Causes of My Back Pain

I got in trouble with my back around 3 years back. I had persistent lower back pain, and then radiating back pain through my nerves to my limbs. It got so bad that I spent a week just in bed rest, and then, after a whole whirlwind of treatment options that included Ayurveda, physiotherapy, and medication, I recovered enough to return to work.

Since then, I’ve tried to examine all the factors around me that contribute to a better back, and this post is a distilling of my learning around mitigations. Note: this is just my personal experience, and none of this should be considered medical advice.

Body Stiffness

I think this was the root cause of my back pain, and what got diagnosed as mechanical back pain. In other words, I should have gotten off my ass more, and gotten more exercise. It’s general muscle stiffness that contributed the most to my sore back muscles. As you grow older, your body’s natural flexibility reduces, and you have to give it booster shots via regular stretching exercises or yoga to make sure you remain bendable. In particular for me, my leg muscles would become rigor mortis stiff at the end of the day, and that led to my back becoming strained as well.

The only thing that really help to avoid stiffness is regular exercise. During the initial stages of my recovery, I used to do regular a daily routine similar to the one in this video:

I continued those for upwards of 6 months until my stiffness and pain went away. Nowadays, I do maintenance exercises, which is mostly a combination of basic yoga Suryanamaskars & leg stretches.

One more thing: have enough water. The importance of water to improving your general muscle stiffness cannot be understated. A healthy adult should have about 4 liters of water a day. That’s four refills of your 1 liter bottle a day.

TLDR: The only real way to fix body stiffness is to incorporate some regular stretching and flexibility exercise into your day.

Weight Gain & Diet

The basic premise behind this category is simple: the more weight you have, the more your back will have to support. And especially if the weight you gain is in the form of fat around your tummy and your thighs, your back muscles will complain more.

Make sure you are within your ideal weight range. A decent thumb rule to find your upper limit is to subtract your body weight in cm by 100 to find your weight in kg. I’m 184cm tall, so my upper limit is somewhere around 84kg.

As you grow older, your metabolism is not as active as it was before, and what you used to inhale in your college days is no longer sustainable as a regular diet. The only way to keep your weight under control is to eat less. I’ve found that Intermittent fasting is the best way to do that. I’ve been doing a 16-8 fast for about 2 years now, and after around a month of adjustment, it became the norm for me. I’ve also experimented with keto in the past, and while I decided a strict keto diet is not for me, I have consciously reduced my carb intake. The other no-no (which I’m still working on) is to have less of everything that your parents will say is bad for you: sweets, fast food, desserts, oily food, and what seems like everything tasty.

TLDR: Eat less, keep your weight under control, and your back will complain less.

Posture

There’s a whole bunch of things I’ve clubbed under posture, but this is everything that’s got to do with how you sit, work, and even sleep. Posture is also easy to understand: make sure your body is not in positions that it was not designed to be for long periods of time, and your back will thank you. The troubling fact is, most of the work that a desk bound human does today are things that are absolutely 100% bad for the back. Human beings evolved as hunter gatherers, and while we’ve moved on to build a society where most of us do knowledge work, our backs are still catching up. So to be good to your back, behave more like the hunter gatherers of yore.

While Working

Do not sit for long periods of time. That’s the best advice for anybody who has got a bad back. Take frequent breaks. I try to take a ten minute break every hour or so. It’s also nice to be aware of an ergonomic work posture:

It’s also great if you get a good chair. Try to get one with adequate adjustments, and preferably with an arm rest. I currently use the Sayl, but there are several more affordable options around. Please try to think of the chair expense as an investment in a back though, since one of the causes of back discomfort may be a bad chair.

While Sleeping

You spend a third of your life sleeping, so it’s great if you do that well. Get a good mattress with adequate back support. Please-oh-please don’t spring for a spongy mattress that curves in. The height of fashion is a memory foam mattress and while I’ve never slept in one I’ve heard good things about them. Just like chairs, mattresses are an investment.

Another good trick to exercise your back is to invest in low-floor furniture: beds, dining tables, et. al. You get far more exercise just bending up and down through the day.

Lack of Strength

In particular, muscular strength, and well developed muscles that support your back. It’s particularly difficult to improve this while you have back pain because any sort of strenuous exercise might aggravate that pain, but it’s imperative that you work on recovering and improving strength once your pain goes away.

There are several full-body activities that naturally improve your strength. I’ve heard swimming is one, and sports like football or basketball are another although I’ve never tried any of this for any length of time. These activities are probably the best ones to attempt early on during your recovery, especially if you love one or more of these things.

The easiest and safest exercise anybody can do would be to go to a gym and selectively work on your strength. I know gym machines get a bad rep for being inflexible, but when you start after an injury, some structure is great for you. Besides, it’s easier for a coach to guide you along. Yeah, definitely do get a coach if you go to a gym after back pain.

Once you have some basic strength, proceed to free weights because the benefits in terms of overall structure and balance is definitely up there. I’ve currently settled on a Kettlebell routine to build my strength. Over the past year, I’ve steadily grown my kettlebell weight to 12kg, and my aim is to up it to around 16kg in the next couple of years. One thing that I’ve found is that it’s not the weight you lift that you should brag about if you care about your back, it’s your form. Here a couple of great videos about swings and cleans:

Good Mental Health

A lot of pain is psychosomatic. Your mind influences your body quite a bit: think droopy shoulders & sleepless nights or just continued persistent tiredness. What starts as a niggling pain in your shoulders or lower back will be aggravated if you don’t find time to take care of yourself. It gets worse if you spend a lot of your energy thinking about what’s troubling you. If you can’t function enough to keep an exercise routine or have healthy food, then your back troubles will only get worse.

There is no magic wand to wave here I’m afraid. I’ve personally gone through a very difficult period and in hindsight, my mental state definitely contributed to the breakdown of my back. The only way out is to take time out to recover. Time heals a lot of wounds, and alongside that, structured help in the form of therapy & counselling help a lot too. Feel free to hit me up if you need good therapist recommendations, I’ll be happy to refer you to good folks.


So that’s it folks! I know this was long, but the road to recovery after being diagnosed with back pain is long. It takes persistent effort to get out of your rut, and structural change in your life if you want long-term health. I hope everybody who suffers from back pain recovers because it’s one of the worst kinds of illnesses when you are relatively young: all the pleasures of life you take for granted (like biking or basketball for me), or even just moving about are taken away from you suddenly. But it is possible to recover, and live a better life.

I’m still on the road to recovery, but my back flareup has been a major positive life event: I’m now more conscious of my age, and how to live a healthier life.

Leading a team

I’ve recently switched to a new role at MobME, and here are my initial impressions and a few lessons learnt in the past few months. This is a rather free-flowing account, but I want to write this down and codify before I forget.

Rule uno: people aren’t resources. There’s a constant management-level question I hear: “How many resources can you allocate to a particular product?” or “How much time and resources do you need to solve this problem?”. I don’t answer such questions at all, or when I do, I talk about the people I have in my team and their skills and limitations. I’ve strongly felt that no organization can grow without taking care of its people, and especially for small startups, to make attrition low and happiness high, this is a concern that should be addressed from the top. Rephrase these questions this way: “Can person X solve this problem?” and “Can person X and Y be reallocated to this task?”.

Following on, every person is special: they have different skills, learning speeds and communication capabilities. Every good person can improve, and they should constantly be pushed to do that. Nobody should be idle and static.

And nobody should do make-work. It’s not necessary because there are always real problems to solve. If anybody is picking up a new language or skill, after a few tutorial-level sessions and a max of two days, he should jump into the new role and start fixing bugs and solving real problems.

Good processes make a good team. At MobME, I’m implementing a few things I learnt while working at Uzanto: Daily End-Of-Day reports for the team, SCRUM in the morning, and constant communication via a small office and approachable managers. The work atmosphere is relaxed, and people are given time to learn. There’s no fixed time for lunch or a quick smoke. There’s an attendance register and people are held accountable for their work and leave.

At the end of the day, Work is Everything™. If there’s a deadline to be met, do or die, we meet it. People remain late in the office (till 1 at night is the current MobME record) and finish work before they go.

What you do when you’re not in office is none of anybody else’s business. Although as a rule, work hard, party hard.

When you lead a technical team, if you have problems you use technology to solve them. This is obvious, but I’ve so often seen this overlooked. You can’t find a way for developers to collaborate? Find an effective source control method. Project management? Bug tracking? Time tracking? A caveat: too many tools is a mess. Find effective and simple ones. We use Beanstalk and Lighthouse along with Google Apps for documents and mail.

As a corollary to the above, not every problem is technical. Instead of inventing one, try simplifying the product or the spec or going back to the drawing board. If it’s too much of a hassle technically, it’s the product pushing back at you, resisting crappy things being done to it. Hear it out and redo things. Redoing things the right way is a good thing. Take time out, fix stuff and it won’t bite you in the ass the next time.

Another gem: keep internal mail to a minimum. When everybody is in the same office, shout out to him (or take him outside) instead of firing off a mail thread. It’ll solve problems so much more efficiently. Having the management & technical wing in nearby offices means that for us, most problems are solved in a week. No network cabling in office? A quick discussion with my operations lead and I get work done. No firing off complaint mails.

Communication is key. Let everybody know your worries. Everybody includes the people under you. A lot of the time, they’ll end up finding a better solution.

The primary role of a technical lead as I understand it is to get work done. It’s not to go off to conferences evangelizing the product (although it’s a good thing to do). Meet the deadlines your boss sets for you. Make sure your people work hard and they learn lots of stuff in the process. Keep an eye out for new technology. Document your processes. When you find problems, fix it and ensure it doesn’t happen again. Get good infrastructure. Communicate problems with the management.

Everybody in sales, marketing, etc. should know more than a little bit of tech. Increase technical awareness and make the process transparent so anybody can ask questions no matter how stupid it is. Often a completely new way of thinking about a problem brings in new technical insights too.

When there’s a problem, criticize. This is hard to do initially, but good people realize that your criticism is for the work and not the person. If they still have issues after you talk it out, ask them politely to leave or toe the line. When you find people improving and processes becoming smoother after you’ve talked it out with the team, it’s a real nice feeling.

And at the end of the day, make people happy and be happy yourself. Which of the lot, is the hardest.

Chak De India

Chak De India

I watched Chak De India yesterday and found the movie disturbing. I’d rather India had lost at the end but still come home to accolades for playing well. Focusing on victory as the singular goal seems to be so wrong. I also thought the movie took a rather unsubtle dig at the media’s reaction to loss and its treatment of a muslim player. [The movie itself was mediocre with Sharukh’s overacting and tripe dialogues; however surprisingly broad: everything from cricket’s unequaled popularity to sexual undertones between the coach and players].

SimpleDB

What’s missing from Amazon’s suite of web services? Two things: SimpleDB which provides database-like persistence and SimpleBalancer, which load balances “services” on multiple EC2 clusters. While it’s possible to emulate both using S3 and EC2 right now, it’s hard to do, and feels really clumsy. When Amazon does engineer these things, expect Google to take a peek in as well. Oh, we live in interesting times.

Hyperwriting

One element of good writing for the independent web[1] which is often overlooked is that your writing is part of a larger story which is not under your control. This is to an extent true for all writing which doesn’t stand alone: an article is part of a magazine just as much as a recipe is part of a cookery book. And like all such writing, it’s perceived as part of a larger whole.

What’s special about the online jungle is that you can’t even assume constant assumptions on the part of the reader. For example, NYT articles are democratic, CNN.com has propganda [;-)], and Fark.com is (adult) funny. If you write your articles in one of these media, and if you keep your average reader in mind (you’d do this is you want effective writing, which is what all this is about) then you’d tailor your articles to suit expectations. But in the larger miasma of the web, how do you decide what and how to read expectations? The web is connected, and the spiders that visit your frayed hideyhole might come on from thousands of different places, and there’s no guarantee of any continuity.

One simple answer is that you create your own universe and let your reader be immersed into it. People buy this oh very quickly. The hypothesis is that every page is special, and a click-through from an adult site is as likely to be impressed as one from a search engine.

As an aside, one technique which is underutilized to propogate this mass-hypnosis is clever linking. Hypertext is alive because it can send your user to other pages. Even though Google has perverted the medium with commercialization, people do like to click on links. Use that fact! Lead them on. Make a story within a story (it’s much better than enclosing an aside in parentheses), or even make them read a worthier one. You get to choose.

Getting back, is there a different way? Creating your universe is oh-very-well, but can you match zillions of varied expectations? A good way is to try to reduce it to a few common ones. A lot of sites use a technique where visitors coming in from a search engine get their words highlighted on the site automagically. Let’s say you come here searching for “porn king” (god forbid). To help you out, my site will highlight all instances of that term in your landing page. Is this good for the visitor? Undoubtedly. Does it match your interests, does it tell your story more effectively? Maybe. In this example, very much not, but it’s still a very user-friendly thing to do.

You probably can cook up a different version of a page for a user that comes in from:

  • a social networking site
  • your girlfriend’s site.
  • a mobile browser (device dependent).
  • a competitor’s website, etc.

Condensed, what I’m talking about is that referrals and clever referral management to rewrite your content could pay dividends. True?

[1] Blogs, pages, documentation, stuff which floats.