AMPLIFY: News + Discussion

Learn more about achieving back pain emancipation - how to amplify your Body Guitar - with news and discussion you can share updated here.

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Why is chronic back pain such a global problem with no widespread treatment moving us any closer to solving the condition?  
 
For the answer, consider these reasons:
  1. We work harder, longer, and play outside less and less.  Look around your office: it's a safe bet that most of your coworkers are sitting, including yourself. As a society, we're only starting to explore how destructive sitting is for our bodies.  
  2. We live in a world where exhaustion rules as a status symbol.  A person will answer the phone only to tell you for five minutes how busy, tired and stressed he or she is.  If we have back pain, we buckle down and keep moving.  
  3. Preventing disease and muscle weakness is a different type of work, the kind of which slips under our general awareness.  We don't get patted on the back for taking time off to work out over lunch or for breaking social norms like sitting at work. 
  4. It's easier to respond to urgent problems as they occur.  It remains far less common to be proactive and deal with important issues before they become problems.  In health care, this can be seen in the lack of focus on prevention.  Instead, current medical communities focus on what it can diagnose or treat.  
  5. Back pain progresses stealthily under a cloud of injuries, spine instability, and poor posture.  Additionally, your body compensates for weak bracing muscles (the ones you need to keep your spine stable and pain-free) like no other part of your body, making recognizing the root of back pain even more difficult.  We have nothing to compare it to, which means we need a new way to recognize causes and solutions.  
 
If you struggle with back pain and rely on customary medical advice, the odds are stacked against you.  Research results produced most recently essentially say nothing works when it comes to treating chronic back pain.  Our medical community's algorithms for treatment are flawed and failing.
 
Chronic back pain is a real problem for many of us, but there is a solution, which while simple in concept requires discipline.   
First, let's rewrite our understanding of what causes chronic back pain.
Second, as a patient, one must understand what to expect in treatment, and what works and what doesn't.  To instill your self-care discipline, seek a trained expert to show you how to care for our back to prevent chronic low back pain.
 
UPRISE: Back Pain Liberation, by Tuning Your Body Guitar, by back pain expert Dr. Sean Wheeler, offers the starting point for a new global conversation of chronic back pain treatment and relief.  
 
[Image Credit: The Lancet, Source: The Economist]

The POSTURE Series, No. 5

By Sean M. Wheeler, M.D.

IMG 6003Chronic Back Pain Specialist Dr. Sean WheelerOur spines aren't designed to live as we today do. 

Our early ancestors sprinted barefoot across the savanna, spear in hand, the picture of perfect ergonomic position. In contrast, today we sit much of the work day at a desk, hunched over computers and phones. 

However, the evidence is clear: standing longer, when in correct posture, is better for us than sitting.  

Standing in this way reduces risk of obesity, diabetes, cardiovascular disease, cancer and lowers long-term mortality. In contrast, extended sitting causes us to slouch, tightens our hip flexors, rounds our shoulders forward and causes pooling of blood in our legs and feet. 

Standing strengthens our feet, calves and gluteus and puts us in a better posture.

The standing vs. sitting choice sounds obvious I gave it a try. I found boxes and outdated medical books on which to prop my computer screen and mouse. Ten minutes in I was feeling good. By 30 minutes I knew something was wrong and sat down. I was not ready for all-day standing, and in all likelihood neither are you.  

Recent studies, including a medical review published in the Cochrane Library, show that people don’t stand much longer with a standing desk and the standing they do is marked by bad posture. This outcome has much to do with bracing muscle® function.

Bracing muscles in the buttocks stabilizing the hip provide endurance for stabilization during standing, and under-utilized bracing muscles have to be built-up by standing with proper posture over progressively longer periods of time. Running or working out will build strength in the action muscles of the buttocks that move you, but not the endurance needed for stabilization during standing.

If you think you can suddenly just stand all day, you may end up as the above study suggests: sitting.

You can test your readiness for a stand-up desk at work while otherwise waiting in a long line that doesn't seem to move, or after you've arrived late at a function and all the chairs are taken.

Stand.

Stand with equal weight on both feet without locking the knees and without leaning forward. For a more complicated task, draw your tummy in, bringing your pelvis under you. Then keep track of how long it takes until you lean into one hip. This period of time is how much endurance you have in the bracing muscles of your gluteus.  Typically this period of time is not long. Once you begin to lean, the foot, knee and hip on that side get sore. This is not what you want. In fact, the leaning is actually worse for you than the sitting.

To achieve the ultimate goal of all-day standing at work, and the health benefits that come with it, budget your standing time as you build the necessary endurance. Stand until leaning, then sit. Time this out daily, slowly adding more and more non-leaning time until the day is filled with proper standing. By the way, propping yourself up, bent over the desk, doesn't count. 

Using this better posture you will soon be standing significantly longer. Expect the entire process to take up to six months, as that is the period endurance muscles require to rebuild blood flow for all-day endurance. 

Think of it like this: you have to climb the mountain before you can stand triumphantly atop it.

 

Sean Wheeler, M.D. is board certified in both Pain Management and Sports Medicine. He is a leading expert on back pain. His recently released book, UPRISE, is changing the way the world thinks of back pain causation and its treatment. With a new vocabulary in aid of understanding the cause of back pain, and new medical approach focused on increasing the endurance of your bracing muscles, Dr. Wheeler puts patients back in charge of their health to achieve liberation from chronic back pain. 

From pain medical expert Dr. Sean Wheeler, 6 steps you must know to successfully navigate your journey from chronic low back pain to pain liberation:

  1. HOW TO ISOLATE THE BRACING MUSCLES® OF YOUR SPINE
    bracing muscles Back Pain Medical Authority Dr Sean Wheeler 1
  2. HOW TO ISOLATE THE BRACING MUSCLES OF YOUR GLUTEUSbracing muscles Back Pain Medical Authority Dr Sean Wheeler 2
  3. FEELING - AND KNOWING - THE DIFFERENCE BETWEEN BRACING MUSCLES AT WORK VS. ACTION MUSCLES AT WORK, AS ACTION MUSCLES COMPENSATE FOR AND 'HELP' DIMINISHED BRACING MUSCLE FUNCTIONbracing muscles Back Pain Medical Authority Dr Sean Wheeler 3
  4. WHAT GOOD POSTURE LOOKS LIKE bracing muscles Back Pain Medical Authority Dr Sean Wheeler 4
  5. HOW TO STRETCH YOUR COMPENSATING ACTION MUSCLES PROPERLY bracing muscles Back Pain Medical Authority Dr Sean Wheeler 5
  6. HOW TO STRETCH YOUR JOINTS PROPERLY bracing muscles Back Pain Medical Authority Dr Sean Wheeler 6

With guidance from your doctor and physical therapist, and similar to how a beginning guitar student gains expertise by learning the fundamentals of their guitar and how to play it, your mastery of these 6 steps serves as the basis for achieving freedom from your chronic low back pain.

It all begins with fully understanding the role of Bracing Muscles in your low back, as diminished Bracing Muscle function is where your low back pain begins and, with restored function, ends.

 

The 6 physical therapy steps described above – including the principles of 180 in 180® and Living Tune Me – are described more fully in UPRISE: Back Pain Liberation, by Tuning Your Body Guitar, by Sean Wheeler, M.D.  Dr. Wheeler is board certified in both Pain Management and Sports Medicine.  He is a medical authority on back pain.  His recently published book UPRISE is changing the way the world thinks about the cause of chronic back pain.  With a new vocabulary to aid understanding of the cause of chronic back pain, and new medical approach, Dr. Wheeler puts patients back in charge of their health to achieve liberation from their chronic pain. 

[Image credit: Architect and amateur luthierRoberto Cipriano depicting guitar bracing,  the internal reinforcement of a guitar’s top and back.]

Dr. Sean Wheeler expert back pain doctorSean M. Wheeler, MD Back pain medical expert Dr. Sean Wheeler advocates the urgent need for change in how those who suffer from chronic back pain are treated and cared for within the healthcare industry, including by medical insurance companies involved in payment approvals for medical treatment.  

According to Dr. Wheeler, decreasing long-term reliance on pain medication as a treatment option is needed, as the repeated use of these medications does not address the systemic cause of chronic low back pain.  

Now comes word of a new study supporting decreased use of opioids for relief from low back pain, in this report from today's New York Times:

"People with chronic low back pain are sometimes prescribed opioids for pain relief, but a review of studies has found opioids generally ineffective.

The analysis, in JAMA Internal Medicine, pooled data from 20 high-quality randomized controlled trials that included 7,295 participants. The studies tested various narcotics...

The drugs relieved pain slightly, but the effects were not clinically significant, and the medicines did little to improve disability...

Measured on a 100-point scale, the magnitude of relief did not reach the 20-point level the researchers defined as clinically effective, little different from NSAIDs [i.e., nonsteroidal anti-inflammatory drugs] like aspirin."

As characterized in the study:

"For people with chronic low back pain who tolerate the medicine, opioid analgesics provide modest short-term pain relief but the effect is not likely to be clinically important within guideline recommended doses."

Beyond today's news of opioid ineffectiveness, Dr. Wheeler commented:

"Fund researching on alternative effective pain management for back pain patients is a pressing need, in a field that has not seen a significant medical advance in four decades.

Research into bracing muscle® endurance as the cause — and source of relief — of chronic low back pain is overdue. 

It is time for our healthcare profession, including health insurors, to effectively address what has become the world's most disabling condition, that of chronic back pain." 

Read more about this latest research on opioid effectiveness in JAMA Internal Medicine, and in The New York Times.

 

Sean Wheeler, M.D. is board certified in both Pain Management and Sports Medicine. He is a leading expert on back pain and his recently released book UPRISE is changing the way the world approaches back pain. With a new vocabulary in aid of understanding the cause of back pain, and new medical approach, Dr. Wheeler puts patients back in charge of their health to achieve liberation from chronic back pain. 

 

weeblesWeebles®

The POSTURE Series, No. 4

By Sean M. Wheeler, M.D.

There is a difference between a teenager slouching and an adult slouching.

It is gratifying, as a nagger [a skill learned from my mother] to constantly bug a teenager about slouching and watch them follow your advice and obtain great posture. Gone is the insecure 16 year old and in their place is the confident 19 year old.

One can’t help but to look upon that young adult and feel a sense of pride in the constant badgering that accomplished such a feat. And yet, the same adult is unable to fix their own posture. Braces, electronic reminders, Lenten resolutions, shock collars, etc. and nothing seems to stick. Sure they sit up taller for a while, but the head is still forward and the middle of the back begins to hurt. It is not lack of willpower, no matter how much one beats themselves up over their posture.

Something has changed.

The fundamental make-up of a teenager slouch verses an adult slouch is completely different. Until the adult is able to understand the difference, they will always have posture problems.

ONE

The tissue isn’t the same.  We joke as adults that a child can stab themselves with a fork and watch themselves heal, but adults pull a muscle putting their belt on and two weeks later they still hurt. It is only funny because it is so true. A young person’s tissue just holds them together better.

Imagine a huge tent for a wedding that has a single large pole in the center. The cloth of the tent is new and taunt. The ropes and stakes that support the tent are strong. The whole structure is stable. Then someone runs into the center pole hard enough to make it wobbly. The tent as a whole is not as stable as it was, but because the cloth and the ropes and stakes are in such good condition, enough stability is maintained to make the tent functional. [This is the case of a young adult who begins to lose their bracing muscle strength.]

As the tent ages, the cloth begins to give a lot more. Tears easier and cannot be relied upon as much to provide stability. The ropes stiffen and become more brittle while the stakes bend. In an older tent, a wobbly center pole becomes an issue that must be dealt with if the tent is to stay up. [Please no comments on tent repair or stability, this is a parable on the aging body, not a treatise on tents.]

When injuries or bad positions occur, adolescents spring back into position like a Weeble. ["Webbles wobble but they don't fall down."] Adult tissue is like the part of the couch that one hates to sit on, because they sink in way too far. It is just not the same tissue.

TWO

Gluteus muscles are weaker. The muscles in the buttock that hold the leg into the hip in a stable position are bracing muscles. Muscles that have to work all day stabilizing the hip joint. As adult sits at their job, or find increasingly more efficient ways of completing their jobs, they slowly begin to lose the endurance of these bracing muscles. Sure, the gluts are still strong, but how is their endurance? When standing, how long until they lean into one hip? This is a sign of endurance in the stabilizing function of the gluteus. When the gluteus is weak, psoas tightens [see The Posture Series, No 3].

THREE

Pelvis is in the wrong position. Adults not only sit more, but have better chairs. Kids sit in terrible chairs and can’t wait to get out of them. Adults take their hard earned money and get the chairs they deserve. Then they lean back into them. They role their pelvis back, allow their tummy to pooch out and sit like this for hours. The days turn into weeks and months and then years and decades. The pooched out tummy becomes a norm that one would never see in teenagers. It becomes a sign of decreased deep bracing muscle strength around the lumbar spine. A teenager with their pelvis in the wrong position is okay because their tummy is drawn in all the time. An adult has to have their pelvis in the correct position because of this lack of endurance in the tummy muscles (not situps).

Adults then try to get their posture back and think all they need do is make a commitment to sitting up straight. Instead, getting their pelvis in the correct position is going to take a serious 180-day commitment to drawing the tummy in correctly, stretching hamstrings and hip flexors, strengthening the gluteus bracing muscles and deep bracing muscles. Add to this, knowing where the pelvis is supposed to be, rather than pretending they have an adolescent slouch.

CONCLUSION

These steps might even make putting on a belt less dangerous to one's health.

 

[Weebles is a trademark for several lines of roly-poly toys designed by Hasbro‘s Playskool Division.]

Sean Wheeler, M.D. is board certified in both Pain Management and Sports Medicine. He is a leading expert on back pain and his recently released book UPRISE is changing the way the world approaches back pain. With a new vocabulary and new medical approach, Dr. Wheeler puts patients back in charge of their health to achieve liberation from chronic back pain. 

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