The trouble with back pain
Eighty percent of people will suffer from low back pain at one point in the life. Many people with chronic pain go from physician to physician, therapist to therapist, chiropractor to chiropractor looking for relief. In reality, our medical model does not serve the back pain community well. The anatomical theories around back pain just don’t work.
Here’s what happens with a typical person. Let’s call him Joe. Joe starts to notice back pain. Like most people, Joe ignores it for a while. Maybe he goes for a massage or to a chiropractor for a relief because: no one likes going to the doctor. Eventually, though, the pain becomes too severe and he goes. A good doctor, unless suspecting something pathological such as cancer or rheumatoid arthritis, sends Joe to physical therapy. A less informed doctor gives a corticosteroid or does an MRI. Physical therapy will work for some, but if the physical therapist has not been trained in Hamer’s classification system, they may treat using the wrong techniques. So Joe goes back to the MD who now gives the corticosteroid and does an MRI.
What do MRIs tell us?
MRIs don’t correlate well with back pain. Recent studies have shown that people who have no back pain also have degenerative disks, osteophytes, and annular tears. So when Joe gets that MRI that shows disc degeneration and osteophytes, his doctor tells him there is nothing he can do. His spine will always be this way. Joe starts to believe his pain will never stop. This belief plays a large role in his pain.
So what do I do?
In reality, people can get rid of their back pain. Physicians and physical therapists have just used the wrong models. Instead of looking at anatomical structures, they need to look at pain patterns. The research has shown this method reduces pain most effectively. If the pain comes from the back, Joe will receive one of six pain patterns: degeneration, dysfunction, combination, stenosis, instability, or pelvic pain. From there, Joe should be instructed on the movement patterns that he should use.
A complete therapy session must include myofascial release. Until you do this, the fascial system will pull the muscle fibers and spine back out of alignment. Myofascial release can help by releasing restrictions that compress nerves, muscles, and ligaments around your back and spine, affecting your posture and compressing on your body. The beauty of myofascial release is that it does not require an understanding in order for it to work. Through the client and the therapist feeling what happens in the body, full healing can occur. It also empowers the client to heal themselves, instead of relying on an expert to “fix” them. Most of a therapy session should focus on myofascial release. By using a whole body approach, the root cause of your pain can be addressed.
What exercises should I do?
Finally, the research shows that stability exercises reduce the return of low back pain better than other treatments. This does involve both the therapist and the client participation. The four muscles, diaphragm, pelvic floor, transverse abdominis, and multifidus, address core stability. Most therapists have only learned to stabilize the transverse abdominis. All four muscles need to activate in order to provide stability. In addition, the strength of each vertebral muscles needs assessment and strengthening. Again, most therapists do not have this training. Using the above modalities, Joe can finally rid himself of back pain.