Baby Got Back Pain

The best thing I did for myself in 2023 was also the weirdest, but all that matters is...IT WORKED.

Today’s dispatch is slightly outside the realm of my typical NFG fare, but it does dovetail nicely with one of my favorite mantras: Whatever works, bitches!

I believe in solving problems in any way that is sustainable for the person whose problems need solving. It doesn’t have to be how other people do it, or how they tell you that you should do it, or even how you did it last time.

You can take a traditional approach or an innovative one; try a conservative angle or a balls-out Hail Mary. All that matters is, you know, SOLVING YOUR PROBLEM.

And I solved a really fucking big problem this year, in a way I never thought would be possible—a way I initially thought was, quite frankly, wackadoodle-doo.

So I thought I’d share that story here, both as a potential solution for anyone who happens to be in my specific situation and also as a general introduction to the “Whatever works” mindset, which has been keeping me happy, sane, and productive for many years now.

Who knows? Maybe WWB will help you solve a problem (or two) in 2024.

Bit of a longread today, so strap in!

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If you have chronic back, neck, hip, or leg pain (or headaches, indigestion or other GI issues, or even a skin condition like eczema) you may find what I’m about to tell you seriously life changing.

Or you may file it away under “Yeah, right” and then in three months or a year or two years, after you’ve tried everything else (twice) you might remember it and search your email for “Sarah Knight back pain” and—if you’re like me—you might be desperate enough to give it an exceedingly skeptical try.

And it just might work.

Folks, I honestly can’t fucking believe I am about to commit these words to print, but today I am going to tell you how I healed myself of more than a year of chronic lower back pain by…talking to my rage.

I know, I know. It never gets any less ridiculous to say that. I’m cringing as I type!

It’s true though, and if writing about it helps other people escape the fog of pain and frustration that comes with daily, debilitating assault on their one-and-only skin suit, I shall shout it from the rooftops.

(Also, we’ll come back to that word “debilitating” in a bit. I have SOME THOUGHTS.)

First, a little background:

In June of 2022, I went to New York for a friend’s wedding, and then left my husband in the city so I could fly home alone to spend three weeks sans distractions going balls-out on writing my new book. We live in the Dominican Republic, so it would just be me and my manuscript, with my two trash cats and a shitload of lizards for company.

The pain began with a weird, swollen lump along what is best described as “the left side of ye olde bikini line.”

Hernia? I thought. Fuck me! I subsequently thought. Maybe I hurt myself lifting my carryon bag into the overhead compartment? This is what I get for traveling alone, goddammit.

One day I took a writing break to meet some friends for lunch, but my hip was so stiff that I couldn’t get comfortable, and I had to cut our visit short. My lower back was hurting by then too, which I attributed to the untold hours of scrunching (I believe that’s the technical term) over my laptop on the sofa, in bed, and perched upon my shitty IKEA desk chair.

I went back to New York that August, and when I shuffled into her office like an ancient crone, my GP listened to my spiel, did some manipulation of my legs to check for reflexes and numbness, and concluded that my stiffness and pain probably were posture-induced—but maybe it was my piriformis muscle (buried deep within my glute, apparently) rather than my actual back, per se.

She prescribed Advil, heat, stretches, and regular get-up-from-the-computer breaks and sent me on my way.

I will spare you the full Long and Boring Account of the Pain, which continued to occur daily, increased in intensity, and soon included regular bouts of searing sciatica for MORE THAN A YEAR after that—but to give you a sense of how pervasive and unignorable it was, here are some things I did in the meantime to try to make it stop:

• Swallowed more than my lifetime allotment of OTC nonsteroidal anti-inflammatory pills. They did not help.

• Took a six-day course of actual steroids. That did not help.

• Tried the prescription drug Meloxicam. It did not help.

• Tried a different prescription pill offered by my doctor in the Dominican Republic and guess what? It didn’t help AND after three days it made me feel psychotic.

• Did three months of daily fucking low-impact yoga (not my jam) specifically designed for herniated lumbar discs, which I was beginning to suspect I had. This seemed like it was actually helping my stiff hip, but I ultimately had to stop doing any exercise at all because my back hurt too much.

• Sat on an electric heating pad while watching TV at home and corseted myself in ThermaCare wraps when on-the-go. (Did I mention I live in the tropics? I developed chronic sweat-zits around my midsection to go with my chronic back pain.) This helped a little.

• Numbed my lower left back with lidocaine patches. This also helped a little.

• Did not leave home without my trusty inflatable lumbar support pillow, which makes a rather disconcerting sound when you deflate it, as per the startled glances of my fellow airline passengers/restaurant dining companions. I’m not sure if it helped or if it was more of a security blanket situation, but I’ll probably keep flying with it because literally anything is an improvement over airplane seats.

During this time, I also did a lot of gasping, thrashing, whining, crying, and feeling sorry for myself.

I also finished writing my book, it was published, and I sat in my uncomfortable IKEA chair for hours at a time doing Zoom calls and recording podcast interviews to promote it. I went back and forth to the States for business and pleasure, which entailed many flights and several multi-hour car trips. I attended another epic wedding, in high heels. And I went on a once-in-a-lifetime trip to Greece, where I hiked up the Acropolis and took a bouncy four-hour speedboat ride through the Cyclades, which, let me tell you, is great for your spinal column.

Ooh! And here’s where we get to the D-word.

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“Debilitating” is defined by Merriam-Webster as “causing serious impairment of strength or ability to function” and by the Oxford English Dictionary as “to render weak; to weaken, enfeeble.”

After multiple appointments (in person and telehealth) with my New York GP and my Dominican doctor, getting two X-rays (for insurance purposes, just to be eligible for an MRI), and waiting weeks for an appointment with a spine specialist on yet another trip to the US, I was asked during my intake whether the pain was “debilitating.”

The implication being that if it was NOT “debilitating,” I should be more patient with the remedies I’d been trying…for the better part of a year.

(At this point, my patience was thinner than early-90’s Kate Moss.)

Because I am culturally conditioned not to overstate my pain lest I appear hysterical, I almost said “Well, no, it’s not debilitating, exactly.” But then the pedantic little princess in me won out and I explained that I considered this a stupid diagnostic question.

I mean, I just got finished telling you (meaning “you,” my doctor; not “you,” my gentle reader) everything I’d been doing for the year leading up to our little confab. If the pain was “debilitating,” how would I have dragged my ass seventy-five blocks via subway to your office this morning, let alone up a mountain to gaze upon the ruins of early Greek civilization?

My pain was lots of things: it was constant; dull and throbbing; sharp and acute; excruciating; maddening; and tear-inducing. However, I couldn’t say I was “significantly weakened or enfeebled by it.”

Like, I’m weak in the best of times, brah—that is my normal “able to function” state. Do we only operate once I’ve completely lost the use of my legs? When I’ve ceased being able to scrunch over my computer and write for a living? Does my pain simply not merit further medical intervention as long as I am willing and able to grit my teeth and bear it?

(This is where, if I had but world enough and time, I would go off on a saucy li’l tangent about [male] doctors not taking [women’s] pain seriously, but that’s a battle for another day.)

Intake Guy said he would put in a recommendation for the MRI, but “We [at the spine surgery clinic] don’t like to do surgery. We like to try everything else first.” Meanwhile, I should get started on a “real” physical therapy program. Apparently the self-guided, low impact, fucking yoga that I’d had to stop doing because I was in so much pain did not count toward my “Have you tried everything?” point total.

The first available appointment at the PT place he recommended was twenty-seven days later. Because we were going to be in the States for a while, I booked it, and I don’t even want to tell you how much it cost.

(This is where, if I had infinite time AND the promise of your never-ending attention span, I would digress into a discussion of the broken US healthcare system, my own privileged participation in it, and how those with less privilege than I are well and truly fucked. But I know I need to speed this along.)

And as it turned out, I didn’t need Intake Guy or his fancy-pants spine surgeon boss anyway—though not for the reasons they were probably telling themselves when they gave me my MRI results: a herniated L5-S1 disc that “shouldn’t really be causing much pain and will likely absorb itself back into your body in a year or so.”

During that appointment I asked the surgeon himself if there was anything else I could be doing to ease the pain or at least not make it worse, while giving the “real” physical therapy a chance to work (or my disc to magically dissolve) and he responded “Well, you could hang upside-down like a bat all day, haha.”

THIS GUY, LADIES AND GENTLEMEN.

Then he told me I could consider an epidural steroid shot (the last stop before surgery), so I did consider it, and I made an appointment to get it, and then a few days later a nice receptionist called to tell me it would cost $1700—with insurance—and would I like to go ahead and confirm?

This was when something inside of me broke (besides my L5-S1 disc, haha).

And I realize I’ve lived a sheltered life in that I hadn’t encountered these kinds of medical expenses until my mid-40’s, but WHAT THE ACTUAL FUCK. Everything I’d read and gleaned from the doctors suggested that an epidural might not even work, and if it did, the effects would almost certainly fade in a few months. I didn’t see how I could justify spending an entire mortgage payment on a hope and a prayer.

So I cancelled the appointment.

I picked up my Kindle.

And I started reading.

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The Mindbody Prescription

I’d heard of Dr. John Sarno a couple years earlier. The chronic pain community had been up in arms over the author of a New York Times article saying he’d cured his decade-long back pain by reading a book that told him it was all in his head.

According to Dr. Sarno, nearly all chronic pain is caused by repressed emotions. By undergoing psychotherapy or journaling about them, he said, you could drag them out of your unconscious—and cure yourself without drugs, surgery or special exercises.

Like I said, wackadoodle-doooooo.

I’d forgotten about it until I was in the midst of my own lower lumbar crisis, and a friend mentioned he’d seen a Reddit thread whose participants couldn’t say enough good things about how they, too, had been rendered pain-free by Dr. Sarno’s methods.

Desperate for relief, I bought the book later that night, started it, couldn’t get past what I saw as a ridiculous premise and clunky and repetitive writing, and put it down.

Then a month or so later, faced with the prospect of that $1700 injection, I picked it back up again.

My husband thought I was crazy to cancel the epidural and put my faith in what sounded like a whole lotta snake oil. I thought I was crazy. But I also figured it couldn’t hurt to give an $11.99 ebook one more try before I turned my credit card over to the Hang Upside-Down Like a Bat Boys.

So I committed to reading the whole thing with an open mind. If it works, that’ll be a goddamn miracle. And if it doesn’t, I’m no worse off than when I started.

And friends?

IT FUCKING WORKED.

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I’m not going to regurgitate all of Sarno’s theories and methods for you here; I won’t be able to do them justice, and I believe you have to read the whole book yourself, thoughtfully and carefully, to pick up everything he’s putting down.

That said, here are some highlights:

Dr. Sarno posits that for many people, back [and shoulder, neck, knee, and other] pain is not caused by a musculoskeletal abnormality—even if one exists. For example, he says that the same disc herniation that I have is present in most people by the age of 20, and yet, the majority of those people don’t have pain; ergo, something else must be causing it. (That’s an example of some of the facile, not scientifically rigorous conclusions he jumps to throughout the book, but like I said, it fucking worked, so I’m way past caring.)

With exceptions for people whose pain is clearly and provably linked to a discrete injury, such as a car or ski accident, he suggests that it is more than likely your brain that is causing you all this trouble.

He calls this condition TMS, or Tension Myositis Syndrome.

It’s important to note that Sarno never claims that the pain is all in your mind, as in, that it’s imaginary. What he means by “in your mind” is that rather than a herniated disc or pinched nerve, etc. being the root cause of your physical pain, it’s your brain that triggers the pain symptoms—by way of instigating a process of slight oxygen deprivation to your muscles.

(Again, this is his purely anecdotal theory based in his decades of successfully treating patients; not on, you know, science. Don’t shoot the paraphraser, please.)

For what it’s worth, this aspect of TMS explains why the heat wraps helped temporarily relieve my pain—because applying heat to the muscle stimulates blood flow and oxygen. Whereas the NSAIDs and steroids did nothing, because there was no inflammation—aka injured tissue—to un-inflame.

So, why would your brain do such a dastardly thing?

Dr. Sarno believes that TMS is essentially a defense mechanism. That the repressed negative emotions that exist in your subconscious without you being aware of them are so upsetting to contemplate that your conscious brain is working to keep them buried—by distracting you with another form of pain that it perceives (incorrectly, but understandably, from an evolutionary point of view) to be more bearable.

Therefore, he says, if you can simply become aware of the existence of these repressed emotions (he calls it your “rage,” but I’ve come to think of it as anxiety, resentment, injustice, fear, or anything else that triggers a negative emotional reaction in me), the pain will disappear because it no longer serves a purpose—and your brain is not wired to expend energy for no discernible purpose.

I know, it sounds kooky as hell, right? But I kept my promise to myself and read the book in its entirety, and then…I started talking to my rage.

I would spend half an hour a day trying to draw connections between the onset of my back pain and the worst stretches of it throughout the year, and what was going on in my life at the time and BOY DID I REALIZE SOME THINGS.

(BTW, I’m not talking “repressed memories” like I just suddenly dug up a traumatic event that I’d buried and forgotten since childhood. It was the emotions I realized I’d been repressing, related to events and situations that I knew full well I’d experienced.)

Once I made those connections, I would sit there and tell my brain—literally, out loud:

“We are not going to do this anymore. I know what’s going on here and it’s not helping. Thank you for your service, but let’s put your considerable powers to work for good instead of evil, m’kay? I need you to send ALL of the oxygen to my major muscle groups and stop it with your silly reindeer games.”

My favorite one-liner became “I have the knowledge, so the pain has no purpose.”

Doing all of this feels just as silly as it sounds, and once again, I truly cannot fucking believe I am writing these words, but what can I say? I was virtually pain-free within a week.

A week! After more than a YEAR of near-constant agony.

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It’s been five months since I “committed to the bit.” In that time, I’ve experienced barely a blip of the back, leg, and buttock pain that had me crying and squirming around on the floor at my parents’ house last Christmas and whimpering my way through eighteen-hours of airtime forth-and-back to Athens in June.

If I feel a twinge coming on, I stop and interrogate my emotions, speak (or even just think) my mantra, and it goes away. Poof.

And you want to know something really wild?

My husband has been suffering from severe, non-migraine headaches for several years and has tried everything to figure out the source and treat them. He got his eyes checked and started wearing glasses; he got a full allergy work-up and started using a daily nasal spray; he went on nerve pain medication that had terrible side effects; he got multiple brain scans.

And much like me, he cut a lot of things out of his life that he thought might be contributing to the headaches—bright sunlight, exercise, proximity to any strong smells or smoke—to the point where he was holed up in our house most days with the windows closed and curtains drawn, just trying not to get a headache.

Still, they came.

When he saw how well the Sarno techniques worked for me, he, too figured What have I got to lose? He read the book, started talking to his rage, and the headaches went away. Just like that. Sometimes he’ll feel one coming on and, like me, is able to talk/think his way out if it.

He’s off of every pill, the curtains are open, the lumbar pillow is in storage, and we have our lives back.

Kooky AF? Yes indeed.

But you know what I have to say about that.

I had these pins made for publication of my book You Do You, which is how you know I’m a serious person.

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FYI: The first Sarno book I read was The Mindbody Prescription, because that was the link my friend sent me. I then also read Healing Back Pain, which was the book the cited in that New York Times article. The Mindbody Prescription goes into more detail about the non-back pain conditions that he believes can be attributed to TMS, including GI and skin issues, and more.

And while I sincerely hope none of this is relevant to your life—if it is, I’m happy to answer questions in the comments!