Somatics and Therapeutics

Because people resort to what they know, and what they know for back pain and lifting injuries consists of drugs, surgery, or manipulative techniques, and because there is something better, I have written this brief blog.

DRUGS

Drugs consist of muscle relaxants and analgesics (pain meds).  Muscle relaxants have the side-effect of inducing stupor, as you have found if you’ve used them; they’re a temporary measure.  Analgesics tend to be inadequate to relieve the pain and, in any case, only hide that something is going on, something that needs correction to avoid more serious spine damage.

MANIPULATIVE TECHNIQUES

Manipulative techniques consist of chiropractic, massage, stretching and strengthening (which includes most yoga and Pilates), most physical therapy, inversion, and other forms of traction such as DRS Spine Decompression.

SURGERY

Surgery consists of laminectomy, discectomy, implantation of Harrington Rods, and surgical spine stabilization.

See the comparison chart of common modalities.

COMMENTS ON EACH

First, I’ll comment on manipulative techniques, in general.  They’re best for temporary relief or for relief of new or momentary muscle spasms (cramp), not for long-term or severe problems.

Most back pain consists of muscular contractions maintained reflexively by the brain, the master control center for muscular activity and movement (except for momentary reflexes like the stretch reflex or Golgi Tendon Organ inhibitory response, which are spinal reflexes).  I put the last comment in for people who are more technically versed in these matters; if these terms are unfamiliar to you, don’t worry.  My point is that manipulative techniques can be only temporarily effective (as you have probably already found) because they don’t change muscular function at the level of brain conditioning, which controls tension and movement, and which causes the back muscle spasms.

Nonetheless, people commonly resort to manipulative techniques because it’s what they know — and they think they’re getting the best!

Surgery is the resort of the desperate, and although surgery has a poor track record for back pain, people resort to it in desperation.  There are situations where surgery is necessary — torn or ruptured discs, fractures, spinal stenosis; situations where surgery is inappropriate — bulging or herniated discs, pain of unclear origin, muscular nerve impingement; and situations where surgery is sometimes appropriate — rare cases of congenital scoliosis.  (Scoliosis — curvature of the spine — is more commonly a consequence of muscular tensions around the ribs and spine, than the result of deformed growth).

Again, the point:  most back disorders are of muscular (neuromuscular) origin — and correctable by clinical somatic education (which is not about convincing people that ‘things are not so bad, and live with it’ or ‘understanding their condition better’ — but a procedure for eliminating symptoms and their underlying causes, and for improving function).  Severity of pain is not the proper criterion for determining which approach to take.  The proper criterion is recognition of the underlying cause of the problem.

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