Back pain and fly-fishing

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The following essay is my attempt to share with you the effect back pain has had on my fishing. Fly-fishing often offers me the only respite to a chronic back pain that has plagued me for twenty years.

Recently I have been treated with epidural pain blocks and will discuss how they worked for me. While I recognize each persons pain and perception of pain differs, even low-grade back pain seems a common complaint amongst fisherfolk.

Many people consider back pain to be the most debilitating pain they have ever experienced. This may be true but I believe there is always someone worse off than myself. However, it seems that back pain is a curse from which I cannot escape.

It affects almost every aspect of my daily life.

It seriously affected my fly-fishing. This year I did not look forward to walking an uneven trail or wading a strong river; and so a large part of the fun was lost for me. Psychologically fishing was the right thing to do, distraction and doing something I enjoy is a part of my pain management program but, on arriving home, I sometimes suffered the consequences.

I am most probably giving known advice to fisherfolk but I feel obliged to emphasize the following points.

Wear a back brace. Get out of the river now and again, lie on your back, relax and do some stretching exercises. I know this is difficult to do when the snow is on the ground in early spring so at least try to do some standing 'keegles' (pelvic tilts), practice your breathing exercises, and relax and enjoy the beaver building his lodge.

An email from a fellow fly-fisher reminded me of one more thing. Travel light! Try getting rid of your vest and carry only a small box containing flies that are suitable for the time of year. You don't see too many old timers wearing vests, experience has taught them to carry as little as possible.

My Epidural Experience

This year (1997) has been particularly bad for me. Used to be I could live with the pain (with the help of a chiropractor and regular exercises). Not this year. For twenty years the pain had been limited to my lower back. Then last year it went to my hips. This year it went to my big toe. That old 'sciatica thing', as my friendly doctor stated.

Fortunately I was able to get an appointment with a pain specialist at our local hospital who explained my options. Since I was in extreme pain, and since the pain was causing severe headaches due to stress, I opted for an epidural pain blocker (a combination of anesthetic and steroids).

Epidural injections are generally considered to be quick, safe and simple. Complications are rare (the thought did cross my mind that I might be that 'one-in-a-million' case). Epidurals are quite frequently used for pain management during childbirth.

My first injection was quite painless, except for pressure felt in the areas of most pain whilst the medication found its way down the nerve. Half-an-hour later I was being driven home.

The pain increased slightly during the next two days. After five days there was a noticeable decrease in my pain and headaches. After nine days I was able to walk reasonably well.

Sixteen days later I was due for my second injection. There had been about a forty percent improvement since the last injection. I had been told to only expect a twenty-five percent improvement but I could hardly walk before my first injection so I considered it a vast improvement.

Results from the second injection were similar to the first. Some additional discomfort for the first two days and a noticeable improvement after five days.

After another sixteen days, time for my third and final injection. By this time I considered my improvement to be around seventy-five percent. Unfortunately, and for some unknown reason, my lower back muscles had gone into spasm and I was feeling quite stiff and sore. The pain in my entire leg and hip was reduced to a slight tingling, for which I was extremely grateful as these were the sites of most pain. Again I do not expect to see any improvement for five days but I am confident that things will get better.

It has been almost four weeks since my last injection. For two and a half weeks I felt my normal self. I had a slightly sore back and just a tiny tingling in my foot.I was able to go for walks and do my regular back exercises without pain.

And then the pain in my back, and in my foot, slowly started to increase until, a week later, I could barely walk. Two days in bed eased the pain but I feel I am back to square one. I knew there was only a forty percent chance of the epidurals permanently correcting my problem but I was willing to take that chance.

My next trip was to see a Sports Medicine specialist. This appointment had been made prior to my seeing the pain specialist.

The nerve response times in my both legs was measured using a set of electrodes attached to my foot and at varying positions on my leg.The response time in my right leg was definitely slower than those in my left leg. The pressure point causing this problem was at a spot just below my right knee and not, as I would have thought, associated with my lower back problem.

I now returned to the pain specialist, armed with this information.

At my subsequent meeting with the specialist we discussed the next steps. 1. Lower back joint injections. 2. The use of a TENS unit. 3. A visit to an orthopedic surgeon for further evaluation.

The lower back joint injections were the first step. Another simple procedure similar to the epidural injections. Only one session was required. There was no noticeable reduction in the level of pain.

On to the TENS unit. This unit was to be worn all day and removed upon retiring to bed.I lost several patches of hair from my lower back, the lower right buttock and the back of my right leg. This method is not designed to cure the problem but to provide distraction in an attempt to break the pain cycle. Unfortunately it did not succeed. On removal of the unit, or whilst the unit was inactive, my pain persisted at its previous level.

In between these trials I borrowed a simple machine that allowed me to hang upside-down. I found that, after a couple of nauseous sessions, there was some relief from my lower back pain. However, I was concerned about my sciatic pain and discontinued this process. I don't think this type of treatment should be considered without professional input.

I have also had one appointment with a masseuse. The muscles in my entire body seemed to be at breaking point and the looseness acheived in the massage process was an eye opener. This is one method that I would willingly suffer every day. It would seem that, although I attempt my exercises every day, my mental condition has me in a continuous state of tension. It is not easy to relax the whole body while the pain is nagging at my brain. I frequently find my jaw and neck muscles clenched rigidly; the massage alleviated this tension.

Six months had passed since my first epidural and I was now due for a second set of injections. The pain in my leg and lower buttock continued to plague me but the massage sessions are most definitely helping. The first of three epidural injections went well but I knew from experience that the effects would not show for a week.

A week later and I seemed to be free from pain. I continued my massage sessions with wonderful results. The thought had entered my mind that this will not last so I am now furiously fishing like there is no tomorrow. I have requested that my second injection be delayed.

In the fall of '98 I attended a Pain Management course at the QEII with a group of fellow sufferers. It was quite intense. Four weeks, three times a week. I can't say enough about this course. The big thing for me was being alongside people that understood pain, and I very much include the therapists in that statement. Without understanding and belief there would have been no point in attending. I can now accept and deal with my pain better by harkening back to what I learnt and the people I met.

Truths Hatch chart I Woodens River I Mill Pond requiem I Maxima leader I Logbook I Wandering willows
Low back pain I Trout weight v length I Fishing regulations I The bug aquarium I Blackflies I Kejimkujik

Pat Donoghue, Canada, ©1997