Table of Contents
Foreword v
Introduction 1
The way it might be 1
The way it is… 2
The way it goes wrong 4
The way ahead… 10
1 How a normal spine works 13
What is a spine? 13
The lumbar vertebrae 13
The spinal ligaments 19
The intervertebral discs 23
The nutrition of the discs 28
The vertebral movements 30
The facet joints 33
The bending human spine 36
The spinal nerves 40
The muscles which work, the spine 41
2 The stiff spinal segment 50
What is a stiff spinal segment? 50
Causes of a stiff spinal segment 52
Unremitting spinal compression reduces disc metabolism 54
Gravity squeezes fluid from the discs 55
Abdominal (tummy) weakness allows the spine to 'sink' 56
Sustained postures accelerate fluid loss and poor varieties of movement prevent fluid replacement 57
Chronic protective muscle spasm compresses the problem disc 63
Abnormal postures increase neurocentral compression and reduce metabolic activity of the discs 65
Injury can rupture the cartilage endplate between vertebra and disc 70
The disc breaks down 72
The way this back behaves 74
The sub-clinical phase 74
The acute phase 75
Acute palpation 76
What causes the acute pain? 76
The sub-acute phase 77
Sub-acute palpation 78
The chronic phase 78
Chronic palpation 79
What causes the chronic pain? 79
What you can do about it 80
Aims of self-treatment for segmental stiffness 80
A typical self-treatment for acute segmental stiffness 81
A typical self-treatment for sub-acute segmental stiffness 82
A typical self-treatment for chronic segmental stiffness 83
3 Facet joint arthropathy 85
What is facet joint arthropathy? 85
Diagnosis by manual palpation 89
Causes of facet arthropathy 91
Disc stiffening allows the facet capsules to tighten 91
Disc narrowing causes the facet joint surfaces to override 92
A sway back causes the lower facets to jam 94
Weak tummy muscles can jam the facets 97
A shorter leg invokes a greater restraint role of the facets 98
Golf clinic 101
The way this back behaves 101
The acute phase 101
Manual diagnosis of an acutely inflamed facet 102
What causes the acute pain? 103
Interrupting the pain cycle 104
The chronic phase 105
Lessening the pain 105
What causes the chronic pain? 107
What you can do about it 109
The aims of self treatment for facet joint arthropathy 109
A typical self-treatment for acute facet joint arthropathy 110
A typical self-treatment for sub-acute facet joint arthropathy 111
A typical self-treatment for chronic facet joint arthropathy 112
4 The acute locked back 114
What is an acute locked back? 114
Causes of an acute locked back 117
A natural 'window of weakness' early in a bend 117
Segmental stiffness predisposes to facet locking 119
Muscle weakness contributes to facet locking 120
The way this back behaves 122
The acute phase 122
What causes the acute pain? 123
The sub-acute phase 124
The chronic phase 125
What you can do about it 126
The aims of self treatment for an acute locked back 126
A typical self-treatment for acute locked back 127
A typical self-treatment for sub-acute locked back 128
A typical self-treatment for chronic locked back 129
5 The prolapsed 'slipped' intervertebral disc 132
What is a prolapsed disc? 132
Diagnostic techniques 137
Disc surgery 139
Causes of a prolapsed disc 141
Pre-existing breakdown alters the propeities of the nucleus and weakens the disc wall 142
Bending and lifting stress breaks down the back wall of the disc 143
Intensifying the breakdown 144
The way this back behaves 146
The acute phase 146
What causes the acute pain? 148
The chronic phase 150
What causes the chronic pain? 153
What you can do about it 154
The aims of self treatment of a prolapsed disc 154
A typical self-treatment for acute prolapsed disc 155
A typical self treatment for sub-acute prolapsed disc 156
A typical self-treatment for chronic prolapsed disc 157
6 The unstable spinal segment 158
What is segmental instability? 158
Diagnosis 162
Spinal surgery 164
Causes of segmental instability 165
Primary breakdown of the disc 165
Primary breakdown of the facet joints 168
Incompetence of the 'bony catch" mechanism of the facet joints 169
Weakness and poor coordination of the trunk muscles 171
Some speculation 172
The way this back behaves 173
The acute phase 173
What causes the acute pain? 174
The sub-acute phase 174
The chronic phase 176
What causes the chronic pain? 178
What you can do about it 178
The aims of self treatment for segmental instability 178
A typical self-treatment for acute instability 179
A typical self-treatment for sub-acute instability 180
A typical self-treatment for chronic instability 181
7 DEALING with acute back pain 183
What acute back pain does to your body 183
What you can do yourself: The 2 Important Appeasing Exercises for Acute Back Pain 185
1 The Wiggly Wagglies 185
2 Knees Rocking Every Which Way 187
8 Treating your own back 190
Helping yourself 190
Preliminary thoughts 190
The Procedures 191
Bed rest 191
The correct way to rest in bed 194
Medication 195
Painkillers and NSAIDs 196
Muscle relaxants 197
Exercises for treating a bad back 199
Rocking the knees to your chest 199
Rolling along the spine 200
Legs passing 205
Reverse curl ups 206
The BackBlock 209
Segmental pelvic bridging 215
The Ma Roller 217
Squatting 219
Toe touches in the standing position 221
Diagonal toe touches 223
Floor twists 225
The Cobra 226
From the Cobra to the Pose of the Child 229
The Sphinx 229
Spinal intrinsics strengthening 230
Reference reading 235
Index 253