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Low Back Pain - Sciatica - Degenerative Disc Disease - Arthritis - rapidly reversible?

Can the pain these ailments, or diagnoses produce be rapidly reversible? When was the last time you associated low back pain or sciatica with pain that was rapidly reversible? For most people those diagnoses and "rapidly reversible" don't fit in the same sentence. However, a book written by an Orthopedic physician, Dr. Ron Donelson is in fact titled "Rapidly Reversible Low Back Pain" (2). The fact is low back pain can often be rapidly reduced, alleviated, and managed when addressed with the correct treatment approach.

Does this knowledge grab your attention? If so, read on. Maybe you, a friend, or a family member have low back pain, even sciatic pain that is not getting better or keeps coming back? If so there is a good chance that you can treat it quite easily with a little help from a physical therapist. Not just any therapist will do. You want one trained in MDT (Mechanical Diagnosis and Therapy - aka the McKenzie Method). What Dr. Donelson describes in his book is that there is a lot of misunderstandings and ineffective treatments being used to treat low back pain and sciatica. This may be one of many reasons patients have recurrent pain, or simply don't get better even with treatment. Looking at the research and the outstanding treatment successes that Robin McKenzie and his approach demonstrated both in the clinic and the research, Dr. Donelson proposes that literally millions of dollars, as well as days, weeks and hours of pain and suffering could be saved. Patients just need to seek out more effective treatment. What make MDT so unique and special you might ask? For starters it is not just "an exercise" as so many believe. What it is, is an evaluation system, a process, that includes many different exercises.

Often times low back in all of it's variations are treated in the same manner. Core strengthening is often recommended, sometimes stretching, massage, or some other intervention. Commonly the same exercises are prescribed for any back pain patients. However, could you imagine going to your doctor with a complaint of chest pain and them not checking to see if it was your heart, indigestion, or a bruised rib causing that pain before prescribing a treatment? In it's most simple form, that is what MDT is all about. It is about evaluating a patient with Low back pain and figuring out WHY the pain is there. Once you know why the pain is there, and how it behaves, then you can understand how to treat it most effectively.

Lets look at that for a moment shall we? Most patients with Low Back Pain will complain of an ache in the back. Sometimes it will extend into the leg or buttock. Often they have tight muscles and difficulty moving. Sometimes the pain and restriction is from the tightness, spasms, or restriction, sometimes it's from pain. Some don't even have low back pain. They may just have an ache in the back of their leg or buttock. So the patient wants the muscles to relax, and pain and tightness to go away. Maybe massage, or heat could help, right? They reduce pain and muscle spasms, right? Well, yes, it might help with the symptoms. However, if you do not get to the cause of the symptoms, they will be back in short order. It's just a temporary relief. It would be like having a leak under your sink and putting a bucket there to catch the water. You've stopped the water from running out onto the floor, but you have not solved the problem. You've have just dealt with the result (symptom) of the problem. What you need to do is determine where the water is coming from and fix that. Then you don't need to worry about the bucket or any of the issues associated with a leaky pipe because you've fixed the problem itself.

As a Physical Therapist with nearly two decades of experience and a history of low back pain myself I've seen quite a bit over the years. Sadly, using the skills I was taught in Physical Therapy school did not help my own back pain. In fact, it may have made it worse over time. It was my own experiences fighting low back pain that lead me to where I am today. It lead me to the advanced Diploma Level of post graduate training that I now use to treat low back pain (and neck pain, or any orthopedic pain) in a very different way then I was taught in PT school. Thankfully it is one of the most rapid, effective, and highly researched treatments available today. It changed my life and now I am able to share that knowledge with my patients. In a 2014 study the findings revealed that patients with low back pain who were being treated by clinicians with McKenzie training had better functional outcomes and required less total visits then when treated with other methods (1).

The power of the system is that it can tell me who I can get better and how, but it tells me who I cannot help. Thus our patients don't spend weeks on end making little progress. If you're not feeling better or noticing changes within a few visits either I can't help you, or we need to re-evaluate why you are not making progress. Sometimes physical therapy is just not the answer and we can refer you to someone who will be able to help you. No need in wasting weeks or months not making any progress.

Deutscher, D., et al. (2014). Physical Therapist' Level of McKenzie Education, Functional Outcomes, and Utilization in Patients With Low Back Pain. JOSPT, 44 (12) pp 925-936.

Donelson,, R. 2007. Rapidly reversible low back pain: An evidence based pathway to widespread recoveries and savings. Hanover, New Hampshire: SelfCare First, LLC.

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