When dealing with serious back pain, you have to realize that your condition is going to have an impact on everyone around you and that it will be toughest on the one you love.

I got an e-mail this morning and could not stand to go another day without telling you my thoughts. Believe me, this question is not unique. Please read the following e-mail, and then I'll give you my response:

Steve,

My husband recently had a severe flare-up caused by a herniated disc. He's had it for five years. Now it's in both sides of his body, from his back to his toes. He is using a scooter to get around. He cannot walk and is hunched over at the waist with severe pain. He is currently taking three meds: Motrin, Vicodin, and Flexeril. They help very little! He has been seen by his doctor, and he will have an MRI plus physical therapy. Can you help him?

What this poor lady must be going through

As you see, the e-mail starts with "My husband"-and that's the first problem. Why is this man's wife the one who's searching for a solution? When I said that a health problem is sometimes harder on the partner, I'm sure I was telling many of you something you already knew. Those who care for a person with a health problem go through the same fear, anger, and frustration-they just don't have the pain.

One reason is that when people have been suffering for a long time, they tend to give up. Or the system just wears them down. Unfortunately, the more depressed the person with the health problem gets, the harder the loved one must work to find the Holy Grail--that one miraculous thing that will help.

What usually happens is that the loved one learns to adapt to the changes and accepts that things will never get better. That's why success is so rare.

Knowing but not doing

The second sentence of the e-mail lets us know that this has been an issue in this couple's life for five years. The fourth sentence confirms that the husband has adapted to change and has allowed the system to accommodate his needs. The use of the scooter is a clear example of this. This man most likely did not just wake up one morning and discover that he could not walk. My bet is that this was a steady decline over a five-year period.

Do you think that if the husband had taken any initiative, he could have kept himself out of a scooter? I do. I've been in the health care profession for 16 years, and I have seen only a handful of back pain sufferers resort to a scooter for mobility.

In fact, the worst case I have ever seen was a 100-year-old woman who was bent in half from her rib cage. Her entire upper body was parallel to the floor, and she could not see more than three feet ahead of where she was walking. But she was walking. And she remained active until she died.

Have you heard me say, 'Don't just treat the symptoms'?

Again, it's my bet that when the pain first started, the husband was not on three different pain medications at the same time. Chances are, he went back to his physician and demanded more and stronger pain killers. News flash-medications don't help the condition get any better.

The worst part about suffering with a condition for so long is that the husband has come to believe that his condition is so bad now that the only one who can help him is a medical professional. He has turned a deaf ear to everything the wife might suggest, which may be causing harm to their relationship.

Help others by helping yourself

The truth is, there are a lot of people who could help him. But it's not going to happen until he first decides to help himself. Did his wife do anything wrong? No. Could she have done anything differently? Maybe, but it probably wouldn't have changed things.

It is also important to understand that it's natural for both parties to feel some frustration. The problem is that neither of them is trying to see things from the other's point of view. In these situations, it is critical to communicate your feelings to each other.

That's why I'm going to approach this from a different perspective-one that people inside the situation often find harder to see. If this advice means more coming from an outsider, that's great. You may want to print out this article and kindly hand it to your loved one. Even if you don't, be sure to at least ask them these two questions:

- Can you live the rest of your life expecting to get better?

- Are you willing do what it takes to get better?

Change your mind-change the outcome

The direct answer to this woman's e-mail is, "No, I can't help your husband because he hasn't taken responsibility for making improvements in his life." I would much rather have gotten an e-mail directly from him, telling me about all the things he has tried and celebrating even the smallest gains he was able to achieve through his efforts.

Both of them-and maybe even you and your loved one-will continue to struggle until they find that one trigger that motivates or inspires them. Exactly what it is or where it will come from I don't know. What I do know is that the sooner they start looking, the sooner they'll find it.

A different way to think

Regardless of the severity of your condition and the amount of progress you are making, it is up to you and you alone to find the inner strength to continue. You must abandon the "What can YOU do for ME" attitude. Try to think differently, keeping the following two principles in mind:

1) There's a difference between knowing and believing.It's really a difference of degree. Believing in something, say, being 100 percent free of back pain, is fine. But if you simply believe it will happen and then have a setback or flare-up, you'll find yourself doubting or questioning that belief on some level. On the other hand, knowing that you're going to get 100 percent relief will help you get through the inevitable ups and downs. So live knowing.

2) Live with expectancy.

You should go through each day confident that you are going to get better and stay healthy. It starts with your thoughts and the words you use. These will affect your actions. For example, if you haven't been able to do something you love for a very long time, tell yourself you're going to be doing it on a specific date in the future. Talk to everyone about it. Read books and watch videos about it. Fill your mind with the joy of it. Then begin to prepare for it. Dust off that fishing pole. Clean that bike. Go buy that new pair of running shoes and have them sitting where you can see them every day to remind you that you expect to run again.

Immediate steps to take

- Change the way you think and feel about your situation.

- Allow others to help you, even if they are not professionals.

- Do not give in or let the system beat you down.

- Recognize small gains as progress and hope that you are getting better.

- Treat both the symptoms and the cause of your condition.

Please don't let five years pass without taking responsibility for your recovery. If you are suffering now, you will only continue to suffer unless you educate yourself and take action.

Regardless of the answers you get to the two questions above, your partner will now understand the pain you've been feeling without your having to say it. Sometimes, being honest with each other is the most powerful demonstration of love. I don't mean to minimize your situation. It may be extremely difficult for this man to live his life, but as long as both of you live expectantly, you can never fail.

Lecture's over, as my dad would say

No matter how bad you problem is, there is a solution. So live knowing you will get better. Live expecting to get better. Live by taking action and not settling until you have achieved your goals...