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Buy the Book
Solving Your Aching Back
A new approach that avoids surgery.
After the common cold, back pain is the most frequent ailment of Americans seeking medical advice. It has been conservatively estimated that 10 to 30 percent of the U.S. population suffers from back pain at any given moment. That would be about 30 million people at a minimum. Several thousand of them are experiencing it for the first time.
What is done about it? Too often surgery, contends Paul Altrocchi, MD, MPH, in an eye-opening , well-argued book, Stop Harmful Surgery: Back Pain, a New Approach at Last, published by Xlibris Corporation.
A graduate of Harvard Medical School and the Neurological Institute, Dr. Altrocchi became an Assistant Professor of Neurology at Stanford Medical School. He writes, “I began to realize that my back pain patients did not improve following recommendations and actually would have been better off had they never seen me.” He asked his colleagues for approval to stop consulting on lumbar back pain until he had figured out why his analysis and management of the ailment was not more effective.
After quite some time, he concluded that it was not his analysis, but the “M.D. model” for treating back pain that was flawed. That model was based on the widespread belief among physicians that back pain resulted primarily from diseases such as disc deterioration and osteoarthritic degeneration of the spine, things best treated by surgery.
After seeing a number of patients who had gone through multiple surgical procedures without any improvement in their condition, he concluded that most back pain was not caused by diseases that required surgery, but by “mechanical” dysfunctions. If he was right, how best to analyze and treat these dysfunctions?
He found the answer at Michigan State University’s College of Osteopathic Medicine. There, he says, “an assemblage of open-minded, remarkably gifted clinicians had put together a different medical model [based] on an intricate knowledge of anatomy and physiology [function], including every bone, muscle, tendon, figment, joint and nerve in the human body.”
He learned this new model carefully and concluded, “The mystifying world of low back pain was no longer mystifying.” Looking back over his experiences, he found that many back pain problems involved people who did much lifting in their activities. He cites the case of a lumber millworker; also a housewife, who twisted to lift a vacuum cleaner from a closet and immediately experienced sharp back pain.
Dr. Altrocchi gives us several fascinating — and heart-wrenching — case histories, along with discussion of studies and research into back pain. The book has useful charts and photos to explain the workings of the spine, and even several cartoons about back pain. He also includes a history of “manual medicine.”
Though there are not yet many MDs who have adopted the new “model” for analyzing and treating back pain, there are others. As he notes, neurological surgeons are trained to do — surgery. Nevertheless, some of them are coming around to the view that surgery should be the last resort, with other mitigations coming ahead of it.
Dr. Altrocchi is frank about his goal in writing the book and sharing his experience: “… to persuade back pain patients everywhere that the caregiver they should seek first seek when back pain occurs is a practitioner of manual medicine.” By that he means, “the best chiropractor in the community, or a physical therapist trained in osteopathic techniques, or, if one is available, a doctor of osteopathy specializing in manual medicine or an M.D. familiar with the osteopathic model for lumbar back pain.
I chose a chiropractor. After three months, I said “goodbye” to back pain.
Mr. Hannaford had chronic back pain from a horseback riding accident. He writes from California.
About the Author
Peter Hannaford was closely associated for a number of years with the late President Reagan, beginning in the California Governor’s office. His latest book is Presidential Retreats.
Letter to the Editor View all comments (38) | Leave a comment
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alice moore| 3.7.11 @ 7:00AM
The author cites heavy labor and lifting as a cause. Poor posture and obesity also contribute to lower back pain.
I know from whence I speak. I lost weight and consciously worked on my posture. Voila! No back pain.
MoeBlotz| 3.7.11 @ 8:07AM
When I was training regularly at the local iron mill,my dead lift was 405 lb. for two reps. not bad for an old phart of 50. My back pain in my late thirties was attributable to bouncing around our nation's highways in the seat of a Kenworth. Fifteen years later my back pain was gone,and heavy lifting did not bother me. Not enough room for details here. At 52 I could snatch 175 lb.,clean 235 lb., front squat 265 lb., and flip a caber 18 ft. long and 13 lbs. Chiropractic visits and proper weight training eliminated my back pain. Now I am working on eliminating the pain in my arse that emanates from Washington,DC.
MoeBlotz| 3.7.11 @ 8:08AM
The caber was 130 lbs., I missed the zero on the previous post.
Ken (Old Texican)| 3.7.11 @ 8:10AM
Mr. Hannaford,
Thank you for that....sincerely. My leg had been "on fire" for years, 24/7. My friends from Baylor who went on to be doctors kept quietly telling me: "Ken, we just aren't very good at back surgery yet. Hang in there as long as you can stand it....maybwe we will get better."
Then my wife literally herded me to a Chiorpractor who has a stretching table...
Three days a week this table stretched me and "hurt me"...but just a little bit...over and over and over."
I was very fortunate that the doc explained very carefull up front what they were trying to do.
ie: build up SCAR tissue to replace the formerly tough rims to my disks...evidently that scar-tissue is similar to disk rim material.
It cut my back/leg pain down to manageable levels in only six weeks.
Ken Renner| 3.7.11 @ 8:52AM
Everyones situation is different. After 7 years of excruciating lower back pain and being treated by physical therapists, chiropracters, acupuncturists, and using oral narcotics, I got almost instantainous relief after having an intrathecal pump implanted. A catheter takes the narcotic directly to the spot in the spine. Wow. I could have kissed my doctor right on the mouth. I didn't though.
Anastasia Mather| 3.7.11 @ 10:04AM
Exactly what has happened to my husband, who has never been overweight. He is a welder/fabricator in a structural steel shop and had an MRI in December which showed a totally wrecked lower back.
I made him switch chiropractors as the first practice was like a Detroit assembly line. Our current chiropractor takes his time, reads imaging reports and is intimately familiar with anatomy and physiology. He uses TENS, manipulation and massage, and has given my husband a set of exercises to strengthen the muscles around his spine.
After two months, my husband's pain has been reduced about 90%, his flexibility has increased and he does not come home drained, pained and depressed.
There is a time and place for every therapy, drug and surgery. It's just that surgery should be a last resort.
Maddox| 3.7.11 @ 11:00AM
Thank you, I have been trying to convince family members of for this for years. A few weeks, often equal to surgical recovery time, can usually repair years of overuse and strain without risky surgery that may cause more problems. Therapy is not only less expensive, it teaches techniques to use in the future to prevent pain and suffering.
buckeyeman| 3.7.11 @ 11:01AM
What a bizarre article for a website concerned with the pressing political issues of the day. This shill for yet another book extolling the value of chiropractic claims that back pain has been "demystified" and yet gives not one single insight as to what that means (yeah, I know, BUY THE BOOK!!! please).
Chiropractic was "discovered" by Daniel Palmer, a former grocer, beekeeper, raspberry salesman, and "magnetic" healer. His first patient was a janitor, Harvey Lillard, whom Palmer claimed to have cured of DEAFNESS.
Chiropractic claims that (virtually) all disease is created by disturbances in nerve energy flow resulting from "subluxations" (partial dislocations) of the vertebrae which can be corrected by physical manipulations. Not a shred of evidence exists that these "subluxations" actually occur outside the fantasy and deception of chiropractic. Sure, a back rub feels good but there is NO science supporting chiropractic. Why was this article published on AS???????
Wayne | 3.7.11 @ 12:01PM
I hate this kind of arrogant comment. You are just projecting your own ignorance. If you don't like chiropractors, don't go to one. But spare us your condescension.
W| 3.7.11 @ 12:14PM
agree with you buckeyman. i have seen clients injured by chiropracters who tell their patients they need manipulation 3X per week indefinetely, they make a bundle charging workers comp ins and auto insurance. i can't believe a neurologist recommends chiropractic care when there is a disc herniation. if there is herniation you need surgery sooner or later
Julio| 3.7.11 @ 1:21PM
W, you are mistaken on a herniated disc. At age 42 I herniated L4 and L5 at the same time. I went through 7 weeks of PT and improved greatly. Grant it, I cannot do some of the same movements I was once able to do but I rarely have back issues. The PT taught me to be more careful with movements, lifting, etc. But I never needed surgery. I have been to both Chiropractors and MD's. Chiropractors like more natural healing methods. MD's want you to take drugs and/or have surgery.
When I first injured my back an MD told me it was a pulled muscle and prescribed muscle relaxers. They did nothing. I went back and told him I wanted to see a PT. He reluctantly and bitterly told me he would write me a script to see a PT. To make a long story short the PT figured out in 15 minutes what an MD could not figure out in 2 separate visits: I had a disc issue.
While I agree Chiropractors like to see you come back 3x a week, at least they don't try to pump you full of drugs like an MD does.
Albert| 3.7.11 @ 11:02AM
I found a physical therapist under my medical plan who is just wonderful. He showed me how to properly stretch and condition myself to avoid back pain. The information in this article I have known for 10 years and it does work. As long as I don't move in odd manners or lift heavy objects, my back is fine and I function normally. Even after a ruptured disc 2 years ago, and after having suffered lower back pain since I was 13, I have no difficulty any more as long as I train well and stretch properly.
Brian B| 3.7.11 @ 11:07AM
--including every bone, muscle, tendon, figment, joint and nerve in the human body--
I'm guessing spellcheck strikes again?
Brian B| 3.7.11 @ 11:11AM
--Sure, a back rub feels good but there is NO science supporting chiropractic.--
That may be correct, but there are millions of people walking around who have been helped by whatever chiropractors do and there are millions hobbling around or stuck in bed after subjecting themselves to the proven "science" of back surgery as well.
Who Knows?| 3.7.11 @ 11:53AM
Hey, bukeyeman---
Luckily, we still live in a free country, which is admittedly yet again under attack by enemies within and without.
So, American Spectator is free to publish putatively inappropriate articles about subjects like back pain, AND accept denigrating comments from people.
By the way, for one who is seemingly anti-chiropractor, you sure know a lot about it.
Anyway, it’s results that matter, most especially when it comes to the excruciating pain possible in the spinal column. As one who at least once was literally brought to my knees with it, and unable to move without experiencing more of it, I can testify that a chiropractor “saved” me.
In 1987, after years sitting at a desk pounding away at a calculator, my back and neck were so stiff, that when a local go-getter chiropractor was hustling up business at our place, I gave it a shot. After many treatments and massages, for a couple of months, I was totally amazed that I was so much improved.
And, for some years after, I’d get “maintenance” adjustments once a month, to stay loose.
Eventually I moved, and decided to see if I could stay healthy without any help, and I was surprised that the back continued to be kopasetic.
Of course, right diet that reduced the body weight to about 140 pounds at 5 ‘ 11 “ helped, as well as much walking and biking. Good posture is also de rigueur---one should walk, stand and sit as if there’s a string holding the body up, with say, God holding it, and always tuck the butt under the spine, holding the shoulders back.
Seeing older people walking all hunched over, with a forward leaning bent back, has always served as a lesson to stay straight!
Anyway, personal experience always trumps any theory one may have. Most such learned conventional “wisdom” is closed minded, and probably needs something bodily painful to jolt it, to allow an opening for true wisdom.
I believe much the same thing is so for America’s “back pain”.
Leftist-socialists have weak spines--- they have no “BACKBONE”!
They are mere KNOWERS, and it is stupefying how confident they are about it, even in the face of such overwhelming evidence that they don’t KNOW what they are talking about.
Wayne | 3.7.11 @ 11:58AM
I remember my brother, a neurosurgeon telling me surgery, chiropractic or 6 months rest get about the same results. He of course was very reluctant to do surgery.
I have found what works for me. It is a simple machine in the Gym most people ignore. It has no moving parts, and it is called an INCLINE. I just do an isometric on it. I can hold the 45 degree incline position of a couple of minutes and it strengthens not only the large core muscles but also the small ones. It is far, far cheaper than a chiropractor. Chiropractors do not work on muscles, and if they are weak, the joints will just go out again.
Steve Evans| 3.7.11 @ 1:33PM
I was sure that someone would mention Back Rx by Vijay Patel, M.D. His approach is to used modified yoga and Pilates exercises to strengthen the core. At age 40 I was on my way to becoming a human question mark. I discovered this book ten years later and am now back to running long distances (something I had to give up at 40).
GENE HAUBER| 3.7.11 @ 2:05PM
Hey American Spectator,
Thanx for the article on back pain.
I think it was very appropriate for you to put this piece on your website. After all, the word spectator implies someone who observes.
I'm very glad that you observed this article. I have been considering surgery, but now I will look into this.
Thank you very much,
Gene Hauber
back pain sufferer
CalMark| 3.7.11 @ 5:21PM
Sometimes, surgery IS the only solution. However, too many M.D.'s just want to cut, cut, cut.
Chiropractors have their place. The competent ones understand what they can do (in some cases, a LOT of good) and just as important, the limitations of their treatment.
Too bad the good chiropractors are drowned out by the quacks, who claim they can cure anything from the common cold to the plague.
Handy| 3.7.11 @ 5:59PM
It is curious that the article itself did not mention pain control. Criouser still that the comments so far have ignored it.
I first expeeienced acute back pain at age 13 after a canoe trip. The sciatica was so bad, that I could not concentrate, and even bought some crutches at a garage sale. The diagnosis was Degenerative Disc Disease. There were no meds prescribed; only exercises, many of which I could not even perform. After more than a year, my symptoms gradually subsided. My nervous system had apparenttly re-routed itself. A subsequent MRI confirmed that I had three troubled disks. Another gadget (the name escapes me now) that measures responses to electrical charges showed that most of the nerves in my legs and feet had indeed switched paths.
Other bouts with severe pain occured several more times. I tried chiropractic, which did more harm than good. Accupuncture was marginally effective for awhile, but the effects wore off after a day or so. No meds throughout all of these periods. Not even when I was hospitalized for several weeks. Only a couple of trips per day to the swimming pool and short strolls on the treadmill.
In my late 30s I became so crippled up, that I had to use a walking stick and was getting more and more bent over. The pain was so intense that I had to use two sweat bands on my five block commutes. Grocery shopping was out of the question.
At the end of my rope, I visited a new doctor. I really wanted him to perform that minimally invasive routine (needle surgery), but he said I was not a good candidate. Nor did he think a laminectomy was a good idea. Instead, he prescribed a course of 30 Darvocets while he mulled over other approaches.
I began with four capsules a day, and after two days was feeling so much better, that the doc said to drop it to two. When I could finally stand up straight again, we dropped that two just one. I tossed my hiking staff, and no longer had to use those sweat bands. We cancelled a CT Scan. Before that bottle of 30 was gone, I felt confident enough to start bicycling and blading again.
Since this treatment, I have only had one bad patch of back pain, and I immediately started taking some narcotic drug (Vicodin?) that mitigated it quickly before it got worse.
Doctors who fail to use all the tools in their bags to relieve pain and suffering are guilty of malpractice. They are probably afraid of the legal system, and that is just wrong.
Handy| 3.7.11 @ 6:34PM
Back braces - the kind theat are sold in pharmacies - can be helpful. Normally, doctors will recommend that they be worn during active hours and taken off when sleeping or resting.
This is bad advice. Such braces should be worn when sleeping, because that is when the muscles can fully relax and heal. Further, if you make involuntary movements in your sleep, the pain may awaken you, just making you more exhausted.
Booze. It may make you feel a bit better in the short run, but during a bout with a bad back, it will only delay your healing. It is an irritant. Besides, if you have one too many and become unstable on your feet, you may just aggravate your condition further. And, you shouldn't be mixing hooch with those much needed pain killers, anyway.
Muscle relaxants. I guess I misspoke above when I said I had received no prescription meds. On several occaisions I was given muscle relaxants. However, these things are all but useless, so I just forgot about them.
Mark Shepler| 3.7.11 @ 6:10PM
Hmmm,
I just turned 50 and this is the kind of article I would never have read. I have worked out seriously and stayed fit all of my adult life. A gym rat of over 30 years, I maintian a 46" chest and 33" waist at 200lbs, race a 400cc two-stroke dirtbike at 50 and can get my heart rate up to over 180 on a bicycle even after a near-death heart attack in 7/09. I have never injured my back mostly because I've been careful to lift correctly and avoid back threatening exercises or activities. And yet, I've got some sort of sciatic problem going on for the last 6 months or so.
It feels like I'm sitting on a hot plate and the pain branches down the back of both thighs, skips the knees and calves but flames up again in the feet. Some nights I wake up in serious pain. I've thought about seeing an Ortho guy or Chiro but am afraid of the recommendations of either. I've had bad or indifferent experiences with both.
I'm in a serious cycle in the gym lately so for now, I'm focusing on building muscle in the thighs, glutes and torso core. A few years ago, I once came within a hair of breaking my shoulder ditching my bike so I concentrated on my shoulders for a few months. Figured if I encased it in solid muscle it'd be alright and it has worked out that way. Hasn't bothered me since even after going down on it again more than a few times.
Gettin' old is a drag, isn't it? I'm not even sure how I got it but I think it was when my bike's shocks blew out. She was all spring and launching like a long-legged frog off the jumps. Ass over tin-cups. Seat came up hard on one and got me good in the derrier. This is my only consolation in the affair- that my problem is likely a combat injury. :)
As for somebody's distress the Spectator ran this article...well...buzz off. What the heck is the problem? It's the internet man, you're not paying for this content and there's going to be a new batch tomorrow. Geez. Besides, of all the publications I read and have read over the years I am most satisfied with AS's editorial judgement. Thanks AS for this timely piece.
Handy| 3.7.11 @ 6:59PM
Sounds like a pretty serious case of sciatica. From your description, you may have actually ruptured a lumbar disk. That's a different matter from my chronic problems, but the symptoms are almost identical. Hope you get better, but seek pain relief ASAP. If you don't, you will start favoring one side or the other. That will simply exacerbate matters.
In choosing a doc, go with a neurologist. They are less "knife-happy" than the neurosurgeons. Orthos are great for arms, legs and hips, but seem lost when it comes to spines. One other suggestion about your choice of a "back man" should be that he has had a bad back himself. That way he can relate to the pain you are feeling much better than someone who knows nothing about it.
Mark Shepler| 3.7.11 @ 7:36PM
Well, it comes and goes and is only really bad if I've been sitting for long hours at work or in front of the tv at night. It seems to have lessened since addressing the region in the gym.
One caution about pain relief. I had another medical issue in 10/10 and just last month- ulcers of the esophagus. They resulted from years of taking Motrin, Advil, or Alleve every night before bed. Just got in the habit of popping a couple to take the edge off the normal aches and pains of an old dude who acts too much like a young one. But they degrade the lining of the stomach and/or esophagus, which I obviously didn't know.
The 10/10 episode was the worst and put me in the hospital for 4.5 days for no other reason than pain management and to be fed and watered. They thought I was having another cardio incident. It hurt so bad I couldn't even swallow water. Imagine that. Gastro guy said the esophagus has more nerve endings per sq in than any other part of your body. Who knew? Now I have to rely on Tylenols which have never done much for me.
Lastly, the absolute worst part of this whole 20 months has been the sudden transformation from a fit and strong man younger than his years who took his health for granted in quiet confidence into one of those old farts that talk way too much about their medical conditions. Sigh... :)
Achy Braky Body| 3.7.11 @ 8:45PM
I know that taking fish oil puts the fire of inflammation out. Inflammation is what causes different types of pain and fish oil's a well know anti-inflammatory, so it might help. It's like a lubricant for every working part in the body and helps immensely in certain types of arthritis too. It helps lubricate the joints in the body as well as contributes to healthier skin and hair. It's also proven to help with inflammation in the brain, which is one of the causes for Alzheimer's, and helps with memory in general.
And if anyone doesn't already know about taking warm baths with Epsom salts for helping to relax tense muscles (and promote sleep!), try it. There's lots of Magnesium in the salts and it gets absorbed through the skin as you bathe. It really helps.
Just my little bit of info.
Handy| 3.7.11 @ 9:55PM
Mark,
I hope you will take this in the spirit that it's offered: Totally supportive.
61 here, and I don't really feel all that old. Did a Triathlon last year and took a 49 year old fox to lunch and sailing in the afternoon. You'd better be careful man. Otherwise, I will steal all the young babes.
Get that sciatica problem fixed, dump the Tylenol, stop the weight training and the steroids, stick to cereal and we will meet on the Bering Sea. Always wanted to do thst Deadiest Catch gig.
Mark Shepler| 3.7.11 @ 11:40PM
Thanks Handy,
I take a 49yr fox to bed every night and have for 33 years since I met her when we were 17 & 16. Besides, we got six kids together. As I like to say to my younger friends when the subject of gallavanting comes up, "the last thing I need in this world is to get mixed up with more p***y." :)
Can't stop working out. I'm worse off without it. I'm just coming off a lazy spell since the ulcers and back in the gym about 6 weeks. I kinda fudged a little. Those stats I recited is my fighting shape but right now I'm at about a 35" waist and 215lbs. A real slob. Already dropped 10 pounds in the last couple weeks. But I WILL be in that shape in another 4-6 weeks, guaranteed. I'm doing 80% calorie burning/20% lifting 4-5 days a week until I'm down to 200-195 and a 33", then I'll go to 60% weights/40% cardio to muscle up a little, then reverse the ratio to maintain. Whole program will take six months. Have done it many times in 30 years so it ain't bragging when it's true!
Seriously though, when I lay off I get heavier, achy-er, have less wind, less energy and generally feel more...old. Attitude takes a dump, too. Also, working out regular keeps the red line on the self-disgust meter at a much lower threshold so it's easier to maintain the most important self-discipline of all for health and fitness- eating habits. And I have NEVER used anabolics. I achieve my physique strictly through diet, serious exercise, and about three 30 day on/30 off moderate cycles of benign supps like creatine, NO2 and protein shakes. Once in trim I lay off those as regular exercising and MX racing keep me fit just fine. That's it.
I like Deadliest Catch and AxMen. I too dreamed about taking that test, especially in that one stretch where they had the 40yr old greenhorn from the lower 48 who obviously was there on some self-actualization quest. He didn't last long. Doubt very seriously if you'll ever find me in the Bering Sea. I'm a native S. Floridian and absolutely, positively cannot stand real cold at a stretch. Down here the seas are never colder than about 70-65 degrees but I still do not go in until late May or June and leave off no later than end of Sept. But some day, a lazy, barefoot cruise around the Carribbean might do just fine.
PCP Smoker| 3.7.11 @ 6:38PM
I was once a disbeliever, to the point where I asked the chiro if he was a "real doctor", but after the session was over, I was a brand new man. Now, I follow that up by getting maintenance session every 6 months. Much love to Dr M.T.
Anton| 3.8.11 @ 9:53AM
My god, do people ever love to discuss their ailments--and exercise regimes!--in excruciating detail. We need a website exclusively devoted to people complaining about their fascinating health issues....
Tony | 3.8.11 @ 11:06AM
Yep ... and just to contribute my own ailment discussion, I have recently retired at the age of 61 and half of my back pain problem vanished almost instantly as a result of not having to drive 30 miles to work everyday. I've just started to work on the other half of my back problem, caused by sitting in front of a computer screen for hours on end writing about my back problem!
For people like me, whose back pain is caused primarily by bad posture, the solution seems to be planning a varied list of activities each day, including walking, cycling, moderate lifting, as well as limiting the length of time I spend sitting. I think I'm beginning to notice a difference.
Now, where's that website for people complaining about their ailments ... ?
Mark Shepler| 3.8.11 @ 2:20PM
Probably in the same place as people who read them and then complain! :)
Creatina | 3.29.11 @ 7:56PM
thats a wonderful post man, thanks for sharing! keep on it.
Creative Recreation | 8.11.11 @ 2:20AM
is good
Creative Recreation | 8.11.11 @ 2:24AM
is good