Why Most Back Pain Treatments Fail
specialists stand ready to serve you. Medical doctors,
orthopedic surgeons, chiropractors, physical therapists,
acupuncturists, and massage therapists. For some back-pain
sufferers, these professionals may prove helpful, but for a
surprisingly high number of others, specialists only ease
pain—or maybe eliminate it temporarily—without solving
the underlying causes of that pain.
Some people, no matter what specialist they go to, or even
if they use a combination of two or more, have recurring pain.
In the meantime they may suffer unnecessarily, through
multiple surgeries, injections, and prescription drug use
(which can increase stress on the body), to say nothing of the
drain on a bank account and the strain placed on the spirit.
So, why do people keep going to these professionals if
they’re not helping? Probably because the treatments help a
little. They can ease pain, loosen tight muscles, and even right
a postural dysfunction—for a short time.
Let’s review the most common professionals whom backpain
sufferers turn to for help—and the limitations of each of
their approaches.
Professional #1: The Medical Doctor
Medical doctors are great at treating trauma and
emergencies. If you are in a serious car accident, medical
doctors are likely going to be your best chance for survival.
However, the same professionals who have impressive track
records for treating trauma have comparatively poor success
rates at resolving everyday aches and pains.
In a trauma, the cause of the problem is very obvious. If
you’re in a car accident and end up with a broken leg, it’s
clear what caused the problem. It’s clear what’s “broken” with
your body. And it’s equally clear to doctors what they need to
do to fix you.
But with everyday aches and pains, it’s not always so easy
to determine the cause. Often there are multiple contributing
factors. But medical doctors—who are trained to look for “the
problem”—by their very nature zoom in and focus on the
back. Consequently, they’ll ask you what you were doing
before you “threw out” your back.
Once you answer that question, the doctor thinks he’s
found the problem. He tells you to be more careful next time
(i.e., don’t bend from the waist, which is horrible advice by
the way), drugs you up until the pain goes away, and believes
the problem has been solved.
Medical doctors aren’t trained to examine the three areas
of body, mind, and diet. Even if they were, they wouldn’t
have the time. A thorough examination of every aspect of
your life overall—and your body, mind, and diet,
specifically—takes much longer than the typical 8-to-15-
minute doctor visit.
When I assess a back-pain sufferer, it always takes me one
to two hours (or longer) to do a thorough job. I’m looking at
posture; examining muscle strength of various muscle pairs;
testing range of motion and flexibility; and observing how a
person walks, stands, leans over, tilts, sits, and more. I’m
Medical doctors are great at treating trauma and
emergencies. If you are in a serious car accident, medical
doctors are likely going to be your best chance for survival.
However, the same professionals who have impressive track
records for treating trauma have comparatively poor success
rates at resolving everyday aches and pains.
In a trauma, the cause of the problem is very obvious. If
you’re in a car accident and end up with a broken leg, it’s
clear what caused the problem. It’s clear what’s “broken” with
your body. And it’s equally clear to doctors what they need to
do to fix you.
But with everyday aches and pains, it’s not always so easy
to determine the cause. Often there are multiple contributing
factors. But medical doctors—who are trained to look for “the
problem”—by their very nature zoom in and focus on the
back. Consequently, they’ll ask you what you were doing
before you “threw out” your back.
Once you answer that question, the doctor thinks he’s
found the problem. He tells you to be more careful next time
(i.e., don’t bend from the waist, which is horrible advice by
the way), drugs you up until the pain goes away, and believes
the problem has been solved.
Medical doctors aren’t trained to examine the three areas
of body, mind, and diet. Even if they were, they wouldn’t
have the time. A thorough examination of every aspect of
your life overall—and your body, mind, and diet,
specifically—takes much longer than the typical 8-to-15-
minute doctor visit.
When I assess a back-pain sufferer, it always takes me one
to two hours (or longer) to do a thorough job. I’m looking at
posture; examining muscle strength of various muscle pairs;
testing range of motion and flexibility; and observing how a
person walks, stands, leans over, tilts, sits, and more. I’m
trying to understand the overall context of what’s going on in
the person’s life. Is he going through a job change? Did he
just get married or divorced? Did he just move?
I’m also looking to understand his dietary habits—what
does he eat or drink, how often, and why? How does his diet
fit into his overall life? How is everything connected?
The Typical Back-Pain Doctor’s Visit
If you have back pain, most likely the doctor is going to
zoom in on the back as the problem. He’s not going to look
at your posture, your feet, your knees, or your hips. He
probably won’t ask about your diet or the stress in your life.
Most likely he won’t take a blood test to examine the levels of
nutrients in your system, hormone imbalances, or the like. He
doesn’t have time or he doesn’t know to even look in these
places. If the problem is in your back, he’ll look at your back,
make an assessment, maybe send you for X-rays, and come up
with a solution. And that solution will, the majority of the
time, be a drug or a referral to a specialist. It’s what he’s been
trained to do.
This tunnel vision means that the doctor figures your
problem is pain, inflammation, or nerve pressure or
damage—or some combination of these—and that he,
therefore, must fix these problems. Prescribing antiinflammatory
drugs is often the first thing he’ll do. The
inflammation must be controlled. He’s right about that—we
want to reduce the inflammation—but the problem is that
drug-based anti-inflammatories are often hard on the body,
and though they may mask the problem temporarily by
providing pain relief, they don’t offer a long-term solution.
Popular recommendations include over-the-counter
options such as Advil, Motrin, and Nuprin, and prescription
brands such as Celebrex and Vioxx (although the latter was
withdrawn from the market because of increased risk of heartattack and stroke).
the person’s life. Is he going through a job change? Did he
just get married or divorced? Did he just move?
I’m also looking to understand his dietary habits—what
does he eat or drink, how often, and why? How does his diet
fit into his overall life? How is everything connected?
The Typical Back-Pain Doctor’s Visit
If you have back pain, most likely the doctor is going to
zoom in on the back as the problem. He’s not going to look
at your posture, your feet, your knees, or your hips. He
probably won’t ask about your diet or the stress in your life.
Most likely he won’t take a blood test to examine the levels of
nutrients in your system, hormone imbalances, or the like. He
doesn’t have time or he doesn’t know to even look in these
places. If the problem is in your back, he’ll look at your back,
make an assessment, maybe send you for X-rays, and come up
with a solution. And that solution will, the majority of the
time, be a drug or a referral to a specialist. It’s what he’s been
trained to do.
This tunnel vision means that the doctor figures your
problem is pain, inflammation, or nerve pressure or
damage—or some combination of these—and that he,
therefore, must fix these problems. Prescribing antiinflammatory
drugs is often the first thing he’ll do. The
inflammation must be controlled. He’s right about that—we
want to reduce the inflammation—but the problem is that
drug-based anti-inflammatories are often hard on the body,
and though they may mask the problem temporarily by
providing pain relief, they don’t offer a long-term solution.
Popular recommendations include over-the-counter
options such as Advil, Motrin, and Nuprin, and prescription
brands such as Celebrex and Vioxx (although the latter was
withdrawn from the market because of increased risk of heartattack and stroke).
These all belong to a group of drugs called
non-steroidal anti-inflammatory drugs, or NSAIDs. Since
they don’t solve the underlying problem (which could be in
the mind, body, and/or diet), the patient ends up having to
use them again and again.
Prolonged use of NSAIDs increases the probability of
stomach ulcers and intestinal bleeding. They’re also hard on
the kidneys and liver. For people who are experiencing
chronic pain and popping pills on a regular basis, the risks can
become serious indeed.
Your medical doctor also may prescribe muscle relaxers. If
you’re suffering from a muscle imbalance, muscle relaxers will
grant you temporary relief. If muscle tightness has you
“locked up” in a certain position (if you’ve experienced a
muscle spasm), these drugs can relieve the rigidity and help
you get moving again. If your muscles are putting pressure on
a nerve (as in sciatica), have caused a herniated disc, or have
become so chronically tight that you’re suffering from
fybromyalgia, you’re only going to gain temporary relief with
these pills.
But again, the doctor is addressing only the pain—not the
reason for the pain. So, most likely, as soon as you stop taking
the prescription drug, that pain is going to come back. Also,
it’s important to point out that there are safer, natural
alternatives such as valerian, white willow bark, chamomile,
and magnesium and homeopathics such as arnica and kali
carb, just to name a few.
non-steroidal anti-inflammatory drugs, or NSAIDs. Since
they don’t solve the underlying problem (which could be in
the mind, body, and/or diet), the patient ends up having to
use them again and again.
Prolonged use of NSAIDs increases the probability of
stomach ulcers and intestinal bleeding. They’re also hard on
the kidneys and liver. For people who are experiencing
chronic pain and popping pills on a regular basis, the risks can
become serious indeed.
Your medical doctor also may prescribe muscle relaxers. If
you’re suffering from a muscle imbalance, muscle relaxers will
grant you temporary relief. If muscle tightness has you
“locked up” in a certain position (if you’ve experienced a
muscle spasm), these drugs can relieve the rigidity and help
you get moving again. If your muscles are putting pressure on
a nerve (as in sciatica), have caused a herniated disc, or have
become so chronically tight that you’re suffering from
fybromyalgia, you’re only going to gain temporary relief with
these pills.
But again, the doctor is addressing only the pain—not the
reason for the pain. So, most likely, as soon as you stop taking
the prescription drug, that pain is going to come back. Also,
it’s important to point out that there are safer, natural
alternatives such as valerian, white willow bark, chamomile,
and magnesium and homeopathics such as arnica and kali
carb, just to name a few.
Professional #2: The Orthopedic Specialist
All right, let’s say the doctor’s prescriptions helped for a
while, but the pain returned. In most cases, he’ll now
recommend you to a specialist, often an orthopedic specialist.
This is a medical professional who specializes in the muscles
All right, let’s say the doctor’s prescriptions helped for a
while, but the pain returned. In most cases, he’ll now
recommend you to a specialist, often an orthopedic specialist.
This is a medical professional who specializes in the muscles
ligaments, bones, tendons, joints, and nerves—all the parts of
the body responsible for allowing us to move.
The orthopedic specialist (surgeon) is going to focus on the
structural issues of your body—looking for major trauma and
injury. If you have a herniated disc, she’s going to zoom in on
how to “repair that disc.” She may say something like, “Your
MRI shows bulging and/or herniated discs at L4-L5, L5-S1”
(referring to the specific vertebrae affected).
When you hear a verbal version of this report, it seems so
clinical and certain. A particular vertebra or disc appears to be
in an abnormal position—which may be factually true. But
what’s not necessarily true is that the vertebra that’s in the
abnormal position, or the bulging disc, is actually pressing the
nerve that’s been causing you pain. That’s just an educated
guess.
The surgeon’s next response is to tell you, “I’d like to go in
and clean it up.” She’s going to either remove a piece of the
disc with scissors and knives or burn it with a laser. The idea
is that once that “offending” piece of the disc is gone, it will
no longer put pressure on the nerve, thereby relieving your
pain. Again, this assumes that a specific disc is actually
pressing on a nerve and that that specific nerve is the one
causing your pain.
Here’s the problem: That bulging disc may not even be the
culprit. In fact, in a study published in The New England
Journal of Medicine, researchers found that 28 percent of the
MRIs they analyzed with disc herniations belonged to people
who had reported never having back pain!
Discs often erode as we get older, but whether or not they
bother us is dependent upon the person. In addition, many
studies show that when left alone, most herniated discs will
heal on their own, often in just months. With time, they
often are absorbed back into the spine or, if torn, they heal,
just like a cut on your skin does.
the body responsible for allowing us to move.
The orthopedic specialist (surgeon) is going to focus on the
structural issues of your body—looking for major trauma and
injury. If you have a herniated disc, she’s going to zoom in on
how to “repair that disc.” She may say something like, “Your
MRI shows bulging and/or herniated discs at L4-L5, L5-S1”
(referring to the specific vertebrae affected).
When you hear a verbal version of this report, it seems so
clinical and certain. A particular vertebra or disc appears to be
in an abnormal position—which may be factually true. But
what’s not necessarily true is that the vertebra that’s in the
abnormal position, or the bulging disc, is actually pressing the
nerve that’s been causing you pain. That’s just an educated
guess.
The surgeon’s next response is to tell you, “I’d like to go in
and clean it up.” She’s going to either remove a piece of the
disc with scissors and knives or burn it with a laser. The idea
is that once that “offending” piece of the disc is gone, it will
no longer put pressure on the nerve, thereby relieving your
pain. Again, this assumes that a specific disc is actually
pressing on a nerve and that that specific nerve is the one
causing your pain.
Here’s the problem: That bulging disc may not even be the
culprit. In fact, in a study published in The New England
Journal of Medicine, researchers found that 28 percent of the
MRIs they analyzed with disc herniations belonged to people
who had reported never having back pain!
Discs often erode as we get older, but whether or not they
bother us is dependent upon the person. In addition, many
studies show that when left alone, most herniated discs will
heal on their own, often in just months. With time, they
often are absorbed back into the spine or, if torn, they heal,
just like a cut on your skin does.
While the presurgical experience seems like a very scientific
one, at some point in the process it deviates from factual
science and becomes educated guessing based on factual
science.
What almost never happens is surgeons probing into the
reasons why you have pain or a disc herniation. They don’t
ask, “What caused the disc to move into that abnormal
position in the first place?”
Without this probing—if muscle imbalances caused the
herniated disc in the first place, for instance—that underlying
problem hasn’t been solved. Even with surgery, the muscle
imbalances within your body have not been rebalanced. Over
time, your surgically repaired discs will face the same pressures
and, likely, end up bulging all over again.
From a surgeon’s perspective, the solution will be simple:
Perform the surgery to remove the offending disc…again.
That’s one of the many reasons why some people go through
surgery after surgery. In many cases the surgeon isn’t cutting
out the problem, just the symptom—leaving the problem to
cause more pain in the future.
If your pain persists and you don’t want surgery, many
orthopedic surgeons will recommend cortisone shots.
Cortisone injections, epidurals, steroid injections, and
epidural steroid injections are all essentially the same thing.
The goal is to inject a chemical into the inflamed area and try
to control the inflammation, delivering relief in the short
term.
Some people feel better by the time they get home, or
perhaps the next morning. However, others don’t feel better
at all. It’s about a 50/50 chance. Because the effects last only a
few weeks, you may have to go back for two, three, maybe
more shots, until you reach the limit. And there is a limit,
because too much cortisone in the tissues can result in
permanent damage, weakening tendons or causing
deterioration in the cartilage of the joint.
one, at some point in the process it deviates from factual
science and becomes educated guessing based on factual
science.
What almost never happens is surgeons probing into the
reasons why you have pain or a disc herniation. They don’t
ask, “What caused the disc to move into that abnormal
position in the first place?”
Without this probing—if muscle imbalances caused the
herniated disc in the first place, for instance—that underlying
problem hasn’t been solved. Even with surgery, the muscle
imbalances within your body have not been rebalanced. Over
time, your surgically repaired discs will face the same pressures
and, likely, end up bulging all over again.
From a surgeon’s perspective, the solution will be simple:
Perform the surgery to remove the offending disc…again.
That’s one of the many reasons why some people go through
surgery after surgery. In many cases the surgeon isn’t cutting
out the problem, just the symptom—leaving the problem to
cause more pain in the future.
If your pain persists and you don’t want surgery, many
orthopedic surgeons will recommend cortisone shots.
Cortisone injections, epidurals, steroid injections, and
epidural steroid injections are all essentially the same thing.
The goal is to inject a chemical into the inflamed area and try
to control the inflammation, delivering relief in the short
term.
Some people feel better by the time they get home, or
perhaps the next morning. However, others don’t feel better
at all. It’s about a 50/50 chance. Because the effects last only a
few weeks, you may have to go back for two, three, maybe
more shots, until you reach the limit. And there is a limit,
because too much cortisone in the tissues can result in
permanent damage, weakening tendons or causing
deterioration in the cartilage of the joint.
How does this happen? Cortisone shots can cause harm in
two ways. First, because cortisone is a type of steroid that
inhibits inflammation, it also halts healing. Injecting an
injured area may relieve pain, but at the same time, it sends
the body’s repair service home, leaving the area defenseless
and weak. The patient, believing he’s cured, goes back to
working the joint, muscle, or tendon, not realizing he could
be doing further damage.
Second, cortisone is a catabolic steroid, which tends to
break down and destroy connective tissues. Actual cell death
is seen near the injection site. So most doctors set the limit at
two to three shots (although I have one client who received
nine!). Regardless of the outcome, if the underlying cause
wasn’t addressed, the pain will return.
Of course, not all orthopedic specialists recommend
surgery right off the bat. It depends on your condition and on
the specialist. Many will suggest rest, physical therapy,
specially constructed back supports and braces, or safety belts.
Again, these can be helpful in temporarily alleviating pain,
but they don’t address the range of underlying problems that
may be causing the pain.
two ways. First, because cortisone is a type of steroid that
inhibits inflammation, it also halts healing. Injecting an
injured area may relieve pain, but at the same time, it sends
the body’s repair service home, leaving the area defenseless
and weak. The patient, believing he’s cured, goes back to
working the joint, muscle, or tendon, not realizing he could
be doing further damage.
Second, cortisone is a catabolic steroid, which tends to
break down and destroy connective tissues. Actual cell death
is seen near the injection site. So most doctors set the limit at
two to three shots (although I have one client who received
nine!). Regardless of the outcome, if the underlying cause
Of course, not all orthopedic specialists recommend
surgery right off the bat. It depends on your condition and on
the specialist. Many will suggest rest, physical therapy,
specially constructed back supports and braces, or safety belts.
Again, these can be helpful in temporarily alleviating pain,
but they don’t address the range of underlying problems that
