The below is the Introduction from my new book “active X backs – an effective long-term solution to lower back pain“. We had a fabulous time at the launch at the Sheraton Hotel, very competently and entertainingly MC’d by Ian Rankin OBE. Thank you to Andreea for organising it, along with the wonderful Cat Anderson of The Edinburgh Bookshop. Check out the video of the launch here. Printing of the book has been delayed (it’s a long story), but it should be with us in 2 weeks! If you’d like to order a copy of the book, please email Andreea at [email protected]
Section 1. INTRODUCTION
Ian bent over one morning to straighten the bathroom mat – a sudden flash of pain shot across his lower back. In his own words, “It was agony”. Over the next 2 days the pain crept down the back of his right leg all the way to his ankle.
Five days later Ian was still stuck in a stooped position. He couldn’t bend forward at all, couldn’t stand upright, and had only managed to get to me after swallowing lots of painkillers and with the assistance of his wife, who had helped to dress him and was helping to keep him from falling over.
Ian’s life was on hold, for the third time in a year. The previous two episodes had settled over a few days, but this one – if anything – was getting worse.
I saw Ian again a week later at which point he was a fair bit better.
The next time I saw Ian was about 15 years later; I was out on a family Christmas walk when I bumped into him doing the same with his family. We exchanged pleasantaries and just as I was walking away he called after me “Gavin, I’ve never needed to come back to you because my back’s never troubled me again. I just followed your advice, and I still do today.”
I’m guessing you’re not as fortunate as Ian. 3 out of 5 Low Back Pain (LBP) sufferers will have another bout within a year. 1 in 5 adults are classified as chronic (ongoing) LBP sufferers. Perhaps like me, you’d like to be with Ian? You’d like relief and prevention.
In 1996 my travels took me to a tobacco farm in Zimbabwe where I watched a crew of people hand-picking tobacco leaves. The “boss-man” told me that it was important to pick the bottom 3 leaves from the plant – that’s where the biggest leaves were, and if you left the plant to grow another couple of days then the leaves would touch the ground and rot. So this meant the pickers would work all day bent double, taking 3 breaks throughout the day – more if it was super-hot. I asked some of them whether they ever had lower back pain. Yes was the unsurprising answer; but only at the end of the day, and they were fine the next morning. And usually, a few months or years into the job this didn’t happen anymore; many of them had been picking for more than 10 years. No one had ever heard of anyone waking up with a sore back, or having incapacitating back pain. Here were people who seemingly put their backs under huge amounts of strain and yet back pain was only a minor end-of-day tiredness. Why?
I’ve specialised in the treatment of LBP for 25 years. As a student osteopath in the early days, I was always intrigued by the fact that some people recover very well from LBP, while many others become long-term sufferers. Long after qualifying as an Osteopath, I took an MSc in the Management of Pain, which furthered my understanding of why so many people struggle to recover, but also motivated me to gain a deeper understanding of the biomechanics of the back and pelvis. I wanted to maximise my patients’ rate of recovery and extend the time they feel well. My goal is to provide relief and prevention. If Ian could achieve such rapid and lasting relief, and the tobacco pickers can prevent it, why can’t we all?
This book really began way back then; with my chance meeting with Ian that Christmas, and my experience in Zimbabwe. I want this book to enable you to be like Ian – never troubled by Lower Back Pain again.
Whether you’re a first timer, or you’ve had LBP (and/or sciatica) a few times in the past, or your life has been ravaged by it, this book will help you to
- understand why you get that pain
- form a recovery plan tailored specifically to you
- and stick to that plan. Forever.
That’s all Ian needed. In fact, I only provided him with the first two; he was perfectly able to do the third himself. And so are you! If you are one of the huge number of people who has suffered for months or years, despite having consulted doctors, surgeons, chiropractors, osteopaths, physios, acupuncturists, physical therapists, healers, etc., then you need a plan. Either you haven’t had a plan, or your plan has been wrong, or you haven’t stuck to it, or both.
LBP is the single biggest cause of disability in the world, causing more disability than Heart Disease, Cancer, Diabetes, Asthma and Alzheimers combined (that’s a whole lot of days in pain). As you might have guessed from my Zimbabwean experience, it’s much less of an issue in countries where people are more physically active, and especially in hunter-gatherer tribes where it’s pretty much unknown. I’m not saying that back pain is worse than having cancer for instance, but it is likely to cause significantly more disability in your life. So if you want to avoid being part of that crowd of sufferers, this book will help you…
I’ve condensed a mass of scientific research and 25 years of clinical experience into this book. I spent a year of my Masters trawling the research and collating and refining an approach to LBP which reflects the latest knowledge of the mechanics of back function and the neurophysiology of pain. For ease of reading I haven’t littered it with references, but put the list of research papers I’ve drawn on at the end. If you want to relieve and prevent LBP, there are three areas you need an understanding of
- How your back works
- How tissues respond to injury
- How pain works
Forming a plan tailored to you
Knowledge is power, but it’s only useful when applied. Your learning MUST lead to action. For that you need a plan. As you work your way through the book, I’ll help you build your own plan; at the end of each chapter we’ll add a bit more to your plan. Essentially, this is a work book. The “Cliff of Pain” is my model to help you see the bigger picture, including all the elements involved in your back pain. It will also help you to deal with each of them in turn in order to steadily move back away from the edge of another episode.
Sticking to the plan
Your motivation will dip (mine does); otherwise there wouldn’t be a multi-billion dollar diet industry. I’ll bet you had a time when you started to feel better, but then let your exercises slip, or went back to your old slumped posture, or whatever. Or perhaps – despite following professional advice – you had a flare up of pain, so you felt it was pointless; the road to recovery – as you’ll see later – is rarely a smooth one, and it’s important to understand this at the outset. You have to expect and plan for flare-ups, especially if you’ve had pain for a long time. This book (and your own determination) will help you to stay right on track.
Here’s a list of things patients of mine have said they’d like to be able to do again:
- Sit for more than 10 minutes
- Play golf
- Put my own shoes on
- Play with my grandchildren/children
- Run a marathon
- Walk to the end of the street
- Sit on the toilet
- Sleep through the night
- Stop worrying it’s going to happen again
- Get back to work
- Enjoy retirement
Can you add to that list? Because I’ll be asking you later what you want to get back to. It’s worth noting that most of these involve some sort of physical activity… If you want to regain an active life, you’ll have to build an active back.
If you want to get back to doing all the things your back stops you from doing; if you want to be like Ian, then I guarantee this book is for you. Of course, if you really want a long term solution, you have to commit. And this book will help you do just that: I guarantee it’ll be the best money you’ve ever spent on (actually fixing) your back. If you haven’t all ready, then please buy the book. Do it. It’s the first step on your way to fixing your back. You can also find complementary resources online at www.activexbacks.com which will help you track your improvement and guide you through exercises tailored to your condition. My intention is to support you in all ways on your journey out of pain. Of course, you’re free to decide whether to take that first step or not…
If you’d like to read the rest of the book, or buy it for a friend, email [email protected]