On occasion nearly everyone experiences short-term back pain from sore or strained muscles. But for many who come to treat their back gingerly because they fear further "injury," a cycle of worry and inactivity results; this aggravates existing muscle tightness and leads them to think of themselves as having a "bad back." Even worse is the understandable but usually counterproductive assumption that back pain is caused by "abnormalities"–bulging disks, a damaged spine, and so on. However, these abnormalities are frequently found in those who have absolutely no pain whatsoever. In reality, most backs are strong and resilient, built to support our bodies for a lifetime; truly "bad backs" are rare.
Drawing on their work with patients and studies from major scientific journals and corporations, the authors of Back Sense–all three are former chronic back pain sufferers themselves–developed a revolutionary self-treatment approach targeting the true causes of chronic back pain. It is based on conclusive evidence proving that stress and inactivity are usually the prime offenders, and it allows patients to avoid the restrictions and expense of most other treatments. After showing readers how to rule out the possibility that a rare medical condition is the source of their problem, Back Sense clearly and convincingly explains the actual factors behind chronic back pain and systematically leads readers toward recapturing a life free of back pain.
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Dr. Ronald D. Siegel is a licensed clinical psychologist and a member of the clinical faculty of the Harvard Medical School since 1984. In 1988 he was disabled by back pain. His personal experience led him to develop the treatments described in the book. He maintains a private practice specializing in the treatment of chronic pain. Michael H. Urdang is a market research consultant with a background in counseling psychology. His bout with chronic back pain was resolved using the methods in this book. Dr. Douglas R. Johnson is a physician and a board certified specialist in physical medicine and rehabilitation. He is currently the medical director of the inpatient rehabilitation unit at Charlton Memorial Hospital and also maintains a private practice in physiatry.
nearly everyone experiences short-term back pain from sore or strained muscles. But for many who come to treat their back gingerly because they fear further "injury," a cycle of worry and inactivity results; this aggravates existing muscle tightness and leads them to think of themselves as having a "bad back." Even worse is the understandable but usually counterproductive assumption that back pain is caused by "abnormalities"–bulging disks, a damaged spine, and so on. However, these abnormalities are frequently found in those who have absolutely no pain whatsoever. In reality, most backs are strong and resilient, built to support our bodies for a lifetime; truly "bad backs" are rare.
Drawing on their work with patients and studies from major scientific journals and corporations, the authors of Back Sense–all three are former chronic back pain sufferers themselves–developed a revolutionary se
nearly everyone experiences short-term back pain from sore or strained muscles. But for many who come to treat their back gingerly because they fear further "injury," a cycle of worry and inactivity results; this aggravates existing muscle tightness and leads them to think of themselves as having a "bad back." Even worse is the understandable but usually counterproductive assumption that back pain is caused by "abnormalities" bulging disks, a damaged spine, and so on. However, these abnormalities are frequently found in those who have absolutely no pain whatsoever. In reality, most backs are strong and resilient, built to support our bodies for a lifetime; truly "bad backs" are rare.
Drawing on their work with patients and studies from major scientific journals and corporations, the authors of Back Sense all three are former chronic back pain sufferers themselves developed a revolutionary se
CHAPTER 1
A New Approach to Back Pain
Back Pain Bulletin!
If you've been suffering with back pain, we don't need to tell you just how bad it can get. It's an ordeal. You suffer, your family suffers, your friends suffer, your work suffers. Your whole quality of life can take a nosedive. There are millions of other people with the same problem, but that doesn't make it any easier to handle. We know that it's hard to believe, but the book you hold in your hands can help--and help a lot. It's about an exciting new approach to understanding and treating chronic back pain that integrates the very best from both "traditional" and "alternative" medicine so you can resume your normal life as soon as possible. It is based on an explosion of recent scientific research that leads to a whole new way of understanding and treating back pain that has become a chronic problem (lingered more than a couple of months).
Simply put, the book makes three major points:
1. The cause of most chronic back pain is generally misunderstood by both sufferers and the medical community. It is usually thought to be the result of damaged or defective parts in the back. This is a perfectly natural assumption, but, strange as this seems, it simply isn't true. A great deal of scientific research has been done on chronic back pain, and the findings point in a completely different direction. So what does cause chronic back pain? The evidence tells us that while the problem may start with a physical injury or strain, those things usually heal quickly on their own. Tight muscles cause the pain to last, and stress is to blame for tight muscles--stress over pain, worries about the future, disappointments over unsuccessful cures, fears of surgery, anxieties about medical bills, problems at work, unhappiness over strained relationships. The pain is certainly not "all in your head." We know that it is completely real. Muscle tension and spasms can cause intense pain.
2. Most current back pain treatment methods don't work very well because they misunderstand the real cause of the pain. Again the research contradicts typical medical practice. If you are like most people, you've taken your back troubles to one or more doctors. You may have been told to rest, take medicine, or attend "back school." Perhaps you've tried special cushions, braces, physical therapy, a chiropractor, or even surgery. You're probably very careful to avoid reinjuring yourself. Some of these measures may have helped to a degree, but they probably haven't solved your problem entirely or you wouldn't be reading this book. Conventional treatments miss the real cause of most back trouble--they simply don't address the stress and muscle pain problem.
Most treatments also emphasize "taking it easy," "trying not to hurt yourself," or waiting for the pain to go away before resuming activity. Yet all the research and our experience with patients show that a quick return to unrestricted physical movement is the fastest and surest way to recovery.
3. We have great news about your hurting back! Back Sense describes a new way to treat chronic back pain that is more effective and less expensive than conventional methods and allows you to resume full activity. Its goals are to help you understand the true causes of chronic back pain, reduce your stress, and restore your life. The especially exciting part is that you can heal yourself without special treatments and without having to accept disability and the loss of your favorite pastimes. The methods we describe have already helped thousands of back pain sufferers before you. They're safe, too--low risk for almost everyone (we'll tell you how to make sure they're right for you).
We know that all of this is very hard to believe if you've been stuck with back pain for months or years. We were also extremely skeptical when we first heard about it. Please take a chance and read on. The news in this book can be your way out of pain.
Happy Ending: One Patient's True Story
Up until now we have been talking about chronic back pain in general. Here is the story of one man's struggle with the ailment--how he suffered and eventually got better. Your own story will be different, but you may find similarities to what you've experienced.
I'm in my forties now, married, a professional. I was in my early thirties when the ordeal began. I was in decent shape and enjoyed outdoor sports. While on vacation visiting my brother, I decided to try out his cross-country ski machine. The next day, when my back started to ache, I figured that the machine had overstressed my muscles. Like most of us, I had gotten backaches before. But when I returned home from vacation, the pain was worse. I got a bit anxious when the pain moved into my leg, since I thought that this might indicate a nerve problem.
After a couple of weeks of pain I was starting to worry. Not only was the ache still there, but my toes went numb when I was walking. I went to my doctor, who looked worried herself. She sent me to see an orthopedic surgeon connected with a famous medical school. The surgeon ordered a CAT scan of my lower spine and told me to rest in bed until the results were known.
The CAT scan report brought dismal news. I was told that I had a herniated L5-S1 disk that was causing leg pain. The specialist reassured me that "many" patients recovered without surgery--provided they rested enough and avoided reinjuring their backs. I did not find this especially reassuring. I was given anti-inflammatory drugs, muscle relaxants, painkillers, and stern instructions to be careful. I grew dizzy, nauseated, and tired from the medicine.
Out of work, and lying in bed for hours at a time, I was bored and miserable. I had plenty of time to remember all sorts of things that hadn't occurred to me in years. I recalled that my mom had been diagnosed with a "slipped disk" when I was young. I remembered that she had spent months in bed and was forced to use a bedpan. I realized that she had never fully returned to normalcy. I began to imagine life as a disabled person, and the idea filled me with dread.
Each morning, upon awakening, I tried to figure out if the pain was better or worse. There was no clear trend. Sometimes my spirits would lift for a few hours if the pain seemed less, only to crash again when it returned.
One day an idea occurred to me. Maybe a physician specializing in sports medicine might take a more optimistic and active position about my treatment. I called and made an appointment for a consult. This doctor took one look at the disk on the CAT scan and ordered me back to bed, threatening that if I did not heed his warning, I'd be "begging for surgery" in six months.
After weeks of bed rest, the pain and numbness were getting worse. I now imagined myself never being able to ride in the car or go for a simple walk around the block. Desperate, I consulted a chiropractor. Confirming the two doctors' diagnosis, the chiropractor prescribed regular spinal manipulations, ultrasound stimulation, a back brace, and ice packs. I was excited to finally have a more active plan for getting better, and I followed the chiropractor's advice religiously. Despite my hopes, it was not long before it became obvious that the pain and numbness were not really going away.
A couple of months later I began dragging myself to work, ignoring the dire warnings. I installed a bed in my office so that I could lie down most of the time. I couldn't sit for more than ten minutes and couldn't walk for more than a block. I wore a back brace, sat on special cushions, and leaned my car seat back to take the pressure off of my spine. More than once I almost got into an accident because I could hardly see through the windshield.
I now thought...
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