As I sit here and type this, I bring my consciousness unwillingly to the nagging, pulling discomfort just to the left of my upper spine, and the related headache. I am quite used to this state of affairs and cannot let it slow me down.
But just in purely economic terms, back pain is a serious problem in the UK. In 2011 alone, 35 million working days were lost to 'musculoskeletal' problems - number one on the sickie list, not very closely followed by 'minor illness'. If someone did a 'return on investment' study on an effective back pain protocol, perhaps sponsored by business, it could make good financial sense. I set out to find out what is possible using my own case as a guide.
The vast majority of musculoskeletal problems are back, neck and upper limb - that is sometimes called iPod Neck. It has to get pretty bad to take a day off, and most people - as I do - just soldier on in constant pain. Going to the GP with back pain can result in a bit of a muddle - possibly some physio, and painkillers. Neither approach helped me except that I discovered Co-codamol makes me feel as if I have the worst flu ever.
Because it is not gut-wrenching agony, and it comes and goes, I feel I shouldn't go on bothering the doctor. But my productivity is nothing like what it was when I was younger, and could bash out up to 8000 words of perfectly readable prose in a day. Which admittedly was a bit extreme.
For my last post, How to Cure iPad Neck l, I went to see the Shoulder Doctor Dr Tony Kochhar, and he began to reveal the multi-headed approach that can work - if not always to cure, but often to alleviate.
For me he suggested the first step was to visit a physiotherapist but not to stop there. Ideally this would be Recoup in Banglore where you work with a variety of therapists all day every day for weeks and come out in top condition. Not an option for most of us!
Instead I visited Shalini Clark in the basement of the London Bridge Hospital. A warmly reassuring presence, she asked me a series of questions and identified that chronic stress 'maintains a chronic pain state' - which pretty well nails it.
After an examination, during which she explained that all the different twinges in left hand ribs, back, head and shoulder were connected, she took me down to the gym. There she taught me two simple exercises to stretch the cramped areas. One involving a firm foam roller and the other a simple stretch on both sides. I went home and bought the roller - although it feels quite extreme stretching your back over it. I have to report that after some slightly alarming crunching noises, the improvement is pretty obvious. She is also very firm about heavy designer handbags - and this matches closely with my experience. There's a gorgeous, hardly used, pea-green Burberry one in my cupboard which will hit Ebay any day now.
Next up was pain specialist Dr Serge Nicolic, originally from Yugoslavia. He was more of a fact and statistic man, which I like, his approach straightforward and calm. What I have is exceptionally common apparently, but the likelihood of its being sinister is negligible. He thoroughly examined my upper body from a more medical point of view which was reassuring. At one point I was asked to squeeze his hands, me saying pathetically that I wasn't so good at removing lids from jars as I used to be. From his face, I think I had gripped his hands quite hard enough.
There are four 'treatment modalities' for these kinds of chronic pain, none of which are mutually exclusive: pharmacology (pills); physiotherapy and related rehabilitation; interventions (ranging from steroid injections to surgery) and psychology. Psychological support does not alter pain intensity, but changes attitudes and helps with stress. A multiple approach is more likely to yield results. The problem with NHS treatment is that it can be bitty with lots of different referrals that are not interconnected.
Nikolic is very clear that there are no miracle cures - whatever you read in the papers, and I had to accept that I may never be entirely free of my problem. Wear and tear, age, stress, old accidents, poor posture while working too hard - it is inevitable. His contrasting example of a completely successful medical treatment was tooth extraction - there is nothing so neat for back pain.
So, I am getting up now from the laptop to bend my back over my trusty foam roller - I have come to rely upon the relief from this stretch. I am working on my core strength too to help support decent posture and trying to increase my overall fitness with plenty of walking. And the doctor has encouraged me to use over-the-counter pain relief to 'keep the muscles quiet' while exercising.
Next up, an MRI scan and possible further intervention. I will keep you posted as to how I get on. If I am to write another novel before the end of the year, something's got to change.