Crooked by Cathryn Jakobson Ramin

I’m a New Year’s cliche.

Early January I started back with Classical Stretch– a PBS series Husband faithfully does every morning and claims great rewards — (no more need for his knee brace when playing tennis, etc.) However, I tend to forget to breathe, which is very, very bad, and as a result, I twisted my back. Cut to severe pain – out of commission. Doctor diagnosed a herniated disc – my second one — darn it. So as I gingerly stretched (breathe, darn it, breathe) and took short walks, I suddenly remembered I had this book ~~ Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery.

I dug it out and found my bookmark still 1/3 of the way through. I restarted and read along as, Ms. Ramin, an investigative reporter takes us through her experiences with back pain, caused by a horse riding accident in her teens, and continued through three decades. In an attempt to search out the best practices among the plethora of back treatment options, she peels back the cover on the often profit seeking ‘crooked’ back pain industry. She interviewed spine surgeons, pain management doctors, physical medicine and rehabilitation physicians, exercise physiologists, physical therapists, chiropractors, and specialized bodywork practitioners. Further she talked to back pain sufferers – those still suffering and those recovered.

The first part of the book discusses the problems of the back care industry, and the often quick leap to back surgery and other invasive treatments. Ms. Ramin, as a journalist, submits herself to various treatments in the name of research and exposes corrupt practices and doctors. The author is not a fan of chiropractors or their treatment practices. They are, it turns out, pretty loosely regulated.

(N.B. I know many people who benefit greatly from chiropractors and, so for me, this may still be an option.)

I somewhat skimmed through this section as I’m not that bad, and neither I or my doctor are even considering surgery. But I did learn that disc problems like mine are not helped by removing or fusing a disc. Herniated discs will go back in place and get well. Which led me to the the second part of the book, which focuses on solutions.

I honed right in on my diagnosis, and learned that discs don’t actually slip. They are securely attached to the end plates of our vertebrae, but they do bulge and herniate. The dubious good news is that as we get older the less likely discs will herniate, because they dry out.

Ms. Ramin reinforces that our sedentary lifestyles with too much sitting, heads constantly forward, and a c-curved spine causes deterioration of the spine, muscle loss, and resulting pain. Then I read (and re-read) the best chapter in the book — The Back Whisperers. Turns out proper reconditioning with exercises and soft tissue work can make such a difference. She talks about how we limit our movements and hold our backs in awkward positions to avoid back pain — which promotes further back de-conditioning. (I’m automatically straightening up as I write this). She goes into detail on the importance of proper body conditioning with correctly executed exercises and how to reduce the effects of poor posture and body movement.

Yes, Crooked reveals the dark side of the (money making) back pain industry and spends a lot of time on what NOT to do. But happily, there’s plenty of advice of what one should look into: Non impact exercise such as Tai Chi, Pilates and Yoga; body movement classes such as Feldenkries; and PT sessions with a certified orthopedic clinical specialist who importantly, should not be connected with a surgery practice. (See I took lots of notes)

In the end, I came away with the sobering thought that there is no cure for chronic back pain. But can it be successfully managed and one can return to a normal life. For me, that doesn’t mean running a marathon — just now the ability to walk and climb stairs without pain. And eventually back to my garden, exercise classes, hiking, working at my book store, and, of course being able to travel/traverse around far flung destinations.

I highlighted this quote:

“You are going to hurt while you go through treatment – I know myself that it is no picnic. But the opportunity cost of not climbing out the other side is not acceptable.” She adds: “Back pain is not the unsolvable enigma of modern medicine, but successful rehabilitation takes sweat, persistence and a lifetime of hard work.”

Talk about hard word, Crooked is a result of just that — with its incredible amount of research. I wholeheartedly prescribe this book and a personal thank you goes out to Ms. Ramin.

What the book doesn’t discuss is that when your back hurts – the universe suddenly makes you fumble fingered – dropping everything from the soap in the shower to your keys — just sayin’.

See you. I’m getting up now to do a beginners Tai Chi session – turns out there’s all sorts of videos on You Tube.

Any other advice from my Book Barmy gang would be greatly appreciated.

My copy of Crooked was most generously provided by the author several years ago.