Back Pain: Worse in Summer?

The pain is so intense that Jerry sleeps in his hot tub (in a sling, attached to a tree).

"Non salire o scendere durante la chiusura" (vinonthemove/flickr)

As a rule I try not to give medical advice to strangers over the Internet. One reader emailed me with a particularly interesting question and desperate situation, though. Someone out there may have insight, so I'm sharing it with his permission.

To protect his privacy, I've changed his name from Mark Billson to Jerry Handsome. (Kidding, neither is his name.)

Hi Dr. Jim,

My name is Jerry Handsome. I'm 33 and I run an auto repair shop in northwestern Minnesota. I'm emailing you because I have a health related question that I'm hoping you can answer for me.

For the past few summers (five, I believe), I've had a pretty consistent back problem that starts in June and ends in September. It begins as a short pang in the lower back and builds (around mid-July) to an excruciating bulging feeling from bottom to top as the summer progresses. I can't work, I can't sleep and the only respite I find is from the jets of my $6,000 hot tub that I purchased at the request of my neighbor/local physician. Once I leave the tub, though, the pain picks up where it left off and I'm back to square one again. This summer it's been so bad, I've actually slept inside of it, thanks to a sling fashioned out of ties that I attached to a tree near the deck which keeps my chin out of the water. If it wasn't for that, I'd be emailing you about what to do about chronic insomnia.

In any event, I've seen about fifty doctors, most of whom don't have an answer except to say that it's either exhaustion, a slipped disc, mental illness, or some combination of the three. I can't say I agree with their assessment given that it literally begins on the morning of the summer solstice and ends on the eve of the autumnal equinox, as if nothing had ever happened. It's on that night that I drink, and drink heavily, in celebration.

I'm wondering if you've heard of any sort of condition like this or anything remotely similar. No one that I've spoken to seems to have, but then again I don't exactly live in a densely populated place where this sort of thing might pop up more often.

I know you're probably thinking, well, you work in an auto repair shop, maybe that has something to do with it. Normally, I'd agree, given that there are heavy tools involved and lots of lifting, but summer is generally slower, and again, the way this thing starts and ends EVERY YEAR isn't exactly commonplace with the way back injuries manifest themselves. Hopefully you have some advice, or can point me in the direction of someone who does.

Love your work, and hope to hear from you,


Hi Jerry,

That sounds awful. The solstice/equinox part is the most strange to me. Some people do say weather exacerbates joint pains, but I wouldn't expect it to be so black and white. You're certain there aren't any other activities you might be doing during summer that bring out the pain? I know life in northern Minnesota can be very different in summer as compared to the rest of the year. I listen to Garrison Keillor. Also I was just up there and, anecdotally, I've never seen so many chiropractors.



Thanks so much for getting back to me. I would say it's a relief, but it isn't (yet)! Fortunately I only have a little less than three weeks before this just ends and I can enjoy my fall/winter/spring. I agree with you that the black and white, start and stop aspect of this is strange, but I don't have any more explanation for it than I suppose you do. Honest to God, it's like a light switch. I really can't pinpoint an activity or event that would set this off. As I said earlier, my springs and summers at work are actually easier! It would be wonderful if you could share it with your compatriots and commenters and see if any of them can dredge anything up, because I'm at a loss for what to do.


That's where we leave it for now. Comment or email me. I'll write about it if Jerry finds a way out of the tree-sling nightmare device, or if he patents it and makes a ton of money and uses that to buy a new, bionic body. Or if he drowns because the sling starts wearing out but he has to keep sleeping in his hot tub anyway because no one can fix his back. That would be on all of us.

I'd be especially interested to hear equinox theories, if passionately told. (I've written a very-little on old schools of thought about medicine and phases of the moon.)