Since I was about 10 years old, I’ve suffered from chronic back pain. I started going to a chiropractor in 9th grade and shortly after high school, I started physical therapy after my pain landed me in the ER. For those of you doing the math, that’s over two decades of pain.
The thing about my back pain is that I’ve never been given a solid diagnosis beyond “you have back spasms.” The issue I take with that is that I’ve seen people have back spasms, and they look nothing like mine.
My back spasms stem from somewhere in my right iliolumbar (think kind of where the hip and back meet), and wraps into my right hip flexor. When a spasm happens, my right rib cage, hip flexor, and iliolumbar ligament feel like they catch on fire, and tilting my head or chin downward make my back feel like the ligament is about to stretch and snap. I’m in excruciating, blinding pain. I feel shaky, nauseated, and sweaty. I can’t think straight and I feel like I can’t stand still or move because both make the pain worse somehow. I’m so thankful I don’t know anyone else who feels pain like this, but it’s isolating being the only person who understands what it’s like.
When I was going to physical therapy, my therapist told me my right hip bone is lower than my left, and it’s tilted slightly forward. She suspected that what causes my spasms is that the muscles and ligaments surrounding my hip periodically try to move everything back into place. My primary care doctors told me the pain was likely caused by growing pains or my period. I don’t know if any of these people are right because more than twenty years after that first spasm, they still occur (although with less frequency).
So why am I writing about my back pain now?
I may not know what causes my pain, but in the decades of dealing with it, I’ve learned some ways to help manage it — ways that don’t include prescription drugs or doctor visits, and I want to share my methods in hopes that it might help others.
I have to preface this by saying that I am not a healthcare professional, and what works for me might not work for you. I think that anyone living with chronic musculoskeletal pain can benefit from these self-treatments, but you should never practice anything that conflicts with your doctor’s recommendations.
How I manage my pain
When I practice regularly, I feel a difference in my body. My back feels stronger, I’m more flexible, my posture is better, and my pain is less frequent. I remember when I was going to physical therapy, I was complaining that my back and hip were hurting more. My therapist said that in order to heal pain, you need to expose it first — in other words, the pain might get worse before it gets better. This is the case for me with yoga. When I fall out of practice and finally return to it, I am opening myself up to the possibility of back spasms until the muscles and ligaments stretch back out and I gain back some strength.
Some of my favorite poses for building flexibility and strength in my hip and back are Pigeon Pose (any variation), Thread the Needle, Cat and Cow, and Revolved Low Lunge. If you’re looking for a good at-home yoga practice, I recommend Do You Yoga and Yoga with Adriene. Both offer a wide variety of practices, including those that focus on hip and back pain, for free (Do You Yoga also has videos only for paying subscribers, if you prefer to unlock the full library of practices).
My physical therapist had me doing a lot of core work, and I didn’t understand why she was trying to strengthen my lower abs and glutes if my back and hip were weak until she explained a very simple concept to me — when you want to strengthen a muscle or muscle group, you need to strengthen its opposite in order to really build strength.
We see this concept all the time at the gym — when it’s arm day, you don’t just work on biceps, you have to do triceps too. The same is true when strengthening weak back muscles… you can’t just do supermans, bridges, and seated cable rows, you have to do planks, lying leg raises, and scissor kicks.
When working out, make sure you protect your back. Listen to your body and know the difference between building strength and straining yourself. Don’t push yourself too hard and risk further pain or injury, and make sure to warm up before, and to stretch.
Something I loved when I was in PT was the TENS unit at the end. If you’ve never used a TENS or E-Stim machine and you’re in pain, this might be something you want to check out. TENS stands for transcutaneous electrical nerve stimulation. This small device has sticky electrodes and leads that connect to a hand-held unit that sends electric pulses to the muscles to contract and relax them. TENS units used to only be available with a prescription, but in the last few years, they’ve become available to the average consumer. I was so happy when my dad got me one for Christmas that I nearly cried! These things are incredible.
I recommend them to all my friends with chronic pain. In fact, I recently lent my TENS to a friend who tweaked his back, leaving him totally unable to run or work out. He wasn’t finding much relief a few weeks after his injury, so I gave him my TENS. He used it a few times a week for two weeks and was up and running again in no time. I’m not claiming it’s a cure-all, but it helps a lot with easing musculoskeletal pain.
It’s so tempting to slow down when you’re living with pain… I know, because I’m guilty of doing this myself. I know it’s a cliche, but a body in motion stays in motion… so yes, rest your body when you need to, but keep it moving. I mentioned earlier that sometimes it gets worse before it gets better, but don’t be discouraged if and when that rings true for you. Don’t use that as an excuse to stop exercising or living your life. If you want to heal, you need to move.
Sleep With A Pillow Below Your Knees
If you have back pain, you’ve probably heard this one before. Sleeping with a pillow under your knees will help relieve lower back pain. We have a bunch of pillows on our bed, and when my back starts to really hurt, I’ll fold up some pillows and stick them under my knees. I usually use more than one pillow so I can get a little more height. The closer I get to an L shape (with my lower legs parallel to the bed or floor and my upper legs perpendicular to it), the more relief I feel. I don’t sleep like this all the time, but when I feel the pain building, I’ll lounge or sleep like this, and sometimes stick a heating pad under my back or use the TENS (never use the TENS and heating pad at the same time!).
Check Your Mattress
It’s also worth saying you should check that the mattress you’re sleeping on is right for your needs. I was on the wrong mattress for years, and I was waking up with hip and back pain for much longer than needed.
We went mattress shopping and I talked to the salesperson about the best mattress for hip and back pain. I also did my own research online, and it didn’t take long for me to realize that my firm mattress with springs was totally wrong for my back. We ended up getting a super soft mattress with individually wrapped coils and a plush topping, and I have never slept better! I no longer toss and turn trying to get comfortable, and I feel like I’m sinking into a giant marshmallow when I lay down for bed.
Do yourself a favor and do the research and some in-store testing to find what mattress is best for your back. You may not need or be able to afford a new mattress, but maybe getting a memory foam or pillow topper could help ease some of your pain. Even a small fix like finding the right pillows (yes, there is such thing as “the right” pillows!) can help ease your pain.
Avoid Your Triggers
This one probably goes without saying, but I’m saying it anyway: avoid the triggers that you know will can or will flare up your pain. For me, that means lifting incorrectly, not purposely cracking my back (my doctors, chiropractor, and physical therapist ALL say this is something everyone should stop doing to preserve musculoskeletal health), and not sleeping on my stomach. It means asking for help when there’s something heavy that needs moving or when I’m in pain. It means not being stubborn, pushing too hard, and ignoring your body — listen to it and do what’s best for its healing and protection.
For years, these are the ways I’ve dealt with my pain. Of course I need to pop some ibuprofen from time to time and there are days when I slather on the Tiger Balm or walk around with a capsaicin patch stuck on my back (I keep them in my desk drawer and highly recommend you do the same), and a good Epsom salt bath never hurts when I feel the pain and tension building (I recommend Dr. Teal’s, and I especially love the Whole Body Relief, Pink Himalayan Salt, and Wellness Therapy soaks), but these ongoing self-treatments have been my best bets in managing my pain on my own, keeping me out of the ER and off prescription painkillers and muscle relaxers.
I know avoiding medications just isn’t reasonable for everyone — every person handles pain differently. My methodology helps me prevent the painful spasms and the dull ache that I used to feel every day, but that’s my body. Sometimes pain meds are unavoidable. My philosophy is that I know these things work in managing my pain, so why not do them until/if I reach the point where I need medication to relieve my pain? Whether you’re on pain meds now or not, adding these practices to your care plan might help relieve some of your pain — just check with your doctor before diving into all of it.
If you have chronic pain you’ve been managing at home and have some other suggestions, or if you have questions about managing pain, drop a comment below!