I’m in training for a trip to Disneyland this fall. “The Mouse is my motivation,” I told the spinal pain specialist. “Going to Disneyland with my 5-year-old grandson will require a lot of walking, and I need to be ready.”
The doctor agreed that is a fine motivation. So now I’m working to better manage my stenosis, bulging discs, mild scoliosis and osteoarthritis — all degenerative diseases that commonly affect people 50 and older. After all, if your back hurts when you walk, you can’t explore a theme park.
The Aging Spine
The National Institute of Arthritis and Musculoskeletal and Skin Diseases defines spinal stenosis as “a narrowing of spaces in the spine that results in pressure on the spinal cord and/or nerve roots.” Bulging discs in the lower vertebrae also put pressure on the spinal cord. Even mild curvature of the spine may complicate matters. And osteoarthritis is simply wear and tear on the skeletal structure, compounded annually because so many of us live so long.
I’ve written about this on Next Avenue before, but it bears repeating: In 1900, the average lifespan for a woman was 48; it was 46 for a man. By 1950, the average lifespan was 71 for a woman and 65 for a man. Today, the average American makes it almost to 78. And if you make it to 65, you likely will get to 80 or beyond.
An Injection for the Back Pain
What those statistics don’t show is that for help with your back pain, you may need an epidural steroid injection (ESI), which is said to be the most commonly performed spinal intervention in the world. An ESI is a combination of a corticosteroid — an anti-inflammatory medication — and an anesthetic injected into the space around the spinal cord and nerve roots. The physician administering the injection uses a digital X-ray machine to ensure the medication is delivered to exactly the right place.
Since having the injection, I’m back in yoga class, back in the pool, back doing physical therapy twice a day.
After the injection, either immediately or over time, ideally you experience pain relief that may last for months or even years. That allows you to become more physically active, which can help you manage the degenerative diseases.
And having an ESI may mean you can avoid back surgery, which often is ineffective.
One study showed that the annual number of ESIs performed on those of us on Medicare “increased significantly from 2000 to 2011 by an overall 130 percent per 100,000 Medicare beneficiaries, with an annual increase of 7.5 percent in the U.S.A.”
I’m one of them. In spite of all my efforts to manage my back pain (see below), by the end of 2016 I had noticed it was alleviated only when sitting, a behavior that is now touted as “the new smoking.”
Are You Sitting Down? Don’t
No less an authority than the Mayo Clinic reports that research has linked sitting for long periods of time with everything from obesity to metabolic syndrome (“a cluster of conditions that includes increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels”) to an increased risk of death from cardiovascular disease and cancer.
It gets worse: The report continues, “Sitting in front of the TV isn’t the only concern. Any extended sitting — such as behind a desk at work or behind the wheel — can be harmful. What’s more, spending a few hours a week at the gym or otherwise engaged in moderate or vigorous activity doesn’t seem to significantly offset the risk.”
Alarmed at just how good sitting felt, I made an appointment with the spinal pain specialist. He recommended ESI. I had the injection in mid-January and am already sitting less and moving more, with far less discomfort.
Try Other Things First
The ESI is not a cure, and it is not without controversy. Rare side effects include stroke or paralysis. And there is no guarantee how long — or even if — the injection will work. Some studies evaluate the effectiveness of the injections as “fair to good” or “moderate.” Most often, before doctors recommend ESI, they suggest:
- Nonsteroidal anti–inflammatory drugs (NSAIDs), such as aspirin, naproxen, ibuprofen, or indomethacin (ask your doctor about side effects, which can be significant)
- Analgesics, such as acetaminophen
- Swimming or using exercise bicycles
- Physical therapy
- A lumbar brace
Other than ESI, there are no good medical treatments for management of back pain. Alternative nonmedical therapies are abundant. The National Institutes of Health says some people appear to benefit from chiropractic treatment and acupuncture.
What Worked — Until It Didn’t
When I was diagnosed with “moderate” back problems about 18 months ago, I was already doing physical therapy exercises every day. Also, I was enrolled in a gentle yoga class and spent time each week walking briskly in a warm water pool. After the diagnosis, I started going for acupuncture treatments.
And like many people with back pain, I tried to balance my physical activity to avoid doing either too much or too little. All that worked, for a while. Over time, nothing worked. I took up sitting. I whined when I had to walk even a block.
Since having the injection, I’m back in yoga class, back in the pool, back doing physical therapy exercises twice a day. I’m so emboldened that I have made an appointment with a trainer at the gym so I can start using the machines there to help me increase my strength and stamina.
Disneyland Dreams Come True
About Disneyland — it’s not the corporate mouse himself I’m excited about. No, I want to go on the Dumbo the Flying Elephant ride, spin in the Mad Tea Party cups and admire the Sleeping Beauty Castle. I’ve wanted to do all that since 1955, when I was seven, the same year that Disneyland opened and The Mickey Mouse Club first aired on TV.
I am a proud member of that club, and after 61 years and several moves, I still have my Official Membership Certificate. On the show, there was a lot of publicity about Disneyland. I spent hours — years — trying to convince my parents that we should travel from St. Louis to Anaheim. We never did.
Now, I’ve convinced my son and daughter-in-law to include me when they tour the theme park this fall with my grandson.
Listen up, body – we’re talking Disneyland at last!
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