programmersguidebackpain

The Programmer’s Guide to Dealing With Back Pain

I’ve been a programmer for fifteen years and have dealt with neck and lower back pain for most of that time.

This is the chronicle of what I’ve experienced and what books, products, changes, medicines, and doctors have helped (and not helped). I’ll begin by describing my hand, arm, and neck pain. Then I’ll discuss my lower back pain and what has helped it.

Numbness And Tingling in the Hands

My pain started less than a year after I began full-time software development out of college.

I started having numbness and tingling in my hands, especially my pinky and ring fingers. I ignored it for a few weeks but it got so bad I went to a hand doctor.

photo credit: Working hard via photopin (license)
photo credit: Working hard via photopin (license)

The hand doctor gave me some stretches to do on my hands and forearms. But my pain got worse, and the entire surface of my hands began to hurt and be ultra-sensitive to touching anything. To this day I don’t know what this was, but it lasted for five months and was incredibly painful. I think it was some kind of myofascial pain caused by tightness in my neck.

After the doctor visit, I began to improve my workstation. I got a keyboard tray and elevated my monitors with old computer books, so that I could be working in a more ergonomic environment.

I bought a book on Repetitive Strain Injury which was good basic information, and then a second book about how RSI is not carpal tunnel syndrome that had good stretching tips and other ways to help improve this condition. From their suggestions, I bought an IMAK Smart Glove wrist brace as well, which helped to pad my hands from the keyboard so that nerves wouldn’t get irritated, and which stabilized my wrists.

These books helped me retrain the way I typed to not do ulnar deviations and other bad practices. But they had another affect as well.

The Pain Moves Up the Forearms Toward the Shoulders

Now my forearms were having to do more work, as I had stopped resting the bases of my hands against the keyboard and instead kept my hands elevated more often. My forearms began to burn when I worked for even an hour at the computer.

I started stretching my forearms and doing various exercises to help keep things loose. After a month, the pain moved into my shoulders and neck. This centralization of pain is something that the books and articles I read talked about. In a way it is a good thing as you are getting closer to the ultimate source of the problem.

I went to an occupational health doctor and started getting regular massages and physical therapy. The physical therapist was having me do many of the exercises and stretches I read about in the books. He also recommend I buy the McKenzie book on treating your own neck. I did that and found a few more stretches to do.

Worker’s Compensation

A brief digression here in case it helps you. After eight months of pain, I began to worry that I would not be able to work at my software job potentially. I inquired into filing a Worker’s Compensation claim and decided to do that.

photo credit: Attaching Fittings to a Cable via photopin (license)
photo credit: Attaching Fittings to a Cable via photopin (license)

I never actually used Worker’s Comp to take a significant time off from work. Mainly the benefit was that I could go to a certain doctor that was not on my company’s regular insurance plan.

That was good, but what I realized quickly was that 1) the doctor had no great solution for my pain, and 2) it was just a big paperwork fest where they eventually pushed me toward agreeing to “maximum medical improvement.”

I did agree to that after about a year, as I wasn’t going to get any better, and I had learned to manage the pain decently enough to keep working. Overall Worker’s Comp did not provide much benefit for me with this condition.

I also wonder if my company didn’t frown upon me taking it. Of course they can’t say that, but it’s something I would avoid doing unless you have a compelling reason to use it.

Chiropractor #1 And Spine Surgeon #1

At a friend’s advice, I went to a chiropractor he recommended. I had been skeptical of chiropractors my whole life but figured I’d give it a shot.

photo credit: BEST OF THE MARINE CORPS - May 2006 - Defense Visual Information Center via photopin (license)
photo credit: BEST OF THE MARINE CORPS – May 2006 – Defense Visual Information Center via photopin (license)

Dr. F did an X-ray and pointed out that I had “military neck.” My neck did not have the normal lordotic curvature in the cervical part of my spine, but instead was rigidly vertical. He was confident, however, that his adjustments would realign my neck and solve my problems.

I went to him twice per week for the next three months. I didn’t get any noticeable improvement from his adjustments.

So I went to a spine surgeon for the first time. He had me do an MRI of my neck, declared that I had no herniated discs and that he could do nothing for me. Disappointingly, he handed me a prescription for muscle relaxers and sent me on my way. No suggestions for what could be happening or how to improve it.

During this time, I continued doing lots of stretches, exercising, and refining of my ergonomic workstation set up. This didn’t necessarily fix my problems, but it helped keep them at a maintainable level.

How to Sleep to Reduce Pain

I noticed that some mornings I woke up and my neck would be in severe pain. One day this occurred, and I went to take a shower. I bent my head forward to put it under the water and my neck went into horrible pain. It hurt so badly that I thought I was going to have to vomit.

photo credit: nap time via photopin (license)
photo credit: nap time via photopin (license)

I took three ibuprofen, laid down face-first on a pillow, and put an ice pack on my neck. I couldn’t work that day and had to spend it stretching, resting, doing heat then cool packs, and taking ibuprofen.

After similar episodes occurred a few times, I noticed that they would usually happen after I had gotten really fatigued the day before, and my neck felt tight, or when I had tried to do some weights or moderately heavy labor (say, moving furniture). I started taking ibuprofen in the evening before bed on such days, which helped.

But I also realized that sleeping on my side would often make my neck feel horrible in the morning. No matter how many or few pillows I used, or how I tried to level it out, sleeping on my side would lead to pain.

I didn’t think it was possible for me to sleep on my back, but I began to try. I bought one of those wavy types of pillows that had a curve for the neck and used that for a year. But it was so uncomfortable I switched to a small couch pillow under my head.

Some nights I would turn over onto my side without even realizing it. Then I’d wake in serious pain. But as I kept at it, most nights I could sleep on my back for much of the night. Still my neck would hurt, as the small pillow did not have much support for my neck.

I eventually found the Arc4life Linear Gravity Neck Pillow and that has made sleeping on my back easier, more comfortable, and much better for my neck. It keeps your head cradled better and overall has a more comfortable neck support piece. They have another pillow with cervical traction that I may try at some point.

Why Not Herniate a Lumbar Disc While Were At It?

My wife and I caught the urban farming bug and after several years decided to move out to a farm in the country. I still worked remotely full-time doing computer programming though.

I thought, “Great, I’ll get strong by doing farm work, which will help me be in less pain from programming.”

What actually happened looked quite different: I was a weekend warrior farmer who had lots of chores to do on the weekend that built up during the week. I had bought eight cows and had a tractor, hay buggy, and chainsaw. One weekend I went out and was throwing sixty-pound stones over the side of my truck, then chainsawing trees and moving huge hay bales. I felt manly.

I woke up the next morning and started working, and my lower back began to hurt. I hadn’t had much lower back pain before, only in the neck, so I took two ibuprofen and thought it would go away. It didn’t. Because without realizing it, I had herniated the L5-S1 disc in my lumbar spine.

You can read about all our misadventures in farming in my short ebook Farm Flop. But this injury began a new saga of pain for me.

My lower back and gluteus muscles were in serious pain. I could not work. I couldn’t drive a car and could barely ride in a car. I didn’t know what I had done to myself.

Chiropractor #2 And Doctor #2

I was driven to the doctor, and she said she didn’t think I had herniated a disc. Just a muscle strain. She gave me some stretches to do and recommended physical therapy.

photo credit: MRI, July 1, 2010 via photopin (license)
photo credit: MRI, July 1, 2010 via photopin (license)

It turns out she was wrong, but I believed her misdiagnosis for the next year. One tip for you if you get such a diagnosis: if the pain improves some over the next several weeks but then returns sharply after doing even mild work, it is likely a herniation or something similarly bad.

My friend recommended a chiropractor he knew, so he drove me to see him. Dr. T was confident he could fix me up. (All chiropractors seems to have this confidence.) He began doing adjustments and my pain improved some, whether on its own accord or due to his work I don’t know.

But then it flared up again, and I couldn’t work a full day or drive for weeks. I could stand for a certain amount of time, or sit for a brief amount of time, but that was it.

I went to Dr. T for three times a week for three months before calling it quits.

One small thing that was helpful during this time was the McKenzie lumbar roll (firm). I used it whenever I was sitting down to help support my lower back. I also bought a Hon Ignition chair to replace the big Office Depot one I had bought a long time ago. The Hon one is a much better chair but is pricey.

Back to the City

I couldn’t do any farming work and was hitting a crisis point. What if I couldn’t provide for my family anymore?

So we sold our farm and moved back to the city. For my home, I bought an Ergotron Workfit sit-stand desk attachment that supported my dual monitors. I had been using one at work, and it helped to be able to stand for periods of time. Coupled with this I bought a Cumulus Imprint standing mat that is a necessity with any standing desk. My pain was such that these were necessities to be able to work, as I physically could not sit down for more than fifteen minutes without serious pain. These two items have been mainstays for me with my computer programming set up.

But even with them, I could barely work a full eight-hour day without hurting. And the lower back spasms and pain would cause other parts of my back to try to compensate, leading to tightness and pain in my mid-back and neck.

I had to quit my job because I could no longer drive all the way across town to where it was. But I found a new job that allowed me to work from home most of the time. At this point, I knew something had to be seriously wrong with my back.

I had a buddy tell me about his inversion table. I read about them, and it seemed to be hit-or-miss with whether they helped, depending on the particular person and back condition. After some hemming and hawing I bought a Teeter Inversion Table, and after using it for the past six months can say it has helped when my back felt especially compressed. I get on it for three or four minutes on a regular basis and then do stretches, including the McKenzie ones, and it helps.

Chiropractor #3 And Spine Doctor #3

To get to the bottom of my lower back pain once and for all, I decided to go with the shotgun approach and see both a spine surgeon and another chiropractor.

The spine surgeon ordered an MRI. The results came in, and he pointed to my L5-S1 joint and said: “That disc is herniated and is causing your lower back problems.” I was relieved to know the cause, but also frustrated that the first doctor had jumped to a diagnosis too quickly and delayed me finding this out.

photo credit: Studio Desks: Eric Benoit via photopin (license)
photo credit: Studio Desks: Eric Benoit via photopin (license)

He gave me cortisol pills to take. They had zero effect. So he gave me a spinal injection of steroids. That gave me relief for four months.

Meanwhile, I went to Dr. C, who, like the other chiropractors, was confident he could fix me up. No doubt in his mind. I told him I gave him a 25% chance of being able to do what he said. But I’d be happy if he could prove me wrong.

Dr. C didn’t believe my disc was herniated. He seemed to mistrust spine surgeons. He took an X-ray and pointed out my military neck. He also X-rayed my hip area and found out that one of my legs was 20mm longer than the other. This leg-length discrepancy was significant and had led to me compensating in other parts of my spine and back.

I bought a heel lift and it was cut to be 9mm. Dr. C didn’t want to go more than 9mm to start, since a 20mm discrepancy is too much to try to overcome all at once, he said.

At his recommendation I also bought an Aspen back brace, which was a big help. The idea is this: if your back is too weak to be able to hold you up sitting or standing for your work, use a back brace when you need to (not all the time) so that your back doesn’t get into a bad posture or into tight knots. During this time I was also doing twenty minutes of stretching every morning along with basic ab exercises and lower back leg lifts to strengthen my core muscles.

To help with the pain, I bought BioFreeze (icy hot). It smelled better than the tiger balm I had been using, and it had less residue. It doesn’t solve anything, but it does reduce the feeling of pain. I also bought a Theracane to massage the knots in my back and neck myself, and it has helped. Being able to reduce the knots and tightness in my lower back and neck myself, without having to pay for expensive massages, is well worth it.

With the chiropractor, I did decompression therapy on a special table three times per week for four months. They strap a belt around your waist and then the table moves to apply force to stretch your back at the right location. The computer ramps up the force, then eases it down in alternating periods. Dr. C was sure that this would solve my problem, expanding the region between my vertebrae that would allow the disc to soak up more fluid like a sponge would. Unfortunately, that did not seem to happen.

I also did adjustments and lidocaine injections in my knotted neck muscles. We did some laser thing that was supposed to reduce scar tissue in my lower back, and a vibe plate that would vibrate your whole body. For my military neck, he had me use a cervical denneroll (similar product here), which I lie on for 15 minutes everyday to increase the lordotic curvature in my neck. So far I don’t know if it is working, but the theory seems sound so I am continuing to use it.

After finishing up my regimen of chiropractic therapy, my lower back pain was right back to where it was. Dr. C’s therapies did not work for me, though I view them as steps in the right direction, learning about my leg-length discrepancy, using a back brace when needed, and the neck roll.

One takeaway for me with this is that chiropractors may be able to help some people, but only for specific conditions (none of which were ones I suffer from apparently). They each seemed to have the attitude that other chiropractors don’t know what they know, and also that conventional doctors like spine surgeons don’t know what they are doing.

Second Spinal Injection And Surgery Looming

My pain was getting unbearable again, affecting every moment of my day. So I went back to the spine surgeon, who said that surgery would solve my problem but that my health insurance company would not approve a surgery until I had done at least one more injection.

photo credit: Hypodermic Needle Injection Hand IMG_7420 via photopin (license)
photo credit: Hypodermic Needle Injection Hand IMG_7420 via photopin (license)

I got a second injection, and it lasted two months. Then the pain began to come back. I spoke with the spine surgeon again, and he said that fusion surgery is the next step. I asked why fusion and not just a discectomy, and he said because the pain is focused in my lower right back and gluteus, not down my leg, fusion surgery is what is best for that type of problem.

I am now waiting to see whether the pain gets so bad again that I have to do the surgery. Part of me hopes that I don’t; but I am ready to be able to live again, to pick up my children again, to not fear that I cannot provide for them due to back pain. Every week my children ask me when I can pick them up again, and whether my back will ever get better, and it kills me to not know when I can respond to them with a definite time.

This is the story of my neck and back pain. I’ve managed to live with it for 15 years and continue working, but it has not been easy. Some days I get very discouraged and fearful. But with these tools and techniques, I have reached a manageable point with the pain for the most part.

My hope is that it helps other programmers with their back pain. Every person and condition is different, but for many only a few of these suggestions or tools could make a big difference for them.

For those who want the tips and products I’ve used distilled down into one short document, here’s the programmer’s back pain checklist of things to try.

Please do leave a comment and share your experience with back or neck pain and what has helped you with it.

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