ONE DAY ABOUT four years ago I noticed a pain in my back. Sometimes sharp, most times dull, it was pervasive and insistent, lodged deep as an internal organ. It must have crept in before I registered it, because once I did I couldn’t remember not having it. Back pain is like that: It becomes part of you, like the thickness around one’s jawline as one ages, or that thing you did that you regret. If you’ve had it, you know that some days it hurts when you move like that, and some days it hurts when you move, and some days it hurts. If you haven’t, you don’t know what I’m talking about. You don’t know how lucky you are.

My primary care doctor asked a few questions, rapped on my spine, made me touch my toes. She smiled sympathetically. “Here’s a physical therapist I like,” she said, scribbling on a pad. “Your insurance will pay for a few massages, or acupuncture if you’d rather. Or both. Or a chiropractor!”

What, no kitchen sink? I thought, suddenly pissy. No shaman? “But what’s wrong with me?” I demanded.

The doc sat down and took off her glasses. “I must see four, five patients like you a month. Nonspecific back pain. No injury. We don’t know what’s wrong with you. What you do is try this, then try that. And expect success. Because really—why expect failure?” I stared at her. “I’d start with physical therapy,” she offered, opening the door for me. “And let me know.”

I called the physical therapist that afternoon, wincing as I bent for the phone book, trying to expect success but wishing I had a slightly firmer grasp on why I should. Over the next few months that wish intensified, as I pulled on stretchy bands and perched on rubber balls, laboring to heed my spry physical therapist by strengthening my core. “But…the pain is on the right,” I pointed out. “This really doesn’t feel like a core issue.”

“It’s all a core issue!” he sang. “Have you tried yoga?”

One by one I ticked off the fixes; one by one they failed to fix me. It wasn’t all for naught—from the chiropractor I learned never to cross my legs while sitting, and that by the way I had scoliosis and should really see him for weekly adjustments. An acupuncturist cleared up a sinus thing like magic, while a massage therapist taught me that even the most severe back pain will temporarily dim against the screaming torture that is deep-tissue massage.

But countless Aleves, dozens of office chair positions, three lumbar support structures, and about 30,000 core-strengthening Kegels later, I had to concede that on the trial and error scorecard, error was winning. I was done messing around. Time for an orthopedist.

He slid me into an MRI tube and showed me the pictures. “I suppose this might be an injury,” he said vaguely, pointing to a place on the field of gray that looked ever-so-slightly grayer. “We-ell…I did fall on the ice a couple years ago…could that be it?” I ventured. “Must be,” he shrugged, virtually oozing medical certainty, and put me down for a cortisone shot. “Now, you never know with this stuff—might work days, could work years,” he said as the needle toured the interior of my flesh. What I got was two perfect weeks.

When the pain came back, I was standing in the kitchen with my friend George, a kindred sufferer from way back. I felt the familiar stab as I stooped to unload the dishwasher, and immediately he saw it on my face. “Your back again, isn’t it,” he said. I burst into tears.