8 ms·

Lost Posture: Why Indigenous Cultures Don't Have Back Pain

102 points by miralabs 11y ago

towelguy 11y ago
Maybe they don't have the luxury to complain that much.
a8da6b0c91d 11y ago
Back pain in the industrialized world is overwhelmingly psychogenic. It's Tension Myositis Syndrome as described by Dr. Sarno. Given only x-rays images, spine specialists completely fail to identify the individuals who report back pain. Most people with no back pain have various structural abnormalities. These people getting back pain and carpal tunnel syndrome were all getting ulcers 60 years ago. Then the idea that ulcers are just an infection took hold so the psychogenic manifestations of stress shifted.
- tosseraccount 11y ago
  I suspect a lot is actually from being out of shape; especially being overweight.
- mhurron 11y ago
  Are you suggesting that back pain and carpal tunnel don't exist?
  - a8da6b0c91d 11y ago
    They exist and are psychogenic. The nervous system, directed by the brain, can induce localized inflammation.
    - greggman 11y ago
      I know it's just my own anecdotes but I find that really hard to believe given how painful my back pain has been. It was so painful once and lasted for about a week that I seriously considered that I would end my life if the doctor told me there was nothing they could do. For me, at least recently, the trigger seems to be lifting something heavy and wrong way. It doesn't hurt that day but the next day I literally can't move in certain directions without searing pain. Just turning in bed, getting in or out of bed, getting in or out of a car, walking, using the toilet, sitting down or getting up, all of it hurt. The doctor claimed it was muscle spasms. She gave me some muscle relaxants and it went away. I've since try to work out more. I haven't had an episode in a while but I can't sleep on my stomach like I used to as curving my back that way has been known to trigger it.
      - abandonliberty 11y ago
        [0]http://rationalwiki.org/wiki/Anecdotal_evidence http://rationalwiki.org/wiki/Anecdotal_evidence [1]http://en.wikipedia.org/wiki/Tension_myositis_syndrome#Medical_evidence http://en.wikipedia.org/wiki/Tension_myositis_syndrome#Medic... The claim here is that a significant proportion of these illnesses are psychogenic; even if your anecdote was convincing it would do nothing to challenge the original argument, as you could easily be part of the 47%[1]. Furthermore, you base your conclusion on the severity of pain you experienced, in your opinion, being beyond what's possible for a psychogenic illness. You don't offer evidence to support this opinion, and, as there are many types of psychological distress that drive people to ending their own lives, I find it unconvincing. In any case, I hope you keep an open mind and find an effective way to manage and improve your health. The lifts recommended in other parts of this conversation might be more in line with your values.
    - berntb 11y ago
      After a few decades in a chair, doctors talk about bone spurs etc on my upper spine. Is that just mental effects on the X-ray machine, which needs its attitude readjusted with a heavy wrench? :-)
    - mhurron 11y ago
      So basically yes, you are saying they do not exist, because if tissue damage or fategue don't show up in an X-ray (they won't) it must be being created by the person themselves. Next time you get a pulled muscle, just drink some tea and calm down, it didn't really happen, you're just too stressed.
      - a8da6b0c91d 11y ago
        A pulled muscle will heal up in a couple weeks. We're talking about chronic pain lasting many months or years.
  - abandonliberty 11y ago
    You have the common and popular misunderstanding of psycogenic illnesses. >Does this mean that the sickness is “all in my head”? No, it doesn't. The people who are in these outbreaks have real signs of sickness that are not “imagined.” They really do have headaches, or they really do feel dizzy. But their illness is not caused by a poison or a germ. http://www.aafp.org/afp/2000/1215/p2655.html http://www.aafp.org/afp/2000/1215/p2655.html
- maccard 11y ago
  Plenty of people have MRI scans that can show herniated discs. Have a look at [1] for a very clear image of what you can see in some obvious cases. Obviously some aren't as clear as the image below, but mine for instance was. [1]http://www.mayfieldclinic.com/Images/PE-HerniatedLumbar_Figure2a.jpg http://www.mayfieldclinic.com/Images/PE-HerniatedLumbar_Figu...
  - a8da6b0c91d 11y ago
    Most people have problems like these but experience no pain or functional impairment.
- Ankur84 11y ago
  > Then the idea that ulcers are just an infection took hold so the psychogenic manifestations of stress shifted. It may be that treatments have been developed for those ulcer causing infections. That could be why you're not hearing so much about uclers. I think the situation might be the opposite of what you're suggesting. It seems ailments that we don't understand are put down to stress. Then we find a physiological cause, and then a cure and then we stop hearing about the issue.
  - a8da6b0c91d 11y ago
    There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place. It's not the case that medicine cured the problem.
    - dragonwriter 11y ago
      > There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place. Once we understood the causes (H. pylori infection primarily, NSAID overuse secondarily) we were able to manage the second and intervene to control the first based on symptoms that develop before the peptic ulcers. Additionally, the H. pylori infection rates are much higher in older Americans (H. pylori infections typically have a long lead time before developing any symptoms), probably because of lifestyle changes that have reduced environmental exposure. So with less and less people having H. pylori infection in succeeding cohorts, there's a decline in peptic ulcers. We know the connection between the causes and the decline. And, yes, some of it is that medicine cured the problem (earlier intervention for H. pylori infections), and some of it is awareness of medicine side effects reduced actions causing the problem (NSAIDs), and some of it is that the age cohort that had been most exposed to H. pylori infection and was most at risk became a smaller share of the population as time progressed.
- anthony_romeo 11y ago
  > Given only x-rays images, spine specialists completely fail to identify the individuals who report back pain. I'm not surprised. X-rays are not the most reliable in identifying all spinal issues. X-rays are more for finding problems with the vertebra or curvature of the spine, not the discs. An x-ray showing mild degeneration could be produced from the same individual who on an MRI could show a severe disc herniation. I'm not a doctor, but I've worked on developing legal cases for disabled individuals, and an MRI is pretty much mandatory. Anecdotally, I have a relative who suffered from severe back pain after a lifting accident, but the x-rays didn't show anything. I told him to ask his doctor for an MRI after a number of months, which indeed demonstrated the herniation.
- fpgaminer 11y ago
  While Dr. Sarno's theories were helpful for my carpal tunnel, and apparently for many others, I would be hesitant to apply TMS to all back pain, carpal tunnel, and other "office chair diseases." I know you said "overwhelmingly psychogenic", which implies you meant not all cases. But I'm not sure overwhelmingly is accurate either, especially for back pain. With carpal tunnel, it's clear based on the plethora of cures with random success that calling psychogenic may often be right. But back pain has alternative, and seemingly better explainations (weak muscles, poor flexibility). So while TMS may be the diagnoses for some with back pain, and a contributor for others, I would not go around slapping it on everyone who says they experience back pain. That said, Dr. Sarno's book is worth the cost of reading. It's very staunchly in the pseudo-science camp, and Dr. Sarno spends a lot of time bemoaning his ostracization from the medical community, but his theories are ultimately interesting, hold some weight, and have been helpful to many. For example, I haven't worn a wrist brace to bed since I read the book (about a year ago). And, even if it hadn't helped, it brought more awareness to just how stressed I was. I do a better job managing my workload and consequently stress these days. Just keep a healthy heaping of skepticism by your side while reading.
- tim333 11y ago
  [citation needed]
WalterSear 11y ago
"An acupuncturist in Palo Alto, Calif., thinks she has figured out why." Ok, lost me right there.
- cristianpascu 11y ago
  I noticed, but looked further. Most people have simoultaneously beliefs of which some are true and some are false. Very educated people don't vaccinate their kids. Which is not to say they are false in any other aspect of life. Indeed, they loose their credibility. But I think it's a matter of critical thinking to be both skeptic and charitable. Otherwise we fall into the classical, but very recent trap: you can't be a scientist and also be religious.
- jerf 11y ago
  Keep reading; in a shocking display of journalistic competence, the journalist interviews someone else who proposes a sensible alternative explanation for the results the acupuncturist may be seeing. The aforementioned sensible alternative explanation is currently related to one of my pet theories, which at the moment hasn't got enough scientific evidence to make a call either way, but: My theory is that the reason "standing up a lot" seems to help people is that it builds core muscles up, which do think I have sufficient evidence that at least one American, namely, me, did not naturally have a lot of. This A: suggests that the argument that science is currently in the middle of about "how much standing should one do" is entirely misguided, dealing with a secondary if not tertiary variable instead of the real problems... and there is a LONG history of this in the health field, so it's hardly a crazy idea... B: explains why "too much standing" could be a problem... "standing" isn't "good", it's just that it builds core muscles, and too much of it is independently "bad", and C: if true would suggest that one could obtain the benefits of standing, and probably more, by directly focusing on building core strength instead of indirectly and more inefficiently building it. I call this a "pet theory" because I believe it to be a reasonable harmonization of several current lines of scientific inquiry, and I don't have the evidence to disprove it, but I also lack the evidence to really solidly prove it. One can see how it might also relate to this article. Having had at least my own experience with my own core weakness, it is actually somewhat astonishing to me that my core can become so weak as to be a source of pain even in my mid-30s. It would be natural to assume that the very things causing pain would itself spur the core on to grow stronger, but it seems at least in my experience the core needs "superstimulus" to grow large enough to even competently do its main job. (I'm not saying I'm confused as to why that's the case... if one looks at the history of our species and considers the working of natural selection, it's not an impossible or nonsensical outcome. It just wasn't my first guess.)
Dirlewanger 11y ago
>Everyone knows that weak abdominal muscles can cause back pain. In fact, Mummaneni says, stronger muscles might be the secret to Gokhale's success. Don't really need to say anything else. Get into weight training and stick to it.
- maccard 11y ago
  The problem with some back pain is you're unable to walk or bend over, let alone actually exercise, until the pain is masked by something else.
  - thrownaway122 11y ago
    So start light. I mean really light. Like lying flat on you back working your core by tensing only specific muscles light. This is how rehab programs start. Then progress. Slowly. Even body weight squats will improve your posture when applied consistently.
  - rwhitman 11y ago
    If you're acute like that there are a lot of exercises that can make the situation much worse, particularly if you don't have a diagnosis and are unsure of where the injury is located. Best course of action is go to a Dr and push them to prescribe physical therapy over surgery or meds. Once you know the site of your pain and have a good physical therapist they will give you safe exercises that protect from additional injury. Some lazier doctors will often resort to pain killers or worse, surgery, as a quick solution, but in most cases a few sessions with a good physical therapist is all you need
    - maccard 11y ago
      If you're acute, and prescribed physical therapy but can't stand, it's not going to work either though. There's no problem with being on opiods for a short period of time to relieve the pain, and allow you to take on a proper course of physical therapy, and get the exercise and movement you need.
- ggordan 11y ago
abandonliberty 11y ago
Author's book successful on Amazon: 4.6/5, 600 ratings, gushing reviews from MD PHDs in the Mayo clinic. Published in 2008.
rwhitman 11y ago
The author mentioned in this article, Esther Gokhale, wrote a book several years ago with the somewhat goofy title 8 Steps to a Pain-Free Back, which I can't recommend enough, especially if you suffer from back pain. It really transformed the way in which I think about my posture and ergonomics in general. One of the things she touched on in the book, which the NPR article seemed to miss, was a hypothesis that poor posture in the Western world is the result of a cultural shift in the early 20th century. Particularly that slouching and unnatural postures were a sort of rebellious statement against the Victorians for 1920's youth. Bad ergonomics and posture became so hip that they found their way into furniture design - something that became very clear to me after having a herniated disc and a vintage mid-century couch in my living room..
- Someone1234 11y ago
  Does one really need the book to learn the "secrets?" Is the entire book basically "stand up straight and your back pain goes away?"
  - Darmani 11y ago
    That's a lot of it, except that it turns out that how to "stand up straight" is very counterintuitive. You will hurt yourself if you just try. Really, the book is not enough; you need the class, or at least the videos. They also teach you better ways of walking and bending.
    - thenomad 11y ago
      "it turns out that how to "stand up straight" is very counterintuitive" That sentence sums up most of my last decade or so's reading and learning on posture nicely :) Posture: it's harder than it looks.
    - rwhitman 11y ago
      In my case I was doing physical therapy for back pain at the same time I picked up the book, so while I was being taught how to change my posture and ergonomics by med professionals, the book was a good companion for expanding my knowledge..
Darmani 11y ago
I took Esther's course in 2013, and it's had a huge effect on my life. Getting into the correct position involves moving some muscles I didn't know I had, but, once achieved, it feels amazing. Sitting feels like being massaged. I can twist my neck further. When I practice karate, all my movements become faster and easier. The only problem is keeping the posture once achieved, as all your old movements can cause you to revert (and yes, it takes some core strength, but that's a small part).
andrewtbham 11y ago
Pro tip: > take a deep breath in and grow tall. Then maintain that height as you exhale.
- nate_meurer 11y ago
  Thank you, these sorts of cues are among the most valuable things trainers provide in my experience.
djc_tech 11y ago
Plus look at toddlers and some Asian cultures. They can squat full dept with no problem. My toddler can squat and stand up without issue. I can - but I've retrained myself and opened up my hips/hamstrings and worked on core strength. baby's mama cannot perform a full depth squat let alone with any weight on the or front rack position. The old Asian lady down the street can and does when she does her gardening. I think that coupled with a lot of people have at least mild APT because of a weak core is the major issue. It causes hip strain.
- rpenm 11y ago
  I wouldn't be surprised if most of that flexibility in Asian cultures comes from using a squat toilet (or open defecation) everyday.
djc_tech 11y ago
Plus look at toddlers and some Asian cultures. They can squat full dept with no problem. My toddler can squat and stand up without issue. I can - but I've retrained myself and opened up my hips/hamstrings and worked on core strength. baby's mama cannot perform a full depth squat let alone with any weight on the or front rack position. The old Asian lady down the street can and does when she does her gardening. I think that coupled with a lot of people have at least mild APT because of a weak core is the major issue. It causes hip strain.
defen 11y ago
Squats and deadlifts are how I cured my back pain. I recognize that I tend to have a missionary zeal about this subject because I think it has had so many benefits for me...but seriously, if you don't have any health issues that prevent you from doing so, you should be lifting heavy weights with a barbell. Your clothes will fit better, people will be more attracted to you, you'll have more confidence, and you'll be amazed at how strong you become. If you're a healthy adult male under 40, 1 hour a day for 3 days a week will get you to "pick up 400 pounds off the floor with relative ease" within a year.
- dragonwriter 11y ago
  > if you don't have any health issues that prevent you from doing so, you should be lifting heavy weights with a barbell. Your clothes will fit better Only if you were wearing poorly-chosen clothes for your existing body before. If you aren't already out on the far extreme of the distribution for height or some set of proportions, you can probably find pretty well-fitting off-the-rack clothes, and if you have, they'll probably fit substantially worse if you change your body shape in any way -- whether its by gaining fat, losing fat, gaining muscle, or whatever.
  - kendallpark 11y ago
    > Your clothes will fit better Unless you're female and then your clothes will fit worse. I have to buy two sizes up in dress shirts and hem the waist down just to fit my shoulders into them.
- mcculley 11y ago
  I second this with a caveat. I have a damaged disc between the sacrum and L5. After several years of back pain and a few visits to the emergency room, I took up deadlifting. I deadlift every other day now and have done so religiously for a couple of years, steadily and slowly increasing the weight. I feel it has been very beneficial for my back issues. I have almost none of the pain I had before. I feel this is a simple remedy that almost no doctor will recommend because of the liability issues. With that said, I advise extreme caution. I lift every other morning and I feel it is the most dangerous thing I do. I'm very careful to pay attention to my form and take the movement slow. Even on a good day, I can feel that disc moving around. On a bad day, I've slipped the disc and lost progress for a couple of weeks while I recovered. So if you're going to try this, take it slow.
xchip 11y ago
"An acupuncturist in Palo Alto, Calif., thinks she has figured out why." Acupuncture is know to work (even if you put the needles randomly) Please bring me a scientist :)
- adamtj 11y ago
  What the article describes is real science. That makes her a scientist. She's also does acupuncture, which makes her a pseudo-scientist. The two aren't mutually exclusive, and here is a person who is both. That's the real story, in my opinion.
  - xchip 11y ago
    To be a scientist you need to know how to research, thing that takes a minimum of 4 years with the supervision of a senior professor. Also your results need to be reviewed by other researchers... And even with all this process in place many times we make mistakes... so imagine what can I tell you about an acupunturist.
- michaelkeenan 11y ago
  Cochrane reviews show that acupuncture works for some types of pain: http://www.ncbi.nlm.nih.gov/pubmed/21359919 http://www.ncbi.nlm.nih.gov/pubmed/21359919 (It's not mentioned in the abstract I linked, but searching Cochrane's site shows that they look at studies comparing acupuncture to a "fake" acupuncture, which is presumably putting needles randomly.)
  - panglott 11y ago
    Well, that appears to be real science about acupuncture. Acupuncture isn't a science based not on whether it works or not (there appears to be some scientific evidence that it can), but rather because it is based on handed-down traditional knowledge and personal experience rather than empirical research. That doesn't make it bad, it just makes it culture.
kendallpark 11y ago
As one that is in and out of PT fairly frequently, I can tell you how absolutely FRUSTRATED PTs and orthos get by people that have lower back pain and want some medication or special chairs or stem, as opposed to buckling down and strengthening their abdominal muscles. Weak abs = lower back pain. For most cases. In my early years playing football, I used to get lower back pain from the contact. I was weightlifting regularly, but always skipped my ab exercises because I hated them. One year I was like, screw it, I'm going to do these. Abs got strong, back pain disappeared. This posturing stuff engages your core and helps keep the spine supported properly. If you want faster results, get in the gym and get an abdominal routine going.

102 points by miralabs 11y ago

Maybe they don't have the luxury to complain that much.

Back pain in the industrialized world is overwhelmingly psychogenic. It's Tension Myositis Syndrome as described by Dr. Sarno. Given only x-rays images, spine specialists completely fail to identify the individuals who report back pain. Most people with no back pain have various structural abnormalities. These people getting back pain and carpal tunnel syndrome were all getting ulcers 60 years ago. Then the idea that ulcers are just an infection took hold so the psychogenic manifestations of stress shifted.

tosseraccount 11y ago
I suspect a lot is actually from being out of shape; especially being overweight.
mhurron 11y ago
Are you suggesting that back pain and carpal tunnel don't exist?
- a8da6b0c91d 11y ago
  They exist and are psychogenic. The nervous system, directed by the brain, can induce localized inflammation.
  - greggman 11y ago
    I know it's just my own anecdotes but I find that really hard to believe given how painful my back pain has been. It was so painful once and lasted for about a week that I seriously considered that I would end my life if the doctor told me there was nothing they could do. For me, at least recently, the trigger seems to be lifting something heavy and wrong way. It doesn't hurt that day but the next day I literally can't move in certain directions without searing pain. Just turning in bed, getting in or out of bed, getting in or out of a car, walking, using the toilet, sitting down or getting up, all of it hurt. The doctor claimed it was muscle spasms. She gave me some muscle relaxants and it went away. I've since try to work out more. I haven't had an episode in a while but I can't sleep on my stomach like I used to as curving my back that way has been known to trigger it.
    - abandonliberty 11y ago
      [0]http://rationalwiki.org/wiki/Anecdotal_evidence http://rationalwiki.org/wiki/Anecdotal_evidence [1]http://en.wikipedia.org/wiki/Tension_myositis_syndrome#Medical_evidence http://en.wikipedia.org/wiki/Tension_myositis_syndrome#Medic... The claim here is that a significant proportion of these illnesses are psychogenic; even if your anecdote was convincing it would do nothing to challenge the original argument, as you could easily be part of the 47%[1]. Furthermore, you base your conclusion on the severity of pain you experienced, in your opinion, being beyond what's possible for a psychogenic illness. You don't offer evidence to support this opinion, and, as there are many types of psychological distress that drive people to ending their own lives, I find it unconvincing. In any case, I hope you keep an open mind and find an effective way to manage and improve your health. The lifts recommended in other parts of this conversation might be more in line with your values.
  - berntb 11y ago
    After a few decades in a chair, doctors talk about bone spurs etc on my upper spine. Is that just mental effects on the X-ray machine, which needs its attitude readjusted with a heavy wrench? :-)
  - mhurron 11y ago
    So basically yes, you are saying they do not exist, because if tissue damage or fategue don't show up in an X-ray (they won't) it must be being created by the person themselves. Next time you get a pulled muscle, just drink some tea and calm down, it didn't really happen, you're just too stressed.
    - a8da6b0c91d 11y ago
      A pulled muscle will heal up in a couple weeks. We're talking about chronic pain lasting many months or years.
- abandonliberty 11y ago
  You have the common and popular misunderstanding of psycogenic illnesses. >Does this mean that the sickness is “all in my head”? No, it doesn't. The people who are in these outbreaks have real signs of sickness that are not “imagined.” They really do have headaches, or they really do feel dizzy. But their illness is not caused by a poison or a germ. http://www.aafp.org/afp/2000/1215/p2655.html http://www.aafp.org/afp/2000/1215/p2655.html
maccard 11y ago
Plenty of people have MRI scans that can show herniated discs. Have a look at [1] for a very clear image of what you can see in some obvious cases. Obviously some aren't as clear as the image below, but mine for instance was. [1]http://www.mayfieldclinic.com/Images/PE-HerniatedLumbar_Figure2a.jpg http://www.mayfieldclinic.com/Images/PE-HerniatedLumbar_Figu...
- a8da6b0c91d 11y ago
  Most people have problems like these but experience no pain or functional impairment.
Ankur84 11y ago
> Then the idea that ulcers are just an infection took hold so the psychogenic manifestations of stress shifted. It may be that treatments have been developed for those ulcer causing infections. That could be why you're not hearing so much about uclers. I think the situation might be the opposite of what you're suggesting. It seems ailments that we don't understand are put down to stress. Then we find a physiological cause, and then a cure and then we stop hearing about the issue.
- a8da6b0c91d 11y ago
  There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place. It's not the case that medicine cured the problem.
  - dragonwriter 11y ago
    > There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place. Once we understood the causes (H. pylori infection primarily, NSAID overuse secondarily) we were able to manage the second and intervene to control the first based on symptoms that develop before the peptic ulcers. Additionally, the H. pylori infection rates are much higher in older Americans (H. pylori infections typically have a long lead time before developing any symptoms), probably because of lifestyle changes that have reduced environmental exposure. So with less and less people having H. pylori infection in succeeding cohorts, there's a decline in peptic ulcers. We know the connection between the causes and the decline. And, yes, some of it is that medicine cured the problem (earlier intervention for H. pylori infections), and some of it is awareness of medicine side effects reduced actions causing the problem (NSAIDs), and some of it is that the age cohort that had been most exposed to H. pylori infection and was most at risk became a smaller share of the population as time progressed.
anthony_romeo 11y ago
> Given only x-rays images, spine specialists completely fail to identify the individuals who report back pain. I'm not surprised. X-rays are not the most reliable in identifying all spinal issues. X-rays are more for finding problems with the vertebra or curvature of the spine, not the discs. An x-ray showing mild degeneration could be produced from the same individual who on an MRI could show a severe disc herniation. I'm not a doctor, but I've worked on developing legal cases for disabled individuals, and an MRI is pretty much mandatory. Anecdotally, I have a relative who suffered from severe back pain after a lifting accident, but the x-rays didn't show anything. I told him to ask his doctor for an MRI after a number of months, which indeed demonstrated the herniation.
fpgaminer 11y ago
While Dr. Sarno's theories were helpful for my carpal tunnel, and apparently for many others, I would be hesitant to apply TMS to all back pain, carpal tunnel, and other "office chair diseases." I know you said "overwhelmingly psychogenic", which implies you meant not all cases. But I'm not sure overwhelmingly is accurate either, especially for back pain. With carpal tunnel, it's clear based on the plethora of cures with random success that calling psychogenic may often be right. But back pain has alternative, and seemingly better explainations (weak muscles, poor flexibility). So while TMS may be the diagnoses for some with back pain, and a contributor for others, I would not go around slapping it on everyone who says they experience back pain. That said, Dr. Sarno's book is worth the cost of reading. It's very staunchly in the pseudo-science camp, and Dr. Sarno spends a lot of time bemoaning his ostracization from the medical community, but his theories are ultimately interesting, hold some weight, and have been helpful to many. For example, I haven't worn a wrist brace to bed since I read the book (about a year ago). And, even if it hadn't helped, it brought more awareness to just how stressed I was. I do a better job managing my workload and consequently stress these days. Just keep a healthy heaping of skepticism by your side while reading.
tim333 11y ago
[citation needed]

WalterSear 11y ago

"An acupuncturist in Palo Alto, Calif., thinks she has figured out why." Ok, lost me right there.

cristianpascu 11y ago
I noticed, but looked further. Most people have simoultaneously beliefs of which some are true and some are false. Very educated people don't vaccinate their kids. Which is not to say they are false in any other aspect of life. Indeed, they loose their credibility. But I think it's a matter of critical thinking to be both skeptic and charitable. Otherwise we fall into the classical, but very recent trap: you can't be a scientist and also be religious.
jerf 11y ago
Keep reading; in a shocking display of journalistic competence, the journalist interviews someone else who proposes a sensible alternative explanation for the results the acupuncturist may be seeing. The aforementioned sensible alternative explanation is currently related to one of my pet theories, which at the moment hasn't got enough scientific evidence to make a call either way, but: My theory is that the reason "standing up a lot" seems to help people is that it builds core muscles up, which do think I have sufficient evidence that at least one American, namely, me, did not naturally have a lot of. This A: suggests that the argument that science is currently in the middle of about "how much standing should one do" is entirely misguided, dealing with a secondary if not tertiary variable instead of the real problems... and there is a LONG history of this in the health field, so it's hardly a crazy idea... B: explains why "too much standing" could be a problem... "standing" isn't "good", it's just that it builds core muscles, and too much of it is independently "bad", and C: if true would suggest that one could obtain the benefits of standing, and probably more, by directly focusing on building core strength instead of indirectly and more inefficiently building it. I call this a "pet theory" because I believe it to be a reasonable harmonization of several current lines of scientific inquiry, and I don't have the evidence to disprove it, but I also lack the evidence to really solidly prove it. One can see how it might also relate to this article. Having had at least my own experience with my own core weakness, it is actually somewhat astonishing to me that my core can become so weak as to be a source of pain even in my mid-30s. It would be natural to assume that the very things causing pain would itself spur the core on to grow stronger, but it seems at least in my experience the core needs "superstimulus" to grow large enough to even competently do its main job. (I'm not saying I'm confused as to why that's the case... if one looks at the history of our species and considers the working of natural selection, it's not an impossible or nonsensical outcome. It just wasn't my first guess.)

Dirlewanger 11y ago

>Everyone knows that weak abdominal muscles can cause back pain. In fact, Mummaneni says, stronger muscles might be the secret to Gokhale's success. Don't really need to say anything else. Get into weight training and stick to it.

maccard 11y ago
The problem with some back pain is you're unable to walk or bend over, let alone actually exercise, until the pain is masked by something else.
- thrownaway122 11y ago
  So start light. I mean really light. Like lying flat on you back working your core by tensing only specific muscles light. This is how rehab programs start. Then progress. Slowly. Even body weight squats will improve your posture when applied consistently.
- rwhitman 11y ago
  If you're acute like that there are a lot of exercises that can make the situation much worse, particularly if you don't have a diagnosis and are unsure of where the injury is located. Best course of action is go to a Dr and push them to prescribe physical therapy over surgery or meds. Once you know the site of your pain and have a good physical therapist they will give you safe exercises that protect from additional injury. Some lazier doctors will often resort to pain killers or worse, surgery, as a quick solution, but in most cases a few sessions with a good physical therapist is all you need
  - maccard 11y ago
    If you're acute, and prescribed physical therapy but can't stand, it's not going to work either though. There's no problem with being on opiods for a short period of time to relieve the pain, and allow you to take on a proper course of physical therapy, and get the exercise and movement you need.
ggordan 11y ago

abandonliberty 11y ago

Author's book successful on Amazon: 4.6/5, 600 ratings, gushing reviews from MD PHDs in the Mayo clinic. Published in 2008.

rwhitman 11y ago

The author mentioned in this article, Esther Gokhale, wrote a book several years ago with the somewhat goofy title 8 Steps to a Pain-Free Back, which I can't recommend enough, especially if you suffer from back pain. It really transformed the way in which I think about my posture and ergonomics in general. One of the things she touched on in the book, which the NPR article seemed to miss, was a hypothesis that poor posture in the Western world is the result of a cultural shift in the early 20th century. Particularly that slouching and unnatural postures were a sort of rebellious statement against the Victorians for 1920's youth. Bad ergonomics and posture became so hip that they found their way into furniture design - something that became very clear to me after having a herniated disc and a vintage mid-century couch in my living room..

Someone1234 11y ago
Does one really need the book to learn the "secrets?" Is the entire book basically "stand up straight and your back pain goes away?"
- Darmani 11y ago
  That's a lot of it, except that it turns out that how to "stand up straight" is very counterintuitive. You will hurt yourself if you just try. Really, the book is not enough; you need the class, or at least the videos. They also teach you better ways of walking and bending.
  - thenomad 11y ago
    "it turns out that how to "stand up straight" is very counterintuitive" That sentence sums up most of my last decade or so's reading and learning on posture nicely :) Posture: it's harder than it looks.
  - rwhitman 11y ago
    In my case I was doing physical therapy for back pain at the same time I picked up the book, so while I was being taught how to change my posture and ergonomics by med professionals, the book was a good companion for expanding my knowledge..

Darmani 11y ago

I took Esther's course in 2013, and it's had a huge effect on my life. Getting into the correct position involves moving some muscles I didn't know I had, but, once achieved, it feels amazing. Sitting feels like being massaged. I can twist my neck further. When I practice karate, all my movements become faster and easier. The only problem is keeping the posture once achieved, as all your old movements can cause you to revert (and yes, it takes some core strength, but that's a small part).

andrewtbham 11y ago

Pro tip: > take a deep breath in and grow tall. Then maintain that height as you exhale.

nate_meurer 11y ago
Thank you, these sorts of cues are among the most valuable things trainers provide in my experience.

djc_tech 11y ago

Plus look at toddlers and some Asian cultures. They can squat full dept with no problem. My toddler can squat and stand up without issue. I can - but I've retrained myself and opened up my hips/hamstrings and worked on core strength. baby's mama cannot perform a full depth squat let alone with any weight on the or front rack position. The old Asian lady down the street can and does when she does her gardening. I think that coupled with a lot of people have at least mild APT because of a weak core is the major issue. It causes hip strain.

rpenm 11y ago
I wouldn't be surprised if most of that flexibility in Asian cultures comes from using a squat toilet (or open defecation) everyday.

djc_tech 11y ago

defen 11y ago

Squats and deadlifts are how I cured my back pain. I recognize that I tend to have a missionary zeal about this subject because I think it has had so many benefits for me...but seriously, if you don't have any health issues that prevent you from doing so, you should be lifting heavy weights with a barbell. Your clothes will fit better, people will be more attracted to you, you'll have more confidence, and you'll be amazed at how strong you become. If you're a healthy adult male under 40, 1 hour a day for 3 days a week will get you to "pick up 400 pounds off the floor with relative ease" within a year.

dragonwriter 11y ago
> if you don't have any health issues that prevent you from doing so, you should be lifting heavy weights with a barbell. Your clothes will fit better Only if you were wearing poorly-chosen clothes for your existing body before. If you aren't already out on the far extreme of the distribution for height or some set of proportions, you can probably find pretty well-fitting off-the-rack clothes, and if you have, they'll probably fit substantially worse if you change your body shape in any way -- whether its by gaining fat, losing fat, gaining muscle, or whatever.
- kendallpark 11y ago
  > Your clothes will fit better Unless you're female and then your clothes will fit worse. I have to buy two sizes up in dress shirts and hem the waist down just to fit my shoulders into them.
mcculley 11y ago
I second this with a caveat. I have a damaged disc between the sacrum and L5. After several years of back pain and a few visits to the emergency room, I took up deadlifting. I deadlift every other day now and have done so religiously for a couple of years, steadily and slowly increasing the weight. I feel it has been very beneficial for my back issues. I have almost none of the pain I had before. I feel this is a simple remedy that almost no doctor will recommend because of the liability issues. With that said, I advise extreme caution. I lift every other morning and I feel it is the most dangerous thing I do. I'm very careful to pay attention to my form and take the movement slow. Even on a good day, I can feel that disc moving around. On a bad day, I've slipped the disc and lost progress for a couple of weeks while I recovered. So if you're going to try this, take it slow.

xchip 11y ago

"An acupuncturist in Palo Alto, Calif., thinks she has figured out why." Acupuncture is know to work (even if you put the needles randomly) Please bring me a scientist :)

adamtj 11y ago
What the article describes is real science. That makes her a scientist. She's also does acupuncture, which makes her a pseudo-scientist. The two aren't mutually exclusive, and here is a person who is both. That's the real story, in my opinion.
- xchip 11y ago
  To be a scientist you need to know how to research, thing that takes a minimum of 4 years with the supervision of a senior professor. Also your results need to be reviewed by other researchers... And even with all this process in place many times we make mistakes... so imagine what can I tell you about an acupunturist.
michaelkeenan 11y ago
Cochrane reviews show that acupuncture works for some types of pain: http://www.ncbi.nlm.nih.gov/pubmed/21359919 http://www.ncbi.nlm.nih.gov/pubmed/21359919 (It's not mentioned in the abstract I linked, but searching Cochrane's site shows that they look at studies comparing acupuncture to a "fake" acupuncture, which is presumably putting needles randomly.)
- panglott 11y ago
  Well, that appears to be real science about acupuncture. Acupuncture isn't a science based not on whether it works or not (there appears to be some scientific evidence that it can), but rather because it is based on handed-down traditional knowledge and personal experience rather than empirical research. That doesn't make it bad, it just makes it culture.

kendallpark 11y ago

As one that is in and out of PT fairly frequently, I can tell you how absolutely FRUSTRATED PTs and orthos get by people that have lower back pain and want some medication or special chairs or stem, as opposed to buckling down and strengthening their abdominal muscles. Weak abs = lower back pain. For most cases. In my early years playing football, I used to get lower back pain from the contact. I was weightlifting regularly, but always skipped my ab exercises because I hated them. One year I was like, screw it, I'm going to do these. Abs got strong, back pain disappeared. This posturing stuff engages your core and helps keep the spine supported properly. If you want faster results, get in the gym and get an abdominal routine going.