Undiagnosed causes of back problems

I wish to share the findings from the workshops I have been running around Australia since February this year. These workshops offer the approach to treating neck and back pain outlined in the book Overcome neck & back pain. Approximately 1,350 people have attended the various workshops since February 2000, all around Australia. All but a few were long-term neck or back pain sufferers, and all had sought treatment previously from a variety of practitioners.

Most to least common

In order of commonness, the most important causes of back pain identified have been an actual leg-length difference, with or without tight hip flexors. The hip flexors are the muscles we use to lift the thigh towards the chest. The first thing we do on the workshops is test leg-length, in the standing position. We do this by looking at the front and back of each person first, to identify any obvious postural problem. We then place a small block under one foot and check how that affects the shape of the spine, and then try it under the other. If there is an actual leg-length difference, it will be obvious when the block is under the foot of the longer leg, because the whole body's alignment changes, for the worse, and this is easy to see! Conversely, if there is an actual leg-length difference, the body looks better aligned when the block is under the shorter leg's foot. If the body looks the same with the block under either foot, we conclude no significant difference.

Functional symmetry

Then we check what I call functional symmetry: we check how the right and left halves of the body compare. We have found that much unexplained neck and back pain can be helped enormously by the simple prescription of a few exercises to rectify any imbalances found. Most people have no idea of their imbalances---we are used to being the way we are, after all.

The hidden causes

Then we proceed to identify what I call the hidden causes. We use the term 'hidden' because they are not usually looked for, and hence remain untreated. For example, in about one fifth of the population, one branch of the sciatic nerve passes through a little muscle in the back of the hip, called piriformis. If this muscle is in spasm, or simply tight, excruciating pain can be caused in the hip itself, or referred down the leg. And if you happen to have disc or joint abnormalities (as did two-thirds of a non-back pain suffering sample recently examined) the sciatica may well be attributed to them. We test this thoroughly and use a couple of extremely effective exercises to loosen piriformis. For most sufferers, the relief is immediate.

There is much more we do, of course, but this will give you an idea of how we begin this interesting process.