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One day not long ago, as I walked through New York's Pennsylvania Station toward my commuter train, I sneezed. My body whipped forward with the force of the sneeze, and I suddenly found myself on all fours crawling around the terrazzo, unable to stand. There was a tremendous pain in my lower back, and the noise I was making was a fair imitation of the bellow of a wounded moose.
Now a man on all fours in Penn Station is not an unusual sight. Even in my pain I could see several other folks on hands and knees variously barking, baaing and mooing—part of New York's herd of unremarkable loonies. So I went unnoticed by the majority of the thousands of homeward-bound commuters. One well-dressed executive pointed me out to his companion, however. "That's why I quit the three-martini lunch," he said righteously. An elderly woman dressed in one of Attila the Hun's fur coats and carrying several paper shopping bags stuffed with old rags stopped. "Ye shall know them by the mark of the beast," she proclaimed, and slugged me on the ear with an umbrella. Insulted and suffering incredible pain, I crawled aboard the train and rode home on all fours, like a steer through Kansas.
After almost two weeks in bed on a diet of Valium and codeine, I could once again blink, flex my toes and count to 10 without searing, crippling pain in my lower back. I was able to hobble about, one side of my body collapsed toward the pain, and generally make my way around the house. During this agonizing period, by reading a number of books and pestering specialists from Atlanta to Boston, I began to learn about "lower back syndrome."
A U.S. Public Health Service survey indicates that 70 million adults have experienced at least one episode of severe and prolonged back pain, and according to the National Center for Health Statistics another two million are being added to that number each year. Experts agree that backache is the second leading cause of pain in the U.S., after headache. And when one thinks about it, as does orthopedic surgeon Dr. Leon Root, a specialist at New York's Hospital for Special Surgery, the reasons are clear. Says Root, "The evolutionary change from quadruped to biped millions of years ago made man a special animal, able to free his hands for complex tasks. But anatomically, we pay an expensive price for that advance—the human back bears a great and unique load, and it is structurally weak." Think for a minute. Our brains and our backs, wherein our evolutionary superiority is most clearly marked, are the most susceptible to pain.
Doctors call what happened to me in Penn Station when I sneezed "acute lumbosacral strain." It involves the muscles of the lower back—overworked, under tension and stress—knotting up in a prolonged spasm. According to Root, up to 90% of all patients driven by pain to see their physicians for lower back problems suffer from muscular strain or tearing, and perhaps from accompanying ligament and tendon damage. The remaining 10% are suffering from congenital defects in the spine, infections, malformations, kidney problems, arthritis and that old bugaboo, the "slipped disk" (which is, properly, neither "slipped" nor a "disk").
Although I was disappointed to learn that my case was so ordinary, it serves to illustrate the problem of "everyback." About a week before my sneeze, I had played squash—violently and all-out. And it was there that my problems began. Root, a fellow sufferer whose own problems began as a consequence of a blind-side tackle in a college football practice, notes that "after the first few nice weekends of spring, orthopedists and neurologists can depend on waiting rooms full of patients with strained backs. When the weather gets good, middle-aged executives—deskbound, overweight, out of shape—suddenly decide that they're Frank Merriwell and I see a long parade of weekend golfers, tennis buffs and gardeners, bent over in pain. And it's all avoidable."
I had played squash at the end of a tension-filled day in which I'd pounded the typewriter to meet a deadline and been harassed by phone calls from a surly loan officer at my bank.
I looked upon the squash game as a physical way to deal with the aggression and stress I felt. I am 37 and, unfortunately, out of shape, overweight and strung tighter than a harpsichord. When I took the court against my skinny, 26-year-old opponent who played squash daily, I was the No. 1 candidate in America for lower-back muscle spasm.
After the match (which I lost convincingly), I felt a tightness and twinging in my back. Stupidly theorizing that if pain is felt while exercising, more exercising will alleviate it, I played again the next day, even harder.
The muscles of the lower back are called upon to do a great deal. A relatively thin band of muscles, where the lumbar region of the spine joins the sacral region, must lift and lower the upper torso. A Swedish physician interested in stress, Alf Nachemson (who designed the Volvo seat), has demonstrated that a man bending over to lift a 50-pound weight puts something like 660 pounds of pressure at the juncture of the lumbar and sacral spine. Consequently, the muscles of the lower back, if improperly exercised, will go on strike. Overworked, contracted unnaturally as a result of the tensions of modern life, a sudden twist to the side or a fast bend, as in a sneeze, may lock the muscles into a spasm that will throw a man to the floor in agony.