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by Stephanie Levin-Gervasi
Lowell House, Paperback $16.00
Introduction
Back pain has been called the bane of the twentieth century and in the
last twenty years an entire medical specialty has evolved to treat it.
A pain in the back is both evasive and pervasive. Fortunately, there are
a multitude of methods to prevent, and often cure back pain. The following
Chapters from my book, The Back Pain Sourebook, discuss women's back conditions,
and ancient alternative treatments for back pain. The treatments are not
my sagely advice on how to take care of your back, but offer options in
your search for a healthy, pain free spine. The book is not an alternative
sourcebook, but discusses conditions and care of the spine, some ancient,
some contemporary such as: rheumatic conditions, traditional treatments,
tumors, surgery, chiropractics, acupuncture, yoga, ergonomics, exercises,
specialists and prevention.
I am not a doctor, but a health writer. I've spent the better part of
my life perfecting ballet, modern dance and tennis, none of which I participate in at the moment. I assumed that fitness, a lithe body and sensible eating habits would ward off world maladies, particularly back pain. Researching this book offered me invaluable insights into why I too, have suffered with chronic back problems. Currently, I practice yoga and dabble in tai chi, both of which I find beneficial for my chronic back pain.
In a nationwide survey chronic back-pain sufferers, found yoga to be the most successful of all approaches to backache relief for non-incapacited backache sufferers.
-Backache Relief by Arthur C. Klein and Dava Sobel
What is Yoga?
Yoga has its origin in India and goes back nearly 3,000 years. A Sanskrit
word meaning joining together, yoga works to unite the body and the mind.
Yoga involves the whole person as the mind focuses meditatively on each
movement.
Yoga is not an exercise, but a series of postures or poses. The gentle
poses are held anywhere from 10-60 seconds. Poses should never be painful.
Because yoga combines both mental and physical activity, the two most common
types of yoga are hatha and raja. There is an interdependency between the
two.
Hatha yoga enhances musculoskeletal strength flexibility, balance, agility
and coordination. Raja benefits the mind by relaxing and quieting the mind.
Benefits of raja yoga are increased mental stimulation and an ability to
handle stress. Yoga encourages the individual to sensitize himself or herself
to their limits while teaching that physical limits often change.
Because yoga strengthens the musculoskeletal system, your back, as do
your abdominal muscles, benefit. Because breathing and relaxation are a
part of yoga, stress is reduced and fresh oxygen flows to the muscles.
Once you've had a back attack, yoga works in a slow, methodical manner
to stretch and strengthen the muscles. Yoga takes a holistic approach that
a back problem is not isolated from the rest of your body.
If I've never taken yoga where do I start?
Visit a yoga class and talk to the instructor. If you are practicing
yoga to strengthen your back, ask about specific postures. Many exercises
prescribed by specialists or that are currently part of back schools, derive
from yoga. It is vitally important to search out a yoga class or an instructor
who understands yoga postures, specifically designed for back problems.
A person with a back problem does not belong in a generic hatha yoga class.
Look for a class, and an instructor who specifically has a background in
yoga regarding back problems. Just as each back problem is unique, so is
each instructor. Seek out a yoga teacher who understands your back ailments.
If there is a yoga institute in your city, call and ask for a referral.
Often universities or community colleges offer yoga classes, as do senior
citizen centers. The Yoga Journal has a list of yoga instructors, classes
and retreats around the country. A good instructor teaches you to pay attention
to your own signal of distress. It is also your responsibility not to push
your body beyond its limits, just because everyone else is doing a posture.
A bad back will not fare well in a yoga class filled with healthy backs.
Chapter 15: A Multitude of Back Treatments
Often back pain sufferers turn to body work in their search to find
an alternative practitioner for their particular problem. Sometimes they
combine body work with traditional modalities of treatment. Body work has
come into its own over the last two decades. Techniques vary among the
different schools.
The following chapter discusses the most popular types of body work
and ancient practices that you may encounter in your search. Rest assure,
that well-meaning friends who have experienced satisfactory relief from
one school of thought, will swear that it is also the answer to your problem.
It may be, and it may not be. Thank them for their gracious concern,
gather a few more testimonials and make your own decision. The differences
and similarities between body work techniques are subtle, all work at realigning
or retraining the body to function naturally. These insightful founders
of these healing methods, such as Feldenkrais, Alexander and Rolf, each
understood that the emotional and nervous system can be organized or rearranged
to heal the physical musculature. They believed that the individual has
the ability to engage in new learning, no matter how ingrained bad habits
are. Sensory re-education is the heart of several types of body work, in
other words, you feel it.
This chapter is not meant to encourage a particular school of work.
It simply offers information on some of the alternatives in the realm of
dealing with back, posture and structural problems. Body work does not
cure a "slipped disc" or "spinal stenosis", it helps
understand the cause or causes that may have contributed to spinal problems.
Then it goes to work at altering ingrained patterns of movement and emotion
related to your particular problem. Some of the body work and practices
discussed have been around for centuries, others for decades. Always seek
a practitioner who is licensed, not someone who is a student or in training.
How expensive is body work? That depends what you compare it to. If
you compare a body work session, or several sessions to a surgery, the
cost for body work is ridiculously cheap. If you compare it to a session
with your chiropractor, the costs are similar or slightly higher. Body
work traditionally requires more than one session. Ongoing body work can
be expensive if your insurance or workman's compensation does not cover
it.
Nevertheless, for the individual who benefits from body work, or obtains
relief from back or neck pain through a few or several sessions on a table
or mat,the cost is comparably minimal compared to the outcome.
If you are skeptical about body work or think it's all hocus pocus,
talk to individuals who have benefited from body work prior to choosing
a particular method. For more information about these types of methods,
see sources listed in the appendix.
Rolfing
Dr. Ida Rolf, a pioneer in body work, was a former organic chemist.
She perfected the technique structural integration called Rolfing. According
to Dr. Rolf, the traditional idea of standing up straight, shoulders back,
stomach in and head high, actually misaligns the spine and deforms the
skeleton.
Rolf's theory postulates that when the body's structure is corrected,
basic chemical changes take place within the body that improve over all
health.
Rolfing straightens the body by correcting the relationship between
major body segments, such as the head, shoulders, thorax, pelvis and legs,
toward vertical alignment. I've been rolfed once, and it was no pleasure
trip. It was, however, very effective.
Rolfers perform deep manipulation of the connective tissue called collagen.
The collagen changes from hands on energy applied, and becomes more pliable.
In a sequence of hands-on manipulation, the Rolfers move the tissue
back toward symmetry and balance that the body demands. Sufficient force
is used to stretch and move the tissue. Pain may be momentarily intense.
Rolfers speculate that pain frequently masks an emotional release. Rolfing
is not as subtle as other types of body work with its movements. Sometimes
people being rolfed recalls a traumatic episode associated with the body.
Often emotion is released after or during a rolfing session. Rolfing
takes place in a series of ten weekly sessions. Sessions last approximately
an hour and cost
Mensendieck
Mensendieck is a paramedical system of correct body mechanics, correct
muscle function, and correct posture based on sound fundamental research
developed by Dr. Bess Mensendieck and has widespread use in Europe, specifically
Denmark, Sweden, Norway and the Netherlands.
Dr. Mensendieck was born into 1861 to American parents in New York City.
Her father, a civil engineer, traveled extensively with his family. Dr.
Mensendieck was gifted both artistically and musically, and made a successful
concert debut in Paris before studying sculpture. It was the awkward bodies
of her models in sculpture that made her aware of the human form. With
a keen eye she began observing children, men and women. She attended medical
lectures on the muscles and finally quit sculpting to attend the University
of Zurich to obtain her medical degree. She came to see the musculoskeletal
system of the body as a remarkable machine with a marvelous capacity for
adapting itself to perform perfectly the most complex movements. In Europe
she lectured around the continent explaining her movements schemes for
correcting the common abuses of the body. Dr. Mensendieck set up schools
around Europe and in the 30's opened her first school in the United States.
The Mensendieck system works on the premises that if movements are executed
in a beneficial and correct manner, that it contributes to a habitually
well-functioning body. It is a unique and comprehensive approach utilizing
exercise rehabilitation to address the body's needs. These include: occupational
stresses, sports-related injuries, post-operative recovery, as well as
chronic back and joint pains produced by bad posture and musculoskeletal
diseases. Mensendieck requires no equipment. It demands motivation and
perseverance to unlearn faulty postural habits that have been a part of
one's life for years.
Alexander Technique
The Alexander Technique is a rethinking of how we perform all of our
everyday activities, specifically the activities that we take for granted.
The educationally based technique is subtle and was founded a century ago,
by a young Australian actor. Alexander found himself plagued with hoarseness
and ultimately laryngitis on stage. Rest restored his voice, but stress
weakened it. Alexander reasoned that he must be doing.something to cause
this. Plotting a course of a discovery, over a.three-year period, Alexander
began to study himself while reciting lines.
He spent hours in front of a three-way mirror. He found that while.speaking
he tightened his neck, which caused his head to be pulled back and.down
into his spine. The result was pressure and strain along the entire back.
Alexander refers to sessions as lessons, and you as the student. Eyes
are always open, you are fully clothed and it's up to the student to pay
attention. Alexander believed that in order to produce awareness that the
head and neck must be lifted off the spine instead of collapsing into the
spine. With this achieved, the neck is freed and the spine lengthens, allowing
a completely different manner of movement. Not so very different from problems
related to contemporary aches and pains, the technique essentially looks
at posture and how one moves the body. It concerns itself with movements
of the body in everyday life. Alexander teachers do not follow formal lessons
plans. Half of a lesson may be on a table, and the other half takes place
while the student goes about a daily activity, like playing flute, washing
dishes or whatever activity produces pain. The technique teaches people
to re-learn consciously how to use their own body in a more efficient way.
It is so subtle that one doesn't work to align the mind and body, but must
talk to the body and have it listen. Through verbal instruction, demonstrations
and light touch, the Alexander technique creates space in the torso. Lessons
are tailored to the individual needs and are done in a minimum of 30 sessions.
Lessons run between $30-$55. There is no risk to this gentle technique.
You'll find variations of Alexander's technique incorporated into back
schools across the country.
Trager
Peter de Zordo began practicing Trager fourteen years ago. A practioner
at the Trager Institute in Mill Valley, California he says that Trager
is a sensory experience. Trager affects change through passive body movement.
It looks at body restrictions and patterns of movement. Peter notes, like
several other types of body work, Trager is not a confrontive technique.
Milton Trager developed his body work, referring to it as psychophysical
integration and mentastics. Mentastics refers to the mind.
In Trager, the mind is everything. Trager was training to be a boxer
when he discovered his exceptional ability to work with his hands while
rubbing down his trainer. Trager quit boxing to take care of his hands
and began the long pursuit which eventually took him to medical school.
What distinguishes Tragering from other body work is the focus and intent
of the practitioner's manipulations. Tragers focus and intent are not specifically
directed towards local conditions in the body tissue, muscles, joints or
skin, like Rolfing, but toward reaching the unconscious mind. It has taken
Trager over 50 years to expand and develop his technique.
Trager mentastics is a system of effortless movements to enhance the
body's sense of lightness, freedom and flexibility. Rhythmic massage and
stretching movements encourage the body to let go. Through a series of
movements, swinging, stretching pressing, and rocking the entire torso,
the body moves into a restful meditative state. Once the body relaxes,
the moves appear effortless. Plan on about an hour to an hour and a half
for each session. Trager carries no risk and is gentle. Cost range from
$50-$75 a session, depending on the practioner.
Feldenkrais
Moshe Feldenkrais , a mind-body holistic health practioner, was an engineer
who worked on the French atomic-research program in his prior life. A judo
master and soccer player, an injury led him to apply his engineering mind
to the mechanics of the body and brain that resulted in the Feldenkrais
technique in the 1940's. There are literally thousands of exercises in
this technique, and the mind and imagination play a key role.
Feldenkrais drew on the works of other pioneers. He recognized that
a great deal of pain results from patterns of movement that involve unnecessary
muscle tension. Insightfully, he felt people could "learn to learn"
to move in a free and graceful way. Feldenkrais held that most people lose
the grace, freedom and joy in movements that they had as infants and small
children. He understood that the relationship of movement with thinking,
feeling and sensing to effect changes in behavior.
He coined this "functional integration". A Feldenkrais session
communicates to the brain precise movements that change habitual patterns
and provide new information to the neuro-muscular system by gentle touch,
movement variation and verbal guidance. A practitioner gently lifts, halts
and supports the head, arms, legs, back and chest as they guide you through
slow, easy movements. Touch is light, not deep.
Prior to his death, Feldenkrais worked with individuals affected by
mutlitple sclerosis and cerebral palsy, posturing that if an individual
had trouble with his movements, he could improve their health and well-being.
In some circles he was considered a holistic guru. For Feldenkrais,
touch evoked cure. There is no risk involved with this method. Feldenkrais
can be taught in a group setting or individually. Group classes range from
$8.00 up, and individual classes may run from $35 upward.
Aston-Patterning
Judith Aston came to Ida Rolf for treatment after several automobile
accident. Originally trained as a dancer, she was told she should give
up her career. Instead she went on to study Rolfing, but felt that the
similar results could be achieved with less force. Aston-Pattering postulates
that no one has a symmetrical body; the body is not linear, but has curves.
Working in a gym on symmetrical Nautilus equipment works against the body's
natural symmetry. Instead of projecting symmetry as the ultimate goal,
Aston-Patterning encourages body parts to cooperate with one another through
a system of learning and education through movement.
Aston-Patterning focuses on three integrated movement systems. An evaluation
determines the restrictions limiting movement options; treatment aims at
facilitating change throughout the body to create an environment where
restricted movement doesn't have to occur and the individual performs exercises
which loosen patterns of tension. The pace and sequence of Aston-Patterning
sessions depends on the individual's need. Aston-Pattering practitioners
work with a variety of back and neck problems and individuals, who like
Judity, were told they couldn't perform a certain activity again due to
injury. The sessions include both massage and movement work so the client
has immediate feedback about how to release tension in the body.
Price between $75-$85. a session.
Hellerwork
Hellerwork is based on the work of Joseph Heller, who also originally
trained in Rolfing. He expended his work to include movement re-education.
Hellerwork uses the same deep tissue manipulations as Rolfing, but includes
verbal interactions that focus on the individual's personality traits and
attitudes toward life. Hellerwork emphasizes structural balance and movement
education. It also incorporates deep tissue massage, releasing fascial
restrictions, postural alignment and body awareness. It's goal is to realign
the body and release chronic tension and stress.
Pilates Method
A herniated disc, with little satisfaction or relief from traditional
modalities resulted in Mathews exploration of alternative possibilities.
He had some success with a healing center who taught him how to relax his
upper body, breath and practice visualization. He felt better, but not
cured. He contemplated laser surgery, but when the surgeon recommended
a more traditional approach, Larry changed his mind. A pain therapist helped
Mathew manage his pain, and recommended Pilates.
Pilates classic exercise has long been the best kept secret of dancers.
Prominent dancers, singers and movie stars discovered Pilates Method decades
ago. Introduced in 1923 in New York, by Joseph Pilates, the Pilates Method
is a form of resistance control exercise.
With Pilates and the pain clinic, Mathew felt like he was on the road
to recovery. After a few months with his Pilates trainer, religiously taking
classes three times a week, Mathew's posture and body mechanics had altered
radically. He walked differently, and says his body is more open.
More importantly, he feels alive and has few days of back pain. Mathew
also discovered that once he hit 40, his body didn't bounce back like it
did in his 20's and 30's. Mathew still practices Pilates.
Pilates works with muscle resistance in the way muscles are designed
to function, not against natural mechanics. The Pilates Method utilizes
mental and physical training to teach people how to work from the inside
out. Because the method looks at the body as a whole unit, it helps to
improve posture, breathing and releases tension.
Pilates method is different from other body work in that it uses specifically
designed apparatus, which create variable resistance through a set of springs.
The apparatus has no relationship to machines in a gym.
However, the exercises strengthen supporting muscles in the body. Each
exercise is designed to stretch and strengthen all the muscles and the
joints to release tension.
The holistic method allows each individual to work at their own pace.
While each piece of apparatus permits over a dozen different types of exercise
movements, several work to strengthen the spine and abdominal muscles.
An individual works independently with an instructor, and each program
is individually designed for each persons need and appropriate physical
level. Pilates has become very popular in the last few years. Risk are
minimal. Lack of understanding how to use the equipment presents the only
risk. Pilates can be done in a group, semi-private or private classes.
Depending on where classes are taken, prices may vary. Typically a private
session can range from $30-$55 Classes are sometimes prepared in a group
of sessions, and again costs may vary. A 12 week session of lessons can
run between $300-$500.
Tai-Chi
Many years ago, I watched an elderly Chinese man perform a cross between
a graceful dance and a martial art. Fascinated with the slow, meditative
movement, I approached the unassuming gentleman and asked what he was practicing.
He said Tai chi. I learned that he was an ancient master, and taught a
class on Saturday morning in the park. I joined the class, and later studied
privately with him. Although I admired the beauty of the movements, I couldn't
seem to concentrate and found my mind soaring above the trees. I quit,
and through the years, as tai chi's popularity grew, I noticed individuals
practicing tai chi on the beach or in parks, and hoped that at another
time I might be a more subtle student of tai chi.
Twenty years later, in another time and place, tai chi reappeared. Authoring
a book stress is stressful. Sitting at a computer screen or in the library
challenges ones backs, eye sight and head. Half way through this book,
I realized I badly needed to balance my stress and confinement at the computer.
I returned to the graceful martial art of my youth, and began tai chi class
one night a week. I marveled at how relaxed I felt after the first few
sessions.
The oldest of tall the martial arts, tai chi is "the mother of
the martial arts. Tai chi was designed to make manifest the I-Ching, or
Book of Changes. No one knows who wrote the I Ching, but the ancient book
declares that everything in nature houses a yin and yang These two energies
are found everywhere in the universe. Originally, the book was used as
a meditation tool and to predict the future, but the philosophy was later
developed into movement, or tai chi. Tai chaicharges that everything in
nature shows the balance of two energies. Tai chi uses the names of animals
to describe the movements and their relationship to the universe. A movement
like " the crane" reflects the yin, or retreating, or less substantial
energy, while "carry the tiger to the mountain" reflects the
yang, or strong forceful forward energy. Both nature and the self , like
a life force, consist of both energies. Tai chi postures that bringing
these two energies in harmony benefits one's health both mentally and physically.
Tai chi originated centuries ago in China to improve endurance, flexibility
and balance. The tai chi practitioner understands that human beings are
constantly changing and always working through inner conflict. Change is
a given in life, tai chi helps you find a balance in that change. It does
so by reducing stress, preserving youth and enhancing good health.
Tai chi is an internal martial art, internal because it is based on
working inside one's system, the mind and body. With the mind, tai chi
controls our thoughts-inside the body it works to control our energy or
chi. Tai chi is a top down method. It connects the mind at the top to the
body at the bottom. It works simultaneously on the mind, body, thoughts
and chi. To practice tai chi, you must become aware of your body or how
you move. For someone with a back problem, tai chi helps you, via the postures,
to move your body correctly. You cannot practice tai chi without first
becoming conscientious of your physical presence. Because most of us use
our body incorrectly, tai chi works with warm up exercises to acquaint
one with how the body should function in movement. Hip rotation, waist
and arm rotations warm the body. Tai chi rotates all the joints in the
body. Chinese medicine believes that if the energy is static or blocked
in the joints, aging ensues. When the joints open, one feels better, and
the aging process is slowed. The tai chi postures rotate all the joints
in the body. Tai chi is gentle martial art, and you must practice tai chi
to learn it. It is a slow, but a very effective process. Every tai chi
move contains elements of yin and yang.
This graceful discipline is as much reflective as vigorous. The effect
is one of relaxation and pleasure. I think of tai chi as the universe in
harmony. As we constantly change and shift, we must learn to balance life-tai
chi is the guardian of that balance. It is also a good exercise for the
back in that it requires a therapeutic routine, in which the mind and body
must move together to maintain that fragile balancing we all strive for.
There is little risk involved with tai chi. Cost varies, but classes range
from $8.00 to $10.00, perhaps higher in some cities. Group sessions may
be cheaper as private may be more expensive. Tai chi can be practiced anywhere,
inside or outside.
Meridian Based Therapies
Traditional Chinese Medicine is a unified healing system which has evolved
over the past three thousand years. It consists of acupuncture, herbal
therapy, massage, exercise and diet. In traditional Chinese medicine, prevention
and treatment of disease is stressed by strengthening the body's own self-regulation,
thus restoring the body's balance within Chinese medicine postulates that
the life energy ch'i or ki flows along invisible body pathways called meridians.
The ch'i or kid is the life force that circulates through the body and
its balance is considered to be the essence of health When the ch'i or
ki becomes blocked at specific pressure points, illness occurs. The following
are a few approaches, based on acupressure-finger pressure, to unclog the
energy paths by manipulating the pressure points, thus balancing the body.
Acupressure
Acupressure is an ancient therapy for tension and pain relief. Acupressure
uses the same points as acupuncture. The distinction between acupressure
and acupuncture is that needles are used in acupuncture and a gentle, but
firm pressure of the hands is the basis for acupressure.
Acupressure is the older of the two techniques. Acupressurist posture
that the power and sensitivity of the human hand, is most effective in
relieving tension related to ailments in self-treatment and in prevention.
In order to relax muscular tension and balance the vital forces of the
body, acupressure uses a system of points. Acupressure sessions focus not
only on relieving discomfort, but on responding to these tensions and toxicity's
in the body before they develop into an illness. The practice of acupressure
has developed primarily through a combination of instinct and hands-on
experience. A session runs between $20-$30, and incurs no risk.
Shiatsu
This method of finger pressure has been used widely in Japan for over
a 1,000 years. During the Tokugawa period in Japan, the shogunate organized
a school of massage for the blind in order to give them a profession. From
that time until the second world war, Anma, or Japanese massage was practiced
primarily by the blind. These blind professionals were known as Anma-san.
They walked through the streets blowing high-pitched bamboo whistles to
alert their clients that they were ready to come into their homes to give
a shiatsu treatment.
Today, the shiatsu practitioner, often a small individual, uses his
or her palms, thumbs, feet and sometimes knees to apply a rhythmic pressure
to the body. By using finger pressure on the acupuncture points, shiatsu
stimulates the Ki to flow through the bones, nerves, arteries and skin.
Moderate pressure applied all over the body stimulates the flow of energy.
While there may be moments of intense pressure, shiatsu promotes a feeling
of well-being and relaxation. The environment is relaxing and peaceful.
Shiatsu can help your back ache by stimulating your life-blood energy
of Ki to flow. While shiatsu applied correctly has little risk, some folks
don't care for the intense pressure. There can be moments where the pressure
borders on pain, but once released, the pain gives way to relief. Ask your
practitioner to adjust the the finger pressure if it is too hard. While
shiatsu is not as relaxing as a Swedish massage which uses stroking movements,
the end result is one of rejuvenation and balance. An hour shiatsu session
costs between $50 to $60. The sessions end with a cupped pounding on the
back to wake up the energy. Truly, you feel like a new man or woman after
a shiatsu massage.
Reflexology
Reflexology is a Western pressure point therapy which focuses on the
feet. Reflexology postures that points on the bottom of the feet are linked
to specific organs. By massaging these areas reflexology promotes health
to corresponding organs. Reflexologists believe that the toxic deposits
collect in the feet and that reflexology breaks them up and facilitates
their elimination. For a list of resources and information about various
body work organizations refer to the appendix.
Since alternative body work has been refined to an art over many years,
you may find components of these techniques in back schools around the
country. If you suffer from back pain, and your physician directs you to
a conservative approach to treatment, back school will certainly be included.
Chapter 16 is not the whole curriculum when it comes to back school, but
a perspective of how back education helps you. |
