Posted: June 7, 2005

Sportsmedicine: Traditional Treatments for Back Pain...

Which Ones Work and Which Ones Don’t?

When Dorothy followed the yellow brick road, she was told to do so by those who wanted her to get where she wanted go. As humans we often blindly follow recommendations by individuals who have good intentions, but may not always be our best option. So I'm preparing this article to compare and contrast what are known as traditional treatments vs. complementary or alternative treatments for back pain.

Remember there is rarely only one reason for your back pain and almost never one silver bullet fix... you may need to try several approaches to find what works for you.

When reading this article and thinking back on your visits to medical professionals, did you have the big picture or were you just following that yellow brick road? If you have been down that road, or if you are just starting to suffer from back pain it's never too late to seek out new and more encompassing information about your condition when trying to find a solution that works for you.

Don't say you've tried everything because you haven't... your solution is out there and you just have to find it!

Orthopedic Care

One of the first places many people go when they experience back pain is the orthopedic specialist (surgeon) and a visit usually last 5-10 minutes. They will typically look at the problem/symptomatic area and often fail to look at the body as a whole. If you've been to an orthopedic specialist for your back pain, did they do a full body physical evaluation (takes 30 mins. or more)? Not likely.

Here are some of the common treatments used / prescribed by orthopedic specialists:

• Cortisone Shots
  Cortisone is a catabolic steroid that is intended to reduce inflammation by killing off the tissue in the inflamed area... now let me ask you, does that make any sense to you at all?

  Not only are these injections quite painful, but they rarely result in any pain relief and if they do it is short lived, usually 1-2 weeks if at all. Plus, it does NOTHING to identify or address the cause of the pain... it is only intended to treat the symptom. It's for those reasons that we do not recommend them.

• Anti-inflammatory Medications
  Just the name should scare you away... just like cortisone shots, anti-inflammatory medications do not identify or address the cause of your pain and for many people, they deliver little pain relief. These medications also deliver serious side effects! The main reason they are prescribed is money... and if you don't believe me, do the research and you'll see for yourself. The drug industry is huge and unfortunately, they have a huge influence on the whole medical community, including the doctors.

  I challenge you to find a drug that will fix your back problem... you'll be looking forever because there is no way a medication can fix a physical problem, so avoid medications at all costs!

• Back Surgery
  Surgery for back pain is very common and more often than not, the individual still has pain afterwards (or it returns within weeks) and sometimes even new problems! Very rarely is surgery the answer.

  For example, many people have surgery for herniated discs. The logic behind the surgery is if you remove the piece, or portion, of the disc that is putting pressure on the nerve the problem is solved. Unfortunately, the same forces that forced that disc to protrude or bulge will likely force more of the disc out, or another disc out.

  Surgery should always be the last resort... and even then I'd question it!

Physical Therapy
Physical Therapy is traditionally the next step after seeing an Orthopedic Doctor. That is if surgery is not recommended. So what should you expect? The process will start with an evaluation and here may be the start of the problem... here is why.... the doctor has to write a prescription with a diagnosis on it. You give the prescription to the PT and he or she will perform an evaluation... chances are the PT will simply confirm the diagnosis from the doctor, however the hope should be that they take the extra step to look for the root cause of your pain. They may but chances are they have several other clients in the office at the same time and simply do not have the time.

So without a comprehensive evaluation to identify the root cause of your pain they will simply treat your symptoms. We have just identified the second problem. The health care industry is required to show improvement with each and every session so the push is to reduce your symptoms to show progress in order for them to get paid. The long and short of it is that yes your pain can be reduced but the root cause rarely gets addressed, meaning that the pain and your suffering will return again and again.

So what should you do? When selecting a Physical Therapy office you may want to ask how many patients the office sees in a day and how many PT's they have on staff... then ask how many patients can a PT work with in an hour. Do not be surprised to hear that a PT can see up to three patients in an hour. That's you and two others at the same time. Do you think you will get the attention and proper treatments you need? I doubt it.

There is a little joke in Physical Therapy when treating patients and it has to do with what course of modalities you will get. The joke is called Shake and Bake and it refers to everyone gets the same treatment protocol... that way it can be timed so that your PT can see other people simultaneously. What goes into a shake and bake treatment? It may start with a spin on a stationary bike or a trot a treadmill, then you will get a 3 to 5 minute Ultrasound over the effected area, followed by Electrical Stimulation to the area with a little Ice strapped to your body and to finish off your session you will get a hand out with exercises you should do at home. Certainly not a recipe for success!

Chiropractic Care
One of the most common treatments for back pain is Chiropractic Care. The approach consists of physical manipulations of bones and joints in an attempt to line things back up and it's recommended typically 2-3 times per week.

The problem with this approach is that the same forces (muscles, tendons, and ligaments) will likely pull the bones and joints right back out of place again. Also, most (not all) chiropractors will spend 15 minutes with you if your lucky.

Ask people who see a chiropractor how long they've been going... I hear of people who have been going for 10-15 years and still don't have a healthy back. Look, the fact is chiropractic care is lacking... Unless the chiropractor combines the two approaches, it doesn't make sense.

The ONLY way chiropractic care makes sense is if you are addressing the muscle imbalances that are pulling the bones and joints out of place to begin with and that requires strengthening and stretching exercises that are chosen specifically to correct your muscle imbalances.

Massage Therapy
Massage therapy, if done correctly can work wonders for people with back pain. This is not to say that it is the best choice and that it will work for everyone... however, most people will get great results from it if the massage therapist has a good understanding of muscle imbalances and how to work on them.

NOTE: Not all massage therapists are the same! Just like any profession, there are varying degrees of training and qualifications. When selecting a massage therapist please check to see if they are licensed and insured in the state where you will be seeing them. You should also ask the massage therapist if they have training in one of the following areas: Orthopedic massage, Medical massage, St. Johns technique and/or has a comprehensive knowledge of muscle imbalances relating to back pain. With that said the benefits are as follows. The root cause will be identified, your discomfort will be addressed and the root cause will be corrected all in an attempt to make you pain free and give you the tools you need to keep you that way.

What can you expect when you see a massage therapist? All massage sessions are one on one allowing you the opportunity to converse with the therapist as well as get the attention you need to get results. You can ask questions about how you compare to other people. Feel free to ask the therapist what approach they will be taking so that you know what to expect. The massage therapist has many different techniques they can use when to dealing with your back pain and some are better than others. On the down side sometimes a therapist can get distracted with other problem areas, it is in your best interest to keep them focused on you back and associated problem areas. Like anything else you may need to try several different therapists before finding the one that works best for you and with you.

Post-rehabilitation Fitness Training

Another overlooked form of treatment that is very effective is post-rehabilitation fitness training. This includes targeted strength and flexibility work to correct and improve the individuals muscle imbalances. This service can only be performed by certified post-rehab fitness trainers and there are limitations to what they can do for you. For example, they can not diagnose a condition, prescribe any medications, take x-rays, etc. However, if they are well trained they can pinpoint your muscle imbalances quickly and get you started on a fitness program that will restore balance to your body and likely eliminate your back pain.

Often times this can be combined with massage therapy and/or manual physical therapy for a total solution. If you decide to go this route, which I recommend you do, be sure to thoroughly check out the fitness trainer and ask to see their certification, insurance, references, etc.

Manual Physical (muscle) Therapy

1. 
   Manual Physical Therapy is NOT the same as regular physical therapy... there are some major differences and here are just a few:

2. Manual therapy consists of hands on muscle work primarily whereas traditional physical therapy consists of heat, ice, ultrasound, electrical stimulation, etc

3. Manual therapist will typically perform a much more thorough physical evaluation

4. Manual therapists will usually be able to spend more time with each patient

5. Manual therapy is more holistic in it's approach and focuses the body as a whole unit... something lacking from nearly all traditional treatments for back pain

So before you say, "I've already tried physical therapy"... did you try manual physical therapy? They are two very different treatment approaches and I highly recommend you consider manual physical therapy.

Conclusion
As you can see traditional treatments are the main stay of modern medicine... not necessarily for the patients benefit, but it's just how the system works best for itself. The system will not change until the system is confronted with a very powerful competitive force. That force may well be complementary or alternative care from the likes of Personal Trainers, Massage Therapists, Manual Physical Therapists, and the like.

So that's what we've tried to do... force change. The traditional treatments that people have been receiving for decades just don't work, and we have found a combination approach that not only works the best, but it's safe, natural, and inexpensive. Check out our "Lose the Back Pain" video now! It will show you how to identify the cause of your back pain and show you the exact combination of steps to take to eliminate it.

If you have tried other treatments with little or no relief/improvement, you owe it to yourself to try this approach... so take charge of your health and get started now working towards not only a pain free back, but a healthy and balanced body! Only you can fix your back... all you need is the right approach!

Article by Brad Walker. Brad is a leading stretching and sports injury consultant with over 15 years experience in the health and fitness industry. For more articles on the prevention & treatment of sports injury, subscribe to The Stretching & Sports Injury Newsletter by visiting www.thestretchinghandbook.com