Written by Patrick Massey, MD, PhD, Daily Herald Columnist. Back pain is one of those chronic medical problems is significantly impacted by lifestyle. Make sure that your lifestyle is conducive to a healthy back.
When I first began to practice nontraditional medicine, I chose to focus on the treatment of low back pain. It had been my experience, in the emergency room and occupational health, the traditional medicine did not address the issue of low back pain in a rational manner. Out of this came the ALT-MED physical therapy approach to low back pain. Over the past 15 years it has been very successful at relieving pain, increasing function and preventing surgery.
When I first started this program back surgery was very common, especially for herniated discs despite the evidence that more conservative therapies may have better short-term and long-term outcomes. I recently reviewed some of the literature on low back pain in surgery and was astounded. Despite improvements in diagnostic tests – especially significant improvements in MRI’s – the rate of surgical procedures for low back pain, especially spinal fusion, has actually increased significantly…over 500% since 1998!!
Why has this happened? Probably because it has become easier to do spinal fusion surgery. Years ago the medical research demonstrated that most back surgeries were unnecessary. In addition, medical research from the US and Europe showed that there is a little association between what is seen on an MRI and the physical findings on exam and even complaints of pain and numbness by the patient.
Robust medical research is shown that conservative therapies such as physical therapy, massage therapy and even acupuncture can help to reduce back pain even in patients with herniated discs and spinal stenosis. This suggests that many of the symptoms that comprise low back pain are related to soft tissue problems rather than the results found on the MRI.
A number of years ago, I published several medical articles demonstrating that even with severe herniation, surgery could be avoided with the right kind of physical therapy and other conservative approaches. Following up with these patients almost a decade later they remain pain-free.
- Massey PB, A Perlman. 1999. Lasting Resolution of Chronic Thoracic Neuritis Through A Martial Art-Based Physical Therapy Approach. Alternative Therapies in Medicine 5:104-105.
- Massey P.B., G.M. Kisling. 1999 A single case report of healing through specific martial therapy: Comparison of magnetic resonance imaging to clinical resolution in severe cervical stenosis. J Alternative and Complementary Medicine. Research on Paradigm, Practice and Policy 5:75-79.
- Massey P.B. 1998. Medicine and martial arts. A brief historical perspective. Alternat Compl Therapies 4: 438-444.
- Massey P.B., D.K. Massey, G.M. Kisling 1998. Martial art therapy for herniated discs and chronic pain Alternat Compl Ther 4:128-133.
There have been significant improvements in back surgery techniques. Unfortunately these improvements may also increase the number and risk of back surgeries performed per year. The rate of surgical techniques such as complex fusions is growing significantly faster than simple fusions or decompression. The complication rate for complex fusions as well as medical expense and mortality is significantly higher and carries an average cost of almost $100,000.
Most back pain does not require a surgical intervention, regardless of what is seen on an MRI. I believe the following simple recommendations are beneficial for long-term health. Of these recommendations, maintaining flexibility is probably most important.
- Maintain flexibility in all directions in the low back area.
- Maintain flexibility in the hamstrings and quadriceps muscles of the legs.
- Strengthening exercises for the legs, back and abdomen are absolute key to good health.
- Do a variety of different exercises on a weekly basis.
- Consider a diet that is low in meat and higher in a variety of fruits, vegetables, nuts and seeds.
- Stress reducing activities such as meditation, yoga, tai chi and even energy-based medical therapy.
- Massage and acupuncture may prevent low back pain.
Posted February 21, 2012.
