I've had back problems for most of my 30's and never imagined I'd have a back pain success story to share. I didn't aggressively search for a solution because I didn't believe there was one. I remember going to a Bikram Yoga class (hot yoga), and the instructor was complaining about back pain. If he was doing yoga all the time, and he still had pain, I thought that maybe back pain was just something that you had to live with. Stretching helped minimally, yoga seemed to help a little, and massage would give me 2 or 3 days of relief.
My pain started in 2007 when I got thrown really hard in Judo (part of a birthday tradition where everyone throws you with their hardest throw). After that I spent several weeks of every year on the couch, barely able to move. For the rest of the time when I wasn't in major pain, I was in minor pain, and afraid for when the major pain was going to return. Walking a lot aggravated my back, so did driving for more than an hour, standing, and most forms of exercise.
My number one fear was that I would get worse and a doctor would recommend back surgery. Of all the people I had known who had got back surgery, most seemed to have gotten worse.
A Life-Changing Experience in Colombia
In 2015, I was planning my second trip to my wife's hometown, Barranquilla, Colombia (South America). Before we left, her mom told her that she had heard of a chiropractor that was on the national news for fixing people's back pain. Her nephew was in his early 30's, was about to get back surgery, and couldn't stand upright. He went to see this chiropractor, Esthanedh Motta. At the end of his first session with Motta, he was able to sprint in the parking lot, then pick up his wife and carry her around, even though he was barely able to walk just a few hours before!
I was told that there were 4 treatments that were 3 hours each, and my cost would be around $3,000. My wife asked if the treatments were painful, and the assistant, who is married to Motta, said it was similar to having a hangnail removed (I soon found out that this was an understatement).
Motta's English is poor, worse than my Spanish (which is bad), and he took me into a large room with what looked like a large massage table.
He told me to lie on the table, and he wrapped a weightlifting strap around my ribs really tight. He held onto the strap with both hands and leaned all of his weight backward to get the strap as tight as possible. He put on his rubber gloves and was looking at my rib and collarbone and telling his assistant something that I didn't understand.
My wife asked if she could stay, and he told her that if she wanted me to get better, she was going to have to leave.
Without warning, he grabbed my feet and started slamming them over my head violently. I screamed, and he did this repeatedly. I'm a Brazilian Jiu-Jitsu instructor, and when we're grappling, we just tap out when something starts to hurt, or we can't get out of something. I knew I couldn't tap out, and I was convinced that he was going to at least break one of my ribs. He did some variation of violently twisting me for the next 90 minutes.
He would take breaks from nearly breaking me in half, remarking that I was strong. Twice the weightlifting strap that was holding me in place broke, and after the second time, he told me in Spanish that I broke two of his straps, and that he was going to get revenge on me. I believed him. It turns out that he was just kidding, but by the end of the first torture/realignment session, I was pretty sure that he was psychotic.
At the end of the first session, he took the second set of photos, and then put them side by side with my "before" pictures. There was a noticeable difference. My head was pretty much over center, my left ribs didn't stick out as much as they used to, my chest stuck out like it was supposed to, and my shoulders were pulled back.
He sat me down and told me that I had homework: I was to do 100 push-ups, and then have sex with my wife! He then looked and pointed at her and repeatedly said: "F*** you!" I looked at her in disbelief and amusement, and she gave me a look that said: "This is Colombia."
When I did my 100 push-ups that night, my elbows and shoulders were making a lot of crackling noises! I called my sister and told her what happened. She was nearly in tears and asked me if I was going to go back. I told her that I thought that he may be a sadist, but he was really good at what he does, and I preferred a few hours of pain to a lifetime of pain.
For the next session, he continued the torture/realignment. I screamed, he got tired. He'd take a break, I'd pray that it was over, and he'd start again.
At one point, during a break, he started talking about the then Ultimate Fighting Champion, Anderson Silva. He told me that he's like a leopard, that he doesn't just try to wound you, and he grabbed me by the stomach (with the rubber gloves he uses to get a better grip), he tries to finish you, and then he grabs me by the throat. Nice story.
I went to the third session, ready for more pain, and he told me that he would just be giving me some self-alignment exercises, and talk about how to keep myself pain-free. He told me that I needed shoes that had a lot of support. He said that if I continued to lift lighter weights with good form, I walked a lot, and I did my exercises, I wouldn't have any more pain.
The Difference Between a Good and Great Chiropractor
I believed that I'd be pain-free for the rest of my life. I took all of his advice, and after about 2 months, my lower back pain returned. I became depressed. Motta had told me that a lot of chiropractors don't know what they're doing, and said not to see one. But now that I was in pain again, I needed help.
I tried physical therapy, and it reduced my pain, but didn't get rid of it.
I had visited probably 10 different chiropractors in my lifetime and had only been impressed with one (who I saw when I was on vacation in California). The others seemed to be good, but had never made a big difference in how I felt.
I asked around for recommendations for a good chiropractor, and my wife had heard about Dr. Rose in Ann Arbor Michigan. I went to see him, expecting to do the normal evaluations of x-rays, standing with both feet on two different scales to see how I balanced my weight, my health history, etc. Usually, there's 1 evaluation that takes 45 minutes or so.
With Dr. Rose, we had 4 sessions that were an hour to an hour and a half! In addition to all of the normal protocols, he had me move my head, arms, and torso to find out the limits of my range of motion in several planes, and where I felt pain, and how much pain I felt during each movement.
He asked me what I do for my job, and I showed him some of the movements I do in Jiu-Jitsu. He asked how I lift weights, how I stretch, and how I work on my computer.
He gave me adjustments that reduced my pain, but I believe it was the lifestyle changes that he recommended that got to the source of my pain.
The first piece of advice was to stop using a laptop on a recliner. He explained that my head weighed over 10 lbs, and leaning forward was straining my upper back to hold my head up. This was leading me to develop a kyphotic posture and causing a lot of tension in my upper back.
He recommended I start using a standing desk where my elbows would be at my sides, and I'd be looking forward, not down. After a lot of experimentation with different standing desks, I highly recommend the Jarvis available on Amazon. We've tested out many other standing desks and rate them here. He recommended that if I was using a tablet, to get a holder so I could look at it at eye-level and not be looking down. When I started standing, my back felt better, I was more productive, and I had more energy. Dr. Rose's advice to start standing at my desk is why I started researching the dangers of extended periods of sitting and the benefits of standing desks; it's how this website got started.
Next, he said to get rid of my old couch. The cushions were worn out, and when I laid on it, my spine wasn't straight. He asked about my bed, but I have a high-quality Tempur-Pedic mattress, so I was good there.
He asked if I slept on my stomach, and I told him that I learned that I couldn't otherwise I'd be in terrible pain. He told me that when I sleep on my side I should have a pillow between my knees, and when I'm flat on my back, to have a pillow under my knees (just like massage therapists have you do). He also told me that sleeping on my side means not turning more than 90 degrees where my belly would be facing towards the bed.
Dr. Rose explained that bending down to pick things up and lifting things is another area where people strain their back. He asked me to demonstrate and I passed the test, bending my knees and keeping my back straight when I picked something up (my wife used to be a physical therapist and she corrected me on that). He showed me that you can also lean forward and straighten one of your legs and lift that leg so that your lifted leg is parallel to the floor.
He also explained that there's a formula for how much stress you put on your back when you pick anything up (not necessarily off the floor). This basically translates to, the further your arms are away from your body and the more something weighs, the more pressure you put on your back. So when you lift anything up, keep the object and your elbows close to your torso. And the worst thing you can do is to reach for something far away, twist while you're reaching, then lift it up.
One of the biggest revelations was that I needed orthotics. He could tell that I was bummed out when he said that (I like going barefoot), and he said wearing orthotics is like wearing glasses: there's nothing to be ashamed of, but you'll function better with help. Not a single chiropractor had told me that I need orthotics, and it made a huge difference.
I've since tried probably 30 different brands of orthotics (everything from the kind you can buy at CVS to custom made), and based on my experience, I created an orthotic review.
In the past, when my back was hurting, I normally blamed training Brazilian Jiu-Jitsu for my pain. It turns out that walking and salsa dancing (which I used to do 3-6 times per week) was actually worse for my back than grappling with college wrestlers. He recommended good orthotics, and wearing them all the time, and getting shoes with good support. Goodbye Toms and cheap flip-flops.
He also told me to strengthen 4 different muscle groups that were weak.
He told me to stop doing everything so we could figure out what was aggravating my back, outside of the other aggravators. No lifting weights, no Jiu-Jitsu, no stretching.
It turned out that the way I was lifting weights wasn't working for me. He recommended that I start doing the Foundation exercises as much as possible. I have since recommended the Foundation program to several friends and students and 2 of them have told me that this program was life changing. One said he has had to go to the hospital due to his back pain, and since he started doing the program, he feels like a teenager again (he's in his late 40s).
Dr. Rose also said that he doesn't always recommend x-rays, as he doesn't want to unnecessarily expose people to radiation, but in my case, he wanted more information. He said that the Foundation exercises would help decompress my spine, which I needed, as the x-rays showed that my L5 (lumbar vertebrae) and S1 (sacrum vertebrae) were starting to fuse together. I had an inversion table at home, which I didn't use, so I started using that every day.
Since standing all of the time isn't ideal, he also recommended that I get a Nada Chair, which almost forces you into a good posture while you're sitting (it's a thick elastic strap that wraps around your back and knees). I later bought a BackJoy, which does the same thing, but is easier to use.
Occasionally I or my wife would visit Dr. Rose and he would say, "This is muscular, me adjusting you won't make a huge difference, you need a good massage." I appreciate when a professional doesn't pretend that they can fix every issue. A good chiropractor knows when they can help you by adjusting you, and when you need something else.
When muscles spasm, they'll start pulling bones out of place, and once you have an imbalance in one spot, your body will compensate for your lack of movement in one area by using a different set of muscles and movements to keep you functional. So one problem can become 5 problems.
In the beginning, I got one massage per week. The pain was terrible. Everything hurt. After a massage, my muscles would relax, but after a little while, the tension would come back, due to my bad postural habits, and the fact that muscles have memory. After I started getting massages where I didn't have a lot of pain, I started going every 2 weeks, then every 3. Being a martial artist and using my body so much means that every 2 to 3 weeks I need a good massage.
I've gotten massages from a lot of different massage therapists. I've noticed that the good ones will tell me where I'm tight and need to stretch. One of the massage therapists that I get one massage per month with, Andrea Burke, who has a background in kinesiology, told me that I have tight lats and a tight chest. The first time I stretched my lats my back was literally popping, I felt great.
Now I stretch my chest and lats a few times per day, and it's definitely helped. I also use a massage gun on larger muscle groups.
Advice Regarding Massage
If you're thinking that massage may help you, ask for recommendations and find the best massage therapist you can. Try different people. Just like with chiropractors, there a few that are bad, most are good, and there are a few that are great.
The source of the pain isn't necessarily where the pain is. I would feel pain and tightness in my lower back, but a massage therapist told me that the source of the pain was in my glutes. I didn't really believe it until I got a glute massage! Since then if I do get some tightness, my prime suspects are my glutes, hamstrings, and IT band. If you have a suspicion regarding the source of your pain, tell your massage therapist. Otherwise, they may just give you a standard massage. Some people swear by massage chairs especially for convenience. One of the downsides to be aware of though, is that the chair can't adapt the massage to your specific needs.
To help prevent tightness in these areas, use a lacrosse ball, acumobility ball, and a foam roller. Foam rollers don't dig as deep as a lacrosse or acumobility ball for me, but if I don't do either, my back pain can slowly creep up on me through tightness in my legs.
I've tried out a lot of foam rollers, and I get more benefit from the spikier ones, such as the Gimme 10. If you're looking for something that will go even deeper, the RumbleRoller is more expensive, but will do the trick. Lacrosse balls are inexpensive, but the only issue I have with them is every kind I've bought has had a strong chemical smell. One of my students lives near a park where people play lacrosse, and she would find them laying around, and for some reason, they didn't smell.
The acumobility ball is basically half of a lacrosse ball on a soft plastic base so it doesn't move. Just like a lacrosse ball, you can put them on the floor and lie on them (which will give you a lot of pressure), or you can lean against a wall with the ball between you and the wall, which will give you a little less pressure. Acumobility sells two kinds, the orange (level 1, softer), and blue (level 2, harder). I use them on my neck, hips, shoulders, feet, and everywhere on my back. They're a lot more expensive than lacrosse balls, but I benefit more from them than a lacrosse ball. I keep two in my car in case my hips or back are a little tight I can sit on them while I drive. I also keep one in my travel bag for when I'm out of town and if I get some tension.
A New Way to Get Strong
Between Motta and Dr. Rose, I felt like a new person. I still had occasional discomfort, but I was 80% better. I ran into a friend of mine, Ron Buchere, at a mediation conference, who is a gifted massage therapist. He looked at me and said, "I can tell by your posture that you have the same back problems I do, you need to start working your core." I was a little bit surprised, as I assumed that with all the Jiu-Jitsu that I do, that my core was solid. But Dr. Rose had told me I had some chinks in my armor, so I did 2 core workouts with Ron that week.
The weight lifting that I had done my whole life was mainly for "beach muscles": chest, biceps, triceps, and shoulders. But many experts recommend that you do two back workouts for every one chest workout.
Since I started doing 2 core workouts per week, using bands and body weight, my chiropractic adjustments seem to "stick" longer.
The Mind-Body Connection
One of my Brazilian Jiu-Jitsu students told me that he had cluster headaches for 16 years. He said cluster headaches are worse than migraines, and that he had seen several different types of doctors and none could find the cause of his pain. He started reading books by Dr. John Sarno, who had extensively researched the connection between stress or life trauma and back pain. One of his books is called Healing Back Pain: The Mind-Body Connection.
A doctor continuing the work of Dr. Sarno (who recently passed away) is Dr. Howard Schubiner. He wrote a book called Unlearn Your Pain. This book is a workbook that takes you step-by-step through different ways of discovering the emotions you are harboring that may be causing your pain. I found this book really helpful.
My student now only rarely experiences headaches. He recently had one and wasn't sure why, and thought for a bit and remembered a fight he had had with his boss. He worked through the emotions and the headache went away. For people who can't seem to figure out where their pain comes from, I would definitely recommend looking into these books.
A New Lifestyle
After making all of these changes, my back is 95% better. Occasionally I get some tightness, and I can almost always pinpoint what I did to cause the pain, such as not doing my core and Foundation workouts (sometimes when my back is doing great I get lazy because I feel like I don't need them). Once my orthotics wore out and weren't doing their job anymore and sometimes I slouch while sitting at my desk.
Now that my back is good, when I do something that aggravates it, I can tell the difference. Before I was doing 10 or more things that were aggravating my back, so I had no idea what the problem was. It's similar to having a clean room - when a shirt gets thrown in the middle of the floor, it stands out. But if there was stuff everywhere, you don't notice it as much.
My reality is that my vertebrae were starting to fuse, as I've been mistreating my back for many years. It would have been great if anyone could have stopped me from wearing a heavy backpack on one shoulder for middle school, high school, and college (now I wear a backpack with both straps, or I use luggage with rollers).
I waited too long to find a good solution, and I don't know if I'll be able to recreate that healthy space between my vertebrae. Time and new x-rays will tell.
The good news is that I still train Brazilian Jiu-Jitsu 3 or 4 times per week, I can drive in a car or walk for hours on end without pain. There are a lot of things I have to do to stay pain-free, but the work that I have to do is worth not being in pain.
The bottom line is that it has been a lot of work, but getting rid of 8 years of back pain in 9 months honestly surprised me. I've mistreated my back for many years, I unknowingly was doing lots of things that were causing imbalances all over my back and core. I'm really happy that I could get rid of my pain 95% of the time, and when I do get pain now, it's usually minor.
I imagine that as I keep doing my core workouts, stretching and Foundation, and I keep good posture throughout my day, that there will be less work. I still get massages and see a chiropractor a few times per month, and I'll probably do that for the rest of my life.
If you're suffering from back pain, seek out professionals who specialize in this area. And there may be a lot of things that you're doing that are causing your pain and tightness.
January 2019 Update
It's been a few years since I wrote this article, and I'm happy to report that I'm still 95% pain-free.
I've found that I occasionally get a small amount of pain if I start slacking on any of my routines or if I push my back too far (like when I moved or was throwing dodgeballs at kids in the martial arts class that I teach).
I still get massages every few weeks, but I've been using a foam roller and a lacrosse ball between massages and it makes a big difference in my back (the pain isn't always where the problem is). I focus on my IT bands and hips.
These are great tools because some days I may start to notice pain, but it's often hard to get an appointment the day that I call - good massage therapists are often booked up for weeks (and I've had terrible massages when I took whoever was available). Using a lacrosse or acumobility ball and foam roller aren't as good as someone who knows what they're doing, but you can get rid of muscle spasms on your own with these tools.
I've also experimented with not using my inversion table for a few weeks at a time and then using it, and I've found that I have less tension in my back when I use it regularly.
I tried slacking on my hamstring stretches, and that resulted in my back being really tight when I woke up in the morning, making it hard to put on my pants, and my massages were more painful. Now I stretch for 2 minutes before I go to sleep and sometimes I wake up and there's no problem.
For years I've been using my inversion on and off, and I can tell the difference. Though I rarely have back pain, and when I do it's minimal, I have less back pain when I'm inverting. Since I started using a better inversion table, I've been consistently inverting twice per day. As a result, I've been sleeping better, my posture is better, and my stress is lower.
I'm still obsessed with how to reduce pain and get stronger and more functional. I often experiment with new routines and new products, such as IntelliSkin (a shirt or shorts that you wear that will correct your posture, similar to when a physical therapist puts kinesio tape on you to activate certain muscles). I recently walked through a Relax the Back store and realized that I had tried out or own at least half the items in the store. I didn't own the zero gravity chair or their amazing inversion table, but now I own both... reviews on the zero gravity chairs and IntelliSkin coming soon!
April 2019 Update
During mid-2018 I started getting occasional headaches, and I was pretty sure it was due to spasms in my upper back and neck. My chiropractor told me to stop lifting weights and do very little Jiu-Jitsu so we could figure out what was causing the issue when we added back activities.
After a few months of minimal physical activity, we hadn't figured out the problem. I figured this was a good time to try out physical therapy again.
I had done physical therapy (PT) years ago for my knees and it seemed to help a little bit, but not a lot. I don't think there's as much you can do for your knees as you can do for your back, so I decided to try it out for my back.
My wife recommended that I look for a physical therapist with a master's degree, and the therapist I found was extremely knowledgeable. Within 5 minutes she found the area of my upper back that was causing the problem. The issue for me came with how their system worked. The physical therapist would work with me for a few minutes, then she would pass me off to one of the assistants. They would choose exercises for me to do based on what the therapist had told them. After one of my sessions with the assistant, my lower back developed a spasm that I had for several weeks.
To be clear, I think PT can be life-changing. Physical therapists are extremely knowledgeable and they do amazing work. I think if I was only working with just one physical therapist, things would have gone much better.
She did tell me that some of my muscles weren't firing correctly, and other muscles were doing the job of the muscles not working. She told me that I needed to strengthen my core. So I started doing yoga.
I mentioned in the first part of this article that I had gone to a Bikram Yoga class and didn't notice a huge improvement. So I decided to try a different style of yoga and different school.
I found a yoga school nearby with a really good reputation that taught Vinyasa and a little Ashtanga. After the first few classes, I noticed that I wasn't getting headaches anymore. I started lifting weights again, and doing Jiu-Jitsu more intensely, and the headaches didn't return.
I started looking for academic research on the benefits of yoga for the back, and a few studies I found concluded that practicing yoga postures had the equivalent effect of doing PT!
I'm now a huge believer in yoga. In addition to a great workout, and rarely having back pain or headaches, my wife has told me several times that my posture has gotten better. I also reduced the amount of massages I get to one every two months.
I would never tell someone that yoga will fix their back issues, but I would add it to the list of things to try for a while to see if it works for you. For one person, PT may take care of the issue, for another it might be chiropractic care, and for another it may be just reducing stress levels. For me it has been a combination of a variety of things to help counteract many years of bad habits.