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Comment by peterbozso | Hacker News Reader

For my fellow chronic lower back painers out there: over the course of many years I tried many things (always staying in the confines of modern medicine). There's certainly no magic bullet, but finally this book (which I have no financial incentives to promote) brought me a long lasting solution:

https://www.painscience.com/tutorials/low-back-pain.php

The whole thing certainly worths a read, since the goal of the book is to make you understand your condition and give you relief partly through that. But for me, the single most important thought of the book is "the issue is (almost) always with the tissue". If you have chronic (lower) back pain and you feel like you have tried everything, I recommend learning and applying self-massage regularly. Combined with other important, conservative treatments (physiotherapy, yoga, swimming, workout, etc.), it did wonders for me and I hope it will for others with similar problems.

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I'm currently lining up a surgeon to do a nerve decompression surgery, which took me 1.5 years to find a surgeon who even does the surgery, for what took me 15 years to learn on my own is something called piriform is syndrome - for which no other doctor or specialist even looked into relating to "sciatica" pain for which it can mimick; it's no wonder many people suffer without resolution, most doctors don't seem even look at known possibilities.

The mind can also be strong, so it seems you may be able to teach some people who's mind isn't too disabled or interrupted by their pain level to engage more strongly to overcome and mask pain signal(s) coming from their body and therefore "heal" it simply with mindfulness.

The program referred to above, PSRT, is based on John Sarno's work. In his book Sarno stresses that physical causes to chronic back pain must be ruled out first. He only treated patients with his mind-body awareness methodology after investigations had ruled out physical causes.

By the way, I can highly recommend this documentary on Sarno (paywalled):

https://vimeo.com/ondemand/alltherage

Understood! As I noted in my comment, the book I recommend also stresses the importance of the fact that most chronic back pain is "all inside yor head" and tries to give some relief by making you understand and ruling out most of the possible non-psychological sources for such pains. I highlighted the self-massage thing only because next to understandting my condition, that was the single most important tool the book gave me to deal with the non-psychological components of my pain. But this might not have been totally clear from my comment above, I am sorry for that!

Had you changed your diet at all during your journey to problem solve the pain?

Not GP but personally I have found limiting caffeine consumption to help a lot with back pain. More than one cup of coffee (12g of beans) seems to result in exacerbation of any minor back pain I may have on that day. I also now take a day or two off from drinking any coffee after a few days of consumption. With this change, more sleep and some light stretching on some days I no longer have back pain. Oh, I also moved to a firm mattress.

I drastically reduced the amount fat I eat, but I did that to accommodate my partner's new diet, not entirely voluntarily. :)

Oh, I was agreeing with your remark regarding the issue almost always being in the tissue!

I see now! Sorry, it was way too early in the morning. I shouldn't comment before coffee... :)

Did you have any MRIs that showed actual damage? That’s the boat I’m in. I’ve tried a lot of things and nothing has worked so far. I’m happy to give another book a shot, but everything else I’ve read so far has not been applicable.

Yes, I have multiple scans of a semi-herniated (not fully herniated, but thinned and a bit bulging) disc in the lower end of my spine, but it's far from being in the state of needing surgery. My solution was (with the help of the book) to identify and treat my trigger points. Regular swimming and bodyweight exercises also helped/helps me a lot, but they help more with reducing the number of painful episodes, not making the pain go away when I have it. I can do that only with massage.

Gotcha. I’ve been slowly adding weight training to my treatment plan, I really should find a pool… thanks for the response!

I am happy to help! I wish you good health! :)

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