Chapter One: Sleep to Dream
Amer is one of my closest friends. We share an exceedingly similar sense of humor, an affinity for portmanteaus, many physical mannerisms, and pain in our middle and lower backs.
Despite all the time we spend together, few conversations of ours take a serious turn. I was somewhat surprised to learn about his chronic pain; I had complained to him many times about my own, and he had to endure my many requests to switch study spots if the chair I was sitting in had bad lumbar support. It was only after I mentioned having spoken to another friend about his chronic pain that Amer first mentioned his own.
“It's particularly bad when I'm standing for too long or after I wake up from a long sleep,” he said. “I would say it started probably when I was around 14 or 15, and it has lasted until today.”
When I asked if the pain onset suddenly or after a catalyzing event, he talked about attending a series of sleepaway camps with disparate bed configurations. Some mattresses were too soft; others too thin; all wrong in their own ways.
“It started only when I was sleeping in places outside of my own bed,” he said. “I thought it was originally something like, maybe it's just the wrong kind of mattress. But nowadays, a couple of years later, even when I sleep in my own bed at home, I'll still wake up with that exact same kind of back pain.”
Amer’s primary care provider was pretty confident that his symptoms were emblematic of muscle tension. But being able to put a name to the root cause provided little by way of relief, nor options for medical treatment.
“My PCP said it was muscle tension, and there's only so much you can do about that. So if that's the case, and she seems pretty confident, then I didn't see the point in going to a specialist, if they would just tell me the same thing, and there's still going to be not as much to do about it.”
Besides some basic stretches and physical therapy exercises, his doctor also advised him to switch up his mattress and pillow specs, which he tried to no avail.
“I've probably tried every combination of pillow and mattress, and I'm not sure it's made much of a difference, so I've resolved to thinking that maybe I will just deal with it because it's not too obstructive.”
In some ways, our experiences with pain in the exact same area were perfect mirrors of one another. I feel the most relief when laying in my hyper-specific bedding configuration; being at rest is what triggered the pain for him, actively hindering his ability to feel rested.
“I can't get more than six or seven hours of sleep at a time.”
Besides sleep, standing or running for long periods of time are also particularly hard for him; for me, getting up and walking around is crucial for avoiding sitting-induced pain. Running is the only exercise where I do not have to make modifications to accommodate my back.
Without a clear path for treatment or enhanced symptom management, Amer said, he has long accepted that his pain is just something he will have to live with.
“Unfortunately, it’s kind of gotten worse over the years. I know that many older adults struggle with back pain. I think that there are available remedies, which I'm thankful for, but I would have to imagine that as I grow older, I expect my sleep quality to get worse, and I expect the back pain to probably become a little bit more of a problem,” he noted. “I fully expect it to persist.”