injections

I developed excruciating lower back pain in 2001. I was a tennis player, downhill skier, and a marathon runner. I was also under a lot of financial pressure in a stressful job as a consumer class action lawyer with my own firm. 

Excruciating back pain challenged my ability to continue working. Forthepeople.com

My doctor diagnosed me with a herniated disc at L4-L5. He said that a piece of my disc was sitting on the spinal nerve. I tried everything to stop my pain but nothing worked. In January 2002 I underwent a laminectomy which removed the piece of disc and some of the vertebral bone next to the herniation to make room for the nerve root.

A laminectomy is a common lumbar surgery to remove some or all of the lamina (a part of the vertebra) to relieve pressure on nerves trapped by herniated discs or stenosis (narrowing of the nerve canals). Wikipedia

After the surgery, my back pain was more intense than before. It was very difficult to get out of bed in the morning. My five-year-old daughter imitated me doing a sort of downward dog yoga pose, with a lot of groaning, just to get out of bed in the morning. I could not move comfortably, nor could I stay still. I remember business meetings in restaurants—just looking at the chairs there I would feel pain.

Few modern chairs help us to sit well. Most chairs either encourage a swayback (left) or a tucked pelvis (right). Wikipedia

I also tried acupuncture treatment, but it was too painful to lie down. It hurt. Hurt to stand. Hurt to sit. Hurt to walk. Hurt to sleep. Everything hurt. 

I received cortisone injections from a pain specialist. I was ecstatic to get a needle in my spine because it gave me temporary relief from the agonizing pain that radiated all the way from my lumbar spine down my leg. Unfortunately, the relief didn’t last. 

Pain from pressure on the sciatic nerve can radiate from the origins of the nerve in the lumbar spine all the way to the foot. Wikipedia

I seriously considered a spinal cord stimulator. It was like an implanted super transcutaneous electrical nerve stimulation (TENS) machine, but I am very glad that I changed my mind as it required subsequent surgeries and I really did not want something implanted in my body. I was prescribed multiple pain relieving medications. 

I participated in a number of lengthy courses, including some pilates and Bikram yoga, that focused on cultivating more strength and flexibility to relieve my back pain. Yoga gave me some temporary relief but nothing permanent. I also used a pilates reformer once a week for several months but it didn’t help. It started to remind me of a medieval torture device. 

Using specialized equipment without knowledge of primal architecture can hurt rather than help. Wikipedia

I also went to a physical therapist and my pain was still not relieved.

Massage from a skilled practitioner can help alleviate soft tissue tension and back pain. Ideally, it would be combined with posture training to get to the root of the problem. Pixabay

In an attempt to relieve my pain on the way to court, I would slouch in my car almost horizontally, with both an ice pack down the back of my pants and the seat warmer on. I remember the pain forcing me to lie down on the floor at an arbitration where I represented a class of homeowners in a case worth tens of millions of dollars. Other lawyers stared at me as if I were a defective space alien. 

Despairing, I thought I would never get better. I knew people with similar levels of pain who had retired. Because of my love of being a consumer protection lawyer and my financial responsibilities, this was not an option. The stress caused me to tighten up even more, worsening the pain. I felt like I was trapped in a downward spiral.

I explored the principle of mind over matter. I meditated daily and continue to do so. I read Dr. John Sarno’s books. Dr. Sarno would say first eliminate any physical cause, then heal back pain by dealing with any repressed anger or other negative emotion. But my pain persisted.

Eventually I came across  Esther Gokhale's book, 8 Steps to a Pain Free-Back, and subsequently took the Foundations Course in 2011 with a Gokhale Method teacher in San Francisco. As I have said many times, Esther Gokhale is my hero! I have given her book to numerous family members and friends. They don’t believe me that there are 21 pages about how to sit in a car—or a restaurant chair—but every one of those pages is precious to me as they have saved me hours of agony. The Stretchsit® Cushion and Esther’s instructions allowed me to drive without pain. The Gokhale Pain-Free™Chair is still my favorite office chair. I still use the stretchlying technique that I learned in detail there, gently introducing traction to one segment of my spine at a time.

This healthy neck stretch is from a recent 1-2-3 Move class for our Alumni.

I now have zero back pain. Because of the Gokhale Method I can finally lie comfortably in bed, sit, stand, walk, bend, and live my life. I returned to running six mile runs along California beaches and trails all over King's Mountain. Due to wear and tear on my knees over the years, I am now an active swimmer, hiker, and biker. 

Out on my bike, I enjoy being physically active again, with the occasional wipeout.

My back has tolerated a recent move into a home with 41 steps. I carry furniture, groceries, etc. up and down those steps with no back problems. I am once again enjoying being the pain-free, calm, and happy person that I used to be.

Out hiking with my wife, Susie.

At the beginning of the pandemic, my tween daughter was the dancer in my house. When her in-person hip-hop class was canceled, she quickly turned online for inspiration, showering me with her 30-second Tik Toks.

I was amused, but resolute that dancing online was not for me. I had my own exercise regime, at the heart of which were a series of Pilates-based exercises that I had incorporated in the hopes of healing a nagging injury. 

But now, 16 months into the pandemic, I’m dancing online too, maybe even more than my 12-year-old. This is thanks to Esther Gokhale and her unbelievably fabulous community who, like me, wanted to find a safe, therapeutic, and fun way of exercising after injuring our backs.

I first heard Esther years ago on a podcast and subsequently checked her book 8 Steps to a Pain-Free Back out of the library. I remember being especially interested in the pictures of women holding their babies so comfortably; I had recently given birth, and I tried my best to imitate the women pictured. 

Me with Baby Yael in 2013. I now see I had a very pronounced S-shape curve. 

From reviewing pictures of myself during that time, I see now that I did a poor imitation, but at the time I didn’t have any pain, so I returned the book to the library. 

However, last November while experiencing non-stop back pain, I purchased the book, which led me to Esther’s website and one-on-one coaching. Six weeks later, after completing the Elements course, this is what I wrote to friends and family in my 2021 New Year’s letter:

I’ve been relearning how to walk, stand, and sleep over the past six weeks. This is what one does when she becomes so desperate for relief from unrelenting sciatica, the kind that starts in the buttock and runs down to the calf. It all began with a yoga injury in May 2019, but the pain became unbearable after our move (hello, stress and grief, and, yes, more disc degeneration.)

An MRI from December 2020 had pinpointed “severe facet arthritis bilaterally” at L4-5, and mild to moderate facet damage elsewhere. I had tried everything from PT to Pilates, from massage to medical marijuana, but what seems to have made the biggest difference is the Gokhale Method, which attempts to reteach the body how to do the work of everyday life without further degrading our discs.

I was skeptical about how much I could actually learn online from a Gokhale coach, given that postural work benefits from hands-on adjustments and corrections. But with COVID-19 raging, this is not the time for in-person classes. Happily for me, my coach was terrific, and after completing the 18 introductory classes, I’m feeling so much better. It’s definitely not a magic bullet, but it’s the best thing I’ve tried so far, and I want to believe that if I keep it up, I’ll eventually be pain free. Here’s hoping I can report that next year.

Seven months later, I am thrilled to say that I am indeed pain-free and living a full life that enables me to care for my family, return to writing, and relaunch my health coaching practice that I had put on hold due to the pandemic and pain.

My recovery has been so complete that in May I undertook training to become a certified canoe instructor and am now teaching at the American Canoe Association’s Camp Sebago in New York. 

Now free from back pain and sciatica I am once again able to canoe.

Even though I feel great, I know that wellness takes regular work, and I’m grateful for the ongoing Gokhale Exercise program. Gokhale Fitness teacher Eric Fernandez has gotten me to enjoy strength training; teachers Kathleen O’Donohue and Roberta Cooks are responsible for me incorporating Moving Meditation into my morning routine, while Esther’s daily 1-2-3 Move program has rekindled my love of dance and taught me steps from traditions that include bharata natyam, samba, capoeira, 50s rock, and reggae. Joan Baez’s music is a fave—she is a student of Esther’s and will often be dancing on the screen with the rest of us. 

Head-loading is a fun way to practice many important posture principles, shown here on the 1-2-3 Move program. 

Esther will also occasionally focus on yoga asanas and offer modifications that have enabled me to safely return to a yoga practice. If you see me balancing boxes (or my canoe) on my head, it’s thanks to all the practice I’ve now had with the Gokhale™ Head Cushion, gently “head-loading” my way to a taller, healthier neck. Thanks to the Gokhale Pain-Free™ Chair and Gokhale Stretchsit® Cushion, I’m also able to sit well at my desk and to drive long distances without pain, something that was impossible seven months ago.

1-2-3 Move often features artefacts such as Greek statues, Indian deities, or photographs of people from different cultures going about their work. Esther points out that examples of healthy posture by Americans are more readily found some generations back, in works such as those by Grant Wood or Winslow Homer.  

A Basket of Clams, 1873, Winslow Homer

My favorite class was the one devoted to the Hindu deity Ganesh, who takes the form of an elephant with a pot belly. While dancing to the “Ballad of Ganesha” by Lil Darkie, we took a cue from Ganesh, who holds himself beautifully, despite his roly-poly largesse. Esther talked about how strong abs are something that everyone, no matter what size, can cultivate. If Ganesh can carry himself well, the rest of us can do so as well. She made a similar point using images of Japanese sumo wrestlers. I deeply appreciate that Esther, raised in India by her Dutch mother and Indian father, takes a global perspective on healing. 

Dancing Ganesh, India, 900–1000 AD, sandstone - Fitchburg Art Museum

As a Functional Nutrition and Lifestyle Practitioner, I’ve come to view the Gokhale Method as nonnegotiable, or what Andrea Nakayama, CEO of the Functional Nutrition Alliance, calls “Tier 1”—the basics that must be in place before supplementation (Tier 2) or any kind of medical intervention (Tier 3). 

Tier 1 includes community support, something that is available in any Gokhale Method group class. These social and emotional components of healing, and the importance of surrounding yourself with healthy posture cues from people, artwork, and music, are frequently discussed during the Q&A on the 1-2-3 Move program. 

In this 1-2-3 Move video, Esther shows how traditional artefacts such as shadow puppets from Java, Indonesia, inspire us to free our arms and open the chest.

The Gokhale Method is not against appropriate medication or procedures. Back in February when I was still having some pain upon waking every morning, I asked Esther what she thought of “injections” as a way to mitigate this. To my surprise she said that she sometimes suggests that her students consider this “Tier 3” approach, but only after they have tried “Tier 1” first. Medical interventions such as injections and painkillers can create a window of pain-relief that enables students to learn to improve their posture and address the root cause of their problem. 

I had already had an injection into my SI joint the previous September, which didn’t give me any relief. So I booked a one-on-one appointment with Esther, who pinpointed an excessive curve in my lumbar area. The transformation I brought about in my spine led to me being used as an example of progress in a blog post about spine shape. 

My “before” (above) and “after” (below) Elements photos show a considerable change from an S-spine towards a J-spine. You can read more about spine shape here.

With ongoing attention to creating more of a J-spine and less of an S-spine I no longer have pain. Perhaps even more importantly, I have greater trust that my body, with the right support, can heal.

Loren Edelson is a Functional Nutrition and Lifestyle Practitioner who writes Given the Givens, a bimonthly newsletter on reaching our full potential, even after receiving a life-changing diagnosis. To subscribe, visit https://loren6c2.substack.com/welcome