Back Pain? Check Your Hormones


I’ve been back from the Himalayas for 2 weeks now. My respiratory system seems to be settling back into the norm. I’m also feeling a little more energetic as the time zone impact (11 Hours +) has faded.

My issue, however, is pain. This week, I attempted to “get back in the saddle” literally, on my bike. Things were going well. I was settled into a hill repeat session and was on climb number 5 when I felt a slight twinge in my back. I have not historically had back problems, however, this was the third time THIS YEAR that I’ve felt an impact from exercise on my back. I continued the climb (I mean, what are the options when you’re halfway up a hill on a bike?) and pulled over at the top to wait for my friend and also assess the back situation. While moving from bike to standing position, I felt a sharp electrical shock; it was immediate L5, right side back pain, the kind that doesn’t allow one to stand straight up. It was a familiar feeling, as I had this same “twitch” about 3 months ago.

Fortunately, I could get into a bending position, so was able to ride home, but getting off the bike and standing was near impossible. Once home, I fell to the ground on my driveway and laid there for 20 minutes. Being that I live on an extremely busy street in downtown Austin, I’m sure I was quite a sight for the passersby.

Once I regained the ability to crawl and then stand, I threw myself into research on what is going on in my body. What I haven’t mentioned are the other injuries and pains I’ve had this past year: a right shin stress fracture, several issues with my right foot this year (years of plantar fasciitis), and of course the incessant hamstring and glute tears that have brought me to near tears.

So……….WTH? I mean – come on – I’ve completed full and half Ironman events, climbed multiple 14-19k mountains on both bikes and on foot, have finished an ultra-marathon, and much more. Why in God’s name is the pain so bad NOW?

Doctors have continually used the “age excuse” on me. One doctor had the nerve to say “well I’m sorry you’re so healthy” implying I should just be happy with my healthfulness and not complain about my pain. I was pissed. And I certainly don’t buy the age excuse. The reason I don’t is the speed at which my “issues” have all come on….within 6-12 months. This is not years in the making.

I have found it comes down to the “h” word. Not hell, but close……….hormones. NIH research validates the fact that, yes, as we age and lose hormones – specifically estrogen and testosterone – we lose the effectiveness of the connective tissue. Connective tissue, as a refresher, is the tissue that binds, supports, and provides structure to the body. Cartilage is one such example of connective tissue. Think knee pain……..and yes, it can be impacted by a reduction in testosterone.

The structure, strength, and stiffness of connective tissue are all impacted by deprivation of sex hormones, which in turn leads to less protection on nerves, joints, ligaments, and tendons.

So the good news is that now we know the possible culprit of pain.

What can we do?

There are two good, immediate options:

Institute a solid stretch, strength, and cardio program. All three elements are essential for improvement. Stretching helps elongate and improve elasticity which can help reduce injury. Strength programs are critical as strengthening muscles around the tissue takes the pressure off the tissue to hold everything in place. Cardio is important as it aids in the circulation of essential nutrients to keep tissues healthy.
Consider bio-available hormone replacement. Research shows that estrogen and testosterone replacement both help reverse negative impacts on connective tissue and reduce joint and connective tissue pain. Testosterone is an anabolic hormone. Its characteristics are well known as a hormone that promotes repair and growth of soft tissue, including muscle and cartilage growth. Male or female, if one has a low testosterone level, then he/she will likely experience more difficulty healing.[1] The same is true of estrogen. NIH research shows that taking hormone replacement can reverse and regenerate healthy connective tissue, including in the intervertebral disc space (um…that’s me and my back!!! Is it you too?)
So the question becomes to dose or not to dose.
There are certainly other issues with taking hormone replacements. I have been down this path already once and was not pleased with the process. In retrospect, I was put on a plan that overallocated each of 3 hormones and added 2 other drugs to my intake.

This time, as I consider taking replacements, I will move much more cautiously and ensure that any dose I take is minimal at first until my body feels ready for more.

I encourage anyone finding new, needling pain in multiple spots, to consider seeing a doctor for hormone testing. Of course, there are always other options for the cause, but now, there’s just one more thing you can consider ?

[1] Journal of Sexual Medicine, 2014

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