Comment by rgrmrts | Hacker News Reader

Comment by rgrmrts | Hacker News Reader

I’m following along this thread in a desperate attempt to find a solution. I’ve been struggling with chronic lower back pain for almost 2 years now. Unfortunately, 2 years of many different physical therapists and doctors (nerve blocks + cortisone shots) later there’s little to no improvement for me (except being able to just deal with the pain/ignore it a bit better).

I wish I could attempt these mind-body treatments but I do have a physical cause. Almost complete sacralization of L5-S1 and bulging disc pressing on nerves. The worst part is I thought a physiological cause would make back pain easier to treat, alas it does not. Surgeons discourage spinal fusion surgery - a well regarded spinal surgeon told me odds of surgery improving my pain were worse than a coin flip.

I’ve also read a bunch of commonly recommended books like back mechanic and 8 steps to a pain free back and they both did nothing for me. I continue to do core exercises and everything else 2 years of therapists suggested to no avail.

> Almost complete sacralization of L5-S1 and bulging disc pressing on nerves.

I have no idea what this is, but the one thing I would have you ask yourself (or the doctors) is: How many people who have this physical condition you have are in back pain.

From what I've read, for example, that most people with compressed nerves/slipped discs do not have chronic pain. If you give a doctor an X-ray of a typical slipped disc, they will not be able to predict which ones had back pain and which didn't.

Yeah, good question. I really don’t know but my guess would be no based on how little most specialists actually know about this stuff

First off - fasting, like 10 days water fast kinda thing. Generates new stem cells that can fix neurological problems, massively reduces inflammation.

Lifespan book by Dr. Sinclair does a deep dive on that.

Next swimming/yoga/qigong - make your muscles be able to better support your spine. Standing desks also help a lot in that regard if you can handle them.

It’s surprising how much crude tools like that can help inflammation/pain problems. It’s usually not just the movements themselves, it is the whole culture of mindfulness around it. You get to spend more time being at peace with yourself, as well as meeting a lot of people who do it too and encourage you. And that helps a ton as well.

I’ve seen several people embark on those paths with “untreatable” problems with good results, but it might be important that this is not treated as panacea - we don’t want to end up like Steve Jobs.

I personally think fasting is incredibly powerful medical short and longterm tool. And the rest is more psychological one, still very powerful too.

I went to wing chun mostly because of the martial arts training, but did qigong too because it was expected in the peer group. I’ve found that even if the explanations of “why” it worked were clearly bogus (blocked energy pathways - earth/fire/air kinda things) the motions themselves and the culture around them was incredibly soothing. Now I myself didn’t suffer from illnesses but I did meet several people there who mentioned turning to it as a last resort, with positive results. Maybe it’s survivorship bias but I’d recon its still effective.

Thanks for the response. I’ve been doing yoga, swimming is not something I’ve tried. Agreed on how crude tools can be effective, I’ve already made lots of changes (I only use a standing desk).

I’m very skeptical of saying being effective, but am open to being wrong. I’ll check out that book, alleviate the rec!

I highly recommend Barbell Medicine's content. Their youtube channel has tons of videos with science backed information for training and dealing with pain, specifically back pain.

Austin Baraki is an advocate for the biopsychosocial model of pain that the parent post is effectively evidence of. I would love if more people read his "Aches and Pains" article: https://startingstrength.com/article/aches-and-pains It contains a lot of surprising information regarding the efficacy of common treatments for pain - and r great argument for why pain is more complicated than a or b being out of alignment.

My advice would be to learn as much about pain, self efficacy, catastrophizing, the nocebo effect, etc. from the Barbell Medicine crew - and if you have the money do a pain and rehab consultation with them. I sincerely think their team is THE best in the world.

Thanks for the suggestion, I’m open to reading another book so I’ll give it a shot.

Been there. Unfortunately once a disc is damaged and starts bulging, it never really can get better. It's odd they discouraged a fusion or disc replacement, obviously I don't know the specifics of your situation, but it was a immediate off-switch to all the pain for me. Did the full gamut of other things including several specious medication recommendations that had me switch doctors several times they were so awful. Steroid injections were a minor relief but not much.

Sadly my US insurance at the time was a right bunch of horrible cunts and refused to cover a disc replacement, only a fusion, but after years of suffering I felt 10 years younger once I was back on my feet hobbling around for rehab.

Well none of the doctors have even discussed disc replacement, only fusion.

I hear you on the insurance front. I’ve had “good” insurance this whole time but I’m still several tens of thousands of dollars more broke now

Going on well over 10 years now with my pain... spinal stenosis and degenerative disc disease. I had an L4-S1 laminectomy and it only helped for 1 year. I've tried all the other stuff you mention as well like cortisone shots, branch blocks, physical therapy, chiropractic, acupuncture etc. and practically nothing helps, even tried basically all of the currently available CBD and THC variants... only thing that always works is really hard narcotics like oxy that I don't want to take for obvious reasons. I can walk on my own for maybe 10 minutes max before I just can't take the pain anymore.

Have you tried this - https://www.youtube.com/watch?v=4BOTvaRaDjI. I found it on reddit and it's been absolutely amazing for my back.

I have not but I’ll give it a go. Thanks for sharing!

I will second fasting as something to try. There is also a comment about taking calcium and magnesium. You might try that as well, plus possibly B vitamins and getting the right dietary fats.

Thanks for the reply! I’ve very consciously changed my diet to one where I pay attention to nutritional content, but yeah I’m sure nutrition has an impact.

I mentioned in another response that I’m very skeptical of fasting doing anything. I’m open to being wrong but I don’t see how fasting could possibly undo real damage to my spine and make the bulging disc stop pressing on nerves.

Did you heard of this book, Pain Free at Your PC? For me it's hard put into practice because of the time demand, but exercises and reasoning is quite good.

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