The proper treatment of spinal problems requires clinical knowledge and understanding which can only be gained after studying the vertebral column and conducting treatment over many years. I have been practising since 1969 and I specialise in dealing only with difficult and chronic cases of back pain that have not responded to osteopathic or chiropractic treatment.
Exercises and Back Care
(consult your doctor before doing any exercises)
There are a few basic tips that I would like to pass on at this point which are generally applicable to all cases of back pain:
(i) Don't buy those ridiculous products that purport to stretch your back, turn you upside down, or which apply traction; appliances such as rollers which apply muscular pressure won't cure you, but at least they won't cause you any harm.
(ii) All exercises for the back should be carried out while lying down.
(iii) Contrary to popular wisdom, don't sit up straight but rather lean back in your chair at an angle with support (without slouching)
(iv) When lifting objects, bend your knees and keep your back straight and chin up, even if it looks comical. This will lock the vertebrae in your back to prevent them from moving and will reduce the risk of strain.
(v) It is essential to keep the stomach muscles in trim to reduce pressure on the back, as the spine is mainly supported by muscles at the front and rear of the trunk. If the front stomach muscles are weak (as in a 'pot-belly'), even the best treatment in the world may not prevent a recurrence of spinal problems.
As for that dreaded word 'exercises', the temptation is naturally to reduce movement in the hope of avoiding pain, but if it is possible, try stretching like a cat every morning before getting out of bed. Arch your back gently up and down while on all-fours, particularly to elongate the back muscles while pulling your stomach in and stretch yourself in the way that Muslims pray. And while you're on your hands and knees, why not gently move your trunk left and right? This will help to keep the spine flexible.
One useful movement you can do on the floor, or while still lying in bed, is to lie on your side with legs slightly bent and rotate or gently 'rock' your trunk back and forth to apply a twisting motion to your spine. You don't need to take your head off the pillow. The rocking motion doesn't need to be to Olympic standards, just gently and slightly rock your trunk back and forth (without jerking, but rather in the way a baby's cradle is rocked) and feel your spine loosening and stretching while your legs remain to one side. You can turn over onto your other side to repeat the 'exercise' and you can bend your legs further in stages by bringing them up closer to your chest (while lying on your side) to benefit the upper part of the spine. As for keeping your stomach muscles in trim (which is essential), simply lie on your back and bring your knees up with your legs bent towards your stomach and hold them or move them a little to tighten your stomach.
Try these simple movements (exercises!) regularly to see the results. It may save you from having to visit us for treatment if your back condition is from a minor cause. And of course, these movements can be supplemented by using our Back-Rack, which we provide to all our patients.
For more protracted spinal problems, the success of any treatment depends on an accurate diagnosis being made of the patient's condition. This is where experience is crucial. Too often one hears of horror stories where the poor patient has been bashed about by a practitioner who is really groping in the dark. "Clunk-click-every-trip" is not the way to treat back problems.
Mobilisation of the spine however is a safe and gentle way of freeing trapped nerves and realigning vertebrae and discs that have become misaligned. Joints are normally moved when the body itself moves ('active mobility'), but joints can also be subjected to 'passive mobility' as in mobilisation, when the joints are moved by another person. The procedure takes many years to learn and is the correct method for freeing or re-aligning stiff joints. The patient cannot move his own joints any more than he can jump over his own knees, and that is why the service of a practitioner skilled in mobilisation is essential.
The branch of orthopaedic medicine that deals exclusively with the spine is known by the name of Maitland-Cyriax and text books written by these two professors are available in most medical reference libraries for those who wish to learn more about the spine.
The proper approach regarding treatment for most spinal conditions is to mobilise the affected joints to free them from constriction, and to increase the elasticity of those soft tissues which may be pressing on spinal nerves. When this is achieved after only a few sessions (or as many as 14-20 for really chronic and difficult cases), the patient will feel a significant improvement and the cause of the symptoms will be cured. The initial treatment however can produce soreness and discomfort, but this soon subsides when the vertebrae are able to move more freely and the whole spine becomes less stiff. Specific floor exercises are given to prevent any recurrence of the problem and the patient is able to get on with their life with their spine (and wallet) intact and their quality of life restored.
It is worth remembering that the spine is a completely mechanical yet wonderful structure of bone, muscle and tissue and the best way of treating back problems is therefore achieved using physical methods. If one thoroughly understands the mechanics of the spine, there should be no need to resort to surgery to remove or modify something that Nature has provided for a particular purpose.
I am not an advocate for spinal surgery except where the spine has suffered a traumatic injury which is life-threatening or which requires an immediate operation. There are 300,000 back operations performed in the USA every year, but I have yet to find in my 45 years of clinical experience just one person who can honestly say that their condition has improved as a result of surgery. There is nothing worse than operating on a person when better treatment methods are available, and when spinal surgery itself has such a track record of failures.
Drugs and pain-killers
Most people probably appreciate that pharmaceutical drugs as prescribed by a doctor or which are available over the counter may reduce pain but they will never be able to treat back problems when they are due to mechanical causes. Only physical treatment can safely free a trapped nerve - there simply isn't a drug on the market which can achieve that, and there never will be one available. Epidural injections only serve to anaesthetise nerves for a while and Cortisone (which is highly toxic and should not be administered more than twice per year) and other anti-inflammatory injections do not treat the causes of any spinal conditions.