# 71: Back in the news: Back Pain • Exercise and strengthen those abs!

Back in the news: Back Pain

Take it from me, back pain is one of the most debilitating, depressing and difficult to treat of all medical conditions. The Times’ excellent body&soul supplement (comes with the Times on Saturday), devoted a full ten pages to this common cause of pain, misery and loss of working hours. It’s a drain on the NHS, industry and obviously the sufferers and their families. Worst of all, it’s notoriously difficult to treat.

GP’s are apparently pretty in the dark about how to treat back pain. Bed rest is frequently prescribed but guidelines available since 1996 have specifically stated that ‘bed rest should not be considered as a treatment’. All in all patients with back problems are often considered as ‘heart sink’ patients and dreaded by GP’s, mainly because they are very hard to treat. The fact that we doctors know next to nothing about back pain is epitomised in the phrase, ‘bad back’. What other condition in medicine is described like this? If you have constant headaches you are not said to have a ‘bad head’. We simply don’t know what the cause of many ‘bad backs’ are. So doctors tend to prescribe anti-inflammatory drugs and pain-killers, which obviously do not address the cause of the problem.

So many patients with ‘bad backs’ end up with alternative practitioners. Many get considerable benefit from doing so and many general practices are even employing osteopaths in their practices to help their patients with back problems. So let’s have a look at some of the things that may be helpful to patients with back pain.

Orthodox Medicine: is essential to make the diagnosis. Your back pain may be due to a problem that requires surgery and for this you need to be examined by a doctor. Just because a cause is not found for many back problems does not mean that there is no point in going to a doctor. Sometimes back pain can be due to a very specific cause which needs a proper medical examination (and perhaps some investigations) to identify.

Osteopathy: Back pain is probably the most common reason for visiting an osteopath. It is my belief that osteopaths often get very good results when adopting an holistic approach to the back and rest of the body. Choose an osteopath with a good reputation in your area. It’s a hands on technique with a few manipulations but a good osteopath will also give you some exercises or stretches to do at home, specially chosen for your particular type of back pain.

Chiropractic: Very similar to osteopathy. They may rely a little more on X-rays than osteopaths and in my experience, they seem to spend less time with you than osteopaths. Again, choose one with a good reputation.

The difference between osteopathy and chiropractic?
“About £30 an hour” (joke by my friend, the comedian, Arnold Brown)

Alexander Technique
This focuses on how we use our bodies. Or more commonly misuse them. Lessons are aimed at replacing bad habits with good ones. It’s wonderful stuff but be warned: you need a lot of lessons and a lot of home practice to get the benefit. Think in terms of 20 to 30 lessons for starters.

Dr Kaplan’s personal advice: Exercise and strengthen those abs!

Here is the best free advice I can give anyone with back pain. Learn how to safely strengthen and build up your abdominal muscles. You will need two things:
1. An abdominal rocker/cruncher: (no more than £20 to £40)
2. Two or three lessons from someone who really knows how to do sit ups to supervise that you are using it correctly.
So why does this work? Building up a strong frontal structural support system, helps hold up the whole body. This takes some of the pressure and responsibility for doing this off the back. Simple and it really works. In my opinion, every GP should know how to teach his or her patients to do situps safely (ie. slowly and without straining the neck).

Homeopathic Tip of the Week

If your back pain is worse in cold, damp weather there are two easily available homeopathic remedies you can try together with any of the methods described above. They are Ruta and Rhus tox. Try one first, taking one tablet three times a day for two weeks. Use strength 6c, which is the usual strength kept by most chemists.