August 7, 2012

Nutritional biochemistry

What does lower back pain have in common with low carb eating?

Read Time 8 minutes

Strange question, huh? Before you get too excited, I’m not about to tell you that a low carbohydrate diet is a remedy for back pain.  Instead, I am going to explain a remarkably parallel experience I’ve had. I never made the connection until this week when a reader asked an unrelated question about lower back pain.

The best, worst experience of my life

As my third year of medical school was winding down, and I was just about to embark on a bold fourth year curriculum of back-to-back-to-back-to-back surgical sub-internships, I was on top of the world.  I was 27 years old, living in Palo Alto, California with my best friends, I had a wonderful girlfriend, I was working hard to prepare for my application to a surgical residency, and I still found time to work out like a wannabe Olympian.  What more could I ask for?

One sunny, June afternoon I got out of the pool after a good workout and felt a very strange pain in my lower back.  After riding my bike a few hundred yards to the weight room, it wasn’t getting better.  Actually, it was getting worse.  So bad, in fact, I did something I’d never done before – I decided to skip my workout and pedal home.

I iced my back, took some ibuprofen, and went to bed.  The next morning I woke up only to realize I literally could not get out of bed.  After struggling for some time I had to call my roommate to get me out of bed and help me to the bathroom.  I called my chief resident and apologized that I would not be able to come in to the hospital that day, and assured him I’d be fine the next day.  But I wasn’t.  Nor was I fine the day after or the day after.

A few days later I managed to limp my way into the hospital for rounds and with the help of the residents and nurses who were kind enough to give me intramuscular injections of a potent drug called toradol, I was able to survive, just barely.  The pain had gotten worse over the week and I was unable to sleep in any position except lying face down over a counter in an “L” shape.  But the worst was yet to come.

Within a few more days, not only was my back hurting, but I was also experiencing profound sensory pain in my left leg and left foot.  I realize this may sound hyperbolic, but I am not exaggerating at all when I say it felt like the skin was being torn off the bottom of my left foot.  The only way I could sleep was to tie my left foot in a plastic bag of ice to numb it and take 100 mg of Benadryl (enough to put a horse to sleep).  When the ice melted, I would wake up in pain and need to repeat the routine.

Within about 3 weeks of this back and leg pain, I was starting to worry that something very serious was going on.  I’d had a backache or two before, and in one case it even took a week to resolve.  But this was very different.  One night, when the pain was so bad I couldn’t mask it with any cocktail of drugs I finally relented and went to the ER.  After a thorough exam, the physician sent me to the MRI scanner (for those of you reading this outside of the U.S., it must sound crazy to think that a patient could have a MRI scan so quickly).

The MRI showed not only a large herniation of my L5-S1 disk (a bulging of the disk between my L5 and S1 vertebrae), but it also showed a free fragment of broken disk sitting directly on the S1 nerve root.  While the large bulging disk was likely the cause of my back pain, the free fragment pressing one of the largest nerves in my body was undoubtedly the culprit in my leg and foot pain.

The next morning I was taken to surgery by a (supposedly) talented and reputable neurosurgeon.  I was actually very relieved and excited, despite never having undergone surgery or general anesthesia before.  I was told this surgery would fix the problem immediately.  But it didn’t.  In fact, as it turned out, this was the beginning of a long, sordid ordeal, albeit with a positive take-away that is the point of my story.

I woke up from surgery and immediately realized the pain was still there, in my left foot.  Worse yet, I had trouble moving my right foot, which was completely fine before surgery.  Over the next few days it became clear I had developed something called a foot drop on my right side.  I would later learn the surgeon had operated on the wrong side and likely injured the nerve on the right side. Things had gone from bad to worse.

Compounding this, the surgeon who operated on me refused to believe my description of what I was experiencing and was convinced I was just being “soft” for complaining of persistent pain and a new problem.  After 2 weeks of further deterioration — and only when another physician examined me, and herself ordered another MRI — did my surgeon agree I still had a significant surgical lesion.

That night I went back to the operating room and, this time, operating on the correct side, the surgeon removed a 4-centimeter fragment of disc from my spinal canal that was still compressing my S1 nerve root (below).

back pathology specimen

The next three months proved to be what I would later describe as the “best, worst” experience of my life – an assertion I still maintain nearly 15 years later.  For a number of other reasons and complications I suffered that I won’t detail here for sake of time and space, I became completely debilitated after developing another complication called a facet arthropathy.  So much so that my mother flew to California to stay with me, just to feed me and drive me around to endless doctor appointments.

My dream of becoming a surgeon had quickly vanished along with any athletic aspirations I once had.  I worried whether I’d ever walk again and had begun to accept the fact that I may be addicted to pain killers for the rest of my life. [For anyone familiar with such medications, I was taking about 200 mg of oxycodone per day – about 40 times what a “normal” person would take following a painful dental procedure.]

Things I once took for granted – walking, being able to lean over the sink while brushing my teeth, sneezing without feeling like my kidneys were being ripped out – became distant and fading memories.

Fortunately, with the help of some remarkable doctors (which included several more trips to the operating room), kinesiologists, and physical therapists, I would slowly learn to move again without pain.  I had to train as hard and deliberately for this as I had for every other athletic endeavor I’d ever poured myself into.

I experienced firsthand what narcotic withdrawal is like and the depression that accompanies it.  I experienced firsthand what an arrogant surgeon can do to a patient.  I learned more about medicine in that year than at any other time in my medical training.

As a postscript to this story, I eventually made a remarkable recovery and was able to begin my surgical residency a year later with minimal pain.  Today my back is stronger than it was before this incident. Except for the few people I have shared this story with (until now), no one would ever know what I went through.  I move through the world like someone with a perfectly healthy and strong lower back.

I also gained a profound understanding of pain and addiction, which became one of the most valuable lessons I carried with me through my brief medical career.  It allowed me to understand what a heroin-addicted person goes through, when viewed through the lens of my own experience with the strongest painkillers.

A few years later I would become close friends with Drs. Marty Makary and Peter Pronovost when our paths crossed during my residency at Johns Hopkins.  Marty and Peter have become two of the biggest pioneers of patient safety and the avoidance of medical mistakes.  My story became one of many presented in Marty’s soon-to-be-released book, Unaccountable.

Years later, based on my experience and research I did while overcoming this injury, I gave many talks on the treatment and prevention of lower back injuries and have become a minor expert on the subject.  If anyone is interested, here is a link to one of my presentations (slides only, no video/audio).

What does this have to do with a low carb diet?

Today, when I pick up anything, whether it be a cotton ball or a piece of paper, I do it with my legs, not my back.  When I lean over the sink to brush my teeth, I support the weight of my torso with my arm.  When I get out of a car or out of bed I position myself not to torque my back.  When I need to lift a 265 pound barbeque out of my car, like I did a few months ago, my lower back is never under strain.  How did I learn to do this?  Through a very deliberate and long process of adaptation.  I had to re-learn how to move, how to sit, how to lift, how to sneeze.  Were it not for the long and painful road to recovery I endured, I may have never learned these things.

Many people who suffer back injuries never really recover.  When they do “recover” from one injury, the rate of relapse is very high.  While no two cases are identical, much of the reason for this lies in 2 factors:

  1. The injured person does not learn how to modify their behavior to avoid re-injury.
  2. The injured person does not take the necessary steps to strengthen and rehabilitate their back.

“Curing” a back injury is not a temporary thing or something that just happens because we wish it to be so. It is a very deliberate lifestyle change.  Over time, as we form habits, we can go from consciously thinking through every necessary behavior change – something easy to do when we are in pain – to a place where the behavior is more automatic. But this takes time.

In many ways, transitioning to a low carbohydrate diet is similar.  Consider the figure below.

4 stages

Just like with behaviors that predispose us to lower back injury, most people go through life just eating on autopilot, but eating the wrong things, the “default” things.  They graze in a reactionary manner without any understanding of how what they eat impacts their body.  They are eating in an unconsciously incorrect manner.

Many people learn that what they are eating is actually not ideal and not predisposing them to maximum health.  They move into a place of consciously incorrect behavior.  They realize drinking a Coke with fries and a candy bar is not good for them, despite still eating them.  Some of these people go one step further and actually make corrections – removing sugar and simple carbohydrates from their diet, for example – but doing so requires great effort and deliberate action.  They are now in the realm of consciously correct eating.

This is the place where most people get stuck.  It hurts.  It’s hard to do.  They get frustrated.  Maybe even ridiculed by friends and family.  Most turn back to consciously incorrect eating with brief periods of re-visiting consciously correct eating.  Hence, only a few people make their way into the final stage of unconsciously correct eating, just as only a few people with serious back injuries ever make it into a state of unconsciously correct movement.

Why?

Because it takes a lot of time and a lot of effort.  It’s different for everyone, but I know for me it took almost 2 years to get to the point of unconsciously correct eating.  I had spent 36 years mindlessly eating the wrong way, just as I had spent 27 years mindlessly moving the wrong way before injuring my back.

Sixty years ago it was quite easy to default into the correct way of eating because we were mostly surrounded by foods that supported such eating.  But, our food environment has changed dramatically and today’s default eating (e.g., high amounts of sugar, grains, highly refined carbohydrates) puts most of us – about 60 or 70% of us – at serious risk of metabolic disease.  One day, I believe, the work of NuSI and others will fix this problem, and through the elucidation of unambiguous science allow us to create a food environment that supports easier (and more affordable) default eating of the right foods.   However, until then we have to go through these stages.

If you find yourself feeling frustrated at how difficult it is to get from consciously eating well to unconsciously eating well, remember that you are on a journey.  If you are consistent and patient, if you remind yourself that you are embarking on a journey to change your life and not a short-term fix to look good in a bathing suit next month, you will embrace the right mindset to find the ‘sweet’ spot of unconsciously correct eating.

I will be the first to admit that this is not easy.  But, if you’re reading this, you’re already down the path and you’ll be better able to help the next person who struggles through the 4 stages of transition because you’ve experienced it yourself.

Photo by Meta Zahren on Unsplash

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

285 Comments

  1. To Sydney,

    This reply is in no way offering advice, merely letting you know you are not alone. I am a 55 year old female, 5’3 @ 207 lbs.(down from 251 on a high fat, low carb diet for two years this Feb.). I too have been morbidly obese most of my adult life. I have experienced significant weight loss and gain. High blood pressure and elevated glucose levels eventually led me to Dr. Attia’s website. I initially enjoyed modest success , then stalled, played with my intake ratios incessantly (you can find my post and fits of frustration throughout many of these posts). Throughout I was in ketosis. Finally, after two years, I have, a. Begun to lose weight again, b. have learned (critical for me) to only eat when hungry, and c. to increase my carb intake (in favor of just one fruit) to the recommended 50grams). I noticed you mentioned eating flax, I do not know if this is considered grains, I have completely eliminated all grains and wheat. This has helped me. I would encourage you to read through these posts, stick with it, and know their are others who share your frustrations and struggles.
    To. Dr. Attia and all of the wonderful people who read this blog, Happy, Safe, Healthy, Holidays and Happy New Year to you and your families!
    Ellen

  2. I remember your surgical nightmare and debilitating back pain well. Your account is accurate. You overcame incredible physical and emotional challenges. It is heart warming to read how your success in overcoming the sequelae of your harrowing experience increased your capacity to empathize and inspire others in similar situations. Kudos for speaking out against the decades long dissemination of nutritional misinformation.

    • Oh my god…Tara…I can’t believe it’s you! How wonderful to hear from you. Can’t believe you stumbled across this. Yup, you sure were there for every agonizing moment of this. Thanks so much for all you did then.

  3. Oh my gosh!. Thank you. Never in my entire thought process would I have thought through this in the way you have expressed.
    I recently lost 100 pounds ( 100 more to go) on very low carb and high protein. Just recently, I felt like this was too hard and it was time to give up Started in May 2012. . I was jut ready to eat some cake (the entire piece) ( once in awhile I will have a half a piece) and eat some popcorn when I came across your article. .
    I too have terrible low back pain and had surgery at L5 S1 .As soon as I get health insurance I will get some treatment. I have a wonderful Doctor who believes in the low carb and high protein and she is extremely supportive. I am so fortunate. I am excited to hold on to what I have learned in your article.
    Again, THANK YOU THANK YOU THANK YOU.
    JDP

  4. hi Peter, Thanks so much for sharing your story and for making this information accessible on your site. I’m 30 years old and have struggled with compulsive binge eating, insulin resistance, and Type II diabetes for many years. Your, Gary Taubes’, and Phinney and Volek’s work have convinced me that my carb and sugar addiction isn’t just a psychological and emotional disorder (though there are components of both), but a biological issue that may have roots in genetic susceptibilities, etc. It helps to know that you took almost two years to move to consciously correct — I oscillate between consciously correct and incorrect (sometimes mostly incorrect), which is enormously frustrating.

    For my and many others’ sake, I’m glad that you have carb-sensitive genes and that you went through the nightmare experience of surgery, relearning how to move, and narcotic withdrawal. I’m hoping that the “bad” cards I’ve been dealt and this nightmare of recovering will one day yield pearls to others, just as they have in your experience.

    • Esther, sometimes I wish I had my wife’s carb-resistant genes, but I can see your point and it’s certainly the ‘glass-half-full’ approach to my genetic draw — at least I can be an example for some. Glad to hear it’s been helpful for you.

  5. Hi,
    Thanks for your information. I’m loving the diet, but…
    You mentioned that at one time you felt so badly you considered giving up the diet. I’ve been on the keto diet for only 5 days now. I feel weak and am having lower back pain in the middle of the night. I’m trying to eat more fat since reading your blog and drinking bouillon (as you suggested) since I perspire profusely. Any other suggestions? Btw, I’m a 72 year old woman just doing it for the weight loss and, of course, looking for a six pack to form any day. lol.

  6. Peter, that’s bad ass; thank you. This reminded me of Dan Ariely’s story. I am loving this blog.

    I was wondering though, did you ever experience any stomach/gut problems on keto-induction? I am in my 9th week and my stomach/gut gets upset at any thing. I had appendectomy in college and I come from a diet of like 3-4 gatorades, 2 cliffbars daily, breakfast cereal etc. keeping normal weight via cycling(prob closer to 0 on your insulin resistance matrix.) I never really had stomach problems post surgery on carbs, though things felt different.

    Do you think gelatin or something would be good for the stomach? I’ve tried charcoal and glutamine and it’s largely a non-solution. Is there anything that will rebuild the stomach? Am I keeping my carbs way too low (pos. acidic balance by Loran Cordain?)

    Thank you again for the inspiration.

  7. my mom is 39 year old and she frequently suffers from lower back ache.we din’t find any apt solutiion for that.pain is aggevated upon consumption of chicken…….can you give me any reason for this aggrevation and pain.
    .

  8. I can never edit my own stuff- previous post should have been: ‘Is a ketogenic diet possible or recommended after gallbladder removal?’

  9. I have just found your website after watching you on TED Talks. I find your 4 stage to health to be true. This year–actually new years day I came down with the stomach flu and decided to quit drinking coffee as I had been living in stage 2 (conscious incorrect) in regards to my stomach troubles (GERD hiatal hernia – ulcerative upper GI from esophagus to as far as an upper GI goes down) for about 6 months. Since January 1st I drink water or herbal tea in place of coffee with creamer & sugar I used to drink by the pot full and have lost 40 lbs since switching over. (From 210 to 170 lbs) This has been the only change in my diet but I am finally at stage 4 and no longer think of or desire drinking coffee.

    • Pretty cool, huh? I think people make to flawed assumptions when they try to enact a behavioral change:
      1. Assume there are only 2 stages — doing it and not doing it;
      2. Assume that if you “slip” it’s over — not understanding the process is a continuum.

  10. What if Back pain is caused by diet? Hi Peter wow your experience was so similar to mine. I also had a ruptured l5 s1 disc. Its hard to describe to people just how painful it is. Since my injury some 11 years ago I have searched high and low for the definitive answer to fixing back pain. In the last 2 years I discovered the Atlas Profilax Method which realigns the spine from the top down. This fixed me and Ive actaully written a book about my experience. I thought this was the be all and end all solution until a little back pain came back. And I also experience back pain during Endurance Mountain Bike Races.. I now beleive the root cause of back pain is Gut disbiosis and food intollerances causing inflamation, poor flexibility and casuing us to hold our bodies in unnatural ways. I have been eating more paleo in the last 4 weeks and have just begun SCD style diet. I have a 100km mtb race on the weekend and it will be interesting to see if this is pain free. Thanks for all your great work

  11. I have read your e-mail while I was surfing the internet and looking up a certain condition I started to have very recently.

    I suffer of a killer pain in my lower back whenever I eat certain types of food, some of that food contain rice or bread with other kind of vegetables or meat… I don’t feel it every time I eat rice or meat though.

    The pain completely vanishes after I finish my food which is weird.

    I couldn’t find an answer to this situation though, and doctors found this situation funny as they didn’t have an answer.

    Is there any help or an answer to this.

    Thank you,

  12. Hi Peter,
    I loved reading your blog about your back. I have been suffering for 7 months now, lumbar herniation and bulging of 3,4,5 and S1 , the sciatica pain has made me want to die at times…..i am on a new drug treatment for me, Lyrica which has helped me a lot in the past two weeks……I have opiates, but i am slowly reducing them at present, with minimal withdrawals (fingers crossed) I still have to use a walking stick, and i have been doing some back exercises daily, but when i go for a walk…….the next day, i have pain in my left upper thigh, middle thigh and behind my knee, and it feels like my bones are breaking, or muscles locking up……it is so painful it takes my breath away…..after a minute or so of no movement, it tapers off…….I am so thankful that the whole leg and foot pain (continuous) is no longer there….occasionally now i get a little in my shin…….and im hopeful it will not come back…..I wouldn’t wish the pain on anyone ever. i want to do more exercise, but im not sure if I should try the ones you’ve suggested yet…….My physio, told me to be careful with my movements……and like you, i have learned a whole new way of moving…..when i get out of the car, i turn my body to the door then get myself out, i bend with whilst sticking my bottom out and my knees well bent….. I also had 3 CT guided Lumbar spinal injections with no positive results, the first one actually caused me more pain….. I was truly inspired by your blog about what you went through……I was actually looking for information on sugar and carb’ intake as a possible cause for back pain, because it seems if i eat sweets or bread on consecutive days my back pain is far worse……i tried going without bread or sugar for 3 weeks, i did seem to lose a little weight but couldn’t tell if it affected my pain, because it was already severe, but ive persisted with the low carb intake ( I am type 11 diabetic on medicaction)…..ive almost cut coffee from my diet, but ive changed up to low fat milk instead of no fat milk, i eat wholegrain bread when i do eat it……..i don’t like red meat much, but like chicken and some turkey, and some fish……i eat a lot of vegetables when i eat salad which is often, and usually eat a boiled egg if i get hungry, which i don’t seem to do much lately……not sure if its the drugs or not………but anyway……..thank you for your blog……its was something that i resonate with and it was helpful with my quest…….thanks again….Nikki…..

  13. David, thank you for sharing your story. Unfortunately it’s one I’m all too familiar with. I’ve had a Herniated disc at) L5-S1 that I’ve been dealing with for about 7 years. Just recently I had a similar situation where I woke up in excruciating pain and was unable to get out of bed. After receiving an epidural, I feel like the pain has been dulled enough that I should start trying to exercise and strengthen my core. Based on how you described how you have changed the way you move and bend, I was wondering if you are familiar with foundation training? http://www.foundationtraining.com, and if so what are your thoughts on it.

    I recently purchased the book and have began doing the exercises carefully as I’m still in acute pain. I’m praying that I’m young enough that I can undo some of the damage to my back through dieting and exercise and avoid surgery. So far the exercises do seem to be having a positive effect.

  14. Peter—-Here is my permutation on this theme—-and believe me I have immense empathy for you. I had just left the Marine Corps where I was training hard everyday as a diver in 1st Recon Btn. I was 27 yrs. old. In the gym one evening doing BB shrugs with 275—my normal weight—I felt a pinch in my low back. The next day I was seated at our dining room table and I rotated and then bent over to pick up a section of the paper from the floor—-BOOM!!!! intense pain down my right leg. I went to the ER, but they wouldn’t give me any serious painkillers. I started eating 4 Advil every four hours. I went to my chiropractor for a week, and he suggested that I see an orthopedic surgeon. My ortho scheduled an MRI a week later—-you know the pain level here—a week seemed like a sentence to 20 years in the pain prison. He showed me a rupture at L5-S1 and also at L4-L5. The rupture at L5 had a large extruded fragment pressing against my S1 nerve root. Here is where things get insanely stupid. My ortho suggested that I wait 6 months before surgery and try passive treatment modalities. I did this and the pain never went below intense for six months—all the while I only used Motrin 800mg. I never really understood how traction could pull an extruded fragment back into a ruptured disk—but I trusted his advice and the second opinion I got from a neurosurgeon was in agreement. Six months later I have the surgery, and I wake up in post-op with a smile on my face—no intense pain down my right leg. Problem was that waiting six months with the fragment pressing against S1 caused the nerve to degenerate/die causing me to lose innervation down my leg to my foot. What I later realized was that the surgical procedure, discectomy/laminectomy, had a very low success rate (1986)—especially with two adjacent discs—and surgeons were being advised to suggest passive treatment first to reduce their litigation exposure. Calf raises are impossible on that side and my lower leg has atrophied to about 1/3 the size of the other. Like you, I have learned how to compensate. I still lift 5 days a week. I keep my abs in tremendous condition to protect my lower back. I can’t really run, but I do walk 4-6 miles daily. I follow a Paleo approach regarding my diet and my weight isn’t an issue. I am thankful for the successful operation—even though delayed. When people tell me they are experiencing intense back pain—I believe them.

    I enjoy your reading your thoughts etc. very much. Thank You

  15. I have this back lower back pain just like the one you had though mightn’t be as serious. I noticed it gets worse whenever I skip breakfast and may be lunch as well and or when I have a generally bad eating habit. Perhaps due to loss of appetite. I have a foot drop on my right foot and this sensory pains not just on the leg but the hand as well. That is to say that, I have this on my right limbs! I need help ASAP! Must I have a surgery? Is there no way medicine rather than surgery can intervene? I am a Nigerian in Nigerian and do not trust our surgeons here coupled with my fear of the operating room! I’d prefer a medical intervention down here. And I will appreciate your help if possible. Never seen anybody with the exact description of my agony as much as yours. I await response from you. Thanks

  16. Peter – I just discovered you. Blog post by Dr. Michael Eades where he lists your blog as is #1 on a list of blogs he reads daily. OMGosh!!!! I am blown away by you! I have read many posts and watched vid’s – the TEDMed video of you apologizing to the patient in the ER just solidified everything I felt to be true about you. You are brilliant – in the truly light-shining way. And you are funny and so smart (and I personally love all of the science) and I could simply go on. But won’t.

    You have become my go-to guy AND as a referral source for my clients – I am an Integral Coach. I approach my life with an “integral life practice” which includes body / mind / spirit / shadow aspects (Jungian) daily practices that work synergistically in creating health and well being.

    Your energy is so vibrant and honest and rare. Thank you for just being in the world and sharing your talents.
    I’m soon heading over to the site of the company you co-founded in 2012 to read everything there.

    Warmly,
    Sheila

  17. I do have a question I don’t think you have discussed and I did not see it in the “coming” section. Forgive me if it is there and I missed it.

    I am wondering your thoughts on the idea of “re-feeding,” as some call it. Eating significant carbs one day a week in order to reset or do something with respect to Leptin and possible other hormones? I’m thinking specifically about Tim Ferriss’ practice around this and why it is important. (I’m guessing you and Tim would have much in common with respect to your “experimental nature.” He is a true guinea pig!) Tim is another go-to guy for me.

    I don’t eat grains at all due to the inflammation that they cause; however, I have considered doing a re-feed practice with potatoes and fruit, for example.

    Maybe you could add this to your “coming” list. Thanks!

  18. Very informative and new knowledge for me….
    I am 24 now and i have experienced lower back pain while in abs exercise 4yrs ago. i see orthopedic doctor and he told me that your lower back is alright. after some time pain has gone but i still fell weakness in my back and soon get under stress a kind of uncomfortable feeling until i flatten my back in bed or sit on foot for some time. it give me some relaxation….
    i didn’t use any kind of medicine except painkiller for very few time and wait that my body system will rehab it and bring it to normal strength…but i didn’t work fully although i lost a lot of weight not for ketosis about which i didn’t know at that time. know i start worrying that this problem might will increase with age.
    what can i do bring it to full strength or normal position.???? i will be very thankful for any help.. frankly speaking i have some kind of phobia form visiting doctors.

  19. …………………………
    ……………………………………………..
    ……………..

    Something Different

    Context: the following two ab exercises do not cause the center lower back muscles to overly tighten which normal ab exercises often do

    1. Ab Exercize

    After a bowel evacuation – while sitting – crunch yours ab’s from top to bottom – turned to side – tilted to the side – tilted to the front – tilted to the front – tense the chest and arms muscles as tightly as possible – the entire spectrum of abdominal and pelvic and chest muscles should get several good crunches – there’s no movement involved here – your just using your mind to make ab’s crunch

    2. Sitting like in your computer chair with feet proped up on computer desk – body in a slight vee posiition –
    crunch all ab’s as described in exercise one for like 12 minutes – you can listen to a podcast while doing this as it makes it more intertesting

    Static Ab Crunches aren’t going to save the world – but will elimintate an all too common cause of ab exercise induced lower back pain

    Low Rep – One Set Only(1to 3 reps) barbell and dumbell exercises -amount of wieght is determined by whether doing a full motion exercise or holding the weight in static positition for ten seconds can give your back muscles the needed stress – this exercise can be and should be done daily as the body can recover from this sort of thing –

  20. I just came across your site today (it was mentioned in a blog post about the findings in Sweden about low carb eating). Your description of your back ordeal brought me to tears. As soon as you described the postures you had to assume for any relief (and the ice packs) and the almost literally indescribable pain, I knew you were going to say it was pressure on a nerve root. I had a C-6 blowout several years ago and my left forearm felt like it was on fire 24/7. I was given conservative treatment, chiropractor referrals, and high Advil doses.

    After a few embarrassing freak-outs over the pain, I had an MRI that showed that nerve root being crushed. I was very lucky: I opted to see a neurosurgeon instead of an orthopedic surgeon, he noted I was close to permanent damage so scheduled surgery within days, and treated the pain with Dilaudid. Fortunately, my pain was gone immediately after surgery (I wish that had been your result!) and I went through the whole ordeal with taking 15-20 pills. I was very lucky.

    It left me with enormous empathy for people who become addicted to pain meds–I have no doubt that would have been me if I hadn’t had surgery as quickly as I did. I also have equal empathy for anyone in that kind of pain–I will always remember which doctors brushed off how much pain I was in and the ones who showed understanding and compassion.

    On to the LC part!

    I love your stages explanation.I hadn’t put it into words, but after having real problems with specific types of ice cream (one example) I had to really work at avoiding them: for weeks, I just wouldn’t go down that aisle, even identifying what section was the last one before the triggery stuff and turning around.

    Recently I realized I was able to go past that triggery cooler, even looking at what had been my favorites, and just felt that it wasn’t relevant to me. I could have been looking at a concrete block for all the pull it had.

    I had gotten to “unconsciously correct.”

    I went back and forth with “consciously incorrect” for some time, and wondered if I should just give up, but every time I pushed into “consciously correct” I got stronger. I hope everyone trying to get on a good LC eating path has the chance to experience that 4th stage. It’s a wonderful feeling, especially when it becomes your personal default.

    Thanks again for sharing your story.

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