Back Pain Diaries

Thank you for visiting Back Pain Diaries blog.

I am very pleased to announce that, following the posts on this blog appearing on the Two Views of your Body Website  and, as a consequence, thousands of requests for my full pain diary from my back injury, I have published the full version of my diaries along with some extra material on painkillers, physiotherapy, positive thinking and acceptance. I hope they help you to know that you are not alone on your own back pain journey.

US Back pain sufferers: Back Pain Diaries: My personal back pain recovery journey 

UK Back pain sufferers: Back Pain Diaries: My personal back pain recovery journey 

This edocument includes a full diary of my back pain and my experience with pain, painkillers, movement, mood and exercise. The full diaries and articles are now be available on Amazon.


I suffered a herniated disc L4/L5 a few years ago and this blog is now dedicated to the posts that have proved helpful to people:

Notes on a Lower Back Herniated Slipped Disc this can still be found on the tab above the blog space as a separate page

How We Understand Pain

Pain and Meaning - slipped discs and pain scales

Pain and Meaning - slipped discs and pain scales

It's been six months now since I suffered a 'slipped disc'. The searing initial pain has faded now, replaced by an uncomfortable tugging on my sciatic nerve. One thing I have noticed is that almost everyone I know claims to have had a 'slipped disc' at one time or another.

They mostly tell me this when they are carrying very heavy boxes or running for a bus, balancing on one leg or leaning forward. Sadly, these are all movements that I cannot, and will never be able to, manage. When I enquire about leg numbness and walking problems, I am met by blank stares - their own 'slipped disc' did not endow the weird feeling of body dissociation on them.

So I decided that I would research what, exactly, 'slipped disc' meant. Damage to a disc in the lower back falls into several categories. A bulging disc is where the disc between the vertebrae pokes out and touches the sciatic nerve, causing intermittent pain. A herniated, or prolapsed, disc, is where the jelly in the disc squeezes out and makes a lump between the disc and the sciatic nerve. This causes damage to the sciatic nerve and affects areas of the leg relating to the position of the damaged disc. My herniated disc at L4/L5 (as above) caused numbness of my right lower leg and my right foot. A bulging disc is not the same as a herniated/prolapsed disc.

The pain associated with a herniated disc is severe. However, because the generic name of 'slipped disc' is given to all these disc conditions, it is sometimes interpreted as a twinge to the sciatic nerve, which is more likely to be a bulging disc. So, not only are you in severe pain, but many people are relating your condition as something that is associated with less pain.

This generic terminology comes from generalisation of pain. Whilst we need some kind of generalisation in order to develop medicine, some data sets that tell us that a condition is common to many people and needs attention, this is at odds with the human experience of pain. The individual expression of pain is an important communication tool, an vital part of us telling another person that we are injured. Whilst some pain scaling tools tell us that someone is in pain, a scaling of 1 - 5 does not tell us anything about their experience, how this affects their lives.

The question 'is it hurting?' from a doctor, answered in the affirmative, or even from 1 - 5, elicits a prescription for pain medication; it does not tell him that one morning four months ago I woke up crying at having to endure this for another day, or felt desperately sorry for whoever had to put my socks on for me.

The meaning of pain is not 1 - 5. High or low. Good or bad. Severe or minor. It is woven into our everyday experiences as we try, in a world that is very different from our pain-free world, it makes meaning of the new difficulties faced by our health.

I went back to my doctor for my six month check up yesterday and asked when the pain would go completely. He told me that it wouldn't. He asked me how bad it was, high or low, 1 - 5, and prescribed me painkillers. He said that what I have is a lifelong condition. I nodded and smiled and swallowed back the tears until I got outside the surgery.

He didn't ask me about the difficulty I have walking and how this affects my job, or how I can't bend to lift my baby granddaughter, or how I'm so exhausted after a day at work that I can't visit my family. That's what pain really means.

I've got a set of exercises, the McKenzie Stretches, that a physiotherapist taught me and, for the time being, these are keeping severe pain at bay, along with the TENS machine; I'm feeling a whole lot better as my back heals and I improve my posture and strengthen my core. I actually feel lucky, because at the beginning of this I was told I might not walk again; I'm beginning to smile again now and my life is back on track.

Writing it down has helped, writing all these experiences in a note book that, now, I can put away and hopefully never have to go back to. And in the future, if anyone every asks me how much my 'slipped disc' hurts, I'll give it them to read and hope that, instead of making an assumption based on a medical stereotype, they will understand how I and my life were affected, and what this meant to me.

For my notes on lower back herniated slipped disc please click here

How we understand pain

I recently had a run in with pain as I have injured my back quite badly. Whilst I was in hospital recovering I began to think about all the aspects of communicating pain that were going on around me.

The first question I was asked was: on a scale of one to three, three being childbirth, how much pain are you in? The baseline on this is seriously flawed as I have had three entirely different experiences of childbirth, at three very different levels of pain. It also made me wonder how this question would be applied to men experiencing pain. Here my pain was owned by a scale of one to three for the benefit of statistical assessment with no definition of my own experience.

The second was being eyed by a suspicious nurse who told me that 'I couldn't be in much pain as I hadn't asked for painkillers at six o'clock'. This entirely subjective view on the part of the nurse was working on an assumption and not on my reality. I had not asked for painkillers at six o'clock because I had no buzzer to summon a nurse and could not walk up the ward to ask. Here my pain was owned by the nurse who was assuming based on his own perception.

The third was an account given by another nurse who told me, whilst holding the key to the pharmacy cupboard, that many patients admit themselves to the hospital with fake illness in order to obtain strong painkillers that give them a buzz. This societal problem of addiction is another way of communicating psychological and societal pain. However, it didn't help me as I was really in a lot of pain. My pain was owned here by an objective risk assessment of whether or not I was faking my injury.

In my five day visit to the hospital, no professionals asked me how I was feeling. Several nurses and doctors looked at me and made an assumption based on how I appeared outwardly or how I was holding my body. An MRI scan revealed my injury had caused a herniated disc (see diagram above). No one acknowledged that my pain was my own, and that I could find words to express it myself. By overlaying my pain with other measures that rely on someone else making and assessment, my pain was negated into a construction of something external to my body. This is not a satisfactory situation for someone who is in acute pain, or in any circumstance.

Because I am not someone who will make a fuss, I was discharged with a prescription for paracetamol and ibuprofen, whereas someone else with the same injury as me who cried and complained more was discharged with much stronger painkillers. It seriously worries me to think that in the NHS today it's the person who shouts loudest who gets the best treatment. What happened to an adult, non-hierarchical conversation about how we are feeling? What happened to someone listening to my expression of how I feel instead of form filling and rating my pain for me?

I took my pain home with me, whereas my pain 'outcome form' still lies in the bottom on my hospital file.

For my notes on a lower back herniated slipped disc please click here

Avoiding the hole in the road

Original Post

My lack of blogging over the past weeks has been due to some extreme focus on writing a paper that has taken my interest. I love being focused and interested; instead of getting caught up in family's and friends' drama I can retreat into my own world of thinking.

Whilst this may sound really boring to some people, it serves me a a kind of gestation time, an incubation of my thinking process where I can be quiet and alone and consider ideas that may, one day, be woven onto the fabric of my external life.

It's been a strange couple of months preceding this, with lots of difficulty and joy, being let down and realising people are not what they seem to be. Lot's of moving around outdated areas of my life to make room for the future, which looks very, very bright. So, instead of constantly going back over old things, reliving learned helplessness and old patterns, I am making my own new patterns. Making these new patterns depends a lot on whether you listen to other people's advice and to yourself.

Years ago someone gave me an anonymous poem (it was passed to me as anonymous, but I now realise it was based on Portia Nelson's 'Autobiography in Five Short Chapters') and it is still relevant today when culling the dead wood.

Edit notes 18th April 2011 Many thanks to the reader who left a comment below. It's interesting because when I wrote this blog I was working from my own memory of this poem, and from notes I took, at a time when I was working very hard to change my life. The comment relates to my not giving credit to the author, which of course I will do immediately. The poem was 'Autobiography in Five Short Chapters' by Portia Nelson. However, my own interpretation of this poem, through the lens of time and personal experience, and maybe even forgetfulness and sadness, has been mistaken for a misquote, and I will remove my own interpretation of this poem on this post, but not from my heart; this was how it filtered through my consciousness when applied to myself, an example of how memory can sometimes distort words to provide personal comfort - and perhaps exactly what the author intended.

The Plot Thickens... learning when to plan and structure

As I start another new story, I'll be blogging my progress. At the moment I am planning my novel, and I'm thinking about what will happen in general, an overarching plot.

I've written several novels to date, and it's been a learning curve. The first couple were a download of some stories I had in my head, with bits added along the way, in no particular order. They were stories about people and what they did, what scrapes they got into, and how they felt.

As time went on and I became more experienced, I discovered that although there is nothing wrong with writing for all you are worth, and worrying about the editing afterwards, as it helps to embed the 'write every day' habit (Nonowrimo is a perfect exercise of this) it makes the whole process a lot more interesting to plan first.

I did plan the other novels on a spreadsheet, chapter by chapter, in the full realisation that the end result would bear no resemblance to my neatly organised, colour coded, boxes. Instead, the novel would develop as it went along. In the first few novels there were likeable characters, perpetrators, crises and an ending, but there was always something missing, kind of meandering that didn't quite hold together.

During the rewrite of my last novel I discovered something really important, that had been lingering at the back of my creativity, squashed into the background because of my resistance to conformity. There is a universal, traditional plot structure. And, further, it helps rather than hinders and flattens. I researched plot structure and sure enough I came up with several variations of the three act, crisis-turning point-crisis-climax-resolution model. I'm particularly keen on Freytag's Pyramids (below) and the three act structure, which has been around since Aristotle's days.

 A version of Freytags Pyramid, combined with the three act structure, is even more helpful.

So why use these structure? Why not just go into free-fall and write a totally unique story with no real beginning, middle and end? Of course, that's up to you, but people resonate with traditional story, because that is what our lives are - a story with a beginning, a middle and an end. It's tempting, for me at least, to be very creative with story, and write something unusual, something different. It's taken me a long time to reel in the feeling that somehow plotting and structure take something away from my novels. This has been my learning curve, realising my own psychic connection with structure.

Writing to a three act structure, around a storied plot, does not necessarily means writing to genre or writing commercially, or, as someone put it to me, selling out your creativity .Rather, it is like a hidden message in the work, a shape that readers can recognise. The detail must be unique and engaging to hold attention, but she shape can still be solid and traditional. It makes sense, if you do want to sell your work, to present it in a recongnisable form: a story.

The Internet is brimming with information on plot and structure, but it is something that many writers shy away from, feeling that the sameness it brings will spoil the wonderful worlds they have created. Structure won't spoil your story, it will provide signposts and navigation for the reader, a matrix to build your world around.

Gestation of ideas in creativity

I'm gearing up for National Novel Writing month. During November I'll be writing about 2000 words per day to progress my latest novel. I'm currently in the gestation stage, where something small will trigger me into thinking along a particular tangent.

I'll develop this over time (sometimes a long time, sometimes in a couple of hours) by collecting clues for my plot. These can range from character formations to backdrop scenarios. Eventually I will have notebook full of - well, notes - that will form the basis of the story. These notes range from single words to scenarios and short stories about the story.

By the time I start to write I know the approximate journey. It's like looking on Google maps to plan where you are going, you can even see the location. However, going there is a whole different journey, and what happens along the way will seriously affect what gets onto the page and the arrival. After finishing previous novels I've looked at the gestation notes and they rarely bear a close resemblance to the story I have ended up with.

I consider the gestation period as my most creative time, where ideas are unformed and malleable. This is a time before I consider the audience for my writing or even the urpose of it. The story is unbound and living large in my inner voice, where it is unchallenged and uncensored. As it emerges onto the page, the story morphs into a container of rules and regulations, a language that allows someone else to understand it.

Words I would use to describe this stage of the process is exciting and uplifting, optimistic and free, because whatever happens in this novel is entirely loosely formed at the stage, just a glint in the mind's eye. I can wake up in the middle of the night with an idea for the story, or it may come to me in the middle of the day as I work at my desk. I carry a notebook and post it notes everywhere, and if I find myself without these, I've been known to phone my own answerphone and tell myself the idea!

I write in first person present and I have to get to know the main character really well before I start to write. I might try to imagine what books they would read, what they watch on TV, how they would dress, the rooms in their house; it always helps to know the mundane things in their day to day life before I try to describe how an extraordinary event affects their existence.

I'm looking forward to writing 50000 words in one month with focus and routine, but first I'm reclining in the garden of my mind with my ideas for a while.

Change is good...

It's been a funny couple of weeks with a couple of u-turns. The most significant was my return to fiction writing. I decided on a change of genre and wrote a psychological thriller - they say write what you know! I 'd had a big break from fiction writing because of disillusionment with the publishing world during the recession, but now I've decided that I can do it for fun, it's is fun again!

It was like riding a bike. The familiar rush of excitement at the plotting stage, the waking up in the night with a new idea. Of course, I was doing the novel for National Novel Writing Month, and reached 50000 words just in time. This time, though, it would be different. I'd been reading Scarlett Thomas books for a while, and really resonate with her writing because it has a scientific and philosophical edge to the content. So I decided that I would try to write something along the same lines. I actually felt like my brain was going to the gym, waking up the imagination neurons and the storytelling axons that had been resting for a little too long.

In previous novels I have written a love story, or a story about relationships, and inserted some quirky, sometimes, downright weird, scenes. So I decided to write something weird and just outside the field of normal vision, and insert a relationship! It's going really well and I'm glad I managed to change my mind about fiction writing. It's fun and a big part of my life. Watch this space for more about 23 Acacia Road.

I've also moved offices to a more modern place outside the city centre. One Central Park is a beautiful workspace and a perfect environment to work, a very different place to where I spent the past fifteen years. My office on Piccadilly, Manchester had a prestigious address, and looked good on paper, but was dirty and cold inside. It just didn't live up to expectations once you really got to know it. My new office hasn't such a good address, but just stepping inside gives a sense of serenity and well being. I was dreading leaving the city centre, but after just two weeks I'm very happy to be working in Newton Heath.

Change is good. Finally. Risky, but good. I've always been a safe routine kind of person - even holidays are a stressful break from the day to day, week to week, year to year. Yet now, I've managed to change two major aspects of my life and I'm feeling pretty chilled out about it. Maybe I'm finally emerging from the my caterpillar constraints and learning to fly? So all I need to do now is take a risk and write some fiction in my new office and who knows what might happen!

Groovy Tuesday! Fractals in nature

Although nature is wonderful to look at and experience on a superficial level, a deeper understanding of how it works can be gained through fractals. Fractals are repeating structures found in nature, from the huge to the quantum. Many people dismiss fractals as 'boring science and maths' because they don't really understand what science and maths is - rather than a belief system, science and maths are one way that human beings communicate meaning to each other in an ordered way to make sense of the world.

What could possibly convey the meaning of nature better than to examine the smallest parts of living organisms and find something so beautiful that we can organise words and symbols around to make sense of life?

Positive thinking - glass half full?

I couldn't let this week pass without writing about an uncomfortable experience with the photocopier repair man. In he came, with his hard black case and his porn moustache, a distinct throwback from the days of Jason King. He unpacked, immediately requested cup of coffee, and began to work on the machine.

Eventually I decided it would be polite to ask how he was getting on. He stood up and looked at me. "Congratulations!" he said gleefully. "What do you mean?" I queried, although I already had a hint of what was about to occur. His eyes drifted to my stomach. "Well, your either expecting or you've eaten all the pies!" I fixed him with my best PMS stare. "I ate all the pies then." He laughed. "Yes. When's it due?" I clarified. "I'm not pregnant." He became a little more serious. "Oh. Sorry." Me, making it worse. "I'm too old to have babies." Him: "No. You're definitely young enough."

Now, passing over all the feminist connotations of this interaction and ignoring the fact that he had practically accused me of lying twice on account of his personal opinion - and that he was clearly weighing up in front of me whether I was 'fit for purpose' - I was momentarily stunned. Then I was elated. The first thing that came into my mind and stayed there was: "Wow, I still look childbearing age!"

My colleague, who heard the conversation, asked me if I was OK. I told her that I was pleased with his assessment of my youth. She looked at me hard. "How do you do that? He's just really insulted you, called you fat, and you still get something good out of it?" I was only half listening to her because I was now starting to feel sorry for photocopier man who was hurriedly pushing his tools into his back case, the sweat dripping from his 'tasche.

It did make me think, though. I'm not the slimmest person in the world and I expect people notice that. After all I am hurtling towards 50 and don't 'diet', don't use any 'beauty products' and take moderate exercise. I think the key is that I don't really care. Obviously, I care what people think of me professionally and I really care that people see me as a nice person. Yet aesthetically, I'm not so concerned. Having grown up being bullied for my ginger hair and having had people point at me in the '70's when I had a child at sixteen (yawn, yawn; cue Alanis and 'I see right through you.'), I have had my fair share of other people's opinions thrust at me. Maybe I'm desensitised. I guess I'm a 'glass-half-full-person'.

I'm not sure if positive thinking is something that comes naturally to people or if it's something we have to work on. I am fairly sure, though, that worrying what other people think and trying to predict the future contribute to negative thinking. Sometimes the worst-case scenario, the most gut wrenching horrible situations do happen and then it's appropriate to feel bad. But on all the other occasions there is usually a the dregs of happiness at the bottom of a half empty glass. I've often heard people say, "I'm a natural worrier!" yet I hardly ever hear people say that they are natural optimists.

So I'm off to sit in the sunshine and feel pleased that I still look young enough to reproduce, happily ignoring my middle-age spread. Made me wonder which is real, though, what other people see or what I think? Or both?

Tori Amos, Manchester and growing old

One of the most wonderful things about Manchester is that it is a major venue for all the big names in music. Aside from producing lots of the greats who return regularly, it attracts most artists on a worldwide tour. In recent years I have seen more bands and artists than I can remember, most notably Neil Young in 2008.

Last night I went to see Tori Amos at the Apollo. A long time fan of Tori, I had been to all her concerts in Manchester and each time there had been a different theme. Sometimes she has a full band with her, sometimes it's just her and a piano. Last night she excelled. Her creativity just shines out of her in what some would describe as quirkiness. I recognise it as that awkward expression of the animated nature of giving something unique to the world, a merging of your inner thoughts with a wider audience, that Tori Amos makes look so painless. The highlight of my evening was Northern Lad, a song of great significance to me and a few tears were spilled.

However, when Tori came on stage, something was wrong and there were audible gasps from the audience. Formerly a supporter of more curvy women, she appeared to have lost a lot of weight and toned up. She was a shadow of her former self. More obviously, her face had changed so much that she hardly resembled the former Tori. Whispers of 'having work done' Mexican waved through the audience momentarily taking the attention from the music.

I doubt that Tori Amos really cares what anyone thinks and that she has her own reasons for having work done, if indeed she has, but it brought up an interesting discussion about authenticity after the show. I was discussing it with a friend later and she asked me if, now I am 'older', I would consider having work done. I told her I wouldn't, mainly because I am scared of the pain, and she confided that she had breast implants five years ago. Another friend regularly has botox injections and another has had vaginal reconstructive surgery.

Personally, I don't see age as pathological. But, as with everything that is relational, it doesn't matter what I think. 'I' am what is private to me, my inner thoughts. It's the 'me' that I show to the world that is aesthetically relational; in this case it's what other's think that cause a mirror for consideration. As ageing is something that we cannot really escape, no matter how much 'work' we have done, and is common to all of us, it's surprising that so many people are grasping at immortality.

Again, it comes down to egocentric thinking. We all want to look and feel good, preferably in as short a time as possible, and with a little effort. The way that the (Western) world is organised is around youth being valuable, an asset that deteriorates with time over a set of superficial milestones that we, amazingly, set for ourselves!

We actually start 'ageing' around twenty-five when cells begin to decline faster. And there is nothing we can ever do to get younger on a molecular level. This concept is inherently linked with our obsessive measurement of 'time' which gives us a rough baseline for how long it will be before we die. The tightening of skin and adding of bits can do nothing to the holistic, symbiotic, ageing being 'I' am, except provide a more aesthetically acceptable model of the 'me' measured against the value of youth.

For Tori, who spends much of her time being photographed and performing, aesthetics are part of the day job. But for a woman who wrote this song with such an amount of awareness, it begs the question of why she feels her relationship with the world needs redefining to such a major extent?

For the rest of us, who perform only in our day to day lives, plastic surgery is no less a quick fix than taking tranquilisers to cure anxiety or drinking to block out the world; at the end of each day we all become a little older. Getting to the root of the problem and going the long haul to reframe that into something acceptable for us is, perhaps, more rewarding for the soul. Plus, surrounding oneself with people who are gentle, uncritical and understand that youth is merely an unattainable psuedo-prize that is held up by consumer-driven market forces and at odds with living. No one can fix the eternal dread of our daily march towards death, but wouldn't enjoying each minute instead of counting time in pathological years of ageing stretch the time we do have left and be more productive?

I'd like to thank.......

In the wake of my news about my identity book (which hasn't really sunk in yet!)(and did I mention it will be published worldwide?) I had a review of who made it possible.

This week sees the five year anniversary of my meeting my partner. About three or four months previous to meeting him I had considered giving up my study of identity due to a serious bout of 'life'. When I did meet him he restored my faith in human nature and gave me the inspiration to carry on. We've worked as a team since then and he's always believed in me, like I believe in him. I still pinch myself every day when I wake up to make sure he's real! So it's thanks to him. I know you read my blog sometimes, so thanks :-)

Another person who inspired me was my former boss, Bruce Guy. He was the first person I had met close up and saw on a regular basis who had achieved something I and was willing to give me advice on how to do it. A lot of it involved abandoning the drama that was wrapped around my life and focusing on what was important. It took me a long time to do that but Bruce always believed I could do it. Certain people have empowered my life with belief including, Mr Welsh, my former English teacher, Peter Banister, my social psychology OU tutor, and Bill Schofield, my grandfather. This goes to show that in this world of patriarchal oppression there is still a dialectic that recognises initiative and tenacity outside the limits of gender.

Then there are all the people at Manchester Metropolitan University who mentored me. They helped me to see that knowledge is there for the taking, it isn't some rare commodity, you just have to be open to it. I heard somewhere that it's how you relate to the subject that counts, and MMU helped me to see that my path was psychology and philosophy but not in university lecturing.

Of course, I must thank my children, a constant source of wonder and inspiration. When I began my job at SaRS I kept a picture of them on my desk to remind my why I had to work so hard. When I was doing presentations at university I always kept a picture of them on my folder to make my continue when I froze with fear. Now I don't see them so often, particularly Anthony, but all of them are equally constantly in my heart, along with my grandchildren, reminding me of my purpose in the world.

Finally I would like to acknowledge everyone who tried to oppress me, to keep me down and who were mean to me: it just made me stronger in the long run. In the dark days before I began my new life I used to wonder why I had to endure what I did. Now I know - it's so I could see the difference and help change it for other people.

Like Alanis says, 'You scan the credits for your name and wonder why it's not there.'

Identity, Women and Health: a new perspective to be published

I received an email yesterday telling me that my book will be published. It was a defining moment in my life, for deeper reasons that the buzz of 'being published'.

About twelve years ago I wrote a book about the experiences of women who had endured domestic violence. I prepared a proposal and three chapters and sent it off to a publisher. About a week later, I naively rung them to ask if they had a chance to review it. The woman at the end of the phone told me that it would never be published because I didn't have 'a profile'. She explained that I would need to produce an academically referenced text and prove my knowledge on the field before any of my writing would be considered. She wasn't rude or condescending, just matter of fact. It was as if a microscope has been applied to the dysfunctional nature of my life to date, something that I had never taken full responsibility for, and all the gaps highlighted in neon yellow.

I was angry at first, but eventually embarked on a twelve year, sometimes turbulent but often affectionate, relationship with knowledge which reached its pinnacle yesterday. It was such an emotional moment for me, the girl who was told by her parents and teachers at the age of sixteen that she would 'never amount to anything', that I burst into tears. It's been hard work and in the process I have become a different person, now I am on the brink of publishing a major theory in identity construction, I realise the journey adage 'it's not where you get to, it's where you came from' applies to me and my work. The two most important words I have learned during that time are: social construction.

The book is mostly written and is due for delivery to the publisher next year. In the meantime, I will adapt it and hone it and dedicate the work to every person everywhere who has been held down by assumptions about class, gender, sex and social status, and particularly women who suffer the medicalisation of natural transitions in women's health.

I'm so grateful for the chance to do this, and for patience I learned along the way that has helped me to understand just that little more about life and truth.