I have lots of comments for you Awaq,

First of all, I have never seen where most treatments involve only pills, injections or surgery.

Nor have I had those as the only treatment from my spine surgeon either and I don't know anyone personally that has had only those treatments either.

A blanket statement that you make make about the inablilty to solve back problems without "muscle imbalances, tightness, weakness and postural problems, belies a real understanding of spinal issues.

The process of dealing with spine issues is not a one size fit's all situation.

Some people can not participate in a good physical therapy program because they are in so much pain and need medication, injections or surgery first to correct their spinal condition.

Physical therapy may or may not help some people, depending on the diagnosis that person has.

If a spine is unstable, then exercise is not going to correct it, but surgery will. Once there is enough recovery from surgery, then a good, solid core strengthening program with a qualified physical therapist is needed.

If the patient is suffering from severe nerve compression, then again, physical therapy may or may not help. If the pain is that severe, then conservative measures such as anti-inflammatores, and steroid injections may be the best treatment to relieve the pain and then proceed to physical therapy.

It is also possible that with severe nerve compression, that the only thing to do is surgery before there is permanent nerve damage done.

There are patients that do not get any pain relief from any conservative measures, including physical therapy and the only way they can survive is with pain meds, injections and then surgery.
Post surgical recovery, then physical therapy is followed with.

There are also cases where immediate surgery is required before the damage is so severe that the patient will not recover.

Accupuncture is an excellent and proven method to help some people but not all. Nothing wrong with giving it a try to help relieve the pain and the participate in physical therapy.

Message is, many times, part of a physical therapy program. It relaxes muscles, relieves tightness and helps the patient to participate in a full physical therapy program.

Decompression therapy that is not surgical decompression is something that has not been medically studied to prove that the method works. Only real studies done have been by those that make the product and sell it.
It is not something I would do, use or suggest to anyone.

Chiropractic is also something I would never do. I have personally seen far to many people made worse by this kind of treatment.

When one is suffering from spinal issues, it can be all but impossible to participate in a physical therapy program and strengthen core muscles.

On the other hand, once one has a spine problem, whether they have had surgery or not, learning proper core muscle strengthening, how to properly bend and stoop as well as move is a vital part of recovery and keeping your spine strong.

These core exercises etc, need to be properly taught by trained physical therapists that work on spines and not just go to a gym to do exercises.

They also need to become a part of your daily life, part of a normal routine and be done at least twice a day for the rest of your life.

Fran

You make some excellent points about there being more to resolving back pain than exercises. I should have worded my post better. My post was more out of frustration because virtually no I know is WILLING to do exercises for their back. Is it because:
1) It hasn't working for them?
2) Too lazy / don't like exercise?
3) Don't want to admit there is something wrong with them. Let's blame it on genetics is the new buzzword.

Just wndering if P/T would truly work for people, would people be willing to do it?

Sorry, but I can't imagine anyone not willing to do exercises for their back if it would or could prevent any kind of spine surgery.

On the other hand, I am reminded of what my own physical therapists have said to me when I first started PT after my first spine surgery.

They where pleasantly surprised that I was "so cooperative with my physical therapy. Followed through with exercises at home. Carefully and fully answered their questions at each visit. Did my best to do the exercises during PT."

I was surprised with the comment and when I questioned them, I was told that the majority of people do not follow through at home. They come in and do whatever they are supposed to do during the visit but don't do their follow-up at home.
Hence, they do not fully recover from any kind of surgery, do not regain the function and ability that they should regain, and end up living in permanent pain and disability.

It was a shocking statement to me. One that I will never understand.

I have this thing about pain, Awaq. I don't like it, don't want it an don't want pain to be a part of my life.
I don't want to live with any disability of any kind, or any limited function if I can do anything to prevent it.

I sure wasn't going to go to PT and waste my time and theirs and not do what I was supposed to do, least of all if it meant I was going to be the one to suffer in the end.

Physical therapy is time consuming, physically exhausting, and a lot of hard work.

It can hurt, but if it does, then the patient should be telling the physical therapist that it does hurt. Either the exercises are to much at that point in time, are not the correct ones, or there is something more going on with the patient and the doctor needs to be seen.

If the patient doesn't tell the PT what is going on and how much the exercises hurt, then there isn't much that the PT can do.

I don't have a good answer for you Awag, and apparently physical therapists don't either.

Fran

Hope you are doing well. I agree and just don't understand why someone would rather live with pain even though the road to recovery may not be an easy one.