Feels like every facet of my life has fallen apart this year

Hey man,

I don't generally post on here but your story hit close to home and I thought I could offer some advice. Ended up in a similar situation earlier this year, and figured you might be able to glean some wisdom from my experiences and the many hoops I have had to jump through related to back pain over the years. I'll caveat the medical advice with the imperative that you should 100% see an orthopedic to confirm your disc injury, but in the meantime wanted to share some books and tips that hopefully can get you back on the mend.

When you said chronic pain, I'm not sure if you're referring to the disc injury or something else, but here are some solid tips/books that I've found over the years from dealing with disc injuries:

1. Stuart McGill's Big 3. McGill is a leading expert on biomechanics and is world renowned for his method on core strengthening and its positive effects on lumbar spine injuries. Check out his book or some YouTube tutorials for the exercises (bird dog, plank, and modified "curl up"). These have made a big difference in my own treatment of disc injuries, and I'd highly recommend for anyone with low back pain.

2. Robin McKenzie's "Treat Your Own Back." Give this book a read in addition to McGill's core strengthening routine. McKenzie's prone press-ups are some of the best exercises for treating a disc injury and is one of the primary movements that PTs will assign for a disc injury, especially for the associated sciatica symptoms that disc herniations often create. However, I'd suggest starting out just lying on your stomach for ~5 minutes at a time, and not immediately starting with the press-ups. Get confirmation from a physician that your disc herniation would respond positively to press-ups (or do a few press-ups, and if they hurt like a bitch, stop). Some people experience more pain when doing the press-up motion, meaning that it needs to be modified for the type of herniation you have, so go easy with these. 

3. John Sarno's "Healing Back Pain: The Mind Body Connection." This one is a bit more controversial and against the grain of conventional medicine, so tread lightly. I would start with the traditional approach first, but since you referred to chronic pain, I thought I'd throw this one in here as well. Sarno's theory is that back pain is predominantly psychosomatic; you experience pain as a result of repressed emotions, reinforced by behavioral responses to pain (I sit and feel pain, therefore every time I sit I will expect pain). Modern medicine has been slow to catch on to the connection between back pain and the mind, but there is increasing evidence suggesting that back pain is not solely the result of structural injuries. Howard Schubiner (one of Sarno's "disciples") gave a talk at Google a few years back that you may want to check out if this interests you. The talk is called "Unlearn your Pain - Schubiner" (tried to link but for some reason WSO isn't letting me). I'd suggest starting with conventional approaches first (PT, exercise, diet), but may be a good addition after ruling out other spinal injuries like fractures.

4. Avoid surgery if you can. When measured against conservative treatments like physical therapy and a tailored exercise program, surgery does not result in better clinical outcomes over the long term. Surgery might yield faster relief, but can be associated with an increased risk of herniating additional discs in the future. If you want more information on the outlook on surgery versus conservative care, flip through the first few pages of "Back in Control" by David Hanscom. He's a spine surgeon who gives a no bull shit assessment of the efficacy of surgery, and how it is generally unnecessary for disc related issues.

Out of all the suggestions I've given, definitely take this point with a grain of salt, and discuss with your physician if you can. There are certain herniations that can lead to issues like cauda equina, which is a medical emergency and requires surgery (loss of bowel control, numbness in extremities, etc., would be the warning signs for this). If it's a minor herniation and not deemed a threat to other bodily functions, then I'd say refer to the above and steer the fuck away from surgery.

5. Reduce systemic inflammation. I actually saw a post about this somewhere else on WSO, and thought I'd toss this in here as well. Try switching up your diet to include anti inflammatory foods (https://www.healthline.com/nutrition/13-anti-inflammatory-foods). Supplements like turmeric and fish oil are also good additions. In a pinch, try dosing with ibuprofen for the first two weeks to get pain down to a more tolerable level as you start rehabbing with McGill and McKenzie's approach. I had less success with this than the exercise programs, but some people swear by it.

Lastly, regarding the relationship stress, I just want to say that I feel you man. I ended up splitting with my girlfriend of ~4.5 years over the summer, and it just about killed me. There are threads on here and elsewhere that have a lot of great advice on this, but what I can say is that things will get better with time, though only if you actively partake in activities that help the healing process. The best thing you can do is proactively reach out to friends and family, and try to rebuild your social network outside of your relationship - I cannot emphasize this enough. I know you said you're working 100 hour weeks which can make it incredibly difficult to stay connected with the outside world, but try to set up a zoom call with buddies from college, high school, etc. at least once a week. This will improve your spirits and give you something to look forward to which is helpful for getting through the first few months. Improving your physical wellbeing with the exercises/tips above will hopefully give you some mental breathing space, and you can use that to get active again. Shoot for a 30-45 min brisk walk daily just to clear your mind. Walking/exercising in some capacity regularly also has shown to have huge benefits for reducing and even eliminating chronic pain, so definitely try to fit in the time for exercising. Also, journaling and cataloguing my daily thoughts at the end of the day was also hugely beneficial, especially for tracking progress and daily wins/losses. Definitely give this a try if you can carve out ~5 min for reflection before going to bed.

At the end of the day, if you need to take some time off to regroup to get your health and personal life back in order, by all means do so. Many people on this site will tell you that there's a one size fits all path for success, but sometimes shit happens along the way that you can't control. Either way, you're clearly a smart/motivated dude if you've made it this far, and I'm certain that you'll figure out how to manage your health issues and get back to business. Apply some of the intelligence that got you your banking job to addressing your health and personal issues, and you'll be golden.

This ended up being a bit longer than I intended, but hopefully you can find something useful in this. Feel free to PM me if you want to chat more about anything outlined above or life in general. Best of luck on your recovery, and looking forward to hearing the comeback story.

Link to study comparing surgical outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223716/

Comprehensive overview for chronic back pain treatments: https://www.vox.com/science-and-health/2017/8/4/15929484/chronic-back-p…