6 Things you NEED to discuss with your back pain patients

prrttherapyEver wonder what life would be like if you lived with back pain?

10’s of million know what it’s like and are desperate to learn how to live back pain-free. I was one of them and if you are as well you know how rough this can be.

Back pain complaints rank as one of if not the top reason a person sees a doctor.

The problem is not many people in pain find solutions that they feel addresses their pain issues.

Why is this?

Many reasons…

First and foremost, back pain is far more of a problem in parts of the world where people are less active, especially if they sit for a living most of the day.

Second, our diets don’t help as we consume many foods which are pro-inflammatory.

To name a few:

Gluten based bakery products

Nightshade plants….tomatoes, potatoes, peppers, eggplant & tobacco

A good way to have patients test for sensitivity to the above items is to choose one (Nightshades or Gluten) and have them swear off of the inflammatory items for 72 hours. Have them note any changes. Then have them add it back into their diet. If aching or stiffness increases (especially the next morning) that will be an indicator of sensitivity.

Third, the lack of adequate magnesium can often lead to muscle tension and sometimes spasm.

Magnesium is the most unique of all minerals as it drives over 300 enzyme systems and no other mineral has anything close to this critical role.

Be sure to slowly increase magnesium as too much can have a laxative effect.

Best sources of magnesium would be: Threonate
Less than ideal sources include: Oxide

Fourth, some people with depression have co-existing or co-morbidity of back pain.

In fact, most spine surgeons refuse to operate on someone’s back if they haven’t addressed their depression and have it under control.

Now tread lightly with #4 here as you don’t want to discuss the “D” word with your patients. I’d suggest asking them about stress levels. If you sense they may be in a depressed state then you could ask if they’ve ever spoken with a therapist, Psychiatrist, etc.

Fifth, one common thing I keep hearing from people who still have low back pain is the exercises they’ve been given don’t seem to help and sometimes make their pain worse.

After a half century of experience, what I’ve learned is that if the person in pain does them correctly and with the frequency advised and still has the same pain or worse as a couple weeks go by, the exercises aren’t likely to be their solution.

Lastly, it’s ideal to keep in mind how primally wired our entire spine is… including our back.

One of the most unique muscles in our body, the psoas major, a low back muscle, is frequently a culprit in the scheme of how low back pain presents itself.

Knowing and addressing these reasons for many suffering from low back pain will help to ease their pain.

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17 Years of Pain… Gone in 2 Sessions!

backpainDear Practitioner:

I’d like to share a story with you. I’m sure you’ve heard it before… someone who after a major accident, fall or injury has been forced to “live with the pain.”

I’ve never been willing to accept this outcome and neither should you!

Abby’s husband was attending our PRRT Live Seminar and asked if I would see her. On 2 separate weekends I spent roughly 2-3 hours (in total) with her. She felt such a dramatic change that she wanted to share it on video.

After amassing some 12,000+ views on our Facebook page, we decided it would be a good idea to schedule a phone call follow up with Abby.

Here’s her thoughts after our 2nd session:

 

A few months later we re-connected on the phone and I wanted to share this with everyone. FYI- the recording is about 55 mins but I wanted to give it to you unedited.

In the call, we discuss:

  • History of injuries (-54:26)
  • Her daily pain level before PRRT (-49:49)
  • Other therapies she explored (-47:28)
  • How it feels to be in pain & desperate for relief (-38:46)
  • The changes she’s experiencing (-36:10)
  • How many years she suffered (-35:08)
  • Her message to others in pain (-34:53)
  • How much time we spent on her treatment (-27:09)
  • Whether she feels it could be a placebo effect (-26:26)
  • Reflecting on her video (-20:56)
  • Her estimate of percentage improvement after each session (-13:49)
  • Update pain scale level after PRRT (-11:16)

 

 

Listening to Abby’s story of transformation from living in chronic pain to a life without pain can give you encouragement for what you too can learn to do.

Here’s the key….

You’ll need to begin to see the body in a whole new light… not based on someone’s technique approach.

“The words life changing aren’t even adequate”

I can teach you this.

Why?

Because I’ve taken the graduate level of Anatomy at USC and then studied for several years under the auspices of the world renowned and since passed on orthopedic surgeon, Jacqueline Perrry, M.D.

Dr. Perry was first a physical therapist and then became an orthopod.

During my graduate work at USC, I assisted her in teaching and was the only therapist allowed to be a “fly on the wall” for her now famous anatomy lectures for the orthopedic residents at Rancho Los Amigos.

Her insights on not only anatomy but also the biomechanics of the musculoskeletal system coupled with her EMG research in muscle function gave me insights which I feel helped me to “see” and “feel” what the human body is trying to tell us.

This is true with Abby and every person I treat.

Most of my patients have chronic conditions of pain which have defied numerous other practitioners in physical therapy, chiropractic, massage, acupuncture, etc.

Many of the patients experienced symptomatic temporary relief lasting minutes, hours, even days…only to have most if not all of their pain issues return.

In Abby’s case, it took me less than 10 minutes to perform my exam after taking a detailed history.

What I found were her muscle still in a “splinted” state from the force of impact of the MVA at age 14.

Remember, the law of conservation of energy states that energy can be neither created or destroyed – only transferred… in this case into her muscles & fascia.

The relief with my gentle, non-force PRRT maneuvers was both instant and painless.

Abby would immediately, without my prompting, begin to move parts of her body which prior to my maneuvers, she was unable/unwilling to move.

The difference now is that the movement felt great as I had transmuted nocioception into proprioception.

“On a daily basis… I’m walking around at a zero”

This happens all the time with PRRT and in seconds when the areas affected are found and released.

More importantly, the results are usually lasting.

Get started today with my 30 day Risk-Free Home Study Course!

Get My PRRT Course Now!

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Should More Physical Therapy be Authorized When Patients See Little Progress?

Blausen 0597 KneeAnatomy Side

I can’t believe what I saw and heard from a woman who came to purchase a couple items from me on craigslist. She mentioned that she’d had knee surgery for a torn meniscus 10 weeks before. I asked her how she was progressing and was shocked with what I heard her say…

 

She continues to be in pain after going to physical therapy on a regular basis since the surgery. She also had just been given authorization for another 10 sessions of physical therapy. When I asked her to describe how she was progressing there was a sense of discouragement, as she still needed to medicate with NSAIDs, which were affecting her stomach adversely.

 

When she described what she was doing at physical therapy it sounded as if the majority of her therapy was designed to try to strengthen her knee. I asked her if I could simply have a look at her knee. I compared it to the other side and palpated for the temperature of her knee – it was several degrees warmer and visually it was swollen, with a reddish color. She was unable to fully extend her knee and it had a springy feel when I attempted to. She obviously then had a residual synovitis which was inhibiting her motor control and rendering attempts to strengthen useless.

 

I explained to her that my experience over a half-century, treating thousands of postoperative knees, would indicate that she was not making great progress to which she totally agreed. Furthermore, the nature of her work, which is being on her feet refinishing furniture, as well as her overweight status clearly was playing a role in further aggravating her knee postoperatively. I shared with her my sense that at this point, two and a half months after surgery, having had physical therapy this entire time, the fact that she wasn’t noticing progress; it was likely that her knee probably had a greater degree of degenerative change than had been anticipated preoperatively. She reluctantly agreed.

 

Additionally, she shared that her surgeon was now saying the reason she’s not progressing was probably she would’ve been a candidate for at least a partial if not a total knee. What concerned me is that this is an example of the over-utilization of physical therapy on someone who doesn’t seem to be benefiting from them on virtually a month-to-month basis. After 10 weeks of little progress it surprised me that she would be authorized for another 10 sessions of the same type of approach.

 

I mentioned to her, reiterating that I was not her physical therapist nor was giving her medical advice, that she might want to consider a couple of supplements that might help with the degree of swelling, pain and inflammation (which she pleaded with me to share). So I mentioned both Boswellia and omega-3 fish oil as two very powerful natural anti-inflammatory supplements that I’ve had great experience with and the literature supports their value. I told her that as the weeks would go by if she was not seeing progress that she needed to discuss with her orthopedic surgeon the likelihood that she was not now going to successfully rehab from this attempt at a partial meniscectomy.  My feeling is they would then need to discuss the other options so that she could seek to be free of pain and still able to perform her activities both at home as well as at work.

 

I hope that sharing this story will bring about a greater awareness of making hard decisions in terms of how a patient should progress. With this procedure a person should normally be noticing improvement week by week. Their need for medication for inflammation & pain should also be decreasing as time passes.

 

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Your head is getting bigger…and I can prove it!

Bet you’re shocked by my statement.

I know it sounds strange but it’s an observation I’ve made over the decades that has proven to be true and I’ve never seen anyone explain this phenomena.

I don’t pretend to have the answer so hope you will.

Here’s how I can prove my point…

Look at a picture of yourself when you were fully grown like when you were in college.

Note the width of your cranium… distance between your ears.

Now, look at a recent picture and note the same distance.

Tell me you don’t notice your cranium has expanded in width.

Here’s all I know about this strange and unmentioned fact…

It sure isn’t that my cranium has expanded because I’m getting smarter.

In fact, given where I am at 68, I should have microcephaly to match my decline.

Now’s your chance to prove me wrong or… explain why my observation is right and begs a scientific explanation.

Click the contact link to the left and send me your thoughts.

I will await your reply.

-John

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JFK’s Chronic Back Pain…Musings on how it may have impacted his life & death

I’ve been trying to watch all the historical segments on JFK given yesterday was the 50 year anniversary of his death.

Here’s just a thought from all I’ve been able to gather…

JFK had a history of Addison’s disease which effects the adrenals.

He took testosterone for some time to put back on weight and muscle mass.

He had the PT boat accident during WWII when his PT boat was cut in half by
a Japanese ship.

Not sure if he had any back pain prior to this war trauma.

Now some things to consider…

Given the literature talks about co-morbidity of low back pain & depression
wonder if JFK had depression as we know Lincoln struggled with during his life.

I heard JFK wore ace wraps around his upper legs and then wove it up to his
lower back along with his constant company of his back brace.

You probably know Dr. Janet Travell was his doctor and used her approaches to help him.

Wonder if some of his back pain was referred visceral pain coming from his adrenals?

Given the stress he was under with the Cuba missile crisis & the war, seems possible
the stress might have exacerbated his Addison’s issue.

One last note I hear…

If JFK hadn’t been wearing a back brace in the limo when he was shot, the 2nd shot would
have been unlikely to have hit him as he too would have slumped from the 1st one like Connelly did
making his a more difficult target to hit his head.

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100 Million People in Chronic Pain

Just saw this statistic… 100 million people in chronic pain!

Hard to believe.

Seems we’re going in the wrong direction with “health care”

Wonder how many of these people are finding solutions and eventual resolution to their pain.

or

Are they:

Medicating with potential addictive meds, recreational drugs including alcohol?

Learning to live with it haven’t given up trying various therapies?

Having problems sleeping?

Finding pain adversely impacts their personal relationships?

Having a hard time trying to continue to work at a job or at home?

Added undesired weight to their bodies due to reduced activity?

Stayed tuned as I will be adding some recommendations to help if you are one of the 100 million!
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What, if anything are you doing to safeguard your practice…

now that ObamaCare will be the law of the land?

Knowing the answer to this question could mean the difference between practice growth vs. demise even if you don’t own your own practice.

Now that the President is here for the coming 4 years it’s time to begin the process of determining how you’ll be impacted and when.

I confess to know nothing about it as I only see fee for service private patients at this time.

Have you done your due diligence researched how your practice will be impacted?

Better to be prepared than to be reactive once phases of the plan are implemented.

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Should You Offer Manual Physical Therapy & PRRT?

When most people are told they will need physical therapy they envision a room filled with various apparatus and a therapist instructing and assisting them with a series of exercises that over time will improve and hopefully restore their mobility.  All physical therapists will agree that exercise is a necessary part of any physical therapy program, but today more of these same professionals are looking beyond exercises that correct muscle imbalances by including manual physical therapy and primal reflex release therapy to their treatment plans.

In manual physical therapy, a practitioner uses their hands to apply pressure to muscle tissue directly and work joints to decrease muscle spasms, tension and chronic pain due to injuries.  The purpose of this approach is to go beyond treating pain and immobility and get to the reasons why a muscle is not functioning properly or why it is causing pain in the first place. 

Just as manual physical therapy is a hands-on detective style approach to physical therapy treatment, primal reflex release technique is a hands on approach that first identifies the areas of the body where muscles are in a state of constant engagement and then uses the patients innate reflexes to correct and treat the pain.  Results of both these hands on approaches are felt almost immediately when performed properly.

All physical therapists and practitioners have the opportunity to learn both manual physical therapy techniques and primal reflex release techniques, but many don’t spend the time and resources to become highly efficient in these techniques.  These techniques are not dependent on labs and tests which means that most insurance companies will not cover the treatments even though they can be highly effective treatments that often treat pain with very few sessions. 

Many practitioners believe this means they will get fewer patients, but with all the changes in health care in the last few years, more individuals suffering from pain are going outside the system to find treatments.  Additionally most states have laws that allow people to seek physical therapy treatment without a referral from a primary care physician.  Your practice could be where those individuals go for fast pain relief.  An investment in manual physical therapy and primal reflex release technique will not only improve and expand your practice, but give you a better understanding of the causes of chronic pain. 

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Omega-3 Fatty Acids & Associated Health Benefits

Omega-3 Fatty acids are commonly taken to help reduce the risk of cardiovascular disease. There are two primary types of Omega-3 acids, Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). DHA plays a large role in neurological development and increased levels of DHA have been linked to decreased progression of age related macular degeneration. Increased EPA is associated with moderately decreased high blood pressure, decreased triglyceride levels and increased HDL levels. One study showed that an increased consumption of EPA reduced the risk of major coronary events by 18% over a five year period. Studies also strongly suggest that an increased consumption of Omega-3 fatty acid decreases joint inflammation which can reduce pain often caused by arthritis.

As a dietary supplement, Omega-3 acid is ideal for patients whose joints are inflamed and are unable to maintain a healthy weight. An increased consumption of Omega-3 acids will allow these patients to improve their cardiovascular health and decrease the inflammation on weight bearing joints.

Omega-3 acids are considered dietary supplements by the EPA so they are safe for healthy individuals to include in their diet. Omega-3 acid has only a few minor gastric side effects for healthy individuals.

Large amounts of Omega-3 acids can be found in fish and some nuts. Flaxseed has an especially high amount of Omega-3 acids although there is some concern that flaxseed and it’s oil may not have as much of the desired benefits as fish oil.

Adapted from materials provided by Mayo Clinic.

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The Greening of America’s Pain

Everywhere we look, people are talking about “greening”. It’s about saving our valuable resources. A couple of our most valuable resources not often spoken of are our time and money. How does this relate to musculo-skeletal pain and  reatment? Quite simply, the traditional model of 3 times a week for 3 or more weeks just won’t fit the “greening” model of the future. What will?

One of the most innovative approaches to rapid triage of musculo-skeletal pain is Primal Reflex Release Technique. PRRT offers a rapid assessment and treatment of the seldom, if ever, evaluated central and   ripheral influences of facilitated joint protective reflexes. PRRT fits the “greening” model as it’s possibly the only  approach whereby it must yield results in a session or two and if not, it should be discontinued and another approach  sought. In a world where patients have little time to be off work for a dozen sessions of therapy and even less money for their co-pay, PRRT offers a true “greening” by it’s ability to resolve many musculo-skeletal pain issues in just a couple sessions. What makes it even more appealing is it’s ability to seamlessly blend with whatever approach a practitioners currently uses.

Look for more approaches like PRRT to move to the forefront as we see more of the “greening” effect in the future of health care.

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