Catherine Svent's life changed the day a doctor in Jakarta told her she needed an operation to fix her herniated disc.
"I couldn't move," says the 42-year-old advertising executive. "I was in so much pain, but I didn't want him to do open back surgery."
So Catherine decided to fight - against the odds and against time. Her back condition meant she had already started to experience numbness in her toes, a symptom attributed to the shutdown of muscles. When this persists, permanent functional problems might arise, and many doctors will recommend an operation.
"I searched for alternatives and through word of mouth I learned about musculo-skeletal physiotherapy," Catherine says.
"The therapist I met helped me to calm down. He explained what had happened, gave me a deep tissue massage and a set of simple exercises I could do at home."
For the first week, she still had to use painkillers, but little by little she regained control and was able to move more easily. Finally, she stopped taking medication. She chose swimming as an additional supporting factor to help build up muscular strength and is now following a regime of daily traditional physiotherapy and clinical Pilates.
"It was a real wake-up call," she says. "I had a long history of back pain. It runs in my family."
And, she adds, "My lifestyle didn't help either." Catherine was used to tight schedules, catching frequent flights and running from one business meeting to the next.
"Today I take it easier and try to do my daily exercises. I'm doing fine and hope not to end up on the operating table anytime soon."
Back pain, especially lower back pain, affects almost everyone at some point in their lives. The American Chiropractic Association estimates that it is the fifth most common reason for all physician visits in the United States. It is the most frequent cause of activity limitation in people younger than 45. Medical care and disability payments for American patients have reached a stunning US$50 billion. Back problems also cost employers billions of dollars in lost productivity.
Stress and a sedentary lifestyle lead to many workers, both white and blue collar, suffering from acute or chronic back pain. Although at times a simple painkiller will do, for many, this pain marks the beginning of years of suffering, and a vicious circle of pain and denial.
"When you are in pain there is a process of events that sends you into a downward spiral," says Brett Money, physiotherapy manager at OM Wellness in Jakarta.
"Surrounding your spine, you have two types of muscles: *stabilizers', which support the spine, and *movers', which move the spine. When back pain is registered in the brain, it triggers an automatic neurological reaction.
"This pain reaction causes the stabilizers to turn off, leaving you very weak, and the movers to spasm, leaving you very stiff. The pain leads to weakness which leads to spasms, stiffness and more pain."
Once patients have entered this circle of pain, many learn to accept it; they then live with this back pain without really resolving the underlying problems.
"One of the best ways to overcome back pain is through movement-based healing. This starts with passively getting the patient's body moving," Brett adds.
"There are many trained professionals such as a chiropractor, osteopath, massage therapist, reflexologist, tukang pijit or physiotherapist like myself who can help you with this stage. It's important that someone moves you to relieve you of pain and spasms."
The second step is to actively move the body. Professionals who can guide patients at this stage include personal trainers, yoga instructors, Pilates or tai chi teachers, rehab doctors and physiotherapists.
It's also important to seek out the cause of the pain.
Poor foot mechanics can be one of the underlying factors that lead to pelvic and spinal distortion, causing back pain.
In this case, support for a holistic healing process, where the patient learns to manage pain by movement podiatry, could come in handy, as Peter Norton, a podiatrist at Body Clinic in Jakarta, explains.
"We do computer gait and in-shoe pressure sensor analysis," Norton says. "People with scoliosis, for example, will commonly have a functional leg length difference, hence a multidisciplinary approach including podiatric orthotic therapy is indicated."
Patients with flat feet, another common condition, could benefit from orthotics because they redistribute the load away from areas of high pressure.
"An orthotic achieves greater surface area, controls the rear foot, thus preventing excessive rolling in, and provides support and suspension in the mid-foot," Norton says. "Flat feet are like flat tires on a car - they cause jarring. When pumped up, it allows for a smoother ride."
In retrospect, Catherine Svent adds that her mind-set was crucial, too.
"I was lucky enough to have found the right therapist for me," she says. "But if I hadn't been determined to fight and if I didn't have someone to trust, it would have been a whole lot more difficult."
Brett Money agrees. "When you're in a state of acute pain, you experience emotions of panic, fear and confusion, which are not healing states," he says.
"First we calm our patients, then we explain to them their diagnosis and symptoms, and finally we reassure that them that the ability to get better lies in themselves.
"I firmly believe that healing process starts in your own mind."
Om Wellness
Jl. Sekolah Duta Raya TC-7
Pondok Indah
Jakarta 12310
Tel: (021) 750-2761
Email: contact@omwellnessgroup.com
www.omwellnessgroup.com
Body Clinic Indonesia
Jl. Wijaya IX no 4
Kebayoran Baru
South Jakarta 12160
Tel: (021) 7278-3827
Email: bodyclinic@indo.net.id
www.bodyclinicindonesia.com
