Spotlight: Gifted by Ainsley St Claire

How do things fall apart so easily?

Kate:

As a former teacher, my mission is to keep the disadvantaged youth of our city engaged with school. My non-profit has been wildly successful with the kids, but now I'm forty mentors short for the Christmas season. It didn't look like we would be able to find enough help, until Jim Adelson got involved. He may have solved my mentor problem, but he's created another: I can't concentrate with this panty melting God around.

Jim:

The community has been good to me. I'd built my successful security business with hard work and determination, and when I got approached to help Kate Monroe's non-profit, it seemed a fitting way to give back. I'd offer to spend time with some kids, but it’s Kate that I find myself wanting to spend time with. With beauty obvious to everyone, and a compassionate heart she wears on her sleeve, she has me reevaluating my priorities.

When the children's Christmas gifts go missing, Jim and Kate are forced together in the hunt.

Can true love fight through the drama to find a happy ending?

Gifted is the first book in the holiday series Clear Security Holidays. This is a standalone holiday romance suspense novel, but characters from the Venture Capital series and from Tech Billionaires can be known to make appearances.

Excerpt

Kate

Forty kids won’t have a Christmas, and it’s all my fault. 

Over two hundred kids from middle schools across the city and county of San Francisco—from some of the most at-risk areas—met the requirements for our contest, and I’m forty donor/mentors short for our upcoming celebration. At two hundred dollars apiece, I don’t know what I’m going to do. How do I break a promise I made to these kids on the first day of school? Go to school for seventy-five days, don’t be absent, don’t be late, and get a passing grade. If you accomplish all that, you’ll get a two-hundred-dollar shopping spree at Bullseye.

Some people think “paying kids to go to school” is a bad thing. But we get paid to come to work, and some people play solitaire on their computers while they sit there. How is that not paying you for just showing up? In a lot of low-income areas—in San Francisco and elsewhere—over half of the students that complete middle school never walk into a high school, and less than ten percent of those who do will go on to graduate. Life isn’t easy for these kids, and going to school every day is not easy with so many distractions. But with some incentive, we see improvement. 

To make those incentives happen, I’ve got to figure out how I’m going to fund these last few students and find mentors to spend the day with them while they shop. I’ve tapped my network, and it’s pretty dry. But I can’t disappoint these kids; they’ve had enough disappointment in their lives.

I open the app to my bank account: three hundred dollars. I was going to use that money for my rent next month, and, you know, to feed myself. Right now, there’s no man in my life to make sure I get at least an occasional dinner. I check the account for my Visa card, and I can squeeze out maybe two thousand dollars to cover ten kids. But that still leaves me with thirty more, and still no mentors. Crap! What am I going to do? 

Tess walks into my office. “Isn’t this great? We’ve never had this many kids, ever! This could mean we have at least a hundred more kids graduate, and fifteen of those will go on to college, plus sixty more to trade schools. This is amazing. Are we going to be ready?”

I force a smile. “I hope so. We’re short a few donor/mentors.”

“In this town, people spend two hundred dollars on dinner without a second thought. We should be able to find a few that will support a good cause.”

“I hope so. I’ve reached out to our board members and asked them to check with their network.”

“How many donors are we short?”

“Forty. I can leverage my credit card for ten of those, but I’m not sure how we’re going to be able to make this work.”

“Kate, if anyone will get this figured out, it’s you. Last year we had barely one hundred kids complete this project. This year we have over two hundred. You need to celebrate that.”

“I will when I lock down the rest of the people we need.”

“Well, then don’t be shy. Bug those board members.”

“I will.” 

But that may not be enough. Somehow, I need to get to the big players in town.

“What about your new board member?” Tess asks.

“That’s Stephanie Paulson, and she does seem pretty well-connected. She must know a few people that can help us.” 

I’ve asked her about this a few times during our meetings, but I need to try again in writing. I don’t think my board members realize how tough it is to keep a nonprofit up and running in this city.

I craft a carefully worded email to remind Stephanie of our remaining need and looming deadline, trying to sound just the right amount of desperate. We’re only a five-year-old nonprofit, but we’re making a difference. I can feel it in my bones. However, if we can’t make this happen for all the kids who earned it, we may not recover. 

I send my message, and after just a few minutes, an email pops up.

To: Katherine Monroe

From: Stephanie Paulson

Subject: RE: Brighter Future Christmas Party

I’m sorry I keep forgetting. Thanks for the email reminder. I’ve forwarded your note to everyone in my contact list with your information. We should be able to come up with more than forty donors. We’re only asking them for $200 and a Saturday morning, for goodness sake! The party on Christmas Eve is a bonus! Let me know if you don’t hear from enough and I’ll rattle the cages, but at the very minimum, I’ll send over a check for $5,000 you can use for the party.

Keep up the good work. 

XOXO

Steph

Suddenly, I can take a deep breath again. This guarantees the needed money, and I’m on the road to having the volunteers as well. That’s probably the most important part. These kids need mentors, and spending the day with adults who’ve accomplished something means a lot. 

My phone interrupts my thoughts. “Kate Monroe,” I answer.

“Hello, Miss Monroe? This is Jamal Jenkins.”

“Hey, Jamal. How are you?”

“I’m doin’ real good. I just wanted to make sure you saw that my name was on the list again this year.”

“You better believe I saw your name. I’m very proud of you.”

“Jose made it, too. And we have four other friends who made it this year. Once they learned they could get two hundred dollars of stuff for just going to school, they were joining us.”

“I can’t wait to see you guys on Saturday when you pick out your gifts.”

“I’ve got a list,” he says proudly. “Is it okay if I bring my baby sister to the party on Christmas Eve?”

“Of course, and your grandmother, too.”

“Just make sure the Santa you get this year is a little more realistic.”

I laugh. Last year’s Santa was our CPA, and he’s tall and really skinny. “I’ll see what I can do.”

“Great. See you at Bullseye next Saturday.”

“I can’t wait.”

I worked as a teacher for five years, and it’s the hardest job there is. Not only are you responsible for educating the next generation, but many students have so much going on in their personal life that you end up being their mentor, friend, confidant, and sometimes parent as well. That’s exactly why I decided to start Brighter Future.

Chapter 2

Jim

Sitting behind my desk and doing mundane things like answering emails is my least favorite activity. I’d rather sit in the rain, soaked to the bone for eight hours, than sit behind a desk. 

Today I’ve got two hundred and sixty unopened emails. I know some of them are unopened because I know I don’t feel like looking at them, but others I should manage. 

Just not today. 

I need someone else to start handling these emails. Ever since we made the national news for helping bring down an international crime ring, we’ve had more inquiries than we can handle. I don’t have the bandwidth to keep expanding. My security firm has only been in business for about eight years, and I already have more clients than I know what to do with and a team spread throughout the US.

Scanning the emails, I delete the junk mail without opening it, but Stephanie Paulson’s email titled “Help” stops my scrolling. 

I click it open. She sits on a nonprofit board that’s looking for forty people to go shopping with a middle schooler next Saturday and cover a two-hundred-dollar shopping spree. 

Interesting concept.

Their goal is to keep kids in school. Thinking back to my own childhood, I remember how opportunities came to me. I was more trouble for my mom than she could handle. When I was seventeen, I landed in front of a judge and he gave me two options: jail for two years or join the Marine Corps. 

I didn’t expect to be in the Marines long, but once I got there, for the first time I felt like I belonged somewhere, and I loved the structure the service gave me. I ended up giving them two tours. During my last tour, my commanding officer was a Naval Academy grad. While in school he’d developed an app that moved artificial limbs to a new level where they could behave like actual limbs. 

When we reconnected a few years later, Nate had created a multimillion-dollar business, and his daughter had been kidnapped by some less-than-savory characters in a local Chinese gang. The police and FBI were overwhelmed, so he reached out to me as an intermediary and to provide some security. We got his daughter back, and that was the start of my security firm. After that, additional work began falling into my lap.

In short, I’ve always felt incredibly lucky. Sometimes it takes unexpected opportunities to change the path of a child.

There’s literature about the nonprofit attached to the message, and I open the director’s memo about her passion for kids and the importance of education. I can’t help but relate.

I peruse the Brighter Future website, looking it over carefully, and I do a background check on the director and founder to make sure everything is on the up and up. Katherine Monroe immediately piques my interest. There are some candid pictures of her on the website, and I open up her PeopleMover page to learn more about her. 

She has all her privacy settings on high, and that impresses me. Using my super-secret backdoor password, I’m still able to look at her account. She has pictures of travels and friends. Her status says she’s single—I’m not sure why, but that seems important. She has pictures at an Oakland A’s game. She must be a glutton for punishment if she likes the A’s. Also, she’s stunning—chocolate brown hair with deep auburn highlights, green eyes that I get lost in, and curves in all the right places. I find my pants are tighter than they were before I looked at her pictures, and I very much want to help her cause.

I have a very high-end clientele. I’m sure I can help her get forty donors. I know exactly what these small gestures mean. Usually, my clients are asking for something from me, but now maybe I can ask them for something. I start with one of my bigger clients, SHN, a successful venture capital firm. Mason Sullivan is the managing partner and has his hands in the pockets of some of Silicon Valley’s best companies.

Before the call even rings, Mason answers. “Hey, Jim. What’s up?”

“Mason, glad I caught you. I just sent you a message, and I wanted to make sure you saw it at the top of your list. One of my other clients, Stephanie Paulson, needs some help, and it seemed right up your alley.” I walk him through what I know. “I thought maybe you and Caroline wouldn’t mind getting involved, and maybe you could pull in Dillon and Emerson and a couple of the other partners to help out these kids.”

Mason is quiet for a few moments. “I think that‘s definitely something we can pull off. Shouldn’t be an issue at all.”

“That’s great news. You think all four of you would be willing to commit?”

“I will check everyone’s calendars, but there are nine partners and their significant others I should be able to drag along. I’ll commit to twenty donors. It’ll be good for us to do something for the city who hosts us.”

“I like it. Send me over a list of names, and I’ll pass it along.”

I hang up and call my old friend and former CO, Nate Lancaster. He’s working on his third successful startup and has more zeros in his bank account than Bill Gates. 

“My man Jim. How’s it hangin’?” he says as he answers.

“Hey, Nate. What’s going on?”

“You know, living the dream. Every day is a holiday.”

“Yeah, in your case that’s probably true.” 

“Hey, man, how did you know you were on my list to call today? Cecilia wants to know if you can stop by for dinner this weekend.”

“I will commit to dinner with you and the family if you’ll consider a favor for me.” I explain the nonprofit and their need. “Can you help me out?”

“Of course. So…can I tell Cecilia you’ll be bringing a date this weekend?”

I don’t have time to date. When I have an itch that needs scratching, I have a few women I can call, but nothing serious. Women aren’t patient with the lifestyle my job creates. I have to be flexible at all times. 

“No, it’ll be just me.”

“She wants to fix you up with one of her friends.” In a low voice he adds, “I know who she’s thinking of, and I like her, but don’t even consider it. Marnie is sweet, but high maintenance doesn’t even describe her adequately.”

“Well, you also know my work schedule. No woman is in for this lifestyle.”

“The right one will be.”

I need to change the subject. “Anyway, I emailed you the information. We need another ten people, so if you know of any others, please ask. Then send me a note with the names of who can come.”

“You need ten? I can probably come up with at least five—one will be Marnie.”

I groan internally. “You just said she was a train wreck.”

“I still think she’d enjoy this.”

“Great. Confirm and let me know.”

I check my email and find a message from Mason. He has twenty-six people from SHN and a few of their clients. Then I see an email from Nate pop up with the five he’s promised. That leaves us short just nine, and I know my team can cover that and then some.

To: Katherine Monroe

From Jim Adelson

Subject: Donors

Hi, Kate,
Stephanie Paulson emailed me about your need for 40 people to take some kids shopping. I’ve come up with a list of 42, just in case some flake out. And I know I can easily talk a few more people into participating, if needed. Let me know if you have any questions.

Jim 

Jim Adelson

CEO, Clear Security

I attach a list of names with emails and phone numbers. I’m actually looking forward to this. Now I just need to hope my Saturday doesn’t blow up and make my time with my award-winning student rushed in any way.

Grab Your Copy Today! 

About Ainsley St. Claire: 

Ainsley St Claire is a Romantic Suspense Author and Adventurer on a lifelong mission to craft sultry storylines and steamy love scenes that captivate her readers. To date, she is best known for her series Venture Capitalists.

An avid reader since the age of four, Ainsley’s love of books knew no genre. After reading, came her love of writing, fully immersing herself in the colorful, impassioned world of contemporary romance.

Ainsley’s passion immediately shifted to a vocation when during a night of terrible insomnia, her first book came to her. Ultimately, this is what inspired her to take that next big step. The moment she wrote her first story, the rest was history.

Currently, Ainsley is in the midst of writing a nine-book series called “Venture Capitalist.” 

When she isn’t being a bookworm or typing away her next story on her computer, Ainsley enjoys spending quality family time with her loved ones. She is happily married to her amazing soulmate and is a proud mother of two rambunctious boys. She is also a scotch aficionada and lover of good food (especially melt-in-your-mouth, velvety chocolate). Outside of books, family, and food, Ainsley is a professional sports spectator and an equally as terrible golfer and tennis player.

Connect with Ainsley: Website | Facebook | Twitter | Pinterest | Goodreads | Amazon 

Cover Reveal: Building Bridges by Lia Fairchild

Building Bridges
Lia Fairchild
(Bridges Brothers, #1)
Publication date: January 16th 2020
Genres: Adult, Contemporary, Romance

Former soldier Logan Bridges never imagined he would go from serving his country to helping raise a house full of children after a devastating family loss.

Dealing with his rowdy siblings and cousins proves to be almost as treacherous as the battlefields he left behind. And though he’s committed to making it work, he soon finds he’s in over his head.

Until someone from Logan’s past, steps in to help.

Mollie has always been independent, but finds herself growing attached to the family, and Logan, discovering there’s more to life than working and solitude.

Logan and Mollie quickly form a strong bond, and when attraction brings them closer, they agree getting involved wouldn’t be good for the children. But when they both struggle to keep the blurry line of friendship between them, Mollie won’t take that step unless Logan can open up and face his painful past.

Goodreads / Amazon / Barnes & Noble / iBooks / Kobo / Google Play


Author Bio:

Bestselling author Lia Fairchild writes romance and women's fiction. Fans of her books praise her endearing, real characters who overcome their flaws to become their own heroes.

Fairchild is addicted to the warmth of Southern California and holds a bachelor's degree in journalism and a multiple-subject teaching credential. She is a wife and mother of two teenagers.

Website / Goodreads / Facebook / Twitter / Instagram


XBTBanner1

Spotlight: Dangerous Game by L.P. Dover

Dangerous Game
L.P. Dover
(An Armed & Dangerous/Circle of Justice Crossover Novel, #1)
Publication date: November 18th 2019
Genres: Adult, Romance, Suspense

From New York Times and USA Today bestselling author L.P. Dover comes the crossover fans having been waiting for! Beloved characters from her Armed & Dangerous and Circle of Justice novels come together in this tantalizing new series!

For years, my family was on top.
Ruthless.
Respected.
Feared.

That all changed with the death of my father. As I moved into the position of power over the Corsino empire, enemies to the family tried to take over my city. They thought I would be weakened by my loss. They don’t know me.

My name is Dominic Corsino, and I have a ravenous appetite for money, power, and women. The last of which I pushed aside when Faith Hilliard, a close family friend, turned up in need of help. I’ve always wanted her, yet couldn’t bring myself to involve her in the dark savagery of my world. Now, she’s within my grasp once more. If I didn’t fear her running from my brutal truth, I would have already tasted her sweet temptation.

But the time for hesitation passes when a fighter in my underground ring is murdered. With my family name at stake, I can no longer hide who I am and what I’m capable of. It’s all coming down to a one winner-takes-all match. If I walk away with the prize, the threats against the Corsinos will be crushed. If I lose, our entire empire will crumble.

It’s a dangerous game … and I’m ready to play.

Goodreads / Amazon / Barnes & Noble / iBooks / Kobo / Google Play

EXCERPT:

The fight was almost done. Dominic’s fighter didn’t have a single drop of blood on him. All it took was a couple more punches and the Salvatore fighter was on the mat, his face a swollen, bloody mess.

Sam hooted and hollered in celebration, prodding me to celebrate with him. “Come on, Faith. Your team just won.”

If only I’d known I had a team. I stood with him and clapped along with everyone in the crowd. Marco handed out the stacks of money to those who made the right bets, and once that was done, he took the largest amount of cash over to Dominic and handed it over. I’d never seen that much money before.

“This seriously can’t be legal,” Sam said, gazing around in awe.

“That doesn’t bother you?” I countered. If he only knew the things I did.

Judging by the look on his face, it didn’t. “Not at all,” he said, shaking his head. He was starstruck. The room was filled with some of the richest people in New York City. With the right connections, his brewery could skyrocket. It was scary how money could blind you.

Tons of people walked up to Dominic to congratulate him and he met them all with a smile on his face. There were even a couple of women who tried to rub up on him and he moved away without giving them a second notice. Deep down it gave me a level of satisfaction to see that, but it still didn’t change the fact that he kept a huge secret from me.

“Why are you standing over here and not with Dominic?” Sam asked, nodding over at Dominic. I met his gaze and when I didn’t answer, he sucked in a breath. “Oh my God, you didn’t know about all of this, did you?”

I shook my head. “Dominic failed to mention it.”

His eyes widened. “What the hell? I’m so sorry. Do we need to go?”

“Probably. I don’t want him knowing I’m here.” A part of me wanted to go right up to Dominic so he’d know I was there, but the other wanted to test him, to see if he’d ever tell me the truth. However, it didn’t look like I’d get to do either of those things. You know how in the movies there would be a crowded room and the two lovers were destined to make eye contact? That was exactly what happened. Dominic found me from across the room and froze. My heart stopped and everything around me ceased to exist. There was no sound, only the pounding of my pulse in my ears.

Sam grabbed my arm. “Faith! What do we do?”

The spell had broken, and I sucked in a breath. By now, Reed had seen me and both him and Dominic tried to get through the crowd. It wasn’t the right time or place to confront him. I squeezed Sam’s arm. “You can stay here, but I have to go. Thank you for tonight.”

Turning on my heel, I hurried toward the door, but I didn’t get far before someone stepped in my way. “I should’ve known you’d find your way down here.”

Dominic and Reed still hadn’t managed to get through all the people, but I was running out of time. I looked up at Isaiah who had a smug grin on his face. “Yeah, well, I’m resourceful like that.” I tried to step past him, but he blocked me again. “Seriously, Isaiah, you need to get out of my way.”

He crossed his arms over his chest. “You’re not thinking of running off, are you?”

I wasn’t the type to run away from anything. I faced my problems head on. Huffing, I pursed my lips. “Actually, I want to go to my room. In a matter of minutes, Dominic will be pushing through that swarm of people,” I said, pointing at the mob behind me. “And when he does, I don’t want to be here. He can find me upstairs.”

Isaiah’s gaze narrowed, but then he nodded. “Okay. I’ll make sure you get up there.”

In other words, he probably didn’t believe me and had to make sure I didn’t try to run away. Instead of going to the door I came in, Isaiah led me to a red door at the far end of the room. Once we made it through, there was a long hallway and a set of elevators. Things were about to change. I could feel it.


Author Bio:

New York Times and USA Today bestselling author L. P. Dover is a southern belle living in North Carolina with her husband and two beautiful girls. Before she began her literary journey she worked in periodontics, enjoying the wonderment of dental surgeries.

She loves to write, but she also loves to play golf, go on mountain hikes and white-water rafting, and has a passion for singing. Her two youngest fans expect a concert each and every night before bedtime, usually Christmas carols.

Dover has written countless novels in several different genres, but her favorite to write is romantic suspense. However, she has found a new passion in romantic comedy, especially involving sexy golfers. Who knew the sport could be so dirty and fun to write about.

Website / Goodreads / Facebook / Twitter / Instagram


GIVEAWAY!
a Rafflecopter giveaway

XBTBanner1

Playlist for Stolen Princess by Nikki Jefford

Thank you to Deissy Rubi Hermunslie and Renee Jean for helping compile this list! And be sure to check out “Monster” by Pot & Kettle which was specially commissioned by the authors of The Monster Ball Anthology year one (which is where the Stolen Princess prequel novella originated).

Ingrid Michaelson – Pretty

Florence + the Machine – Sky Full Of Song

Jillian Jacqueline – God Bless This Mess

The Maine – Forever Halloween

Pot & Kettle – Monster

David Bowie – As the World Falls Down (Labyrinth)

Fantasia – Falling in Love

Evanescence – Sweet Sacrifice

Maggie Rogers – Give a Little

Lorde – Team

Taylor Swift – After Glow

Labrinth, Sia, & Diplo – LSD – No New Friends

Kygo – Firestone

Lady Gaga – Bad Romance

Evanescence – My Immortal

Miley Cyrus – Wrecking Ball

Katy Perry – Unconditionally

Cover Reveal: King of Hearts by R.H. Tucker

King of Hearts
R.H. Tucker
(Kings of Karmichael, #1)
Publication date: December 5th 2019
Genres: Romance, Young Adult

Derrik Tyler has it all. He’s a world-famous rock star with a legion of adoring fans and has obtained teen idol status. He even has a Hollywood starlet who wants nothing more than to be the only girl in his life. It’s a publicity stunt only his band knows about, but that’s not detracting her from trying to turn their fake relationship into a real one. Yep, he has it all. Except the girl who stole his heart before his life turned into a rock n’ roll rollercoaster.

Zoey Jacobs has been friends with Derrik and the Kings of Karmichael, since before they became the hottest band in the world. She even dated Derrik before he was known as the King of Hearts—the biggest teen heartthrob in the last decade. But that’s all in the past. She’s just a few short months away from graduating high school and moving on to college.

When spring break rolls around, Derrik invites Zoey along for the last leg of the band’s tour. What should be an amazing road trip turns into Derrik’s personal mission to win back his first love. But can two people from different worlds reignite a past relationship, or is a teen icon and a future college freshman too big of a gap to cross?

King of Hearts is the first book in the Kings of Karmichael series. The series is interconnected, but each book can be read as a standalone.

Add to Goodreads / Pre-order


Author Bio:

RH Tucker writes cute & edgy YA romance. He also lives in Southern California, consumes too much caffeine, eats too much pizza, and firmly believes Rocky Road is the best flavor of ice cream.

You can sign up for my newsletter for previews, excerpts, and short stories at:
https://www.subscribepage.com/rhtuckernewsletter

Website / Goodreads / Facebook / Twitter / Instagram


XBTBanner1

Spotlight: Ending Back Pain: 5 Powerful Steps to Diagnose, Understand, and Treat Your Ailing Back By Jack Stern, M.D., Ph.D.

A totally new paradigm for treating back pain
Virtually every American will suffer from back pain at some point. Dr. Jack Stern, a neurosurgeon and professor at N.Y. Medical College, brings relief to these millions of sufferers (including himself) who literally ache for help. Based on the latest scientific data, Dr. Stern developed a five-step approach with a multidisciplinary, holistic perspective that’s been missing from conventional back pain wisdom:

• Step One: Unlock your back's unique pain code, because everyone's back pain is different
• Step Two: Prepare to work with health care professionals, because in today's healthcare environment you need to advocate for yourself
• Step Three: Ensure proper diagnosis, because diagnosis is the key to proper treatment
• Step Four: Embrace various pathways to healing, because there may be more than one way to treat your pain
• Step Five: Live a life that supports a strong, healthy back, because you don't want your back pain to become a chronic problem
• Engagingly written and chock-full of enlightening case studies, Ending Back Pain finally shares the program that’s already helped more than 10,000 grateful patients.

Excerpt

Most feelings of discomfort in life have clear solutions. For a stuffy nose, decongestants do the trick. For a pounding headache, aspirin or Tylenol comes in handy. But what do you do about a relentlessly aching back? As most of us know, the answer is not nearly as clear-cut as we’d wish. And unlike infectious diseases that often have targeted remedies (think antibiotics for bacterial infections and vaccines for viruses), ailing backs are like misbehaving, obnoxious family members—we can’t easily get rid of them or “fix” them. They also have a tendency to stick around and bother us nonstop, lowering our quality of life considerably and indefinitely.

Perhaps nothing could be more frustrating than a sore or hurting back. It seems to throw off everything else in our body, and makes daily living downright miserable. With the lifetime prevalence approaching 100 percent, virtually all of us have been or will be affected by low back pain at some point. Luckily, most of us recover from a bout of back pain within a few weeks and don’t experience another episode. But for some of us, the back gives us chronic problems. As many as 40 percent of people have a recurrence of back pain within six months.

At any given time, an astounding 15 to 30 percent of adults are experiencing back pain, and up to 80 percent of sufferers eventually seek medical attention. Sedentary people between the ages of forty-five and sixty are affected most, although I should point out that for people younger than forty-five, lower back pain is the most common cause for limiting one’s activities. And here’s the most frustrating fact of all: A specific diagnosis is often elusive; in many cases it’s not possible to give a precise diagnosis, despite advanced imaging studies. In other words, we doctors cannot point to a specific place in your back’s anatomy and say something along the lines of, “That’s exactly where the problem is, and here’s how we’ll fix it.” This is why the field of back pain has shifted from one in which we look solely for biomechanical approaches to treatment to one where we have to consider patients’ attitudes and beliefs. We have to look at a dizzying array of factors, because back pain is best understood through multiple lenses, including biology, psychology, and even sociology.

The Challenge

So, why is back pain such a confounding problem? For one, it’s lumped into one giant category, even though it entails a constellation of potential culprits. You may have back pain stemming from a skiing accident, whereas your neighbor experiences back pain as the consequence of an osteoporotic fracture. Clearly, the two types of back pain are different, yet we call them “back pain” on both accounts, regardless. Back pain has an indeterminate range of possible causes, and therefore multiple solutions and treatment options. There is no one-size-fits-all answer to this malady. That is why diagnosing back pain, particularly persistent or recurrent pain, is so challenging for physicians.

Some people are able to describe the exact moment or series of moments when they incurred the damage to their back—a car accident, a slip and fall, a difficult pregnancy, a heavy-lifting job at work, a sports-related injury, a marathon, and so on. But for many, the moment isn’t so obvious, or what they think is causing them the back pain is far from accurate.

The Two Types of Back Pain

If you are going to experience back pain, you’d prefer to have the acute and temporary kind rather than the chronic and enigmatic kind. The former is typically caused by a musculoskeletal issue that resolves itself in due time. This would be like pulling a muscle in your back during a climb up a steep hill on your bicycle or sustaining an injury when you fall from the stepladder in the garage. You feel pain for a few weeks and then it’s silenced, hence the term self-limiting back pain. It strikes, you give it some time, it heals, and it’s gone.

The second type of back pain, though, is often worse, because it’s not easily attributed to a single event or accident. Often, either sufferers don’t know what precipitated the attack, or they remember some small thing as the cause, such as bending from the waist to lift an object instead of squatting down (i.e., lifting with the legs) or stepping off a curb too abruptly. It can start out of nowhere and nag you endlessly. It can build slowly over time but lack a clear beginning. Your doctor scratches his head, trying to diagnose the source of the problem, and as a result your treatment options aren’t always aligned with the root cause of the problem well enough to solve it forever. It should come as no surprise, then, that those with no definitive diagnosis reflect the most troubling cases for patients and doctors.

What Are the Chances?

Chances are good that you’ll experience back pain at some point in your life. Your lifetime risk is arguably close to 100 percent. And unfortunately, recurrence rates are appreciable. The chance of it recurring within one year of a first episode is estimated to be between 20 and 44 percent; within ten years, 80 percent of sufferers report back pain again. Lifetime recurrence is estimated to be 85 percent. Hence, the goal should be to alleviate symptoms and prevent future episodes.

Excerpted from Ending Back Pain: 5 Powerful Steps to Diagnose, Understand, and Treat Your Ailing Back. Copyright © by Jack Stern, M.D., Ph.D. Published by Avery. All rights reserved.

Buy on Amazon | Barnes and Noble

About the Author

Jack Stern, M.D., Ph.D., is the author of Ending Back Pain: 5 Powerful Steps to Diagnose, Understand, and Treat Your Ailing Back. He is a board-certified neurosurgeon specializing in spinal surgery, and cofounder of Spine Options, one of America’s first facilities committed to nonsurgical care of back and neck pain. Dr. Stern is on the clinical faculty at Weill Cornell Medical College and has published numerous peer- and non peer– reviewed medical articles. He lives and practices in White Plains, New York.