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Chronic back pain

Jan 11th, 2014

Mary Williams asked The Guru for the following Physiotherapy Advice:

Dear Guru.Too long to detail I’m afraid but in summary back pain began 9 years ago after difficult birth of son and interventions.

Since then I have tried everythong from chiropractors to Alexander technique to physio to Bowen therapy and all the rest you can think of. Most have made no impression some have made it significantly worse.The only help has been two years of one to one pilates twice a week which has relieved pain and sciatica to some extent but done nothing and even made worse my recently developed shoulder and neck pain which often leads to terrible headaches. In desperation I went to see yet another physio who did manipulation approx 3 months ago and since then I have been much worse with sciatica back and increased shoulder and neck problems.

Also I am so stiff, haven’t put my socks on for 9 years. I am in my late 40s and can’t bear to think that I will spend the rest of my life like this. Is there any way such a long standing problem can be helped? I could add a lot more to this but you have the essential details here.

The Guru Responded:

Hi Mary
.
What a sorry tale, but I really don’t think that’s your lot….
.
Even though you give a really brief insight to what’s been done, there
are a few nuggets that show that all’s not lost.
.
I don’t think it’s necessarily what’s been done, but it’ll be more a
case what hasn’t been done that will make a big difference. Some of
the treatment that you’ve had has made you worse. Clinically that’s
not great, but I think it means that the clinician is doing 1 of 2
things. Either they are doing the wrong techniques in the right area
or they are doing the right techniques in the wrong area. The clinical
reasoning behind this is key.
.
Pilates is great, and can be a long term solution, however if you
don’t have the ability to move better (comparable to areas that need
to move less) then it becomes frustrating as either your symptoms
stagnate or your start to hurt (and overload) somewhere else as you
try too hard at the specificity of the exercise. Less is most
definitely more.
.
I’m not sure that you’ve got lots of things wrong with you, and don’t
think that you should chase your symptoms. If you identify the driving
cause you can forget (respectfully) about the symptoms. I also don’t
think that you should try to stretch your low back, as you’ve too much
movement here – which you can’t control and why it’s painful. The
stiffness is your body recognising that you’ve got a very mobile
lumbar spine. To prevent further damage it tells the surrounding
muscles to switch on and stiffen up to protect the mobile joints
underneath. Stretching these muscles will stretch the joints….and
the process continues.
.
So yes, I think can be helped. The Guru is also aware of hook and line
gimmicks to get people to book for treatment that they don’t need.
I’ll finish with this…I think I can either provide a long term
solution or I can tell you if I think that physical intervention won’t
help, and so may need to look at invasive options. Either way I can
find a solution to your problem – you shouldn’t need to suffer in
silence. Come and see me and if you don’t understand, dig or follow
what I think I won’t charge you a bean. Zip. Nada. Zilch.

Mary Responded:

Dear Guru, thanks so much for your written comment and verbal advice.I have read your advice to others as well and can really see the sense in what you’re saying. I have now booked to see you next week. I didn’t add that 8 years ago I had a ‘slipped’ disc-I can’t imagine how I forgot to put that in as it has so overshadowed my life since but I guess I was more caught up in the present pain of the moment. Thanks again for your time but more importantly still, for offering me some hope that I may be able to change things for the better.In the meantime, I’m sticking to a daily constitutional in the park and trying to keep off the painkillers.

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