Teenage Back Pain Poem: Explaining persistent nerve sensitisation and myth busting disc bulges

Our friend Leanne Rath recently sent us an email detailing a challenge that she has been given – explain to a 17 year old young man why he continues to have back pain 2 years on from an initial episode. Not only did Leanne accept the challenge, she smashed it….. with poetry. We are in awe of Leanne’s propensity and perspicacity for purple prose and asked if we could share her verses via our blog. Leann​e has very kindly agreed.

TEENAGE BACK PAIN POEM

When I was 15 playing sport, I’d really have a crack

I roved the pack and bowled them out, until I hurt my back

Now “did I hurt it” or “did it hurt me”, I could not be that sure

All I know is two years on, I’m over it and it’s still sore

Trying to explain pain may seem like an obvious treatment thing

But trying to understand it, well “What was it that she was saying?”

All I know is one day playing “Burkey’s” with my Dad

I took a screamer, reached right out and since then it’s been bad

Fast forward months and months and months when the pain ran down my leg

I couldn’t bend, or sleep or sit, or play sport – please I beg

They said not to scan it; to wait and see what would resolve

But I wasn’t confident without a scan, What if I had a disc bulge?

More months went by and playing cricket was a distant memory

I’d grown a lot, and the nerve pain continued to limit me

I shuffled into full forward to join The Final footy game

Thank goodness for creative thinking – we won, that’s our claim to fame

Slowly, very slowly, I accepted the change in pace

Not playing sport in teenage years, was not what I wanted to face

So we did the scan; the MRI; a disc bulge was there to see

But they said it wasn’t that bad; the pain can go even if it is still part of me

So now I’m confused about what it means; trying to understand that discs don’t hurt

And how do I get better; can a disc bulge return to sport?

I guess the only way to “explain pain” for me to understand

Is to go back to the beginning and take the story in hand

It’s all about the context and how the body and mind respond

And how many factors can trigger me to biologically “turn on”

Because pain is a response linked to mind and body stuff

If only I could “get this”; know it; it might not feel so tough

Way back when this all started, sport and growing happened lots

So maybe they are part of it: along with things I have forgot

Sport, growing, “nervy discy” things that happen when you grow

Lots of physical moving things that are the easy things to know

But other things are happening in teenage times of life

Stress can also bubble away and contribute to the strife

Of growing tall and trying to fit to certain kinds of moves

For bowling cricket balls at people; Is that really how I “groove”?

So what’s the disc bulge got to do with all of these many things?

Knowing that would really help to keep my mind “in the wings”

If a disc interacts with all the other normal growing parts

And with stress and sleep and worry about holding in your farts

I guess it’s something that we don’t try to fix; a disc that doesn’t hurt

It’s the nearby nerve that got sensitive and out of me pain did spurt

The sensitive nerve is a new bit maybe I could come to know

That it loves to move and circulate to change for the pain to go

Trust that sensitive nerves can change away from danger signs

And with this pain can simmer down and “peter out” in time

The disc may bulge, and return to sport and just be part of me

I could come to know that this can be my reality

Because disc don’t hurt but they can be part of a danger sign in some

But if I build more safety in around my world, the danger can become “none”

I guess what we are saying is that for my pain to truly change

The safety in me has to be stronger than the “discy” danger range

Maybe a bulging disc signals danger by getting too close to the nerve

And the nerve responds by changing its “armour” to the “outside of the nerve” world

Build in lots of safety you say, moving, sleeping, not worrying

About things we can’t change, like bulging discs, just one such thing

That may have contributed to the danger along with growth, and sporting load

That resulted in a sensitive nerve response persisting so far down the road

Soothe it, move it, glide it, slide it, circulate the juice

And give it time to settle after what the growth induced

Work on building trunk strength and coordination to match the sporting goals you set

And pace your mind to accept the pain that not “just a disc” can invent

– Leanne Rath

Leanne is a Specialist Sports Physiotherapist (FACP), ​having attained this clinical specialty through Fellowship exams conducted by the Australian College of Physiotherapy ​(2008). Leanne has extensive experience with elite athletes and dancers, and is an accomplished instructor and presenter in the fields of hip/pelvic pain and injury management ​for patients wishing to return to active lifestyles.  Leanne consults ​for primary and second opinion case review from Phyiosports Brighton in Victoria.