How we got here

A quick story

Have you had terrible back or neck pain? Like debilitating? At 21, my pain originated from a combination of years of competitive golf, competitive volleyball, marching with heavy drums, and work stress. The first 10 years were manageable - I was even able to somehow get through a half ironman. But it got worse. In 2009 I could no longer sit down (think about how life works if you can't sit down). Then I spent much of 2011 on the floor, unable to even stand up without a plastic brace. After visiting so many doctors with no positive results, and having two "successful" surgeries that still didn't allow me to sit down, I eventually found an acupuncturist who started getting my energy flowing again and qi gong master who promised he could get me physically functioning again - and he did. The approach was completely opposite from what most of the doctors had been telling me, and it importantly put me in control of daily maintenance rather than relying on medications or continuing visits to drs. It took me 4 brutal years of suffering to find the approach that worked, but life is back to normal. I hope to pass on what I learned in a format that is a little more Western than I learned so that it can help you as quickly as our bodies will allow.

The simple answers

Tension is the problem, but not the source problem. Reduce tension physically by breathing and coordinated movement, and minimize the formation of tension by bringing your spirit into balance with your body and your mind. Healing then improves and pain leaves. This treats the source, and is in stark contrast to an approach of medication, which often numbs systems and stifles natural healing, or surgeries which patch the part that hurts but usually not the source. It also focuses on movement coordination, which is often a major contributor of pain until you figure out how to move properly.

Things I tried

I visited many, many doctors and here's what I learned from them:

Professional What they said What they did Did it help? My perspective
Osteopath Wear a brace and go to physical therapy to see if you improve Minor manual manipulation No I was too far gone to know if this would have helped
Orthopaedic surgeon I can have you on the operating table next week N/A Didn't try I was just a number that netted revenue
Neurosurgeon 50/50 chance we can take your back pain away, higher chance of leg pain going away. Do the surgery. disketomy and then a fusion Discektomy = no. Fusion = sort of, at least I could stand, but pain didn't change and I still couldn't sit.
Chiropractor I can help take your pain away - visit often. adjustments Sometimes, temporarily Helps with acute situations, but should not be used regularly for long periods of time or else the joints get worn out.
Physiatrist I can give you more cortisone shots. Cortisone epidural shots in my spine Not really Cortisone shots are sometimes needed, but they are just killing off your tissue. Not a good long term approach.
Physical therapist Do these exercises. Exercises No Unless you have a very comprehensive therapist, usually they just aren't trained on the bigger picture and have a very specific course of action. Great for simple injuries like a broken bone, but not for more complex issues where they don't have a course of action if pain continues
Personal trainer Varied by trainer - each one specific to the discipline they knew Exercises No
Swim instructor You need to learn technique better or you will hurt yourself. swim lessons No, and Yes One tenured instructor put me in so much pain I could not stand up anymore; another significantly reduced pain caused by swimming. There is a lot to know about swimming and if you don't do it well, you are likely to hurt yourself more.
Egoscue Do these exercises and you will feel better. Exercises A little The theory is good - relax your body and it will heal. I use several of the lessons still and believe this has helped a lot of people. I also believe that qigong is just a mor advanced version of Egoscue method.
Craniosacral Come in 1x/week to undo imbalances that you have compiled over years. Manipulation A little It is very hard to know if the work being done here has a direct correlation on pain reduction.
Neuroprolotherapy I will give you injections in your butt that should help. Injecting sugar water around your nerves No Recipe to walk like a cowboy for the rest of your life. The goal of the therapy is to build out scar tissue around your nerve to insulate it, but I'd much rather heal than purposely injure the body.
Massage Come back all the time. Massage Usually Focusing on the spasm areas is always effective. The rest didn't have any meaningful effect
Feldenkreis Relax, concentrate on awareness of these moves while breathing. Movements Focus on breathing an movements. For this to work, you really have to be able to focus (and block out anything else going on in your head). It is a different view into consciousness and awareness of your body and stress that likely can help people.
Qi gong Learn the principals of movement and your pain will go away. Movements Yes Provided significant increase in flexibility and reduction in pain, and after learning the moves I could practice myself without need of an instructor.
Bar Method / Daily Method Get stronger and your pain will go away. Exercises No Moves are too orthogonal and cause internal stress. Probably fine for people without injuries, but dangerous otherwise
Manual therapy Let's focus on areas that are most messed up - I will slowly move them to relax/untangle them. Manipulation (slow) Yes Forces the target areas to relax. Always felt better after, though it takes awhile for the therapy. Really good if you are not mobile or not able to get area to relax.
Acupuncture (Traditional Chinese Medicine) Come back often and we will get rid of your qi blockers and help you heal faster. needles No No impact.
Acupuncture (5 Element) We can get your spirit back with our treatments, which will lead to health needles and discussion Yes Removes a lot of the internal blockers to your body being able to heal itself. Five element worked very well on me (with a very experienced master acupuncturist who studied under J.R.Worsley).
Botox injections in the back Injections will reduce pain down the leg. Injections Didn't try Sounds like a bad idea - effectively you are killing parts of the body off, and pain returns as your body tries to heal itself
Yoga Do these exercises and you will feel better Classes with flowing poses Yes, but only after I had enough strength and the pain was sufficiently gone to not hurt myself.

The problem with medications

You are working your organs overtime just trying to process the drugs internally. That makes it very difficult for your body to heal itself. There are also negative side effects you must deal with (one friend is addicted to morphine and can't do business in saudi arabia!). It becomes a crutch.

How stress is related

Stress is a major culprit in causing pain. When you are stressed, you get tense and your breathing gets shorter. That means your muscles tense up clamp down on nerves, causing pain. Often times, the pain then causes you to tense up even more, getting you into a worsening spiral. Also, the short breathing doesn't allow your muscles to relax, leaving you in a state of tension. And of course, all the pain causes more stress, kicking off yet another negative spiral. Stress comes from many places - work, family, kids, money, inability to do things you used to be able to do, driving in traffic, sitting in uncomfortable positions, feeling existing pain, etc. The best results come when you can find a way to reduce stress from these areas and give yourself enough mental space to relax. Also, key to the training is to be able to drive stress down in these areas - not necessarily by doing less, but by being smarter about how you handle it. For example, checking emails at all hours of the day is a recipe for constant stress - you can find routines to push this stress out for periods of time without actually reducing productivity.

Doctors and business models

After all the treatment, I've come to the following conclusions: Drs. truly believe they are helping, and also have a way of overstating what they can achieve. Sometimes they achieve great results. But other times, they can do their part perfectly but not solve your problem - and they don't like to take responsibility for that. It's like asking a question of "can you heal me" and getting a response back of "I'm an expert in XYZ and can solve XYZ"

Most doctors want to be perceived as the one in charge of describing your treatment. They want to be the one calling the shots. However there is a natural biased towards the treatments that they understand. They don't really want to give other treatment options when there is still something they can do, even if the other treatment options might be preferred. In one case I had a Doctor Who did not want me to do a parallel treatment that would certainly be beneficial because it would cloud whether the attribution of my getting well was from her treatment or the other. The goal is the success for the patient, not the success and proof of a specific method. Because of this inherent bias there are only two options to choose from they give you the best chance of success. One option is to choose one doctor to act as the primary across all of your treatment options. They must have the ego integrity and mind expansiveness to be able to integrate the different therapies together on your behalf. The other option is to play the role of yourself as the leader of a group of disparate cabinet members each with their own views on your treatment plan, often strongly conflicting with each other. In this case you'll find some doctors are far less willing to engage, and at other times this will dry out a contentious dialogue. I always found it best to push around the perspectives of the different doctors so they all were aware, and many of them found this a disturbing approach to their normal practice of not taking other's input.

What can I do the other 166 hours per week?

One of the most frustrating parts of seeing all these practitioners was that most of them tried to implant a sense of "I'll get you better" when I was only spending minutes or at most a few hours per week with them. Well, there are 168 hours in a week - if I'm doing only a few hours per week to get better, what am I doing the rest of the time to help my condition improve? That's where I started to ask "what can I be doing the rest of the time, or at least for a significant amount of time each day?" The answer was more complex than I expected - it was more than what I could be doing, it involved monitoring what I was doing, how I was feeling, where tension was developing, what caused it to develop, whether I was breathing properly, and on and on. In addition to that, there was the more basic "do this everyday" or "do this when you start to feel a certain way". That's made all the difference. It means I'm in more control of my situation than I've ever been. It means I have tools I can use. I'm not waiting for a visit to a practitioner to get to feel better, or waiting for medication, or completely out of control of the situation.

It's up to you

The biggest revelation came after years of no progress. Drs. all wanted me to get better, but ultimately they were only signing up to do what they knew how to do. Their success didn't mean I was healthy and out of pain. If I had kept going with many of the promises I never would have found the way to getting healthy. Every situation is going to be unique - sometimes it will be the surgery or the physical therapy that solves the problem, but often times it is going to require several pieces to come together in a holistic way. That's up to you - if you want it, you have to manage everybody to make it happen. Nobody is managing all the pieces for you but you.

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