Surgery and drugs couldn't fix my 13 years of crippling back pain. But six months of physio did: Emma Forbes on her last-ditch remedy
21:00 GMT, 14 April 2012
21:01 GMT, 14 April 2012
Ever since the birth of her first child, Lily, 15 years ago, former Radio 2 presenter Emma Forbes has suffered back ache, although those two words barely do justice to the agony that has often left her bedbound, shedding tears of frustration, unable to walk or to rest, sleep or eat.
In her darkest moments, after surgery failed, she admits to wondering if she would ever know a life without pain.
Just like 80 per cent of pregnant women, Emma first suffered the condition during pregnancy.
Emma Forbes had 42 metal clips put into her spine to fix two slipped discs but was soon suffering again
Known as postpartum back pain – and dubbed ‘baby back’ – the problem is due to hormones such as relaxin being released to soften the joints and tendons, particularly in the pelvis and lower back, preparing the body for labour.
In one fifth of cases, this develops into chronic (long-term) back pain, and numbers are spiralling as a result of increasing obesity rates in women, say experts.
Although never overweight, Emma was one of the unlucky ones.
‘Before being pregnant, I’d never had back pain,’ she says.
‘It started in the base of my spine and travelled down one leg.
'Everyone I spoke to seemed to have a remedy – try Pilates, try yoga, see a chiropractor.
‘If I lay down flat, I could relieve the pain, but when I stood up it returned.
'It was worse when I was driving, or having to sit still or stand for any length of time. I thought it would disappear after I gave birth.’
Emma had a 38-hour labour with Lily and required an epidural.
‘I put on two-and-a-half stone in pregnancy, which is a lot for my size ten frame,’ she says.
‘Because I had an epidural, I couldn’t feel any pain, and I think I had extremely bad posture when I was giving birth.’
Hers was a classic case of baby back, according to orthopaedic specialist Dr John Outhwaite, of the Nuffield Orthopaedic Hospital.
He says: ‘It’s common in pregnant women, not simply because of the weight of the child, but also the fact that the mass inside the abdomen distorts the transverse abdominal muscle, which is the key muscle for switching on and off our core stability.
‘It is stretched and squashed in pregnancy and its movement and efficiency are disrupted when carrying a baby. If you have weak core muscles, you will get a bad back.’
Emma with Lily and Baby Sam. 'After his birth the pain became unbearable… I was told, to my horror, that I had two slipped discs,' she said
Key blood supply is also affected by pregnancy.
‘Metabolically, the baby is very active, and a huge percentage of a woman’s blood supply is diverted to feed the child.
'This creates a weakness in the back muscles because they are being starved of blood.
'A prolonged birth can cause acute injury to the soft tissue in the lower spine, causing chronic pain.’
Emma says: ‘I struggled on, trying cranial massage, a chiropractor, acupuncture and massage, but nothing worked.
'Then I became pregnant with Sam (now 13) and after his birth the pain became unbearable.’
The 46-year-old, who lives in London with banker husband Graham Clempson, 47, visited her GP, who referred her for a magnetic resonance imaging (MRI) scan showing the inside of the body.
‘I was told, to my horror, that I had two slipped discs,’ says Emma.
The spine is made up of 24 bones called vertebrae stacked on top of each other. Discs are the protective, circular pads of gel-filled cartilage that act as cushions between the vertebrae.
A slipped disc occurs when one ruptures and the gel inside leaks out.
The damaged disc can put pressure on the whole spinal cord or on a single nerve fibre.
This means a slipped disc can cause pain in the area of the protruding disc and in any part of the body that is controlled by the nerve the disc is pressing on.
In Emma’s case, the damage was in the lumber – or lower – spine.
The spine is made up of 24 bones called vertebrae stacked on top of each other. Discs are the protective, circular pads of gel-filled cartilage that act as cushions between the vertebrae
‘The surgeon said I could hope it would go away but the only real option was surgery. I knew this would be debilitating, that I’d be flat on my back for a while. I said, “I just don’t have time!” His expression said it all.
‘I soldiered on but a few weeks later, in 1999, I was being driven down the King’s Road in London with my sister Sarah and I said, “Stop the car.” The pain was so unbelievable I was in tears.
'I then knew I had to do something. I rang the Wellington Hospital in London and they rushed me in as an emergency patient and I had one-and-a-half hours of surgery.
‘When I came round I was euphoric – the pain had gone. I’d had 42 metal clips inserted in my spine, and I had to learn to walk again.’
Emma had a microdiscectomy, where the surgeon cuts away the bulging part of the disc via an inch-long incision in the back. This relieves the pressure on the nerves, alleviating pain.
After five days in hospital, most patients are allowed home.
However, recovery can take six weeks and some studies suggest that up to 25 per cent of patients will need further surgery for recurrent pain.
Emma’s initial recovery was a false dawn.
‘I carried on happily for a year – and then the pain came back with a vengeance.
'I was mortified. I felt I couldn’t go through it again. It was ruining my life.’
Emma struggled on until 2009, when a physiotherapist, David Bolton, was recommended to her by a friend.
Twice a week, for half-hour sessions, Emma's physio manipulated her back and legs with gentle movements (file picture)
‘He was a last gasp for me, because otherwise I could have been facing surgery again.
'Some people have this operation two or three times as the problem often recurs.
'By the time I went to see David, I was in so much pain I could barely walk into his consulting room – I shuffled in sideways.
‘His approach was calming and he taught me how to let go of the fear of my pain.
'I was walking around holding myself tensely upright, as if someone was about to punch me in the back.
'I was over-protecting myself, and making things worse.’
Twice a week, for half-hour sessions, he manipulated her back and legs with gentle movements.
Emma says: ‘He wasn’t pummelling me, rather gently moving me about, manipulating and rotating my spine.
‘Every day I had to do set exercises of twisting and stretching involving my spine, often lying down.
'Within six months, I was pain-free.’
Emma has now been without back pain for two years, and David’s treatment has allowed her to begin exercising gently.
‘I can’t play tennis but apart from that my life has improved immeasurably,’ she says.
‘Every morning I wake and realise with a jolt of happiness that I have no back pain.’
Emma sees David every two weeks for maintenance sessions – not cheap at 90 but, she says, well worth the price.
‘I know I will always have to take care of my back, as the damage has been done.
'At least now I have got rid of the awful grating pain that had been dominating my life.’
Dr Outhwaite agrees physiotherapy is one of the best forms of treatment because it mobilises the spine and is self-correcting, rather than drugs that can just mask the problem.
He says: ‘Operations are vital in some cases. What you should not do is try to ignore the pain and hope it will go away.
'If untreated, it will only become worse.’