Wednesday, February 08, 2012

Back Pain Solutions

Dr Loren Fishman is the Medical Director of Manhattan Physical Medicine and Rehabilitation in New York City and the Author, 'Cure Back Pain with Yoga'.

She writes in the Huffington Post:

The Alexander technique, developed more than 100 years ago by Frederick Alexander, helps students become aware of and stop habits and muscle use that may be contributing to pain. Mild, hands-on work and instruction for postural improvement teaches students techniques for sitting, walking, standing and many other activities of daily living. Students who praise Alexander technique sometimes tell me they feel it has "lengthened" them or "created more space" in their spines. Some believe that the Alexander technique works through release of tension, decompression of the spine, more balanced muscle activity and improved flexibility.
In a study published in the British Medical Journalresearchers discovered that patients who had 24 Alexander technique lessons during a year experienced just three days of discomfort due to back pain, compared to 21 painful days for those receiving conventional medical care. A short course of six Alexander technique lessons (plus exercise) had a better result than either massage or conventional medical care.

PAIGE MCKINNEY COMMENTSThe article offers a good description of the Technique, and a link to an excellent2009 NY Times interview with Paul Little, lead author of the BMJ back pain study. Because the author of the Huffington Post article suggests a mix-and-match approach to “alternative therapies,” I feel compelled to report that from my own experience with back pain, mixing and matching never helped. In fact, it was only when I decreased the number of approaches to dealing with pain that I found relief. Sometimes less is more.

Dr. Fishman writes:

Spondylolisthesis: In Greek: 'listhesis' means slipping. In your back, one vertebra slides out of alignment. It usually slips forward, but sometimes back or to one side or the other. It's a radiological diagnosis, and state-of-the-art EMG techniques can determine if that's your problem. PT to strengthen abdominal muscles (front back and sides) and possibly an abdominal binder are good treatments, but some yoga also helps, as does Alexander Technique, which can work wonders with posture.

Spinal Stenosis: This is where the canal inside the spine gets too narrow, compressing nerves. You may need an MRI to be sure of the diagnosis. Posture is the best conservative solution -- Alexander Technique is probably the single best treatment, though PT is helpful too. Stenosis may worsen inexorably over time, and then it's one condition where surgery may be the best option.