Ending Chronic Back Pain

 

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MUSCLE/MOVEMENT MEMORY:
the cause of back muscle spasms and chronic lower back pain

Changing muscle/movement memory doesn’t involve “strength training”, stretching”, “work hardening”, “getting adjustments” or “neutral spine position”. It involves patterned repetition of movements that cultivate control over muscular tension in healthy patterns of movement and posture. Healthy patterns of movement are both comfortable and strong.

Learn how muscle/movement memory underlies most back pain, lifting injuries, disc bulges, spasms, and sciatica and how the cause (muscle/movement memory) can become the cure (new muscle/movement memory).

BENCHMARKS OF SUCCESSFUL RECOVERY of BACK HEALTH — WHAT YOU SHOULD EXPECT FROM SOMATIC EDUCATION

  • easy movement in all directions
  • full confidence in your power to lift things
  • easy ability to look over your shoulder
  • no further need
    • to be restricted to neutral spine position
    • to strengthen back or abdomen
    • to get adjustments
This article demystifies chronic back pain and its treatment, explains why improvements from manipulations are so often temporary — and tells you about a better alternative — one you can start right away and for free — and access to more if you want it.

You’ll also see my answer to an AllExperts.com questioner. Somatic education exercises cause rapid improvements in back comfort, security and mobility (within two practice sessions).  Back muscle spasms ease and soon end.

Click to consult Lawrence Gold, C.H.S.E., by telephone.

[ commentary ]

… the cost of hiding pain with long-term use of pain meds

see also: “How to Self-Relieve Low Back Pain”“A Functional Look at Back Pain and Treatment Methods”
ARTICLE BY LAWRENCED GOLD, REPRINTED FROM THE TOWNSEND LETTER FOR DOCTORS, NOVEMBER, 1994

on this page:

You may have tried (or been subjected to) the following: strengthening, stretching, pillows, braces, a special bed, pain relievers, ultrasound, electrical stimulation, yoga, decompression, laser light, most heat, muscle relaxants, massage, high-tech surgery, or other approaches — acupuncture, biofeedback, relaxation techniques, bodywork. Well, some approaches are more effective than others. What determines effectiveness is the “key-in-lock” relation to the cause of the problem.

A Basic Understanding
of Back Pain

Back pain is usually only secondarily a problem of your spine or discs, and primarily a problem of your back muscles — generally of being musclebound.”Musclebound” means too tight, prone to spasm, and resisting lengthening movements.

Musclebound back muscles pull vertebrae too close together, compress discs (making them bulge), trap nerves (causing sciatica), and reflexively involve other muscles that cause shooting pains and restrict breathing.

That’s it, in a nutshell.  The rest is details and technical explanations.

How Do Back Muscles Get Musclebound?

In a word: conditioning. Any kind of conditioning involves repetition and formation of habits of one kind or another.

The conditioning that causes back muscles to become musclebound are of three general kinds:

  1. repetitive movements
  2. sudden violent injury
  3. stress (emotional or nervous tension — referred to by Dr. John Sarno as “tension myositis syndrome”).

Repetitive movements form muscle/movement memories to hold muscles at a heightened state of readiness to contract (tighten) — which increases muscle tone (nothing but the resting tension level) and creates muscle fatigue (soreness).

Sudden, violent injury triggers protective reflexes to “hold you together” — reflexes that commonly persist indefinitely after the incident/accident (due to muscle/movement memory formation) and that cause many people never to be the same even after therapy.

Stress (nervous tension) means what the words say — and what, in popular parlance, the expression “uptight” means.

Conditioning sets up brain-level learning to hold muscles tight and ready to contract (spasm). Then, a minor situation can trigger spasm, which causes pain, which causes cringing, which tightens muscles further, which causes more pain in an increasing cycle that can amount to a severe episode of immobilizing back pain or which can level off into a chronic pain situation.

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Conventional Therapeutics and Back Muscle Spasms

Conventional treatment methods consist of strengthening, stretches, spinal adjustments, muscle relaxant drugs, traction (spinal inversion, mechanical disc decompression), laser light, pain medications, and in more extreme cases, surgery. None of these approaches directly addresses muscle/movement memory, but only its effects, muscular contraction and/or the sensation of pain.

STRENGTHENING

When we consider weak muscles as the cause of back pain, there is some truth to the idea — muscles in constant contraction get tired and feel weak. However, the problem of weakness gets solved as soon as muscles resume their resting state. So the problem isn’t weakness; it’s muscle fatigue. Your back isn’t weak; it’s tired from overexertion of its muscles.

STRETCHING

When we consider stretching tight muscles as a solution to back pain, there is some validity to that idea — muscles in constant contraction are short, self-shortening. However, the problem of muscle tightness and shortness gets resolved as soon as muscles resume their resting state. So the problem isn’t that muscles need stretching; it’s that they are constantly shortening due to conditioned reflexes of the nervous system.

SPINAL ALIGNMENT ADJUSTMENTS

When we consider spinal alignment as a solution to back pain, there is some validity to that approach — muscles in constant contraction pull on the spine and distort its alignment. However, the problem of spinal alignment isn’t a problem of the vertebrae. Bones go where muscles pull them, the control center for the muscular system is the brain (not the doctor or therapist).

DRUGS — MUSCLE RELAXANTS and PAIN MEDS

When we consider relaxing habitually tight muscles with drugs, we can understand the rationale for the approach. However, drugs do nothing to the patterns of movement and tension controlled by the brain; they only dull the system and the muscular tension patterns remain.

Likewise, pain medications. They dull the pain while the muscular tension patterns remain. Degenerative damage continues unabated.

SURGERY

Most surgery deals with the consequences of either violent injury or congenital defect (necessary) or of long-term muscular tension patterns. Of course, no surgical procedure can change the brain’s programmed muscle/movement memory; you can’t change programming by cutting. Usually, it’s the reverse; muscles get tighter after surgery.

Now you can understand the track record of conventional therapeutic approaches to back spasms.

If these approaches don’t address muscle/movement memory, what does?

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Somatic Education

Somatic education changes muscle/movement memory by clinical brain-level teaching techniques and somatic education exercises.

Through a learn-by-doing process, somatic education rapidly alters muscle/movement memory and immediately improves physical comfort, muscular control and freedom of movement. It affects the brain the way biofeedback does — new learning — but with two important differences: (1) speed of results and (2) the integrity/durability of the improvement. Improvements are usually solid and need no further professional help. Somatic education tames muscle-spasms and frees musclebound muscles with major improvements from each clinical session and feelable, cumulative improvements with somatic education exercises (if used, alone).

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Taming Spastic Back Muscles

Habits, including muscular tension habits, exist as patterns of memory. Tension habits can be unlearned, and actually, relearning muscular control is what has actually happened when a person has triumphed over back pain, whatever method has been used. The muscle/movement memory patterns that underlie back pain ease up and the patient has recovered control of his or her back muscles sufficiently that they relax (which they do, unless in use).

Problems of muscle tension cannot be “cured” by manipulation because muscle tension is not a mechanical condition that “stays put” when manipulated; it’s an automatic, reflexive action pattern — a habitual muscular behavior — controlled by muscle/movement memory. Lasting relief from muscle tension occurs when muscle/movement memory changes.
Somatic education uses three basic techniques of muscle/movement memory training, but the most important one (by virtue of its speed of effectiveness) uses an action pattern similar to yawning (or a pleasurable morning stretch), but magnified in its potency by certain techniques. We call this “the Whole-body yawn”; the technical name is “The Pandicular Response” (first discovered by researcher A.F. Frazier and first employed clinically by T. Hanna, Ph.D.).

To repeat, the idea behind the “strengthening and stretching” regimen for back spasms is based on a misunderstanding; it’s a misunderstanding because the muscles involved are almost never weak; however, they are almost always very tight and very tired. It’s a misunderstanding because the muscles involved are not “short” (in a fixed sense, like a rope being too short) and therefore, in need of stretching, but “shortening in contraction” (in ongoing activity — when muscles tighten, they always shorten and thicken), in need of relaxation to lengthen.

Sore muscles don’t need strengthening; they need rest and refreshment. They don’t need stretching; they need to relax and lengthen — and that lengthening takes pressure off of joints, nerves, spinal discs, and bursae (“bursitis”).

You need to regain your full range of muscular control, from full strength to full relaxation, something you can’t regain by being manipulated by someone else; you regain it by a form of learning, albeit a specialized one for which you will probably need training.

| TO TABLE OF CONTENTS |

EXPLANATIONS OF

BACK PAIN TERMS

Contraindications — When This Approach Won’t Work

One of our automatic reactions to injury is to tighten up. That’s part of the pain of every injury and one that can outlast the healing period by years. It’s the “cringe response”, an automatic reaction that protects the us from further injury by pulling away from the source of pain. Sometimes, back muscles tighten in such a protective reaction —

where actual damage, such as a ruptured disc or a violent accident, has occurred. In such situations, surgery may be necessary and somatic education will either not help or will produce only temporary relief, at least until after surgery, unhappy news for some, but realistic. If you’ve seen a doctor for back spasms, he or she has either discovered that you need surgery or that you don’t. Surgery is a last, desperate resort and most doctors are reluctant to recommend it. If you have been sent for therapy or given drugs, yours is not a surgical situation, meaning that your spasms are not happening in reaction to injury, but as a stress-reaction. In most cases of back spasms, there is no injury, only muscle pain, from the “tension” part of “nervous tension.”
So, why do back spasms occur? Now, you have part of the answer — the physical part. However, there’s also, in many cases, a lifestyle part. Let’s look a little more closely to see the underpinnings of Dr. Sarno’s insight. | TO TABLE OF CONTENTS |

The Role of Stress in Back Pain

One thing you will almost always notice about people with back spasms, if you have observed, is their high shoulders and swayback. Touch the muscles of their lower back, and you will find the same thing: hard, contracted muscles, not soft, weak, flabby muscles.The major source of back spasms is the lifestyle of being “on the go” — driven, driving, productive, on time, and responsive to every situation. This is a new idea for most people, so here’s the explanation.

Our post-modern lifestyle triggers an ancient neuromuscular (bodily) response (known to developmental physiologists as the Landau Reaction); this reaction involves a tightening of the muscles of the spine in preparation for arising from rest (sitting or lying down) into activity (sitting, standing, walking, running). The Landau Reaction consists of the muscular responses involved in coming to a heightened state of alertness in preparation for moving into action; triggered incessantly for years, it becomes a tension habit — one that often outlasts the moment (or stage of life) when it was necessary.

(The general viewpoint taught in physical therapy, it should be noted, is that the Landau Reaction is a temporary developmental response seen in infants that does not persist into maturity. However, the muscular action pattern seen in mature adults under stressful conditions is identical to that seen in infants experiencing Landau Reaction — shoulders, back, and hamstrings go into action (get tight).)

 

How You are Now

  • in pain
  • fatigued from pain-impaired sleep
  • self-limiting your activity
  • energy depleted by pain
  • on the medical treadmill
  • paying for medical treatment
  • spending time in treatment
  • clouded thought processes
  • under stress

How You Could Be

  • comfortable
  • refreshed by sleep
  • fully capable of activity
  • natural vitality available
  • therapy over – your time is your own
  • money available for other things
  • time available for other things
  • thinking more clearly
  • feeling easier about life

Many Back Pain Issues Come from the Same Cause

Many medical conditions regarded as separate disease entities — degenerating discs, facet joint irritation, pinched nerves, sciatica, headaches, and insomnia — stem from a single condition: the sensations of contracted back muscles. This is not an oversimplification; its an exact statement of fact: These medical conditions arise from excessive tension, compression, and strain on body tissues — muscle, cartilage, nerve and bone. They cannot be “cured” by manipulation because the body is “doing it to itself” and does not stop doing it to itself until The Landau Reaction is brought to a condition of quietude and free movement is restored.Somatic educators usually find, upon examination of a person’s musculature, that their pain comes not from an injury, but from overworked muscles; is not a medical problem or an injury, but a conditioning problem that often causes diagnosable medical problems. Their clients have back muscles conditioned into a painfully high state of tension. Most of the time, people can be brought to relax back spasms through somatic education of muscle/movement memory, and when they do, the pain and the problem disappear.

Though injuries from traffic accidents, falls, etc., also trigger muscular reactions that can become habitual, the Landau Reaction is behind most of the back-spasm epidemic in our society. It’s a consequence of accumulated stress.

While you can’t avoid the Landau Reaction (it’s a necessary and appropriate part of life), you can avoid getting stuck in it. If your lifestyle puts you habitually in a state of reaction, you have to “de-habituate” yourself from it, so that your rise in tension occurs only as a momentary response to situations and does not become your chronic state.

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INTRODUCTIONS TO NINE SOMATIC EDUCATION EXERCISES TO END BACK PAIN

from Get Free from That Back Pain

9 Movements to Re-condition Your Back for When Therapy Hasn’t Worked

Do the FREE three-day test — exercise #1, twice daily. That’s long enough to feel a worthwhile difference.

 




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What You Can Do

If you have pain, numbness or tingling in your extremities, your problem is more severe and requires a medical evaluation to rule out serious disc or nerve conditions. Even if you have surgery, you will still need to learn to relax the tight muscles that initially caused the problem. If yours is not a surgical situation, then somatic education is probably viable for you.The new methods used to de-habituate Landau Reaction are highly reliable and have no adverse side effects, apart from occasional temporary soreness the day after a session, soreness that fades out in a day or two, leaving you more free, comfortable and stronger than before.

Read about clinical somatic education.

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EXPLANATION

Explanation of fine points for relaxing spastic muscles to recover comfort and free movement. Gentle somatic back exercise for lower back pain, from LESSON 1, The Cat Stretch Exercises.

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OUTCOME

This is a recording after a session with a client, so you can hear her feedback as the session ends.

Quick Help: Back Exercises for Lower Back Pain : ~ Quick Help for Back Pain ~Programs for Complete Recovery : ~ The Cat Stretch: The Cat Stretch Exercises ~~  Get Free from That Back Pain ~

The following inquiry came to me via AllExperts.com, reproduced as originally typed(except that I added numbering to the “findings”).Name: TiffineySubject: Severe back pain & Cat scan?

Question:

I injured my back in 08 unloading a semi, I had partial laminectomy surgery on L5-S1. This did help the severe pain running down my right leg, I was left with permanet numbness in a small strip going down my right leg and little toe. I continued to have severe pain in my lower back and tingling down both legs. They kept treating me with narcotics and about 7 other medicines and countless injections. I hate narcotics, so I chose to have the stimulator placed. This device truely works for me, it has little issues like the battery flipped and it required surgery to fix, but for the past year I have had a pain free life! A few weeks ago I started coughing and found I had pneumonia, the coughs were deep and after coughing in my kitchen I had a sharp pain, that has not went away, its horrible pain!!! I had a cat scan, cant get MRI due to the stimulator.

Can you please help me understand the results? and is there anything that can be fixed?

  • Transitional vertebral body at lumbosacral junction.Compatible with lumbarized s1 vertebra on right.
  • Moderate degenerative change between broad-based transverse process on left at s1 and left superior sacrum.
  • At L3-L4 a minimal diffuse disc bulge is identified, which flattens the ventral aspect of the thecal sac.
  • L4-L5, left foraminal discogenic changes, moderate narrowing of the inferior aspect of the left L4 neural foramen without nerve compression at this time. Mild bilateral hypertrophic facet arthropathy and ligamentum flavum hypertrophy are indentified at L4-L5.
  • At L5-S1 post partial laminectomy on right. There is loss of disc height at L5-S1 compatible with degenerative disc at this level. A vacuum phenomenon is identified at L5-S1. Mild diffuse discogenic changes at L5-S1, appear focally prominent in left foraminal location. moderate bilateral hypertrophic facet arthropathy at L5-S1. There is subsequent bilateral narrowing of the L5 neural foramina, which is moderate on left and mild to moderate on right, without definite evidence of L5 nerve compression in their neural foramina.

Thank you so much!

 


Hi, Tiffiney,

Well, sounds like you’ve “been through the mill”. (Sigh) There is a way that is so much easier. If you were my client, I expect it would be something like one or two weeks to be mostly or completely out of pain.

I’ll say more at the end, including what you can do to treat your own back pain (which takes somewhat longer).

As to your results, let’s get to them item by item.

Then, I’ll summarize at the end.

So:

~~~~~~~~~~~~~~~~~~~~~

    Transitional vertebral body at lumbosacral junction. Compatible with lumbarized s1 vertebra on right.

~~~~~~~~~~~~~~~~~~~~~

A “transitional” vertebra is one more vertebra than are usually found in a person. For lumbar vertebra, the usual is five (5) — “L1 – L5”. A transitional vertebra in that location is “L6”. I don’t know what this physician means by “compatible with”. Perhaps he means, “comparable to” — S1 — by location. “Lumbarized” means that it has become functionally part of the lumbar spine, and therefore flexible, rather than (as usual) part of the sacrum, and therefore essentially inflexible (the flexibility occurring in most people at the sacro-iliac joints). ** This shouldn’t be a problem. If it is, it has to do with something else than the existence of this vertebrae. We’ll get to that.

~~~~~~~~~~~~~~~~~~~~~

    Moderate degenerative change between broad-based transverse process on left at s1 and left superior sacrum.

~~~~~~~~~~~~~~~~~~~~~

The essential question, here, is, What caused the degenerative change *at that location*? Vertebrae don’t just decide to degenerate, one day, and the location of degeneration is an important and suggestive clue. Yes, what caused it … we’ll get to that. But a clue: compression and movement: friction

~~~~~~~~~~~~~~~~~~~~~

    At L3-L4 a minimal diffuse disc bulge is identified, which flattens the ventral aspect of the thecal sac.

~~~~~~~~~~~~~~~~~~~~~

~ Aha! the tell-tale disc bulge! and minimal! What causes discs to bulge? Well, what causes the tires on your car to bulge at the bottom? Pressure. What causes pressure on the discs in the spinal column? The spinal muscles! In this case, the lower back (lumbar) spinal muscles, by pulling the spine short, by pulling vertebrae closer together. What this item tells us is that you have tight back muscles, enough to cause a bulge but not enough to press on nerves. This sounds suspiciously like tight muscles are the source of the pain. Doesn’t it.

~~~~~~~~~~~~~~~~~~~~~

    L4-L5, left foraminal discogenic changes, moderate narrowing of the inferior aspect of the left L4 neural foramen without nerve compression at this time. Mild bilateral hypertrophic facet arthropathy and ligamentum flavum hypertrophy are indentified at L4-L5.

~~~~~~~~~~~~~~~~~~~~~

He must have meant, “discogenic left foraminal changes” — changes in the openings in vertebrae where nerves come out of the spinal column. But “without nerve compression”. In other words, inconsequential.

HOWEVER, the “hypertrophic facet arthropathy” means that the contact surfaces between neighboring vertebrae, “facet joints” are irritated. Again, the likely culprit: tight back muscles compressing vertebrae. Ordinarily, space exists between facet joints (for flexibility), but when tight back muscles pull vertebrae together, their facet joints rub. Too much rubbing, they get irritated and sore.

I don’t think the ligamentum flavum (the strip of ligament that runs along the front surface of the spine) is hypertrophic. I think it is somewhat shortened and thickened by vertebrae being pulled together.

“I think I see a pattern, here.”

~~~~~~~~~~~~~~~~~~~~~

    At L5-S1 post partial laminectomy on right. There is loss of disc height at L5-S1 compatible with degenerative disc at this level.

~~~~~~~~~~~~~~~~~~~~~

Let me tell you a secret — a secret everyone already knows: When we experience injury or pain, we tighten up around the painful place. We can get pretty tight — so tight our muscles hurt!

Pretty obvious, huh?

Well, you had surgery. You tightened up in what we call, “trauma reflex”. Where did you tighten up? Well, that’s a bit unclear. You have a transitional vertebra, which would be “L6”, and the laminectomy would be at “L6-S1”. But this report says, “L5-S1”. Makes me wonder.

In any case, you tightened up exactly at the place where a “broad-based transverse process on left at s1 [rubs against the] left superior sacrum.”

Hmmm, the same culprit. I think I see a pattern, here.

~~~~~~~~~~~~~~~~~~~~~

    A vacuum phenomenon is identified at L5-S1. Mild diffuse discogenic changes at L5-S1, appear focally prominent in left foraminal location. moderate bilateral hypertrophic facet arthropathy at L5-S1. There is subsequent bilateral narrowing of the L5 neural foramina, which is moderate on left and mild to moderate on right, without definite evidence of L5 nerve compression in their neural foramina.

~~~~~~~~~~~~~~~~~~~~~

The vacuum phenomenon, despite its science-fiction sounding name, is a quaint observation made by radiologists. There is no “vacuum”, but gas in the disc space radiates light when irradiated, as in during the scan. There is no real “vacuum”; it’s a reference to how vacuum tubes emanate light. You know — radiologists’ sense of humor. What’s interesting is why gas would collect in the disc space.

We’ve already covered the rest.


So, I’ve laid it out, but I’ll summarize: Whatever made it necessary for you to have a laminectomy was still at work after the laminectomy. Moreover, whatever the laminectomy, itself, did, it prompted further reflexive contraction of the muscles nearest the laminectomy and for some distance, away from it.You were already very contracted (and close to spasm) in your low back when were unloading the semi; you were even tighter when you had pneumonia and coughing fits.

What happens in a coughing fit? We contract, repeatedly, and may stay contracted. Coughing was enough to send you into spasm.

I suspect that the tingling down your legs comes from very tight muscles in your buttocks compressing your sciatic nerves.

So, how to address all those muscular contractions?

You’ve tried so much. You need something categorically different.

Therefore, I’m sending you to a page that outlines what I think you need.

http://somatics.com/back_pain.htm

You’ll notice that it links into a number of other pages. Follow links only after you’ve read all the way through, and start with the first one that interests you.

Here, a page of access to practitioners.

and an interesting page on “herniated disc impinging on the thecal sac”

regard,

The Institute for Somatic Study and DevelopmentSanta Fe, NMLawrence Gold, C.H.S.E. Publications | Credentials | Personal PageTelephone  505 699-8284  | Skype lawrencegold | PRIVACY POLICY | CONTACT US: | COPYRIGHT INFORMATION

 

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4 Responses to Ending Chronic Back Pain

  1. Pingback: Back Spasms — The Inside Story | Stress Muscularly Expressed | Somatics on the Web — Lawrence Gold, C.H.S.E.

  2. Hi, after reading this remarkable piece of writing i am also cheerful to share my familiarity here with friends.

  3. Pingback: Relieving S-I Joint Pain | Understanding the Sacro-Iliac Joints | Somatics on the Web — Lawrence Gold, C.H.S.E.

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