The right stitch at the right time saves more than nine!
I support NICE’s recommendation that persistent non-specific low back
pain should be managed earlier than is presently done, more actively to
reduce the risk of long term pain and disability, with self-management
starting with advice and information being a key focus of this management.
Most low back pain persisting beyond 6 weeks result from the failure
of doctors to refer early to manipulative physiotherapists who emphasize
early restoration of the normal range of motion and correction of poor
posture over pain management. The result of this is stiffness of the
physiological and accessory joints of the spine, progressive deterioration
of back structures,loss of back function and chronicity.
NICE’s recommendation that low back pain be managed with structured
exercise programme tailored to the individual patient, manual therapy
which can accelerate the rate of healing of the damaged back tissues
through improvement of blood supply to them which is complementary to
mobilization exercises and postural correction is therefore clinically
reasonable.
Expert manipulative therapists know that only a few low back pain
patients will benefit from spinal manipulation as most cases will only
require appropriate mobilization exercises and postural correction
without which there will be perpetuation of patients’ pain and therefore
it is inappropriate to refer to practitioners who have no proper grounding
in exercise and manual therapy and postural education like manipulative
physiotherapists.
Interventions like acupuncture needling, thermal modalities,
electrical stimulation, bed rest, and medication that aim to reduce pain
have not been proven to be effective in managing low back pain since this
pain is only a symptom of musculoskeletal injuries and relief of pain
without mobilization exercises, manual techniques and postural correction
will definitely be nothing more than symptomatic and credit for any
improvement without mechanical intervention should be given to nature.
Remember the saying, “time heals wounds”.
I hope Professor Underwood now knows that post-graduate training in
Mechanical Diagnosis and Therapy (MDT) at the McKenzie Institute
International is available not only to physiotherapists, but also to
doctors.This makes it possible for practitioners concerned to acquire
skills that will help them understand the importance of early back
mobilization and postural correction so that we do not refer patients to
surgeons when they can be conservatively managed.
All over the world, doctors and physiotherapists with Mechanical
Diagnosis and Therapy (MDT) training have been using non-invasive self
treatment, mobilization exercises and postural correction prescriptions to
save people from the side-effects and organ damage that could result from
dependence on non-steroidal anti-inflammatory drugs, opioids, tricyclic
antidepressants and the dangers of surgery.
It is my hope that the National Collaborating Centre for Primary Care
in the nearest future will make recommendations that emphasize prevention
and conservative treatments that address the underlying cause of low back
pain over invasive treatments that aim to alleviate symptoms.
Rapid Response:
The right stitch at the right time saves more than nine!
I support NICE’s recommendation that persistent non-specific low back
pain should be managed earlier than is presently done, more actively to
reduce the risk of long term pain and disability, with self-management
starting with advice and information being a key focus of this management.
Most low back pain persisting beyond 6 weeks result from the failure
of doctors to refer early to manipulative physiotherapists who emphasize
early restoration of the normal range of motion and correction of poor
posture over pain management. The result of this is stiffness of the
physiological and accessory joints of the spine, progressive deterioration
of back structures,loss of back function and chronicity.
NICE’s recommendation that low back pain be managed with structured
exercise programme tailored to the individual patient, manual therapy
which can accelerate the rate of healing of the damaged back tissues
through improvement of blood supply to them which is complementary to
mobilization exercises and postural correction is therefore clinically
reasonable.
Expert manipulative therapists know that only a few low back pain
patients will benefit from spinal manipulation as most cases will only
require appropriate mobilization exercises and postural correction
without which there will be perpetuation of patients’ pain and therefore
it is inappropriate to refer to practitioners who have no proper grounding
in exercise and manual therapy and postural education like manipulative
physiotherapists.
Interventions like acupuncture needling, thermal modalities,
electrical stimulation, bed rest, and medication that aim to reduce pain
have not been proven to be effective in managing low back pain since this
pain is only a symptom of musculoskeletal injuries and relief of pain
without mobilization exercises, manual techniques and postural correction
will definitely be nothing more than symptomatic and credit for any
improvement without mechanical intervention should be given to nature.
Remember the saying, “time heals wounds”.
I hope Professor Underwood now knows that post-graduate training in
Mechanical Diagnosis and Therapy (MDT) at the McKenzie Institute
International is available not only to physiotherapists, but also to
doctors.This makes it possible for practitioners concerned to acquire
skills that will help them understand the importance of early back
mobilization and postural correction so that we do not refer patients to
surgeons when they can be conservatively managed.
All over the world, doctors and physiotherapists with Mechanical
Diagnosis and Therapy (MDT) training have been using non-invasive self
treatment, mobilization exercises and postural correction prescriptions to
save people from the side-effects and organ damage that could result from
dependence on non-steroidal anti-inflammatory drugs, opioids, tricyclic
antidepressants and the dangers of surgery.
It is my hope that the National Collaborating Centre for Primary Care
in the nearest future will make recommendations that emphasize prevention
and conservative treatments that address the underlying cause of low back
pain over invasive treatments that aim to alleviate symptoms.
Competing interests:
None declared
Competing interests: No competing interests