AMPLIFY: News + Discussion

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5069adae5efe077c6c692453622e451bTiger Woods
By Sean M. Wheeler, M.D.

Professional golfer and chronic back pain sufferer Tiger Woods appears to be doing worse, much worse.

Golf journalist Robert Lusetich, formerly of Fox Sports, reported this week that Tiger Woods' condition has worsened since a pair of back surgeries in Fall 2015. Lusetich, author of “Unplayable: An Inside Account of Tiger’s Most Tumultuous Season,” indicates Woods can’t move well and has pain while sitting.

Although Woods' agent was quick to deny the Lusetich report and a video of Woods swinging a golf club was posted @TigerWoods, Woods has become the face of modern medicine's failure in treating chronic back pain.

He is athletic, strong, active, determined, rich, employs the best trainers, golf coaches, physical therapists and travels to see the best doctors he can find. With access to any professional help he wishes, if anyone should be able to overcome chronic back pain it is Tiger Woods. Yet, after three surgeries his back pain keeps him absent from the professional tour.

As predicted here one year ago, Tiger Woods is another victim of the healthcare industry's decades-long lack of progress in the treatment of chronic back pain.

With Woods the latest victim, what does this say to the many worldwide sufferers of chronic back pain?

Today's medicine relies upon a mistaken treatment theory of "get the patient out of pain and back to normal activity, and all will be well." If this theory were true, it would work successfully with an uber-athletic, driven-to-return-to-his-previous-activity patient with access to every available resource such as Tiger Woods. The theory does not work, because modern medicine ignores the human body's power to brace.

When the power to brace functions in unison with the power to move, the human body performs without chronic pain.

A baby begins to walk as she gradually masters the innate use of her bracing muscles, so that her young body is able to brace itself permitting self-directed movement, including the taking of her first steps.       

Understanding how our bodies must develop this power to brace within months of birth, and combine it with the power to move, offers deep insight into how we learn to walk, and how our bodies retain mobility through a lifetime — or lose it — whether professional athlete or couch potato.

The power to brace is provided by specialized Bracing Muscles® found in six high-performance locations within the body — ankles, feet, low back, neck, shoulders, hips. 

At peak capability and as the label implies, bracing muscles brace, providing all-day stability by not moving, while our action muscles provide dynamic movement.

As the condition becomes chronic, back pain indicates a diminished or even full loss of the body's power to brace the low back. In losing the stability that comes through fit bracing muscles, no amount of moving [for example, no amount of strength training] will bring back this needed bracing stability. The lack of stability leads to compensating use of action muscles, which leads to more pain and increasing back pain severity. 

How did modern healthcare reach this point? Let me count the ways:

  • Modern medicine does not understand the cause of chronic back pain; 
  • Reliance upon a failed algorithm for back pain diagnosis;
  • Failure to distingush bracing muscles as unique within the body, leading to a misguided belief bracing muscles may be strengthened while the patient remains in pain; and
  • A mindset that bracing muscle fitness may be restored as quickly as can action muscle fitness, within a few short weeks.

For Woods and all back pain sufferers, modern healthcare must focus first on restoring the body's bracing power, before any focus on movement.

Given medicine's lack of effectiveness in treating this disease, a new prediction for Tiger Woods.

Assuming the Lusetich report is true, Woods may look for products touted as back pain remedies outside of established medicine, as do many who suffer, such as a spinal cord stimulatorinversion table, perhaps even acupuncture. He will attempt a return to golf and fail to return to his competitive standard, having not found a medical specialist who understands the role of bracing muscle fitness in back pain causation. For both Woods and his fans, only memories of past golfing greatness will remain.

Chronic back pain sufferer Tiger Woods; all that is wrong with modern medicine's understanding of the world's leading cause of disability.

Dr Sean Wheeler The Human BackThe Human Back © Sean M. Wheeler, M.D.By Sean M. Wheeler, M.D.

Reading a Guitar Bench interview with luthier Kevin Hall recently allowed me to appreciate challenges encountered during my own professional journey.

One of discovery, in the search for back pain liberation. For my patients, and for all who suffer beyond the reach of my clinic.  

Hall, who began repairing guitars in the late 1960s, shares a wealth of experience, from guitar styles and tonewoods, to the wisdom behind his build philosophies:

“Builders who start off as repairmen tend to look at instrument design and construction a little differently than those who come to the trade directly as apprentice builders.  Working as a repairman gives you a...jaundiced view of the world, since most of what crosses your bench has some form of problem...”

“If you have to repair distorted tops on a number of examples of one make or model, or see a disproportionate number of neck resets needed in another, you...start looking for the causes of such [problems]. That serves you well when you start to build your own [guitar].”

As a young doctor in general practice, I acquired my own jaundiced view of chronic back pain patients. Neither I nor anyone else could help them, and any recovery seemed random. The longer they hurt, the less likely they heal. Repetitive visits to my clinic began with hope and too often ended in disappointment.

It was an outcome I dreaded.

In spite of this dread, I accepted a fellowship in pain management for the unique skill set it gave me paired with my sports medicine specialty.  My frustration in treating those in chronic pain remained however.

To channel this frustration, I threw myself into searching for the cause of chronic back pain.

Says Mr. Hall, offering an instructive comparison:

"[Performing many stringed instrument repairs]...invariably makes you think about instruments in a different way and teaches you something which may...improve your own product.”

I found myself thinking about our medically accepted patient treatment system in a different way, and seeking answers challenging over four decades of medicine's "wandering in the wilderness."  My treatment protocol evolved and improved, leading to my “a-ha” moment to help patients heal from back pain, by creating the Body Guitar framework as the new way of thinking about the cause of, and effective treatment relief for, chronic back pain.

My epiphany included a recognition of the incredible design of our musculoskeletal system: Our backs are designed perfectly.

Flawless.

We can learn to redesign our lives to remain physically active.

Throughout a lifetime.

And as medical professionals, we too can learn to modernize our healthcare system to accept and treat the cause of chronic back pain.

Achieving pain liberation.  

As nature intended.

 

[Image © Sean M. Wheeler, M.D.]

Dr. Sean Wheeler's new book, UPRISE: Back Pain Liberation, By Tuning Your Body Guitar, presents the cause of chronic low back pain and provides a roadmap for leaving this condition behind – for good. UPRISE conversations are welcome @DrSeanWheeler, Facebook, Google+ and at LinkedIn

An investigative review published this month in JAMA Internal Medicine, Prevention of Low Back Pain, seeks to determine the effectiveness of preventing low back pain as discussed in multiple media reports.  

Researchers affiliated with the George Institute for Global Health at the University of Sydney in Australia and other institutions, surprisingly finding few high-quality studies among some 6,000 conducted worldwide, selected 23 found to be methodologically robust for their review.

Researchers concluded "success" in preventing low back pain is “discouragingly limited,” with favorable results achieved solely through exercise – of any kind.

Professor Chris D. Maher, PhD, FACP, overseer of the review, defined pain prevention "success" in The New York Times as:

A reduction in “the risk of having an episode of low back pain in the next year by 45%.” 

An NPR report by Rae Ellen Bichell interpreted the results even more pessimistically, with exercise reducing the risk of repeated low-back pain in the year following an episode by only between 25 and 40 percent.

Think about this for a moment.

The best medical result for those who exercise is a 45% chance of a low back pain nonrecurrence for one year.

Why would medical professionals deem this a successful result: the best treatment answer to chronic back pain prevention is patients should exercise regularly, and even then less than half will achieve relief?  

Is any other disease studied so little? With conclusions revealing such unpromising results?

The most enlightened finding of this latest review should be an eye-opener to everyone in the healthcare industry: modern medicine does not understand the cause of chronic low back pain.

Lower back pain is the leading cause of disability worldwide.  According to global burden of low back pain estimates, “...further research is urgently needed.” And yet we see a scarcity of high-quality studies.

Until now, few studies systematically examine what really works against repeated back pain and what doesn’t. —Gretchen Reynolds, NYTimes Well blog

While this latest review brings attention to the lack of research, it also highlights how the medical profession's approach to the problem is wrong.

The direction of research must change.

To move forward and relieve this global burden, low back pain medical research must escape old thinking, and move to a new intelligence.

Says sports medicine and pain expert Sean Wheeler, M.D.: "The medical community, including medical insurers, must understand cause."

Yet, the answer to the causation question has been found, with the needed shift in thinking about cause of chronic back pain is maddeningly small and intuitive. Recognition of this change is what spins the entire discussion of low back pain on its ear.

Says Dr. Wheeler:

We should all be challenging the status quo of accepted back pain treatment practice.

I offer a viable alternative from our global inertia in the pages of UPRISE, where I systematically identify and challenge the manner and methodology of how my profession has understood and treated back pain during the past 40 years. In UPRISE I put forth solutions.  And call for more ideas and further research.

Is this where the revolution gains traction?

What will it take for individual healthcare professionals, insurers, and philanthropic donors to question what they’ve been taught and believe about chronic back pain?

Let us question, and challenge. It’s time for everyone within the healthcare industry to move to a new mastery for patients everywhere.

 

Dr. Sean Wheeler's new book, UPRISE: Back Pain Liberation, By Tuning Your Body Guitar, clearly presents the cause of chronic low back pain and provides a roadmap for leaving this condition behind – for good. UPRISE conversations are welcome @DrSeanWheeler, Facebook, Google+ and at LinkedIn

Sean M. Wheeler MBy Sean M. Wheeler, M.D.

“[A]s an industry, we must work together to prove ourselves worthy of the esteem this [profession]...holds. We demand...high prices for our product, and our clients...place both their trust and money with us without question. We must continually raise the bar above “selling” and provide our clients with the best, unbiased and unexaggerated points of view possible."

These are fighting words from guitar maker Gerald Sheppard. And beliefs I share in my chronic back pain management practice.   

According to Sheppard, selling shenanigans in guitar sales include “developing an artificial reputation of mystique about the wood” to move inventory off the shelf.

In the chronic back pain industry, selling also exists: of the Same Old Thing. For the past 40 plus years, the medical establishment treats back pain based on misunderstood and incomplete knowledge. Some are needle jockeys who push higher revenue injections, rather than treatment addressing the real cause of the patient's chronic back pain. Patients do not get better, or they get better only to have their pain quickly return.

And so it continues.

Needed systemic change has yet to occur within not only the medical profession, but also among the health insurance industry, the latter in relation to treatment insurance carriers approve for payment. 

Whether in lutherie or medicine, as professionals we must set our egos aside to put our patient first. We expect more from ourselves, and from each other, given the trust our patients award us.

In my first years of practicing medicine, a mentor taught me to pause while making a diagnosis or patient treatment decision, and ask: “Is this about me, or is this about the patient?

Armed with this awareness and more questions – through medical fellowships in sports medicine and pain management, I soon arrived at an inevitable crossroads.  Would I remain complicit in “selling” our dinosaur of a treatment process?  Or question it?

I questioned it, and answers came.  Answers with far-reaching potential to emancipate humankind from chronic back pain, as I share in UPRISE, a self-empowerment manual for chronic back pain patients, and a new understanding tutorial for healthcare professionals, from which both learn how to tune, keep in tune, and play their low back, their Body Guitar, liberated from chronic pain.

Each day a patient’s experience and outcome improves is an enormous win.  But for things to truly change, as professionals we must raise the bar:

  • Continue to put the patient first. 
  • Free ourselves from the status quo flawed approach.
  • Ask questions.
  • Share the responsibility. 
  • Push the conversation beyond assumptive thinking and current comfort levels.
  • Communicate and share innovative understanding such as Tune Me
  • Move forward with research.

I trust those of you in pain management will be open to and share the concepts of Body Guitar and Tune Me with your patients – putting them first - as reflected beautifully in the philosophy expressed by our thoughtful luthier in Tennessee: 

"...to help the guitarist present a piece of music to the best of his or her ability, and for it to sound the way it was intended to sound.”

As in lutherie so in medicine, as responsible medical professionals we must set our egos aside to put our patients first.

It's a decision we can each easily make.

Fretting Hand Body GuitarWith guitarists and the music they produce, tastes differ. Perhaps you are a fan of Eric Clapton, Jeff Beck, Bob Dylan, Sérgio and Odair Assad – or maybe Albert King. You are drawn to their music, something about their playing thrills. 

Good guitar playing is sexy. As is good posture in someone who knows how to move.

While few achieve mastery of playing like some of these performers, we can and should master our Body Guitar. For who wouldn’t want to stave off for themselves the leading cause of disability worldwide?

A beginning music student must first know their guitar, strengthen fundamental movements, and learn good habits before they play songs. Similar concepts and perseverance are required of Tune Me, described in sports medicine expert Dr. Sean Wheeler’s new book, UPRISE: Back Pain Liberation, By Tuning Your Body Guitar.

The aspiring guitarist learns how each hand performs a coordinating role in producing music; one the fretting hand, the other strumming. Your instructor shows you the correct positions to play basic chords with your fretting hand. With your strumming hand, you learn to strum different patterns on the guitar strings. As student, your job is to practice these chords over and over so they become innate, automatic. The same dedication is required for correct strumming.

As with learning anything new, challenges arise. Perhaps you are impatient and think you don’t need to spend time practicing repetitively, or you simply want to try showing off before you can actually play. Or you assume you know how to play the guitar, without unlearning the assumptions to which you cling. Or you’ve a weakness in one of your fingers, which you might only discover the hard way, such as through injury while playing.

Just as playing guitar requires two coordinating hands, escaping chronic back pain requires two coordinating activities: exercise and posture.

Exercise, unlike how you now understand the word exercise.

With Tune Me, your doctor first identifies the source of your pain in the deep bracing muscles of your spine, then provides you either the physical therapy or exercises, often both, so that you may repetitively "practice" as diligently as you would guitar chords with your fretting hand. Mastery of strumming is akin to your good posture practice, and will become second nature as you keep at it.

Not unlike the impatience a beginning guitarist may experience learning fretwork, physical therapy and exercises may be frustrating when results seem not to appear immediately. Yet, as any great musician knows, practice takes time. Just know the physical therapy and exercise in which you engage is Circulation Training, to increase blood flow to your bracing muscles, with results something you can’t actually see. It's exercise unlike what you assume exercise to be

Like daily practice by master guitarists to retain their virtuosity, Tune Me is not just for beginners but rather is a commitment requiring continued practice.

Good posture is your goal. When you practice good posture, the bracing muscles of the spine, lower back, neck, glutes, and feet get a workout simply by standing correctly.

– Dr. Sean Wheeler in UPRISE, at Chapter 6, "Tune Me"

To achieve a strong, beautifully aligned body doesn’t happen overnight. UPRISE to the challenge. Master your Body Guitar. Become your own virtuoso Body Guitarist. Live in tune with ease, confidence and openness, liberated from chronic back pain.

And leave the fret behind.

On this day as every day, a dream within your reach.

 

You are invited to UPRISE, to become informed of the cause of chronic back pain and how to overcome the disease through mindful tuning of your Body Guitar® by reading UPRISE: Back Pain Liberation, by Tuning Your Body Guitar. Then share your copy with a friend or loved one.

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