Joined: March 3, 2008
Excerpts from medical journals:
?Conclusions. Examination of patients expectations of and satisfaction with surgery revealed that patients frequently had unrealistic expectations of their surgery and as a consequence tended to have lower levels of satisfaction.? SPINE Volume 27, Number 13, pp 1471 - 1477 The evaluation of the surgical management of nerve root compression in patients with low back pain.
(Comment: Perhaps if they quit selling blue sky, patients might not have such high expectations. This year a man came to town for treatment telling me this story: He?s a male, 30?s, his back goes out. He gives it a year to heal on it?s own. After that year he estimates he?s 70% better. His surgeon convinces him his condition can be improved upon with surgery. It takes him a year to recover from the surgery and in the end he is no better than before. He is convinced to have another and another. After the 4th surgery he is now tilted over to one side.)
?Conclusions. Previous back surgery is associated with significantly worse general health status than those without surgery? SPINE Volume 29, Number 17, pp 1931 - 1937 The effect of previous low back surgery on general health status.
?Conclusion. This pilot study showed no difference between surgical or medical management for recovery or improvement in patients with discogenic paresis.? SPINE Volume 27, Number 13, pp 1426 - 1432 A pilot study on the recovery from paresis after lumbar disc herniation.
discogenic paresis is muscular weakness, or partial paralysis, currently thought to be caused by nerve damage from a disc.
?Conclusions. Patients whose outcome after lumbar disc surgery does not remain stable present a major problem in the calculation of prognostic factors.? . . . . ?The indication for surgery was either radicular pain that was resistant to conservative treatment or radicular neurologic deficit.? SPINE Volume 24, Number 8, pp 807 - 811 Variability of outcome after lumbar disc surgery.
?Conclusions. ?In the majority of our patients, standard decompression and fusion procedures were not ?successful.? . . . ?A number of patient characteristics have been found to correlate with the outcome of surgery: in particular, young patients and women have fared best.? . . . ?Loss of neurological function (strength, sensation, bowel and bladder conotrol) was reported by patients more often than improvements.? Neurosurgery Vol 28, No. 5 pp 685 - 689 Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operations.
(Comment: Did you notice how surgery works best on the young? Because their bodies are resilient, more like a hot dog vs bacon.)
?Conclusions. There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low back pain.? SPINE Volume 29, Number 19, pp 2126 Prolotherapy Injections for chronic low back pain.
?Since that time spinal surgery has witnessed an industrial explosion, resulting in a multibillion dollar industry.? . . . ?Now consider the ?fusion cage explosion.? In the year after the 1996 approval of the BK and Ray cages, sales in excess of $100 million were realized. Four years later the efficacy of these stand alone devices is very questionable.? SPINE Volume 26, Number 18, pp 1947 - 1949. Presidential Address: Surgeons, Societies and companies: ethics and legalities.
Here?s another interesting story. Male, 50?s comes in. He?s had 4 disc surgeries, and after the fourth one he?s had sciatica every day since. He?s learned to live with it, and actually came to me for treatment of numbness and tingling in his hands as he works with them. After a number of sessions working his arms, hands and neck he tells me that since I started working on him his sciatica has completely disappeared. And I?ve not touched him below the level of his neck!
What to make of this? I call it putting slack in the system. Our muscles are all connected, just as one freeway leads to another. By putting slack anywhere in the system, it can help the system as a whole.
This is my theory as to why surgery ever works at all: by cutting through muscles they may put some slack in the system.
THE BOTTOM LINE
Surgery is NOT the answer for back pain.
Orthopedists, through no fault of their own, are operating, literally, on a flawed premise.
Successful surgery for low back pain is the exception and not the rule. They are selling people blue sky. And who would have surgery if their doctor sounded less than confident in the diagnosis?
Do your own personal survey of those who have had surgery. Are they their old selves again? Look at chronic back pain blogs on the internet. Many people are having multiple procedures done to them, and continue to suffer immensely.
Patients are so brainwashed into thinking a disc is pinching a nerve, the most minimal improvement is seen as success, and well, what more can you expect? You feel you are permanently flawed.
Disc theory has been engrained in us for generations. I was raised on it, and used to believe in it myself. How else to explain radiating pain, or chronic pain that fails to resolve with conservative measures?
Any radiating pain is given the catch all term ?sciatica?. It?s automatic. It?s how we?re taught. I used to do it myself.
It is not recognized that muscles can cause radiating pain, or nerve symptoms. As Dr Sarno has observed, there is no apparent spasm. And he?s right, it is not apparent.
If it?s in the muscles, why doesn?t massage work?
What is being taught in massage schools does not work on tough cases, and in some situations makes people worse. I?ve heard it many times from patients over the years - deep muscle therapy made their condition worse.
Here?s a recent example: I left a student to care for a difficult case while I was out of town. We?d been working together on her and making consistent progress after she?d been laid up 7 weeks straight sleeping on the floor of her living room, life having stopped in it?s tracks, unable to stand, sit or walk, radiating pain and tingling down the leg, her foot would be numb for weeks at a time. We were making consistent progress and I encouraged her to continue with my student while away.
Because he was just out of massage school he didn?t yet realize the limitations of what he?d been taught. Instead of continuing as I?d shown him, he had to try out some of what he?d learned at school. He thought he was being very gentle, and even she said he was very caring and in constant communication with her to make sure she was ?relaxed?, but she had difficulty getting up off the table after the treatment and spiraled downward from there as though she was back to square one. When I called to check on her she was in tears, and inconsolable. It?s because many forms of muscle therapy are over pressing and irritate the pattern. Resuming with proper treatment, it took a month of therapy to get her sitting and driving again, and another month to get her back to work. Two doctors had told her she needed surgery for a disc.
Sometimes you can get away with what I consider over pressing forms of massage, and sometimes you can?t. That?s why we are stuck on the disc theory of back pain.
I have students right now who just paid 12k for a year of massage school and they?ve never seen anything like what I teach them.
There is a better way to treat muscles, and it solves the mystery of back pain.
I simply ask the patient where it hurts and think of associated patterns. Working together as a team, I put them in touch with the exact source of their pain, and without fail they will exclaim ?that?s it, that?s my problem?.
It?s hiding in the muscles. We just haven?t been treating them correctly.
AMR is new, most medical professionals have not heard of it. It will amaze you. It is uniquely tapped into the deeper truth of back pain.
Joined: May 11, 2004
Physical therapists have known for some time that not all surgical intervention for low back pain is successful.
For your little "magic bullet," this is the "evidence" area - bring on your evidence.... no testimonials... no "expert" opinion.... bring on the evidence. Psst... there is no "magic bullet" for back pain.
As SJ said - you are preaching to the converted here when it comes to backsurgery and blaming the disc for pain. However, you find yourself in the lions' den when you start preaching "the deeper truth of pain"......We especially love it, when a technique is preambled with terms like "deeper" and "truth"....and "new"....Tasty morsels for us here.
Maybe you will discover the brain one day (stuff between the ears, often involved in human functions) and its role in pain perception. Little hint: pain can exist without pathology and pain can exist completely and only in the brain......
But of course! This would deflate the lovely balloon you let up - the one with the horn, tooting your expertise and discoveries.....
< Message edited by Sebastian Asselbergs -- March 3, 2008 9:12:18 PM >
Joined: December 22, 2007
I might suggest discussing your methods and approaches on the following forum. I think they would love to hear your ideas. They are very open-minded and are always willing to listen. Please give my regards to Diane in particular. I'll let her thank me later.
Joined: March 3, 2008
well bite down hard folks, cause it's all steak and no sizzle.
you're dam right it ain't magic. it's technique and a lot of hard work.
I'm so with you on testimonials, anyone starts telling me one, I don't want to hear it.
at least look at danny's testimonial, and les mccann, those are not typical cases by any means, and when I took on those cases I had no idea whether I could fix them or not. and that's how I proved it to myself. from fixing the tough cases when all else came up short.
how to prove it here? I don't know. but if you apply what I have to teach, you can prove it to yourself.
I've got everything to share and nothing to hide. when I met thomas griner way back when, I was just like you cats. didn't want to hear it. didn't believe it. heard it too many times. much to my own surprise, his is the ONLY technique that surpassed my wildest expectations. again, it's not magic. success is hard won.
you know surgery isn't the answer. the facts don't add up. there must be an answer somewhere, and I promise you this is IT.
just check out what I have to say. use your bs meter. there isn't any on my site.
like the earth being round and not flat, you'll get on board now, or get on board later.
it's sort of exciting being on the cutting edge. and it sort of sucks.
Joined: March 3, 2008
wait a second, clinical case studies are evidence.
here you go:
I can hear you now, ?Are you saying a disc never pinches a nerve? Would you not agree it?s possible, a large herniated disc could pinch a nerve??
I would have said yes, but cases such as this challenge everything we think we know about back pain.
Danny Fehsenfeld, a 30 year old actor, first hurt his lower back doing a fight scene in a commercial.
Entangled in wrestling maneuvers, his low back went out. The nurse on the set assured him he?d be ok, and that he need not go to the hospital. He couldn't walk for a week, and like an old man for a couple more. Being a tough guy, he never sought treatment, took ibuprofen here and there, and in a couple months his back felt fine again.
Several months later he was snow skiing. It was the end of the day and his legs were tired, but you know, one more run. He went over a jump and upon landing his back went out again, only this time he felt numbness and tingling into his testicles, and pain on urination.
This will, of course, send a guy to the doctor.
An MRI was taken showing a herniated disc at L5-S1 but it?s severity was misread.
Here?s a guy who has tried physical therapy, chiropractic, acupuncture, not that it didn?t help some but it wasn?t fixing his condition.
So he goes to the director of the spine institute at Cedar's Sinai in Los Angeles, and foo foo doctor to the stars, Dr Goldstein.
Dr Goldstein was surprised to see a large disc herniation nearly occluding the entire spinal canal.
If you have 13 mm of space for the spinal chord it?s considered a surgical emergency, Danny had 5 mm. In some states it is illegal not to do surgery in such a case. Surgery was deemed imperative, that herniated disc was compressing the nerve roots leading into his testicles, and there was concern he'd done permanent nerve damage and recommended he see a urologist. (the urologist reported none)
Note * The spinal chord itself ends at around the level of the second lumbar vertebrae and turns into a horse tail of nerve roots, or ?cauda equina?, that travel the remaining distance in the spinal canal, and then exit between vertebrae at their respective levels. Thus chord compression at the L5-S1 level is called compression of the cauda equina.
Surgery was scheduled but worker's compensation insurance wouldn't authorize to pay for it, and he was sent for review to the workers comp doctor who said, "You know, it's my job to say you don't need this surgery, but I agree with your doctor. You have one of the worst MRI's I've ever seen. You could sneeze and go paralyzed for life! You must have this surgery!"
This would scare the dickens out of most people, but Danny is amazingly self reliant and did his own research of the medical literature. He found that herniated discs can shrink or disappear on subsequent MRI?s all on their own. He said if you talk with enough people who have had disc surgery, you find it is no panacea and to be avoided if at all possible. So to satisfy his own curiosity before having major back surgery at age 30, he insisted on and got a second MRI.
He returns to consult with Dr Goldstein on the results of the second MRI and the doctor greets him and says, "Congratulations! You must be feeling much better. The disc herniation is greatly reduced. Surgery is no longer necessary!"
Danny says, "Really? To be honest I still feel the same.? ?You mean you don't know what's causing the numbness into my testicles?"
The doctor finally admits, "Danny, in our business there are no certainties?.
Now this is the truth.
Doctors sell the disc theory as though it is fact, but it is not a fact.
Danny then found me. I?d come to understand some time ago a typical herniated disc was nothing more than a muscle pull to a weight bearing joint. But one of this size? Even I thought this would pinch a nerve. And numbness into the testicles? That was a new one.
We?re all the same but we?re all different. Each person, you figure them out.
Fixing tough cases is not magic, it?s technique and hard work. It took 8 hour and a half sessions before we cracked the egg of his condition, and Danny could see the light at the end of the tunnel. We discovered a spasm pattern into the groin and as I worked it he exclaimed ?that?s it, that?s what?s causing the numbness and tingling into my testicles.? At some point we broke through the pattern in his low back and he said ?that?s it, that?s the original injury to my low back?.
With this work we put you in touch with exactly what the problem is.
Joined: March 3, 2008
I didn't believe griner either, and doubted him just as you doubt me now. but when he touched me, I knew he had something. though had no idea how profound it would turn out to be.
I didn't have that many lessons w/ him and wasn't that good when I left off. but with practice I started fixing the sort of tough cases I couldn't fix before. it kept proving itself to me over and over again. that's why I sound so confident. and again, it isn't magic.
tough cases can be time and labor intensive.
if the case above doesn't speak to you, I don't know what to say.
Joined: May 11, 2004
Brian... honestly, it isn't my job to prove you right. It is your job to prove yourself correct.
Your "clinical case studies" haven't been published in a peer-reviewed journal, therefore they cannot be entered as "evidence." They are just little glimpses of your memory of some supposedly spectacular responses to your method. They count for no more than "expert opinion." It cost $2,400 for that clinical example. You also didn't provide any final outcomes... what was his functional level prior to treatment and what was it at discharge? Has he had a return of the complaint?
For a comparison.. independent data provided to me by Blue Cross indicates that patients that attend physical therapy services provided by me for low back pain for whatever reason on average costs BCBS $463. I have data that I collect on outcomes and pain and I KNOW the average level of function AND the average, best and worst pain levels when services are initiated and upon discharge. Why on earth would I be interested in your 8 - sessions of 1.5 hours at a cost of $2,400 to the payor? You give me nothing to determine that your belief and your testimonials are better than my performance statistics. From what I am seeing, your method is an expensive route and I'm better off satisfying my patients with the evidence that I use while at the same time being a cost-effective option for them AND they don't have bruising OR higher pain levels that they have to adapt to with the use of evidence to guide my practice.
So, Brian... again, you have no evidence, except for testimonials, expert opinion and the glimpse of a financially expensive option available to us. I'm sorry, your clinical route is not of any interest to me. When you are ready to discuss "evidence," I'm more than willing to consider what you believe to be the new "magic bullet" for back pain. Psst... there is NO magic bullet though...
Joined: April 4, 2007
bbronk: "I hate testimonials....now listen to my latest testimonial as I attempt to sell you my latest repackaging of snake oil." Evidenced Based Practioner: But, all you're doing is providing the same, anecdotal, testimonial rubbish with each post." bbronk: "Huh? Oh wait, listen to my next testimonial......."
bronk - Can you please bring some substance to ANY of your upcoming posts? What was once mildly amussing is now just annoying.
Jess Brown, PT Board Certified in Orthopaedic Physical Therapy
Approximately, most of the people suffer from chronic back pain and reason behind it is poor posture, excessive weight, poor work station setup and lack of exercise. Other than surgery we can reduce back pain. To reduce the risk of the back pain, we should understand the cause behind it. Start exercising slowly and listen to your body. Set up your work station ergonomically. Don’t sit too long and try to stretch your body as much as you can. Don’t hesitate to visit a physician in case the back pain increases and start with the treatment if needed.