Review of Easing Back Pain

Produced by: Dr Mansukh Patel and Coby Langford Reviewed by: A BackCare Helpline Volunteer (April) After Chris Hughes, BackCare Helpline Manager, asked me to review this Programme, I went into the usual phase (for me) of procrastination, during which I happened upon an article in my latest Physiotherapy Update, which mentioned the importance of 'self efficacy'. This is basically about the patient knowing enough about their body and their condition to know what their body is saying and what they should actively do about it. Great idea. Just think about it. That's what anyone wants, isn't it?

So I decided to use that idea as a measure for evaluating this exercise package. Well, its split into 4 parts, with lots of jingly music between them, which you may or may not like. After the introduction, there is a theory session and then a stretching and strengthening programme. In the theory section there is a lot of complicated theory about muscle imbalance, which is a current trendy overview in musculoskeletal physiotherapy. It seems to make sense: strengthen the postural muscles so the doing muscles don't have to compensate. Fine. Firstly, why are the doing muscles so hard and tight? Usually to protect something - like a minor or more serious annular tear of the disc, or an inflamed arthritic joint, or they may be tight because they have shortened over time. If it is the latter, stretch by all means, but stretching alone will not necessarily sort out the underlying cause. And this programme does have some good stretching exercises pictured on the enclosed leaflet. Now about postural muscles. You don't get postural muscles back to doing their job (I didn't say strong because strength is not the point), by doing staged exercises. Their job is to work for a long time in a good posture. What you need to do is to get into that posture, and they will be doing that job. Done! Sorted! That's easy, the hard bit is re-learning those postures and movements for everyday life. Doing that is your daily exercise all the time - its what these muscles are made for - posture. As to guidance on when and how often to do the exercises - there was nothing significant about how to understand the signals your body is sending out. Just don't do the twisting exercises too much, and if you are in an acute phase, ask your osteopath when you should start exercising - so not much 'self efficacy' there. I've come across lots of this same common sense idea - don't overdo it, listen to your body. But who says what to listen out for? Who could benefit from this programme? Someone who has been inactive, may be bed bound with general illness or multiple injuries and needs a general back conditioning programme to get them into the condition to use good everyday life to keep their back well. There you have it. Easing Back Pain can be purchased from Life Foundation School of Therapeutics www.backpain-international.com Tel 0161 288 8248. Priced £14.99