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Off-Topic Podcast on back pain

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Thanks Dan. It's a sad fact but I would have to agree with about everything she said in that podcast. I know the number one answer on this forum whenever someone makes a post about backpain is "see a doctor" but my own experience is I've never once been helped by a doctor.

I raced motocross when I was young (40 yrs ago) and screwed my back up pretty good. I have literally spent 10's of thousands of dollars on orthopedic surgeons, specialist, chiropractors, and every kind of physical therapy you can think of in an attempt to find some relief but all to no avail. Absolutely no relief whatsoever and in some instances they made it worse.

Between doctors, surgeons, and the pharmaceutical companies I have absolutely no faith at all in the medical industry whatsoever and choose to put my health in my own hands from now on.
 
I haven't read the article in the link yet - will try to later - but in recovering from my back injury, I was helped by an excellent low-back specialist, an MD. I was also helped greatly by learning about strength and flexibility, and if I may be so immodest, by my own diligence in finding what _I_ needed to do in order to improve.

-S-
 
Listened to it. My biggest takeaway is being honest with oneself about true pain versus just discomfort. A weak muscle/muscle group is going to complain when exercised, but it's what is needed to improve overall. Debilitating sharp pain is different from pelvic tilt due to too much sitting and the abs and glutes being weak (the low back takes the load and the hip flexors are chronically flexed pulling the entire hip area out of whack).
 
I listened to the podcast and have a few reactions/observations:

--She makes a lot of good points about the industrialization of back pain treatment and the influence of money in driving treatment that is not necessarily effective.

--I think her tone in using the word "scam" is a little unfair. I think that most medical professionals involved in treating low back pain are sincere in trying to help people and believe in the efficacy of their treatments, and that medical/surgical treatments are not as uniformly ineffective as she paints them. The financial dynamics she describes are real, and a lot of medical/surgical treatment may be unnecessary or counterproductive, and injudiciously or inappropriately applied, but that doesn't mean (all or most) doctors are cynical scam artists purposely exploiting desperate patients as they gleefully rub their hands together and snicker at their patients' gullibility.

--She focuses on exercise/physical therapy from a biomechanical point of view ("stretch this, strengthen that, activate this"), but doesn't address current pain science and the neurological dimensions of pain at all (except in a superficial and almost accidental way when she talks about the patient's mindset toward pain and recovery), which I think is a terribly gigantic omission.

For anyone interested in finding out more about pain science, here is a link to a site that has assembled a bunch of free resources (videos, podcasts, and webinars) on the topic. Paincloud.com - Evidence-based pain management Disclaimer: I have not watched most of these (Lorimer Moseley and Jason Silvernail are the two authorities from these resources I am most familiar with).

The Science of Stubborn Aches, Pains & Injuries is a site that is mostly targeted toward laypeople, but extensively referenced.

A great discussion forum for practitioners that emphasizes a neurological approach to pain is: Forums - SomaSimple Discussion Lists Somasimple is fascinating, but can be overwhelming. When you first start reading threads there you will probably has no idea what people are talking about. But if you invest the time to read a lot anyway, you start to develop a context for understanding the principles being discussed. This thread Jason Silvernail [moderator] - SomaSimple Discussion Lists is Jason Silvernail's list of recommended threads to new readers to get oriented.
 
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Yoga plus good mattress can really help with back pain if you have the "all clear" from your doctor. Find a class with a teacher who is comfortable working with your injury and uses props. Yoga isn't supposed to hurt so if the teacher encourages you to go into pain, find a new teacher. Definitely check into private sessions. Good luck!
 
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