me yet again just how much variation there is in physiotherapy practice, with so many different opinions, ideas, and suggestions of tests, investigations, and treatments for something as common as an acute episode of low back pain with a touch of radiculopathy.

As much as I understand variation in all things is often a good thing as it gives options, if we as a profession can’t agree on some simple core principles of who, how, and what to do for the most common musculoskeletal issues, then we are in serious trouble.

Because as much as I know, there is variation in other areas of healthcare such as medicine, and many doctors have many different ideas, opinions, and suggestions about how to manage something like a common cold, I’m sure all would agree that a common cold doesn’t need complex assessments, unnecessary investigations, or regular expensive treatments.

Until we can get a better handle on this variation within physiotherapy there is only going to be increasing confusion and chaos around our assessments and treatments, which I fear will lose us the trust and respect of not only other healthcare professionals but also the public. And if we lose the trust and respect of the public physiotherapy will be quickly pushed out to the fringes of healthcare along with the other quacks and nutjobs who claim miracle cures and quick fixes with their trinkets and charms.

As always thanks for reading

Adam