It seems strange to many people that their backs should be troublesome when they've been in bed for some time. This is the very time you would expect it to be well rested and, after all, doctors so often advise bed rest for bad backs. However, rest actually aggravates the underlying problem.
When a muscle is in spasm there is an increased supply of blood to the muscles and tissues, but the muscle pump does not work efficiently. Extra fluid, or oedema, builds up, leading to an increase in waste products and oxygen deficiency. When you are asleep your muscle pump is at an all-time low. Oedema accumulates until it reaches a maximum level which, from the experiences of my patients, seems to be around three in the morning or later. The pain often wakes them. The worst moment is often experienced when the sufferer tries to get out of bed. By this time even slight muscular effort is enough to cause a cramp.
When you get up and move around some of the fluid is squeezed out of the tissues, improving the circulation, and the likelihood of a painful cramp diminishes. In a short time, the back can become symptom-free and comfortable?
Why is it that I can manage a fairly energetic task such as digging in the garden and not feel any pain, only to experience agony once I sit down.
A curious fact, you may say, but it makes sense when you think about it. While you are gardening, the movement of the back muscles is sufficient to squeeze out enough blood despite the increased blood supply to the muscles brought about by the effort to keep them below the threshold of pain. However, the increased blood supply produced by the extra muscular effort does not immediately diminish when the digging stops. It continues for some hours after the actual work is finished and floods out of the muscles since, when the body is at rest, the pumping effect is now greatly reduced. So later in the day, or even the next one, you experience pain when you are simply seated watching television or possibly relaxing in bed.
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Patients often extol the benefits of exercise. A daily swim or gentle workout is the ticket to a pain-free life. The trouble is that once regular exercise ceases, the intermittent pain starts again.
Charles was twenty when he was involved in a car accident. He suffered a mild whiplash injury but the symptoms disappeared very rapidly, without any treatment. He was badly shaken up at the time. Ten years later, he felt a click in his back as he picked up his three-year-old daughter. He sought help from an osteopath, who relieved him of the pain, but from then on Charles started to complain of painful twinges in his back when he got up in the morning and after long journeys. On the advice of a friend, Charles took up yoga. He was overjoyed at how much it helped ease the aches and pains. He kept it up for nearly three years and was relatively symptom-free during this time. Then he got a job promotion, which meant a busy schedule and no time for yoga. Only a month after stopping the regular activity he started to experience pain in his back again.
Exercise may keep you out of pain but it often does little to correct the basic problem. It works by activating the muscles pump and so decreasing the likelihood of the muscle going into a cramp. The muscles are prevented from turning a constant protective spasm into a cramp by the regular replenishment of exercise. Once the exercise stops, it does not take long for the muscles to move into a critical state.
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I am commonly asked whether age makes any difference to the severity of back trouble. Can you help my mother? She is nearly eighty and has been told she is now too old for treatment to be able to work, is one example. In my experience, people of a mature age respond to treatment more quickly and easily than most other age groups. By the time a person reaches the age of sixty-five his or her muscles begin to weaken and they probably stress themselves less. It follows that the spasm could also be weaker. In many cases the back undergoes a spontaneous improvement around this time.
Gladys, aged seventy-three, came to see me because she had a painful right knee. She had damaged it about six months previously. It had not recovered and was actually slowly deteriorating. It was the only joint in her body to be affected so I asked her, among other things, whether she had had back trouble. She said that she had suffered back pain on and off for many years but that in the last five years she'd had much less pain and had more or less forgotten about her back. The telltale spasm could be felt, and after it had been treated, her knee made a slow but good recovery.
Young people often seem to be able to cope with an injury without suffering any pain for many years. This is probably because they have resilient repair mechanisms and usually move about a great deal, even though the muscles are in spasm. Then, when they reach their twenties or thirties and they are less actively involved in sport, their repair mechanisms stop doing such a good job. The traffic-jam situation in the back begins to worsen and the person may well start suffering episodes of pain. It is also possible that the childhood aches and pains which adults so readily label growing pains are actually the start of back trouble.
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No. The level of fitness and general muscle strength of the sufferer has a profound effect on the course of the treatment, but in exactly the opposite way to what you'd expect. In an extremely fit person, spasm is tremendous. These people may experience pain more easily and the pain may be more severe. Many tough men have been brought to tears by the pain.
One of the most worrying patients that I have ever treated was a man who had recently been the world's non-Japanese Judo champion. He was about five feet, eight inches tall and seemed about the same width. He muscles in his back were absolutely enormous and felt as big as an average person's thigh. He had suffered back trouble for some years and had attacks of extremely severe pain.
I was almost worn out every time I treated him because the spasm of his back produced a resistance that must have been two or three times more than an average person's back. When I got him, say, seventy-five per cent better, the spasm or pressure of the back muscles on the joints was still probably as great as that of a less fit person at their worst. The number of treatments that he needed for a full recovery was three or four times more than usual.
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You may well find that two of the worst things for your back trouble are sitting for long periods in a chair, or even more disastrous in a car or aeroplane. Indeed, a car journey is probably about the most difficult situation that an injured back can be asked to tolerate.
Let us consider what happens to your back when you are immobilised in the sitting position. The back muscles are stretched as the thighs go out at a right angle. A poorly supported back will become more curved, and also stretch the back muscles. In addition, the limited movement diminishes the muscle pump.
Now add the motion of the car. The muscles in your back will have to work hard consistently to keep you upright against the stresses of a motorcar in action. When turning corners, the muscles have to resist the trunk lurching sideways; when braking, they must resist the body falling forwards; and, when accelerating, they may have to resist some backward movement.
There will also be little jolts through the spine from the bumps on the road, which fractionally may increase the bruising of the facet joints and thus the spasm of the back.
It's hardly surprising that a car journey should give rise to problems. However, once the journey is over and you start to move about, the muscle pump is resumed and the trouble soon subsides. For this reason, it is wise to plan a series of short stops on a long journey. Keep the muscle pump activated by taking a little exercise; even walking around the car can be enough.
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Most of us can recall countless childhood reprimands for poor posture. You probably make a point of correcting your own children for slouching and stooping. However, as we saw in Chapter One, we have very little voluntary control over our posture. In general, posture is controlled by an automatic mechanism based on the small brain, or cerebellum, which controls repetitive functions in the body. If, say, the body tilts forwards a little in an involuntary movement, muscles tightening to pull the body back into a normal posture will automatically correct this. If, however, the back is injured and some groups of muscle have gone into spasm and thus an increased contraction, it is easy to see that the normal posture can be upset. The curve of the back would either be increased much as the tightening strings on a bow, or, if the opposite group if muscles were affected, then the normal curve would tend to be flattened.
Many people believe poor posture leads to back pain, but slouching and stooping are the effect of back trouble rather than the cause. However in poor posture some groups of muscles are stretched so when there is a rise in waste products and a lack of oxygen these muscles will go into a cramp much earlier than they would have done if there had been a better posture. It is important to realise that it is back trouble which gives rise to poor posture and not the reverse. Once the back has been treated and the muscle spasm reduced, then the posture will usually correct itself.
To illustrate this, we will look at the story of Arabella who, from the age of twelve, was forced to try every trick in the book to correct her posture.
Arabella, then a twenty-year-old student, was in absolute agony when she came to see me many years ago. Two weeks previously, she had lifted a television and felt a click in her back. She'd also suffered slight pain at the moment. The next morning she was in severe pain in the lumbar region, which did not respond to bed rest or anti-inflammatory drugs and painkillers.
When asked about any previous injuries, Arabella remembered falling off a swing at the age of eight and bruising her back. It recovered very rapidly, as so often happens in a child, and did not need treatment. Four years later, Arabella's parents and teachers started nagging her about her posture. She remembers walking with books on her head, practising endless stretching exercises and fighting a continual battle to keep her back straight. Her back started to ache at the age of seventeen for no particular reason and this was put down to growing pains. She remembers vaguely that she lifted something fairly light and the next day she felt some pain.
Arabella stood with a marked increase of the thoracic curve of the spine (the curve of the spine enclosed by the ribs). She was in too much pain to test movement but on palpation I could feel a severe spasm of the muscles on either side of the lumbar spine and this was also present in decreasing intensity as far as her neck. It took eleven visits in all to get things right but by the end of the treatment she was altogether more comfortable. She also felt better in her general health and her posture improved considerably. After almost fourteen years, Arabella has had no more back trouble. The nagging about her poor deportment has also stopped.
Not everyone is as fortunate as Arabella. If the excessive curve has been present over a long period of time, in some cases the vertebrae can become wedge-shaped to accommodate this. Although the person is free from pain, a slight residual curve remains and becomes the normal posture.
The opposite situation to an increase in the back curves takes place if the muscles on the other side of the backbone produce the more powerful spasm. In this case, the pull of the muscles on the outside of the spinal curve will pull the curve flat, resulting in little or none of the original spinal curve.
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One of my patients once experienced the first agonising pain in his back when he read a letter informing him that one of his companies had gone bust. Does anxiety bring on back pain, he was keen to know? What is the connection? It is my belief that almost always, if and only if a patient has an underlying back problem, then states of anxiety, tension, fright and excitement can indeed be among the factors which produce pain. In some cases, they may even seem to be the only factors involved. To explain my point I would like to consider the subject in some detail.
Although man has been variously civilised for probably twelve thousand years, the fact remains that most of the physiological functions of the body still relate entirely to the primitive state. In those early times, anxiety was generally linked with physical danger, resulting in the subjective sensation which we call fright. This activates a special push-button mechanism called the sympathetic nervous system, which is associated with the adrenal glands. The body is immediately put into a state of great efficiency for the suspected emergency.
The sensation of fear stimulates the system and the body reacts rather like a ship clearing the decks and getting the guns ready for a fight. In the case of the body it may be flight rather than fight, but either way it must do all that is necessary to increase its chances of survival.
Those survival tactics include, amongst others; increasing body temperature through the muscle activity of trembling. Everything works better at a higher temperature (think of a snake whose muscle temperature depends on its environment it hardly moves when cold but becomes a very quick-moving animal in the hot sunshine). All body functions improve at high temperatures. The pulse speeds up, the blood pressure and blood sugar levels rise, and the blood is re-routed from the skin (which goes white) and stomach (causing butterflies) to the muscles and brain where it will be most required and, in the context of back trouble, the muscles are put into a contraction, ready for action. This makes the muscles work harder and may result in a cramp. This series of fight-or-flight reactions especially apply to the upper muscles of the arm, shoulder girdle and thoracic spine. The lumbar muscles are also involved, but to a lesser extent.
In terms on nature, the time element is minimal. You are either dinner yourself or you have to get your dinner in a relatively short space of time. It is all over very quickly. The sensation of fright or anxiety prepares the body for rapid and efficient action.
In contemporary times, we all suffer anxieties and tensions. They may not require the same urgent response as in primitive days, but they are a form of the same fear and the body automatically reacts. The reaction is much less intense but in our stressful lives it can continues for hours, days, weeks or even months. Under these conditions the increased tension in the muscles can easily be the critical factor in turning a symptomless back into a painful one.
Despite this however, in some cases, there is no doubt that where there is prolonged anxiety and tension, the continual pressure of the tensed muscles on the facet joints and the poor nutrition caused by the interference to the muscle pump may actually bring about damage to the facet joints. Thus prolonged stress can actually bring about back trouble in the absence of a pre existing injury.
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While I do believe that anxiety and tension can certainly be precipitating factors in the onset of back pain, I am convinced that back trouble is not psychosomatic; although certainly, many complaints are psychosomatic. Patients, like Judy whose story follows, have a mental problem, which they cannot face. This problem manifests itself in physical symptoms, which are usually designed to generate sympathy or change the sufferer's way of life for the better in some way.
Most cases of back-related problems are due to damage; however, some psychological cases do exist, like Judy's.
Judy came to me complaining of a very painful knee. Although it had been operated on twice, she said there'd been no improvement. I was not able to find any clinical signs to account or her problems and so I began to ask about any other worries or concerns. After a while she confided that she dreaded having sexual relations with her husband. An ideal excuse presented itself when she had banged her knee on a table six years before, and the pain gave her a substitute for a headache.
As the years went by, her subconscious manufactured the pain for the escape it have her. She wasn't aware she was doing it. She genuinely believed her knee was in a bad state. I referred her to a psychiatrist and once she faced up to the real problem, her pain vanished.
Judy's pain was psychosomatic. She couldn't cope with a problem and therefore resolved it by suffering physical symptoms. Many doctors believe back pain is psychosomatic. Patients are often told there is no actual physical cause for their pain and they come to me for a second opinion. On examination I always find the pain to be very real and sometimes wonder why the sufferers have not complained more.
The first thing Edna did when she walked into my consulting room was to hand me a letter from her doctor. The letter said that although Edna complained of pain between her shoulders and in the lumbar region, he could find nothing wrong. He said he was only allowing her to come to me because she had insisted so strongly. He stated that her main problem was psychological and that the best thing I could do was to endorse the need for her to go to the psychiatrist that he was recommending.
Edna, a forty-eight-year-old secretary, told me that she had become increasingly tired and low over the last seven years, and that she had started suffering occasional aches in her upper back over this time especially during and after typing. She had been having treatment with diet and antacids for indigestion for two and a half years, but each time this only gave relief for a few months.
In the last few months the pain had become somewhat worse and she was now experiencing a new pain around her left chest. She had had physiotherapy with heat massage and traction on and off for some time but this only gave temporary relief.
Detailed investigation ruled out heart trouble and no apparent problem could be found, so I conducted my own examination. During the consultation, Edna revealed that she had been involved in a bad fall on a skating rink fifteen years before. I was therefore not surprised to find intense spasm of the internal muscles. This was particularly obvious in the mid to upper thoracic spine. My examination confirmed the physical nature of her problem and a very tender fourth thoracic spine pointed to the cause of the chest pain.
After fourteen sessions of treatment with my form of physiotherapy and manipulation to the thoracic spine and muscles, Edna was altogether better.
By their very nature psychosomatic complaints are designed to gain sympathy and attention. Back pain, however, is greeted with laughter or boredom. A painful back is second only to a mother-in-law as a music-hall joke, and if people do not laugh when you complain of your pain then the chances are their eyes will glaze over as they stop listening after the first sentence. People do not feel sorry for back-pain sufferers and the pain certainly does nothing to improve a patient's way of life.
I am satisfied that out of several thousand people that I have seen with back problems I have yet to meet one with a painful back for psychological reasons.
I do however believe that when a patient has a mild back problem brought about by some accident or injury the extreme stress that they are put through for possibly three years while litigation is pending, produces a great increase in the protective spasm due to the tension overlay and this could well make a moderate back problem considerably worse by the time the case has been settled. For this reason it would benefit all round where these cases be settled in a much shorter time than is now the case. I also believe that Judges are sadly misled by the fact the patients will undergo a considerable temporary improvement after the litigation is terminated, as the tensional spasm lifts, and this leads to the completely erroneous opinion that the patient has been exaggerating the symptoms to obtain a better settlement.
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It is often greeted with some amusement if one suggests that the weather has any effect on painful backs and arthritis. Similarly, people laugh when anyone claims he can forecast a change in the weather by the state of his rheumatics. Yet, the fact remains that many back-pain sufferers do actually feel less pain on warm, sunny days or in clear, mountainous climes. Why should this be so? Weather definitely has an effect!
Firstly, I would like to stress that humidity is not usually an influencing factor, as so many people believe. It is a common assumption that when the air is humid there is probably poor evaporation from the surfaces such as the skin, lungs and the nose and throat, which leads to an increase in total body fluid. This, they mistakenly believe, would cause any already inflamed areas to become more swollen and, in the case of joints, more painful.
But humidity is not necessarily a bad thing. After all, we are sent away on a seaside holiday or a cruise as a pick-me-up after an illness or operation. The confusion is not helped by contradictory advertisements in the same magazine the one claiming to improve the atmosphere in the home by humidifying the air, and another by dehumidifying it. Which one are we supposed to believe?
To put matters straight, let me repeat that humidity is not a factor is back pain; it is the state of electrical charge or ionisation of the particles in the air, which causes these differences in the level of back pain. In sunny weather the air is predominantly negatively charged. With wind and wet weather, the air becomes more positively charged. The body is unaffected by negatively charged particles, but a positive charge (ions) can cause trouble (see below). An ion is a charged particle of gas; i.e. the air, or particles of pollen or dust. In sunny weather, when the air is charged with negative ions, patients can cope with particles that may cause an allergy. On wet and windy days these same particles may incite an attack of asthma or hay fever.
So let us look at what happens when you breathe the positive ions into the lungs. The ions pass through the lungs to the blood where they react on the platelets, causing them to secrete a substance caused serotonin. It is the serotonin which increases any inflammation and this intensifies any aches or pains. It also makes people feel lethargic, headachy and depressed.
A thunderstorm illustrates my point most dramatically. Before the storm there is a plethora of positive ions and all the symptoms that go with them. Most of us can predict the oncoming storm because we feel a heaviness in ourselves. A few flashes of lightning restore the negative charge and, although the steaming humidity remains the same, people suddenly feel quite different. All the aches, pains and headaches go and everyone feels bright and alert. Ionisers, if of a suitable type and adequate output, can be a great help in the home or place or work. One if the output of an air- conditioning plant can cure the sick building syndrome.
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When no definite cause is known for back pain, then people will blame almost anything they can imagine. Weight and height are common scapegoats I have been told that it's because I'm too tall, too short, too fat, or too thin. Yet, from my experience, these factors are rarely to blame.
Overweight people are often told that the excess poundage is the cause of their back problem, but this is not often the case. After all, most of us know very overweight people who have no trouble with their backs. Being overweight is not a cause of back pain in itself but if you already have a troublesome back then it may aggravate the situation. The extra weight may alter the curve of your back, thus stretching the muscles. This would increase their workload and also make a cramp more likely. Attacks of pain may occur more easily and with greater frequency.
It is possible that back packs, which are often heavy compared with the strength of the person carrying them, may subject the facet joints to a load that over a period of time could damage them; initiating back pain.
Height is often thought to be a cause of back problems, especially in men. Many patients have been told that their backs are unstable, as they are so tall. This, they are told, is the cause of their pain. Similarly, several short, stocky men have been advised that their size makes them liable to back trouble.
In the course of my work, when I am called on to give evidence in court cases, they often involve the award of compensation for injury. In one extraordinary case, a six-foot, two-inch-tall woman had been in a car accident, and a doctor assessing her injuries said that fifty per cent of her back injuries were due to her height; this should be taken into account in reducing her claim, he said. When asked to comment, I pointed out that in my practice there was little difference in the incidence of back trouble at different heights and that I regarded her height as irrelevant.
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A common precipitating factor in the onset of a muscle cramp is a deficiency of calcium. The patient often suffers from cramps in the muscles of the calf or feet while resting, especially at night. They can be so bad that the sufferer needs to climb out of bed and walk about to relieve the pain. Cramps are generally worse at night because of the slowing of the arterial circulation. The lack of movement causes the muscles to have a fall in oxygen and an increase in waste products. This precipitates a cramp. Calcium can be given by injection or by mouth to prevent these cramps and bring long-lasting improvement. Some other trace elements such as magnesium can also reduce cramps.
Salt deficiency is a common cause of muscle cramp, although not often in the back. A deficiency is usually due to excessive sweating in very hot weather or during a high level of physical activity (the problem is known as Miner's Cramp). The salt level in the body falls to an unacceptably low level and the muscles go into a violent cramp. This may occur in any muscle and is made worse by exercise. A drink containing salt will usually bring instant relief.
If all the muscles in the body are in a near state of cramp due to any of these deficiencies then it follows that the muscles in the back may well become painful under conditions that would not normally affect them.
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Food allergies can be a precipitating factor in the onset of a muscle cramp and pain; while they are generally accepted as the cause of swollen joints, catarrh, fatigue and headaches, I have noticed an occasional relationship between food and back pain. Indeed, I have referred several patients to food-allergy specialists to complement their treatment. Results have been most satisfactory.
The main allergic or sensitive condition that has an effect on the spine is a low-grade food allergy. We all know the acute type that occurs when you eat something like strawberries and shortly afterwards your face and other parts of the body become swollen and often covered in a rash. It is not this type of allergy but the lower grade allergy, or food intolerance as it is often called, that we are discussing here. Food intolerance is a term devised to avoid conflict between what medical experts deem criteria for an actual full- blown allergy and just a food sensitivity.
Common foods that are considered cause intolerance to many people are coffee, milk and white flour. Food intolerance can have the direct effect of causing a build-up of oedema in the group of muscles associated with the shoulder blade and joint, collectively known as the shoulder girdle and thereby lowering the threshold, making a painful cramp much more likely. Elimination of the offending food can have a marked effect on the onset of symptoms.
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Viral infection seems to be becoming more and more frequent and can sometimes be the cause of severe back pain. Many people, instead of catching a cold in the normal way, have a slight snuffle and then start to suffer pain in their backs. Often, they will show no obvious signs of a virus; usually they feel very tired or unwell and generally run down.
A viral infection gets into the bloodstream and travels all over the body. It settles in a muscle by entering the individual muscle fibres and multiplying in them. This causes inflammation of the muscle and can lead to pain.
A virus can attack the muscles in a normal back and be severe enough to immobilise the patient. People with bad backs, however, have an increased blood supply to the inflamed area and, as the infection is carried in the blood, the back receives a disproportionate amount of the infection. Once the infection has gone, then the back pain disappears and the back is usually left with no after-effects. Similarly, the increased level of activity caused by the infection on long-standing back trouble almost always reverts to the original level once the infection clears. Both the pain and the infection can be lessened with a short course of anti-inflammatory drugs.
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Many women who are starting the menopause suffer aches and pains between the shoulders and in the lower part of the neck. This is caused by a deficiency of oestrins (female hormones) normal at this time in a woman's reproductive cycle which probably leads to an increase in the tissue fluids. Hormone Replacement Therapy (HRT), which replaces the body's lost hormones, can be most effective in ridding the patient of pain.
The other great advantage of HRT is that it acts to limit osteoporosis, or thinning of the bones. It is most distressing to see women in their seventies and eighties with badly curved thoracic spines which are clearly very painful. Every so often I see an unfortunate patient who has a vertebrae that has collapsed simply unable to withstand anymore the weight of the body. I believe that there are far too many older women with serious back problems due to decalcification of the vertebrae. Their pain could easily have been prevented with HRT in their earlier years.
Salcitonin is a substance that helps suppress bone from reabsorbing. This is particularly useful to help women who are unable (or unwilling) to take HRT. Some women react badly to HRT and are not realistically able to take it. Others fear the increased risk of hormone-related cancers with HRT, but almost all the work in this country suggests there is no greater risk. It is also possible that a hormone-related cancer stimulated by HRT grows faster and so may be discovered earlier, before it has had any chance to spread.
In my experience HRT can not only usually drastically improve a patient's health, but also does a great deal to prevent the ravages of osteoporosis.
Until a few years ago it was hard to put the clock back to relieve such patients of their weakened bones. Now fortunately there are substances, which can help, the body actually restore the calcium to the bones. Two of these are Etidronate (didronel) and Alendronate, which is somewhat more potent.
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This is a very complex question as there are several conflicting forces at work in your body at this very special time. As you will recall, the drug cortisone was discovered when medical researchers began looking into why women suffering from diseases such are rheumatoid arthritis suddenly felt the condition improve when they became pregnant. It was discovered that this was due to the fact that the suprarenal glands on top of the kidneys secreted a considerable increase of their product cortisone. It is so called because it is the cortex or outer layer of the gland that secreted the substance.
This means that there is a powerful anti-inflammatory agent working throughout pregnancy, which will tend to make a chronic (long-standing chronas means time) back better to the point of being symptomless. After a while, however, the chemistry in the body changes in readiness to produce milk and this results in a relative deficiency in calcium.
Unfortunately, the lack of calcium makes the muscles more likely to go into cramp. Many an expectant mother suffers from cramps in her feet or calves at night which a typical manifestation of a calcium shortage. The calcium deficiency affects the back muscles and makes them more sensitive so that back pain begins to be a possibility again.
Two more factors also tend to cause the back to be a problem in later months. The first is that the extra weight of the baby causes awkward stresses and an increased curve of the lumbar spine. This may lead to cramps of a very painful nature in the affected muscles. The situation is made worse by the fact that the ligaments of the pelvis begin to soften to allow expansion at the time of birth. The back muscles must therefore work harder to maintain posture. This again leads to an increased tendency to cramp.
To avoid these problems in pregnancy it is important to keep the calcium in the body at an adequate level by including calcium-rich foods (milk, cheese, sardines, broccoli) in your diet or taking it as a supplement if necessary. During pregnancy the body carries an increased quantity of fluid, thereby making oedema and circulation difficulties more likely. Exercises are also important to keep the circulation in the back muscles working as efficiently as possible.
If an expectant mother is known to have a back problem I find that it is best to give treatment after the second month of pregnancy as a precaution against trouble later on. If the patient has a bad attack of pain in the last months of the pregnancy, treatment with surged faradism, ultrasonic waves and remobilisation are safe (as long as the pregnancy is normal) and will almost always abolish the immediate pain. Ultrasonic waves are quite safe for the expectant mother. I usually suspend treatment at this point and suggest that it is resumed after the baby has been born.
Drugs should be avoided during pregnancy for although the anti- inflammatory drugs are not thought to cause problems they have not been proved to be safe.
Anthea, aged twenty-seven, came to see me when she was seven months pregnant. She was in agony with lumbar (lower back) pain. She had suffered backache of a minor nature for some years. She said it was painful if she sat for too long or after carrying heavy shopping or standing over a sink or cooker.
Soon after she became pregnant her back felt altogether better and she had no pain at all. She was obviously delighted and thought that her back problem was over. However, at about the sixth month she began to have cramps in her feet, which would wake her up in the night. She often had to get out of bed to relieve them and they were getting worse.
The day before I saw her she had been bending over to put a joint of lamb in the oven when she felt her back ‘go'. The pain rapidly became agony and remained so until I saw her. I treated her with physical medicine, which largely freed her of pain. The next morning she had a modest return of the pain so the following day I repeated the treatment. She had no further pain but still came to me five months later, as recommended, and was treated eight more times until all the spasm had gone.
Anthea has had no more backache for five years. She had another baby eighteen months after the first and was free of pain throughout the pregnancy.
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From Brian Bradnock
FRCSEd, FRCSOrth, Consultant Orthopaedic Surgeon
"Dr Sherwood's ideas on the causation and treatment of back pain
will surely revolutionise modern-day treatment."
From The Rt Hon John Gummer MP
From The Rt Hon John Gummer MP
"Dr Sherwood has been a great
success ...... he makes people better"
From Tom
Since I was a teenager I have suffered severe pain
in my legs and shoulders. I have seen a number of different doctors
including an orthopaedic surgeon who took a bone biopsy from my
right hip. More...
From Abby Holgate
To aptly describe the immense benefit that Dr
Sherwood's treatment has had for me, I would have to cast my mind
back and consider the sheer quantity of people I had been to see, in
an attempt to help and understand what was wrong with me. More...
From Jessica and Bob Steel
Our son Jonathan, started suffering from
Tonsillitis around October 2002. At that time he was 2 years and 7
months old. He was constantly on antibiotics, which helped for the
short term, then only while he was taking them. More...
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