Mild Spinal Degeneration & Medical Mythologies

[BruceMC]

I happen to belong to the SuperTopo climbing forum where I often come across references to cases of 'spinal degeneration' that are causing various climbers to experience pain syndromes. But I thought the following string contained so much misinformation about the origins of back "problems" that it had to be in a class by itself:

http://www.supertopo.com/climbers-forum/1930459/Moderate-degenerative-disc-disease-whos-dealt-ot

Pay particular attention to all of the medical myths about back pain that various people on the forum take as clinical truths. Note the combination of various drugs one climber advocates as a panacea for disk degeneration. It's amazing how many believe something called 'degenerative disk disease' and its attendant back pain are an unavoidable consequences of the aging process, something sure to make surgeons and pain clinics wealthy for eons to come. It would be interesting to see how many false assumptions you can spot in this dialog.

I might add that climbers a group are intensely competitive, easily wounded by criticism, perfectionist and obsessive compulsive about their climbs and climbing projects. Sounds like an excellent breeding ground for TMS symptoms, don't you agree?

 

[JanAtheCPA]

Yikes, Morcomm - that's a scary thread, all right. Although I would say there seem to be very few posters there who are at all perfectionist about spelling, or even writing sentences that make sense at all, LOL! Geez, our community definitely does better than that (and you're amongst the best writers we have, so you don't take after these guys)

The article that was mentioned, How Yoga Can Wreck Your Body (NYTimes, January 2012) is truly scary. It seems to start off talking about using common sense, but gets more and more technical about the apparent dangers of certain yoga poses. Sigh....

 

[BruceMC]

That's funny, Jan, because at least one of those guys (I won't name names!) has a Ph.D. in physics and is a senior scientist at Lawrence Radiation Lab in Livermore. I think they all take a certain perverse pride in not bothering to clean up their writing because they assume everything they're expressing is self-evident truth. But did you notice the authoritative position one writer takes about bulging disks pressing on nerves and thereby creating sciatica and lower back problems? Based on the opinions articulated here, it sounds as though everyone over 60 years old is going to be bedridden and in need of spinal surgery just to get around the house. Then, how come my grandfather could still do backflips when he was 80 and walk three miles a day outdoors in Montana on into his 90s? I think one guy does mention that there isn't any direct correlation between spinal anomalies and back pain, but he's sort of drowned out by other self-appointed "experts" who believe there has to be. After reading this thread, I can see how people just repeat different items of medical mythology to so many other people so many times that the public finally accepts them as canon. Based on the findings of Nature's MRI (and of course I'm not a doctor and cannot diagnose his condition), it sure sounds like there's not anything very much wrong with him.

 

[yb44]

I notice that there isn't one single mention of anything non-physical going on in these guys' lives. I see what you mean about all the misinformation. It could scare anybody witless.

Speaking of yoga wrecking your body, there was an article recently about Pilates that had everyone scratching their heads and wondering whether to carry on with their classes.

http://www.dailymail.co.uk/health/a...duce-pain-improve-posture-hidden-dangers.html

 

[BruceMC]

Pilates made my stomach muscles get rock hard, but didn't seem to relieve my lower back pain and sciatica. Seemed like my back pain didn't have anything to do with strong stomach muscles. Seems like any exercise, including Pilates, could act as a 'trigger' to initiate a TMS pain episode.

 

[yb44]

Absolutely. I had an episode of sciatica shortly after starting sessions at the beginning of last year. I soon discovered what it was that caused this relapse and it was not the exercising. A couple of times while I was seeing a TMS therapist I mentioned the possibility that I had injured myself in some way. Her response was simply how could something I had been doing week in, week out suddenly injure me? These symptoms quickly disappeared. One time I started my routine and got this extremely painful headache out of the blue. I actually went home thinking I could not carry on that evening. By the time I got home, mystery headache was gone. I felt duped by my brain but resolved not to fall for that old trick again.

I wouldn't say my abdomen is rock hard or that I never get backache (still trundling down the bumpy road on my journey to recovery). It keeps me active and gives me confidence that I can do other forms of exercising.

 

[BruceMC]

Yes, yb44, it does seem odd that none of those guys notices any correlation whatsoever between psychological stress and the onset of shoulder, back and/or knee pain. You sure do notice though from reading this just how much the public has accepted the full range of medical mythologies about the physical causes for various aches and pains, especially the notion that spinal degeneration is inevitable with advancing age and that you have to address it using various physical modalities from chiropractic to acupuncture to supplements to surgery (assuming you've moved down the degeneration path that far!) But of course I heard directly from a specialist in geriatric medicine at Kaiser-Permanente that back pain was a direct result of spinal degeneration due to the aging process, so it isn't like this stuff isn't banging around in established medical circles either. Only problem with that diagnosis it seems to me is that it doesn't answer the salient question: How come I'm way better today than I was three years ago despite the fact that I'm three years older? Seems more likely to me that in 2008 I had a "relapse" because I was really keyed up then with a bunch of emotional issues left over from the death of my mother in January 2001. In 2008 I was also imposing a bunch of stress on myself while writing a book, pursuing a ballet dancer, running 8 miles per diem, plus, during my off days, riding my road bike 30 to 40 miles. Obviously, something was cooking inside and just looking for an excuse to boil over and manifest as TMS pain.

It was interesting to note this past weekend that when I drove up to Tioga Pass and slept there at 10,000 ft, I didn't have any back pain. However, when both my climbing partners didn't show up, I got really mad and frustrated inside and my back and left leg started hurting for apparently no reason. I wondered about going up to altitude too, like not being acclimatized might cut down on the flow of oxygen to muscles, nerves and tendons and result in TMS pain (if Dr Sarno is correct and poor circulation due to emotional repression is at the root of TMS symptomatology). It does seem that TMS pain symptoms do vary according to how rested you are, in what kind of shape you're in, and whether you're emotionally stressed or not. However, Dr Z seems correct too when he suggests that when you're doing what you like to do and having achieved some personal goal like taking a perfect photograph or summiting a peak, you've also solved an existential problem that, in turn, short-circuits the TMS pain cycle. My own experience suggests that although physical variables like being in shape or getting acclimatized do impact the TMS process, it's really those psychological rewards that stop it in its tracks and prevent its recurrence.