Are you so defeated and frustrated by your struggle with back pain that you’re beginning to think that surgery might be the only answer? If you’re worn out from months or years of back pain, a surgical option might be looking pretty good right now — except for the fact that your doctor may have told you that you’re “not a surgical candidate”.

So now you’re angry with your doctor because you’ve been told you there’s nothing more he/she can do for you.

Maybe you’ve contemplated finding another doctor who’ll consider doing surgery…but this may not be your best course of action. Here’s why:

Medical research is one resource that most spinal orthopedic and neurosurgeons consider heavily when making a decision about whether to perform surgery. And over the last 10 years, the research has pointed away from using surgery as a good solution for back pain.

Unfortunately, much of the research is conducted retrospectively — after the surgeries have been being performed for several years and the results are tabulated from patient experiences. This means that you are the guinea-pig!

Another study was recently published in the Journal of the American Medical Association showing that complex back surgeries for problems like arthritis (and if you’re over 35, you’ve probably got at least some arthritis), have increased dramatically over the last few years — and so have the risks.

You can read a summary of the study here.

Here’s what you need to know: the number of complex surgeries for back pain has gone up, and so has the rate of life threatening complications such as heart attack, stroke and pneumonia. AND - these surgeries are not getting results, despite the risks.

Why would a surgeon perform a high risk procedure for back pain, when there’s no research to indicate that it improves outcomes and there is research to show that there’s an increase in complications?

Well…there’s a big financial incentive to perform complex surgeries. And patients are often desperate enough to agree to any new procedure hoping that it’s the latest “magic bullet”.

But there is no magic bullet — it doesn’t exist. To recover from back pain, you need to embrace a holistic approach, and your path to healing will be unique.

So what are you supposed to do? First, get informed. Conditions like arthritis, which is very common by the way, respond best to non-invasive treatments such as an appropriate combination of gentle exercise, nutritional support, stress reduction and postural adjustments in everyday activities.

After 30+ years of treating people with back pain, I’ve found that the combination of Pilates and Franklin Method is by far the most effective way to relieve and heal back pain. You may have heard of Pilates, which has been around for almost a century, and emphasizes core strength, flexibility, balance and posture, but The Franklin Method is a relatively new addition to the mind-body scene.

In the next post, I’ll be sharing some videos with you that give you a sneak peek into this powerful combination for back pain relief. In the meantime, have a look at these videos that I made for my Pilates students — they’ll give you a little taste of how Pilates + Franklin Method = A Happier, Healthier YOU.

To Healing Your Back Pain,

Lindy

Filed under: Back Pain studies, Pilates, The Franklin Method, back pain, healing back pain by lindyroyer
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You’ve probably tried just about everything for your back pain…

…there are too many options, too many choices. Including remedies your relatives and friends tell you about. Some of these remedies might actually be helpful, like taking a bath in mineral salts, or avoiding night-shade vegetables to decrease inflammation.

And some are just plain woo-woo.

How are you supposed to sort through the huge amount of treatment and therapy options that are available, when there’s so much conflicting information?

You certainly don’t have the time or the money to try absolutely everything. And trying everything will probably make your back worse in the long run anyway.

So what are you supposed to do?

Well first, realize that you’re a unique individual — there’s not another like you. There never has been, and there never will be again. You are the sum total of your unique genetics, experiences, beliefs, thought patterns, education, family history etc. etc., and your healing journey is unique to you, and you alone.

There’s no one “back pain cure” recipe out there that’s specific for YOU.  Because YOU are unique.

There are, however, basic principles of healing that can guide your journey. Things like your nutrition, exercise and attitude have a direct affect on your health. If you’re putting crappy food into your body, your chances of healing your back pain are poor (just like putting bad gas in your car and expecting it to perform optimally); if you smoke, your back pain probably won’t resolve completely; if you think you can’t heal…you won’t.

Another principle is that your body responds to the movement and postural patterns that you’ve had for your lifetime. These patterns are often the cause of your back pain.

Any physical back pain program you do should incorporate your entire body — from feet to head, right to left, inside to outside.

If you’re working with a Physical Therapist, chiropractor, doctor, personal trainer, movement therapist, exercise physiologist, or any other practitioner who’s working with your physical structure, they should be working with your entire body — not just the parts that hurt.

In fact, the parts that hurt are just the symptoms…the real cause of your pain usually lies in your posture and movement patterns.

Here’s where Pilates can be very helpful, because Pilates addresses your whole body.

A P.T. friend of mine, Lise Stolze, is currently doing a research study on Pilates and low back pain. Her study was recently featured on the Denver local news >>> Pilates for low back pain study.

If watching this piece gets you fired up to try Pilates, you should know that there’s “Pilates”… and then there’s “Pilates for Rehabilitation”. Finding a highly trained Pilates practitioner can sometimes be like finding a needle in a haystack, especially if you live in a small community.

A good Pilates practitioner should have a comprehensive certification, and a minimum of 400 hours of education in Pilates specifically. They should also be educated in working with back pathologies and other diagnoses. Ideally, find a center where P.T.s and Pilates practitioners are working together.

And if your P.T. or instructor spends all their time focused on your back, without looking at the rest of you…run the other way!!

Leave me a comment about your experience with Pilates, or any other form of exercise — what are your frustrations about exercise and back pain? What tips or techniques do you want to know about?

I’m in the process of making a series of FREE videos, and I want to make sure you get the back pain information you need — so leave me a comment and I’ll get going on these right away. I’m here to help and support you.

To healing your back pain,

Lindy

Filed under: Back Pain studies, Pilates, back pain, healing back pain by lindyroyer
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Have you ever felt like you’re alone with your back pain? That your family and friends just don’t get it.

…and your doctor doesn’t get it either.

Despite the fact that billions of dollars are spent every year in the US and other countries on treating back pain, and billions are lost in productivity because of it, back pain still seems to be somewhat of a mystery.

There’s just no definitive solution to your back pain. Sure, there are plenty of choices in the form of drugs, surgery, pillows, beds, exercises, etc, etc. But there isn’t one simple thing that you can do that’s guaranteed to cure your back pain.

You’d think that we could figure out some kind of solution to back pain, since it’s been studied for so many years in most industrialized countries of the world. So is there anything we can learn from the more than 1200 back pain studies and trials that have been published?

One thing that’s been established as a result of all this research, is that recommended guidelines for treatment of have been implemented in many industrialized countries…but are doctors actually adhering to the recommendations based on the published evidence?

Keep in mind that low back pain is initially treated by general practice physicians, both in the US and many other countries. And often, after a visit to your doctor about your back pain, you feel like you’re on your own.

So, perhaps we could learn something from a recent Australian study published in the Archives of Internal Medicine that looks at whether low back pain is being treated by GP physicians in accordance with international best practice guidelines.

You might not be too surprised to learn that Aussie general practice docs are NOT treating “new” LBP patients as recommended. One of the recommendations is that imaging (X-rays, CT scans etc.) is not initially advised, and yet in 25% of the cases, imaging was ordered by the doctor. It’s been established in both the US and Australia that imaging is not necessary for first onset low back pain, unless there’s a “red flag” in the initial examination.

There’s also some inconsistency with the guidelines about drug prescriptions — even though analgesics such as acetaminophen (Tylenol) are advised, many docs prescribed more dangerous medications like anti-inflammatories (such as Advil or Motrin), or opioids.

This is all quite interesting, but the portion of the guidelines that’s being ignored THE MOST by doctors, is the recommendation that doctors should be giving their patients advice and education about exercise and lifestyle options. The study found that only about 20% of the patients were provided with any sort of advice or education by their doctor. No wonder you feel like you’re on your own after you visit your doctor for your low back pain.

I’ve got a few problems with this idea of your doctor giving you advice and education about your LBP (never mind the fact that it’s not being done anyway).

Here’s why this scenario doesn’t work:

1. Your doctor doesn’t have the time – 15-20 minutes isn’t long enough for you to get  any education about how to care for your back.
2. Your doctor doesn’t have the training to educate you about posture, body mechanics, exercise and to give you the information that will help you understand the relationship between your body and your spine. Several recent studies of medical schools in the US and Europe have pointed to the fact that doctors are inadequately trained to deal with musculoskeletal conditions such as low back pain…and they have NO training in developing an exercise prescription, or analyzing movement, posture or body mechanics.
3. Expectations of our doctors are that we’ll get a diagnosis (= an “answer”), a prescription for the medication that will “cure” us, and perhaps a referral (for more tests, to a specialist etc.). This is an unrealistic expectation — both from the doctor’s perspective and from the patient’s…no one can find and treat the root cause and then “cure” your back pain in a 15 minute visit.

What you really need is a way to get advice and education from an expert in low back pain exercises, body mechanics and lifestyle modification so that you can understand your own body and cure your back pain…

So where can you go?

Where can you get the education and training you need to cure your back pain, without relying on unsafe medications to mask the pain, or spending thousands of dollars on unnecessary tests that won’t get you any closer to pain relief?

Well…in the current environment, where general practice doctors are stressed for time, and inadequately trained to deal with low back pain conditions, it seems as though you’re on your own. You may get a referral to a physical therapist, but in the US, PTs are just as time-limited as your doctor, getting only a few minutes each visit to work with you one on one.

You might try a chiropractor, acupuncturist, massage therapist or other practitioner, but many of these practitioners have no training in movement analysis, exercise prescriptions or body mechanics.

But there’s good news! You’re not alone…there are options:

1. Find a Physical Therapist who is trained in both manual therapy (working with your body to improve your overall alignment) AND movement. Pilates, Feldenkrais and Franklin Method trained PTs are ideal.
2. Find a Pilates teacher who has comprehensive Pilates training
3. Find a Feldenkrais practitioner
4. Find a Franklin Method Teacher
5. OR…Sign up today for the MASTER Your Back Pain System - the most comprehensive low back pain program on the web. The 30 day MASTER system combines the latest in movement science research, nutritional advice, the “how to’s” of sitting, standing and sleeping without pain, as well as a step-by-step weekly program to keep you on track.

So even though your doctor may not be following the recommended research-based guidelines for treating your back pain, there’s no reason for you be alone. There’s support, advice and education available…you just have to know where to look.

You deserve to have a healthy back, so if you need more resources, or have questions about successfully relieving your back pain, please leave me a comment below.

To healing your back pain.

Filed under: Back Pain studies, back pain, healing back pain by lindyroyer
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A new study published this week in “Archives of Internal Medicine”, shows that acupuncture is effective for back pain relief. The study followed a random selection of 638 men and women with chronic back pain who had never received acupuncture. They were divided into 4 groups:

• One group received customized acupuncture treatment
• One group received standard acupuncture treatment considered to be effective for low back pain
• One group received “simulated” acupuncture where a toothpick was used on standard back pain acupuncture points but the skin was not penetrated by a needle
• One group continued doing whatever they’d been doing such as taking medication or doing physical therapy

All patients in the acupuncture groups received the same number of tretments over a 7 week period, and all patients in the study were assessed at 8 weeks, 6 months and 1 year.

All three groups who received acupuncture treatment reported “meaningful” improvement (60%) in their abilities to perform activities of daily living compared to the “usual care” group (39%). One year after treatment, 65% of the acupuncture group reported continued improvement compared to 50% of the “usual care” group.

There was no measurable difference between customized, standard, or “sham” acupuncture - all were more effective than “usual care”.

In reading the comments on this study that have been posted this week, it’s curious to note that most of the focus has been on the question “what is acupuncture, and what does it do?” If using toothpicks is the same as using needles, how does acupuncture work?

In commenting on the results of the study, Arya Nick Shamie, MD, associate professor of spine surgery at the University of California David Geffen School of Medicine and a spokesman for the American Academy of Orthopaedic Surgeons, stated that “this paper has confused the issue even further as to how acupuncture works.” He also stated that perhaps “toothpick” acupuncture had a placebo effect.

Perhaps there’s a placebo effect.

Or perhaps acupuncture points can be stimulated without penetrating the skin.

The bottom line is that acupuncture is a relatively safe treatment option and seems to be effective. Rather than asking the question “what does acupuncture do?”, or “how does acupuncture work?”, we need to look further.

I’d like to ask Dr. Shamie the following question, “What can you learn from this study that will change your own treatment approach?”

Rather than shining the light on acupuncture, I think there’s a bigger question here. The real question for me is, “what is back pain?” If acupuncture, a technique that doesn’t directly treat “the pain”, is so effective, what’s really going on with back pain?

With the billions of dollars that are spent annually on treating back pain, and the additional billions that are lost due to decreased productivity and poor quality of life, it’s curious to note that little attention has been paid to simple and low cost alternatives like acupuncture. Or to exploring why acupuncture works better than standard medical treatment. Why do we continue using standard medical treatment when studies such as this show it to be less effective?

Why is standard medicine still using dangerous, costly and ineffective treatments like drugs and surgery?

Whether or not a placebo effect is at work with  acupuncture, this study shows that back pain is not just about treating “the diagnosis”. Or even “the pain”. If finding a herniated disc, spinal stenosis or arthritis using our advanced imaging technology were the answer, we’d all be feeling 100% pain free.

But we’re not.

There’s something going on beyond the physical diagnosis.

Back pain is now occuring in huge numbers. This was not always the case. What’s happened in our modern society that’s exploded the back pain epidemic to the level that it is today? And why do we continue to pursue treatments that are less than 50% effective? Like surgery. Or “usual care”?

Did you know that there is now a diagnosis code for “Failed Back Surgery Syndrome”? That’s how common it is. And yet we consumers continue to accept the “standard of care”.

We’re seeing studies like the one mentioned in this post, where the best questions the experts can come up with are how and why acupuncture works. These are, of course, important questions, but…

Wouldn’t we be better served by asking “What are we missing in the usual care approach?”, or,  “If acupuncture works, why are we still prescribing drugs, basic exercise, and surgery?”, or, “How can we train our physicians to be more effective in their patient interactions and quality of treatment so that they address what’s going on beyond the diagnosis?”

I’ll start having more respect for the medical business when studies like this are pursued. Medicine needs to investigate all treatment options for back pain, and not just the ones that make the drug, surgical and insurance companies wealthy.

More questions need to be asked.

Filed under: Back Pain studies by lindyroyer
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