When pain makes you feel less of a man

After a decade of living with pain, Rushdy has put together a 10-week course to help others, especially men, deal with chronic lower back pain. — Photos: KARIM RUSHDY

It's tough being a man, especially when one has limitations carrying out physical tasks.

Karim Rushdy, 40, can tell you all about it.

A decade ago, his lower back pain was so severe that he was left bed/sofa-bound for most of his waking hours.

That was sheer torture for someone whose work involved travelling to remote places to facilitate leadership programmes.

In 2012, shortly after an experiential programme in Mongolia, Rushdy woke up not feeling right in his lower back.

He assumed the pain was just a muscle strain from jumping in and out of pick-up trucks.

He consulted a few doctors, but without doing any imaging tests, they all had different opinions.

Then he landed in a top spinal surgeon’s clinic in Hong Kong, where he was previously living.

Rushdy shares: “I don’t remember having any back issues until then, but I found out later that I must have had a traumatic injury when I was younger.

“The magnetic resonance imaging (MRI) showed I had acute lumbar spondylosis, which was compounded by a cracked vertebra from playing rugby during my schooldays.”

Lumbar spondylosis is age-related degeneration of the vertebrae and discs of the lower back.

He adds: “Because I hadn’t gotten the crack treated, one of the vertebra wing tips had doubled in thickness as the bone tried to heal itself, and this was causing some instability.

“The degenerating discs, bone spurs and nerve compression caused severe discomfort in my back and legs.

“The doctor’s hypothesis was that it was a congenital condition that had led to early spondylosis.”

Rushdy was only 30 then – too young to have the condition.

His world turned upside down and he spiralled into a deep abyss.

“My option was to operate to fuse the vertebrae together, but I would lose mobility.

“The doctor said he would perform the surgery immediately if I was 60, but at 30, he said I should avoid it and try to function as best as I could.

‘The other option was to insert two artificial discs, but the technology was pretty new then and not much success data was available.

“Interestingly, multiple research has shown that over a two-year period, spine surgery is less effective in pain reduction.

“I owe him a debt of gratitude for his advice,” says Rushdy.

He was sent home with strong painkillers, and for more than a year, he was physically, mentally and emotionally incapacitated.

The pain would come and go, and was often debilitating.

Thankfully, Rushdy’s empathetic employer allowed him to go home to lie down after a few hours at the office.

“It was a sad existence.

“I couldn’t go out and have dinner with friends, I couldn’t sit down for more than 15 minutes without having to stand up and walk around, and I couldn’t hike, swim or enjoy strolls with my wife, Rebecca Jo.

“Shortly after my diagnosis, Rebecca became pregnant, so in between flare-ups, some activity was possible!” he says, laughing.

When Rushdy’s daughter was born, he wasn’t allowed to hold her as Rebecca was worried he would get a flare-up.

“It was that bad and tough on me, because as a new father, all I wanted to do was to hold my baby.

“Also, since my job involved travelling to deliver programmes around the world, it made living in a small place like Hong Kong bearable.

“Then suddenly, I was stuck.

“I couldn’t travel and it felt claustrophobic.

“With my personal and professional life suffering the adverse impacts of these symptoms, and with no course of action or treatment proving effective, I lost hope.

“I was filled with fear of the future and was basically depress-ed,” he says.

The medications left nasty side effects, so after a while, he tossed them aside and decided to start on the path of non-surgical and non-pharmaceutical intervention.

An awakening

For 18 months, Rushdy tried different modalities of treatment to avoid surgery: physiotherapy, Chinese bone setting, osteopathy, chiropractic, Rolfing, energy work, traditional complementary medicine, inversion therapy, natural supplements, prescription muscle relaxants, opioids, etc.

Rushdy playing with one of his daughters in the park, an activity he enjoys when he is not in pain.

But nothing worked.

He explains: “What I was seeking was the elimination of pain, but now I know that healing is coming to terms with things as they are.

“We are conditioned at a very young age to get rid of pain quickly and to escape it, but the physical sensations are not the problem.”

Rushdy had almost exhausted all avenues when a colleague asked if he was familiar with using meditation for pain relief.

He wasn’t and the colleague introduced him to molecular biologist and author Jon Kabat-Zinn’s work.

Kabat-Zinn is widely considered the pioneer in applying the Buddhist concept of mindfulness to Western medicine and secular society.

In his programme called Mind-fulness-Based Stress Reduction (MBSR), Kabat-Zinn combines the fundamental principles of mindfulness – namely, moment-to-moment awareness – with meditative practices and brain science to alleviate the suffering caused by stress, anxiety and chronic pain.

Rushdy read Kabat-Zinn’s book, Full Catastrophe Living, which lifted his mood and literally saved his life.

“What he says resonated deeply with me, especially the way I related to pain.

“Since I had a lot of time on my back, I bought more of his books and listened to his audio tapes daily, and slowly, I started having one realisation after another,” he shares.

The pain was still there almost constantly, and the degeneration continued, albeit at a slower pace.

What changed entirely was the way Rushdy viewed and responded to it.

“I was no longer consumed by the pain, nor did I identify myself with my condition.

“The biggest insight I gained through observing the arising of these sensations, emotions and thoughts was the realisation that they are transient – not the truth of things – and that our response to them can be a conscious choice, rather than conditioned habit.

“I just have to live through each moment, and that was an awakening,” he says.

A new Rushdy was born.

He’d practise MBSR techniques and meditate lying down.

“After months of meditation, I was able to tap into the knowledge that I gained from the different practitioners I had consulted.

“So, I crafted my own bodywork routine – yoga, pilates, stretching, Rolfing, etc.

“My mobility returned after years of not working out, then I got into the pool to work on my cardiorespiratory conditioning and to create space within the vertebrae.

“Lots of people think meditation is inaccessible to them because they can’t sit cross-legged on the floor – it’s not about the position, but the attitude and intention,” he says.

Concurrently, he also started making lifestyle changes.

He reflects: “The irony is that I had this condition that negatively impacted my life, but I was probably more in tune with my body than before.

“I learnt so much in the process and I started to listen to my body, prioritising sleep and a healthy diet.

“I respected my limits.”

Much to his wife’s delight, Rushdy crawled out of the black mental pit he had been in.

Addressing toxic masculinity

One of the exercises Rushdy does to work on his mobility.

He still has flare-ups of pain, and sometimes, it can spark the old depressing thoughts again.

But Rusdy has found that meditation helps short-circuit his memory of the bad thoughts.

Like all dads, he wants to do things other dads do – put his two daughters on his lap, play games in the park, throw them around in the pool, etc.

He says: “Even now, with the last flare-up in December (2021), I couldn’t do those.

“The girls are very understanding and know their dad has this challenge now and then.

“I’m not a macho guy, but it’s more of having this toxic masculine conditioning, which is deep-rooted and goes back to our ancestors.

“Our strength lies in the core in more ways than one, literally and figuratively.

“And when you can’t get out of bed to pick up something or your wife is carrying the grocery bags ...

“I used to think people were looking at me and wondering why my petite Chinese wife is doing all the work and I was just walking.

“I was very self-conscious,” says Rushdy, who was born in Scotland to an Egyptian dad and Irish mum, but currently resides in Malaysia with his family.

One memory that sticks to his mind is one occasion when the family had landed in Heathrow Airport in the United Kingdom.

With only one child then, Rebecca had the boisterous toddler in a sling and refused to allow Rushdy to pull the bags off the carousel.

“I wanted to shrivel up and disappear because all these people around were looking at me.

“They didn’t know what my condition was, and all they see is a man and his wife.

“And there I am, making my wife carry the baby and bags!

“Rebecca is very protective of me and I struggle with that.

“With men, this is a very common occurrence and is not talked about enough.

“We just feel weak and useless,” he admits.

Looking back, Rushdy, who quit his job last year and is studying to become a mindfulness teacher, says: “It’s been a 10-year journey, but two years were languishing, the next two were getting back up, and the rest, rebuilding, tinkering and learning about inner work.”

Compiling his decade of experience in dealing with chronic pain, he has put together a 10-week course called Back to Being, to help others transform their relationship with chronic lower back pain.

While creating this course, the topic of conditioned masculinity and chronic pain came up repeatedly.

He says: “It is hard enough to overcome that conditioning on a good day.

“Add chronic pain into the mix and it becomes a whole magnitude harder.

“Chronic pain forces you to confront and rethink your masculinity.

“I believe the journey and insights would inspire men living with the spectre of lower back pain.

“Like me, they would have often asked themselves what kind of man is dependent on others and finds even the most basic activities of life a challenge.

“It’s time to redefine these outdated notions that asking for help is a sign of weakness.

“This, in turn, will help people to truly thrive and live out their full potential.”