Back Pain: Lending a Hand

If your partner suffers chronic back pain, you may be his best ally. Pennsylvania Osteopath Andrew Kirschner has come up with a plan for couples to ease the aches. Instead of watching your spouse shout in pain, you can help alleviate the agony. Kirschner developed a mild form of osteopathy—orginally for his elderly clients, who didn't respond well to the intense cracking and crunching of traditional osteopathy. He found that a lot of people preferred this kinder, gentler approach. Even his football-playing clients raved about his soft-tissue massage. Now these simple techniques are showcased in the book, Back Together: Hands-on Healing for Couples, which shows how you can actively reduce your partner's pain.

Q: According to the American Academy of Family Physicians, 50 percent of Americans have chronic back pain. What's behind this surge?

A: It's a combination of things in the American lifestyle. We've changed the way we do a lot of normal tasks. We shop on the Internet, we use the Internet for entertainment, we have 600 cable channels. This leads to a lot of sitting. And, in terms of the geometry of the spine, sitting is probably the worst thing you can do. If you look at the way your spine is constructed, sitting is the same thing as bending forward about 90 degrees, except you're not using your muscles to support that position. It puts a lot of stress on your lumbar vertebrae.

Q: In Back Together you focus on techniques that couples can use at home. Why is it beneficial for a spouse to take an active role in managing a partner's chronic pain?

A: Unless you have a severely dysfunctional relationship, you've got a vested interest in seeing that your partner is comfortable. You've got more at stake than a professional practitioner does. When I do these techniques in my office, I get a decent result. But if I teach the patient's partner how to do the same technique, the spouse will get a better, longer-lasting result. There's energy and chemistry between partners that I could never replicate. Also, spouses are generally available to a patient when they're at their worst, which is when these methods can be most beneficial.

Q: What is the most common effect of chronic pain on couples?

A: The psychological dynamic of a couple in this situation is complicated. Initially, the partner who's not in pain has the best of intentions and tries to do all she can to help. But in the modern world bills need to be paid, kids need to be cared for, and there comes a point when resentment crops up. The healthy partner gets tired of shouldering the burden.

Q: But your book seems to suggest that healthy partners should do more, not less. How do these exercises help minimize resentment?

A: The book offers spouses the tools to participate in their partner's wellness. You feel powerless when you're sitting with your partner and he says, "Ahhh. I'm in terrible pain." You say to yourself, "I don't know what to do." This can be frustrating, scary, and after a prolonged period it can get annoying. The techniques I outline in the book offer spouses easy, effective tools to give their partner relief, which can go a long way in alleviating tension.

The Techniques

The Lower Spine

This soft tissue massage relaxes the muscles in the cervical spine, which can suffer from extended periods of sitting. When done correctly, it restores normal movement to stiff muscles and joints, and prevents the progression of tightness in the lower spine.

How to do it:

1. Your partner is lying on a solid, comfortable surface.
2. Starting at the crown of the head, slide your fingers down your partner's neck to the base of the skull. (When you reach it, you'll feel a bony ridge protruding from the back of the skull.)
3. Gently move your fingers in the area just below the ridge.
4. Cup your partner's head in the palm of your hands and lift it off the table. Make sure to extend your fingers down the neck so that the weight of her head is fully supported.
5. Repeat once or twice until the area becomes completely relaxed.

Or try this:

The following technique also releases tension in the cervical spine, and can help prevent long-term damage caused by stiff muscles and joints.

How to do it:

1. Your partner is lying on a solid, comfortable surface.
2. Line up your fingers on either side of your partner's neck.
3. Using a slow circular motion, apply waves of pressure, starting at the base of the neck and ending at the base of the skull.
4. Be gentle, but remember that your fingers should "drag" in the direction of the tension as opposed to sliding across the surface of the skin.
5. Repeat one or twice until the area becomes completely relaxed.

The Upper Back

This technique relieves pressure to the upper back caused by driving and typing for long periods. Prolonged extension of the arms can affect breathing and cause restriction of the shoulders, upper back, and ribs. This restores natural motion by mobilizing the ribs and allowing tense muscles to release.

How to do it:

1. Your partner should be lying on his stomach, with his arms positioned above his head, bent at the elbows. His cheek should rest comfortably on the floor.
2. Place the heel of both your hands in the middle of each shoulder blade. (Your fingers should be pointing toward the lower back.)
3. When your partner exhales, press down, applying even pressure to both shoulder blades with the palm of your hands and fingers.
4. Alternate by applying gentle pressure down the back, moving slowly toward the buttocks.

Top to Bottom

Based on a traditional osteopathic technique, this simple exercise works to prevent and alleviate a host of back problems caused by too much sitting. Sitting forces the lumbar spine to flex in an unnatural fashion, putting pressure on the posterior surfaces of the discs. This technique counteracts the effects of sitting for prolonged periods by loosening up the muscles in the sacrum (the bone at the base of the spine), which supports the weight of the upper body.

How to do it:

1. Your partner should be lying on his stomach, arms at his sides. His cheek should rest comfortably on the floor.
2. Positioning yourself at his side, place one hand on the base of the spine with your fingers pointing toward his head.
3. Place your second hand on top of the first, with your fingers pointing in the opposite direction.
4. Apply firm downward pressure; shift your weight from your left leg to your right and back again.
5. Repeat this movement.

How to Survive Chronic Pain

Don't obsess: If you're suffering from chronic pain, obsessing over it can magnify your discomfort and leave your spouse feeling powerless and annoyed. Letting your partner know when there are opportunities to help, and giving updates on your condition is perfectly acceptable, but avoid constant griping.

He's not an invalid: If your mate is suffering from chronic pain, it's easy to treat him like an invalid. Playing Florence Nightingale may appear harmless at first, but ultimately you'll grow to resent the role. At worst, this behavior can lead your partner to adopt an unhealthy dependence.

Be grateful: When you're in the grips of chronic pain, it can color every aspect of your life. Reminding yourself of the good things in life often requires a conscious effort. Try to remember how lucky you are to have someone in your life. Remind yourself that pain is transient and should not be allowed to affect who you are as individuals or as a couple.

Hit the sheets: When you're battling chronic pain, sex often falls by the wayside. But ignoring physical intimacy isn't in your best interest. There are few things as therapeutic as intercourse. According to Kirschner, "Sex mobilizes the spine and the endorphin release that accompanies orgasm is a natural pain reliever."