Category Archives: Low Back Pain

No, according to these three credentialed experts at The Conversation. A snippet:

There is a common belief that “good” posture is important to protect the spine from damage, as well as prevent and treat back pain. Good posture is commonly defined as sitting “upright”, standing “tall and aligned”, and lifting with a squat technique and “straight back”. 

Conversely, “slump” sitting, “slouch” standing and lifting with a “round back” or stooped posture are frequently warned against. This view is widely held by people with and without back pain, as well as clinicians in both occupational health and primary care settings

Surprisingly, there is a lack of evidence for a strong relationship between “good” posture and back pain. Perceptions of “good” posture originate from a combination of social desirability and unfounded presumptions.

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Steve Parker, M.D.

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I read Sarno’s Healing Back Pain many years ago. I’ve mentioned Sarno on this blog at least once. Sarno claims to alleviate many medical problems with his psychological approach. Whenever my wife or I get a migraine or flare of low back pain, we jokingly refer to is as “repressed anger.” Dr Sarno helped Dr Stephan Guyenet (PhD) with his low back pain.

From Paul Ingraham:

Sarno is articulate and has some important ideas, yes — but he’s also gotten into the business of selling miracle cures. The more recent the book, the less he sounds like a doctor and the more he reads like a mind-body medicine guru trying to convince you that you can heal anything if you can just master the right mental attitude.

Yuck. I don’t care for that. I don’t like it any better than I like the opposite extreme: denying the importance of the mind in medicine is just as foolish as exaggerating it.

History has shown us that it is all too easy to sell books by promising that the “power of the mind” can do whatever you want to believe it can do. Sarno has jumped on that old bandwagon. And so, unfortunately, it is not possible for a serious thinker to take Sarno at his word straight through his books. It is necessary to take the good, and filter out the exaggerated, the grandiose, the empty promises.

Source: Critical Analysis Review of Dr. John Sarno’s Books & Ideas

Steve Parker, M.D.

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A position you’ll see in the Five Tibetan Rituals for prevention and treatment of back pain

Fanatic Cook posted some (potentially) myth-busting videos featuring Dr Stuart McGill that may challenge your preconceptions about core exercises.

He [Dr McGill] says that a flexible back or a strong back are not protective of back injury. In fact, they are associated with more injury. The muscles of the back are meant to stabilize, to prevent movement. This is true for abdominal muscles and others of the core or torso. However, since back and stomach muscles are in constant use, they need to be maintained to provide endurance.

Now I don’t feel so bad about not being able to touch my toes by bending over at the waist. I regained the ability to do that eight years ago by following the Core Performance program. But that regimen took about five hours a week—more than I wanted to invest long-term

Source: How To Strengthen Abdominals Without Injuring The Back | Fanatic Cook

Chronic low back pain patients were some of the most difficult to manage back when I had an office-based medical practice. From The Australian:

Most cases respond to simple physical and psychological therapies aimed at keeping people active and able to stay at work, according to a series of papers published in The Lancet.

Instead experts claim many back pain sufferers are wrongly being treated in hospital emergency departments, referred for scans or surgery, encouraged to rest and stop work, and prescribed powerful opioid pain killers.Co-author, University of Sydney author Professor Chris Maher said millions of people across the world are getting the wrong care for low back pain.

“More care does not mean better care. More aggressive treatments for low back pain have little proven benefit and have the potential to make things significantly worse for patients,” Professor Maher warned.

“Evidence suggests that low back pain should be managed in primary care, with the first line of treatment being education and advice to keep active and at work.”However, in reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery, or prescribed pain killers including opioids, which are discouraged for treating low back pain.”

Source: Back pain being mismanaged, warn experts

I suspect back extension exercises are a key preventative measure.

One of the article’s quoted experts said it’s important to address obesity. I’m doing my best.

Steve Parker, M.D.

The Old Spartan thinks so.  If memory serves me, James Steele II is also an advocate.