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How a seemingly straightforward injury became an endless odyssey—with no relief in sight.

October 2009

It started with a twinge, a little catch at my beltline that arrived, subtly and without warning, in May 2008. I'd thrown out my back a dozen times before in a variety of ways—moving a bed, chasing down a fly ball in a pickup softball game, even during a, let's say, amorous encounter that, given its excruciating outcome, was disappointingly unacrobatic.

I attributed this injury to an overambitious weight workout and, being 41, I figured it would loosen up in a few days. Almost 18 months later, after innumerable visits to doctors, physical therapists, and alternative medicine practitioners, both Eastern and Western, I'm still waiting.

My back woes always had played out the same: After a day or two of debilitating pain, the muscles would start to relax by day three or four and then return to normal within a week or so. This was different. It felt deeper, structural rather than muscular, and within about 48 hours that innocuous twinge had exploded into blinding agony, as if a railroad spike had been driven into my spine. It pitched my upper body stiffly forward, freezing me into the hobbling, geriatric tilt that would be my default gait for that summer.

An MRI revealed two problem discs, one bulging, one herniated. The procedure was ordered by a pair of specialists: an overly slick back doctor who favored pinstripe suits over hospital garb, and his nurse practitioner, who, when it came to bedside manner, did all the heavy lifting. The doctor made two fleeting cameos whose purpose, in retrospect, was to sell me on the inevitability of surgery. Both times, he breezed through the exam room so quickly that I had to blurt out my symptoms with the self-conscious haste of a stage-frightened game show contestant. By contrast, the NP, like most nurses, seemed genuinely interested in my suffering and in finding ways to alleviate it.

This doesn't mean that she could, because the back is a mysterious thing, the fulcrum of your physical existence, the hinge upon which your life twists, turns, and pursues happiness or wallows in misery. Eight of 10 Americans suffer back pain at some point in their lives, and the price of treating back pain each year can run to $50 billion in the United States alone, according to the National Institutes of Health. Yet there are no lower-back walkathons or benefit concerts, because no amount of money the medical profession throws at the problem provides many useful answers, let alone a foolproof remedy. When it comes to the back, no one really knows anything.

The inscrutability of lower-back pain forces its sufferers and their "caretakers" to sometimes grope for solutions, and the first two on my list were steroid injections and physical therapy. I don't mind needles, but the not-quite-numbed sensation of the steely projectile lingering near my spine for several minutes, poking around my insides and occasionally scraping bone, never got easier, even after I'd done it four times. At least the injections eased some of the pain and inflammation, and the temporary relief freed me for physical therapy.

My first physical therapist's office resided in the basement of a health club, fittingly, because this unapologetic dungeon master had a pet technique that would've been frowned upon at Guantánamo. The "therapy" involved me lying facedown on a table while he tried to force my leg back up over my head, all while ensuring me that this maneuver was crucial to wedging my herniated disc back into place. The most pliant Cirque du Soleil performers can't bend like that, and, within a handful of torturous visits, I limped away uncured.

As winter arrived, I continued to search for an elixir. My trusted NP got me into another physical therapist who taught me slow and steady exercise routines that began to release the wrung-out-washcloth tension around my spine. Simultaneously, I found a chiropractor whose gentle manipulations eventually evolved my posture from stooped-over Homo habilis into upright modern man.

The moderate success these two had was ironic, because a portion of each visit with them included suspicious interrogations about what the other one was doing. "He's jerking your leg off the side of the table? No one but I should be adjusting you like that," said the chiropractor. "She's stretching you that way? Be careful about how she does that," countered the PT. I heeded and ignored them as my body saw fit; by this time, seven months after the injury, I was up for anything that might help me roll over in bed, climb in and out of my car, or even cough with just a little less misery.

Somewhere amid all this I tried a half-dozen sessions of acupuncture, which dampened the pain slightly but fell far short of nirvana. Naturally, such Eastern voodoo is uncovered by my uninspired health insurance plan, and the costly alternative treatment introduced me to the other mind-numbing component of mind-numbing pain: the billing process. My chiropractor visits were well-covered for several months, a mere $11 copay per visit, but the moment the clock ticked over to 2009 my deductible ratcheted back to $500. Now each visit cost $84, and for reasons I still haven't determined (and am disputing), my insurance company has applied almost none of these costs to this year's deductible. Meanwhile, the University of Colorado Hospital, the PT's parent organization, has a bizarre policy of creating a new account number for each visit. Within a few weeks I started receiving a different bill for each of my dozens of appointments, with follow-up reminder bills every 10 days or so, a process so confounding that my credit rating will likely recover at the same snail's pace as my fragile vertebrae.

Which is to say: maybe never. Although my self-prescribed regimen of exercises—cherry-picked from my combative, contradictory specialists—has eased much of the chronic pain, I still have no idea when or why it might flare up again. Some days I play pickup basketball with no ill effects; other days I wake up barely able to walk, for no apparent reason. When it comes to one's back, the so-called experts can't really help. The only remedy, I've found, has been the Eastern approach of living in and deciphering the moment, combined with the Western approach of anticipating the next one—hoping like hell that it doesn't include a railroad spike. m

Luc Hatlestad, a senior editor of 5280, profiled John Fielder in the September issue. E-mail him at [email protected].