Preface A friend of mine once suggested that all doctors should experience, at least once, the illnesses and treatments they see and prescribe. With reference to low back pain, they may have had a point! Last summer, following a particularly rigorous landscaping endeavor, I awoke with low back pain. I am a fairly fit 40-year-old man who works out at the gym, three or four times a week; I run, I cycle, and I play soccer on a Sunday morning. I am pretty much used to the aches and pains that follow an overzealous bench press or a vigorous defensive tackle. The adage that "after 40 the pain really never goes away, it just changes location," seems ever more true, a reality softened by the occasional anti-inflammatory, savior of the masters athlete. However, nothing could have prepared me for the shock of not being able to move or even cough without tear-inducing pain from my back. I see patients with all kinds of orthopedic injuries and was aware of the impact of back pain on patients' ability to function even remotely close to normality. I was aware of the difficulty in gaining pain control in low back pain, its intractability and emotional connotations, far more than many other conditions considered 'more serious.' Yet here I was, barely able to make it to breakfast (a meal I consider most vital to daily survival), half crying, half laughing at the severity of the discomfort emanating from some ill-defined area called my 'low-back.' And what was worse was the fact that I had not even sustained a sympathy-worthy injury to cause all this. I had simply moved a little dirt to provide space for some new hostas! Not to be defeated by this simple 'muscle inflammation,' as I had clinically determined it to be, I put the 'practice what you preach' plan into action. Ice packs, Tylenol, an anti-inflammatory, and a couple of simple stretches and I should be out planting by noon, I reassured myself. But an hour later I'd made it no farther than the bathroom, more out of dire necessity than by overcoming discomfort. I was getting a little annoyed. After all I had an awful lot of things to do and a barbecue to attend that evening. My wife Penny (and co-author of this book), as always, was very supportive and understanding, offering a never-ending supply of ice/heat packs, massage, acupuncture, and other naturopathic remedies -- even a trip to the pharmacy to find something 'stronger.' This last offer may have been her chance to escape my increasing and inexcusable grouchiness, a perfect example of the emotional aspect of severe, yet inexplicable pain. Well, the hostas never got planted -- but I did make it to the barbecue. A man in pain has to establish priorities! And I did indeed improve and become more mobile. The acute discomfort subsided as quickly as it had arisen. However, 4 weeks later I was still feeling the occasional twinge, continued to be a little stiff, and woke once or twice at night with an ache in my low back. Did I reassure myself that this was quite typical for a 'lumbar strain,' that there were no concerning features in my symptoms, and that overall I was gradually getting better? Of course not! I conjured up every serious back condition ever reported in the medical literature and managed to fit the symptoms to my discomfort. Doctors indeed make the worst patients. Needless to say, by 6 weeks I was completely pain free and back to normal. My quite unnecessary X-ray, as I expected, showed not even a hint of anything abnormal. Some individuals, however, have a different experience with their back pain. It may not resolve so quickly, it may persist or recur. It may be more disabling and disturbing to their daily lives, occasionally becoming chronic and threatening their overall mood and well-being. We begin the book by answering the most pressing questions you may ask when you experience back pain: Should I See a Doctor? Who Treats Back Pain? What Are the Causes of Back Pain? We next provide full descriptions of treatments, from ice packs through medications to surgery. We then bring these treatment strategies to bear upon specific back problems, from acute lumbar strain through recurrent back pain to chronic arthritic conditions. To orient yourself to the medical terms involved in describing back pain and back care we recommend that you quickly glance through the Glossary at the back of the book and return to it whenever you encounter a term in the book that requires clarification. Similarly, we recommend that you glance at the Back Anatomy and Pain Pathology illustrations at the front of the book and bookmark this section for quick reference as you read further. Perhaps the best way to introduce you to the complex language of back pain and back care is visually through these simplified medical illustrations of the bones, nerves, muscles, and ligaments of the spinal column. In the effort to make this book authoritative, we have based our information on current medical research. These sources are listed in the 'Selected References' section at the back of the book. And in the effort to be comprehensive, we have called on a team of expert consultants, namely Dr Michael Ford, a surgeon who specializes in back surgery; Helen Razmjou, a physical therapist who specializes in mechanical diagnosis and treatment of low back pain; Sabine Stojanovich, a certified personal trainer and rehabilitation conditioning consultant; and Dr Charles Gregory, a psychiatrist who specializes in chronic pain management. We bring to the book our own expertise, Stephen as an orthopedic surgeon, and Penny as a naturopathic doctor with special knowledge of nutritional supplements and weight management. We are also the co-authors of Healing Arthritis: Complementary Naturopathic, Orthopedic, and Drug Treatments as well as The Complete Doctor's Stress Solution . Penny is also the author of The Naturopathic Diet: A Guide for Managing Weight, Preventing Illness, and Achieving Optimum Health . We trust the comprehensive information presented in The Complete Doctor's Healthy Back Bible will lead to a speedy recovery and to the prevention of this most common ailment in the future. -- Stephen Reed, MD and Penny Kendall-Reed, ND Excerpted from The Complete Doctor's Healthy Back Bible: A Practical Manual for Understanding, Preventing and Treating Back Pain by Stephen C. Reed, Michael Ford, Penny Kendall-Reed, Charles Gregory All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
