My Pain

It all started innocently enough, some pain in my neck and upper back. I have a job that requires that I sit and bend forward. I get into some very poor postural positions. Over the 25 years I have worked, the various aches and pains have come and gone. I have sought medical consultations a when the pain became troublesome. About 20 years ago, the pain worsened and I was told to use aspirin and muscle relaxants were prescribed. They helped but the muscle relaxants made it hard to work or drive and they did not cure the problem.

After bugging my physician a few times he prescribed a corset brace to be worn when I worked. It helped more than the medication. It had two slightly flexible metal bars that fit on either side of my vertebral column from below my belt to above my shoulder blades and had arm straps that held my shoulders back. It kept my back straight. It fit under my clothes and was not very noticeable. It did force me to have good posture and helped with the pain. I would wear it off and on as needed for pain control.

I also was encouraged to do various exercises to strengthen my abdomen and back muscles. The exercises did not seem to help but the brace did. In time, the pain would go away and I would leave the brace in the drawer for months if not years. It eventually fell apart from age.

One of the disadvantages of the corset was that it was warm, particularly in the summer. The next time my back kicked up, I asked my physician if there was something that was not so warm. A Taylor brace was prescribed. This brace had two inflexible metal bars that ran the length of my spine and a metal bar that circled my torso at the level of my hips. This was much more restrictive than my first brace. My spine was rigidly immobile. It provided even better pain control, than the original brace. However, that was at the loss of some mobility. I simply could not turn or bend my back. It was more difficult to work in because it kept me so rigid. I used it only when pain got to the point of dictating my life.

This was about the time I did a flip off a diving board. As it turned out I could still do the flip but I paid for it with a sore neck that got more painful as time went on. Eventually I went in for x-rays; no vertebral, bone, damage had been done but the soft tissues, muscles and tendons obviously had been stretched and were quite were sore. They tried muscle relaxants and a simple foam collar. The foam collar was uncomfortable and a little claustrophobic. The muscle relaxants worked but they limited what I could do because of the sedation that came as a side effect. A 4 poster brace was next prescribed and I used it when not working, off and on for about 6 weeks. The pain decreased and the brace was put away.

My lower and upper back symptoms came and went over the years. They were coming more frequently and lasting longer as I turned 40. The pain was nothing I could not handle but it was bothersome. When I did wear the braces, my wife would tease that I looked like the walking wounded. She was concerned that I would weaken my neck and back muscles if I wore them and that would make the pain worse. This all went on for about 10 years. The various screws that held the Taylor together would loosen, often at inopportune times. Suddenly the brace would let go and I would have to find the screw and a screw driver to put things back together. The screws became more and more difficult to keep tight. In addition when I woke up in pain it was a hassle to have to get out of bed put on the back brace and the 4 poster neck brace and then try to get back to sleep.

Sleeping on my back totally immobile from head to hips is difficult. In addition the two braces were separate and caused pain in my upper back which was below the neck brace and above the back brace. My upper back probably was being forced to be more mobile than desired because these were the only vertebra that was not supported. A year or so later I asked if there was not something that was a single piece that would be easier to put on when I needed to be braced.

My physician sent me to a orthopaedic laboratory to see what could be done. They decided I could use a clamshell brace and made an appointment for the fitting. Little did I realize what I was getting into. When I arrive they put me in a stockinet material from my thighs to my head. Next they started wrapping me in plaster casting material. This went on for about 30 minutes until I was cast from my hips to my chin. This was a little frightening.

As it set, the plaster warmed as it hardened. I was truly immobile but my back felt great. I asked if I could try this for a day to see how well this position would work. They explained that the cast was not strong enough. They would have to add many more layers of material and it would be much more difficult to get me out of it. So while it was semi hard they cut the cast off with scissors. This they told me would serve as a mould to make a framework on which to build the brace.

Two weeks later I came back for the final fitting. The new brace went from my hips to my chin. It was great for pain control. There was a plastic shell that covered my back and a second one that covered my front. It was held together by 3 wide straps with Velcro on both sides. I was encased from my chin to my hips. I slept in this brace exercised in it and wore it when I was in pain and was not going anywhere. I am very self-conscious to be seen in any of the braces.

While the brace was great for pain control, it was very restrictive and made some normal motions almost impossible, typing, tying my shoes, picking things off the floor were very difficult. It also was very warm. It was solid plastic with a few small holes for ventilation.

I went on a weight control program and lost 70 lbs. The clamshell no longer fit. I had the original Taylor brace replaced. The new one had the two metal bars on either side of my spine and the metal bar that went half way around my torso at the hips. There was a second bar that went half way around my torso at the base of my ribs. These two bars were joined by two vertical bars one either side from the base of my ribs to the top of my hips. The front was a corset type enclosure but the sides and back were open. It was cooler to wear than the clamshell. My spine was rigid from the pelvis to my upper thoracic area. I was prescribed an Alpine collar for my neck pain. The lower cervical and upper thoracic areas were still a problem. I could wear the back brace without it being obvious under my clothes.

However, I was asked many questions about why I was wearing the braces when I wore the neck brace. Why are you not wearing them full time? Do they hurt? Are you in pain? I got lots of unneeded attention and sympathy. It seemed that I should accept the pain and not use the braces if I wanted to avoid the attention.

For years I mostly put up with the pain and would only use the braces when at home and when the pain was a problem. The pain slowly got worse and when I turned 50, I went to a spine specialist who begrudgingly suggested the use of braces were OK if I limited their use to a few hours a day. He sent me to a physical therapist that worked on the mobility of my spine and neck. She suggested I should use them more rather than less particularly when I exercised. She also gave me exercises to help strengthen my back muscles. Long airline flights tended to set my back and neck off, particularly if I fell asleep. The PT said I had to wear the braces if I were going to fly more than a few hours.

The physician insisted I keep a diary of time and pain levels. He was not happy when it showed that the brace use decreased the pain I was having or that I was wearing the braces more than four or five hours a day. He did not offer other solutions, however. He just kept telling me I should limit their use. It was a bit frustrating to not be given some other options. The PT pushed for more use.

I decided it was time to get a second opinion. The new spine doctor checked with x-rays and CT scans. As it turned out I had 5 vertebrae with stress fractures that have collapsed to some extent probably from many years of working bent over plus a couple of slightly bulging disks. She decided I needed a different brace. In addition to the back brace I now am in a Florida 2 poster brace. The goal is to stop the progression of the curve of my spine by supporting the vertebrae that are collapsing. There is some hope that the braces will reverse some of the curve. She is suggesting wearing 5 or 6 hours a day, when I fly and if I have pain when I sleep.

When I have these two braces on I have little spinal mobility from my pelvis to my skull. I can turn my head about 15 degrees from sided to side, less than that up and down and nothing forward or back or side to side. It is hard to go down stairs as I cannot look down. Driving is out of the question. Even getting into a car is difficult. Typing is tough because I cannot look down to see the computer screen. Reading is difficult because the book must be held up in front of my face. I have worn them on long flights and they help a make flying manageable. I find that I can sleep comfortably on a plane when braced. My head does not fall forward or to the side when I go to sleep. Of course, when braced it is not possible to do anything but sit up straight.

I have no pain, but I get a lot of unnecessary attention and unwanted sympathy. The questions range from how did you break your neck? I didn’t. Are you in a lot of pain? No. Do you need help? No. We can get you transportation to your next departure gate. Why not? We will give you early boarding. Sure. Do you need help with your bag? No. I really do not need the attention as I feel silly enough in the braces with out all the extra offers of help. It is very difficult to get through airport security. Typically I must take off my coat and shirt so they can examine the braces. Some times they wipe them down for an explosive test. Some times it is just a thorough pat down. This takes about three times the normal time to get through security. The metal sets off all the alarms. I have tried checking them though with my carryon luggage and putting them on after security. This gets some real stares when I step out of the restroom all braced up and I had gone in without the braces. Sometimes it is easier to just accept the pain and forget the braces.

The good news is when I accept the fact they will draw attention, the braces help with the pain. Just being able to sleep on long overnight flights is wonderful. I sleep in the two braces most nights, exercise in them and wear them if we are home alone. My wife still says I look like the walking wounded. Fortunately, if I am busy occupied doing something, I can ignore the pain. The pain is neither devastating, debilitating nor does it dictate my life. On the other hand, with the braces I can be pain free, but restricted as to what I can do.

Eating is problematic. Because of the pressure on my chin, it is difficult to open my mouth. If I leave them on for more than 8 to 10 hours, I miss them when I first take them off, but my pain is diminished the next day. This is short lived and by the third day I am back where I started. I had my dentist make be a soft bite guard to protect my teeth because the pressure on my chin kept my teeth in tight contact when I am asleep. This is probably important because my teeth and jaw joint gets sore when I sleep in the braces.

The questions I face are the inconvenience of the braces worth the pain control they provide? Is there a way to get by feeling self-conscious when in public in the brace? In some ways it would be easier if I had to be braced full time to get use to the brace and their restriction and to get friends and family use to seeing me wearing them. As it is now, I have been told to use them as needed for pain control, to try and not wear them more than 8 hour a day except when travelling.

Interestingly, I am almost an inch taller when braced. Surgery has been mentioned several times. However, I have had several friends that did not have good outcomes one nearly died and was fighting infection for several months after fixing a disk in his neck. The pain will have to get much worse to risk the potential bad outcomes.