The End of Back Pain, by Dr. Patrick A. Roth, M.D. (Softcover, 2014)|
(You can print this review in landscape mode, if you
want a hardcopy)
Reviewer: Mark Lamendola, author of over 6,000 articles.
Any book on this particular topic is likely to get a two or three star rating
and is nearly guaranteed to max out at a four. The reason? Most authors on this
sort of topic follow the "if you have a hammer, everything looks like a nail"
approach. They have a particular expertise, and it makes a lens through which
they see the problem. Their particular take on the subject may be very effective
for some people, but it's incomplete. It may help in some other situations, be
useless in some, or maybe even do more harm than good.
So how did Dr. Roth manage to pull off a five star rating?
By not doing what most authors on this sort of topic do. He repeatedly
states he does have his own bias, so you might expect him to laud the
virtues and superiority of allopathic medical treatments. Drugs, surgery,
and not much else. But he doesn't do that.
The core concept of the book is "developing your core," a concept that
most elite athletes have embraced for many years because a weak core has
negative implications for your athletic performance.
But it's also a concept germane to physical health. The "normal" decline
we see in strength, mobility, and general vigor doesn't need to invariably
begin in our mid-twenties. It can, through proper diet and consistent,
programmatic training of the body's core, be delayed for two, three, or even
four decades. As can the chronic aches and pains (mostly of the back) that
afflict so many people.
So, OK, a surgeon prescribes a cohesive exercise plan. Unusual, but still
not a balanced approach. For example, what about chiropractic? Dr. Roth
covers that, also. In fact, he describes its benefits as "amazing". But as
with the many other treatments he discusses, he puts it into context rather
than claiming to have "the" answer to back pain. Yes, programmatically
working that core to keep it strong and supple is his main "cure" but he
puts that into context also.
I discussed this book with a retired medical professional.
Coincidentally, she had seen Dr. Roth on The Dr. Oz Show. She's had two
spinal fusions, a surgery that Dr. Roth performs. She said she'd been able
to delay this surgery for quite a few years, using many of the treatments
and techniques described in this book. Notably, she didn't do the core
training. Maybe if she had....
Very early in the book, Dr. Roth makes it clear that back pain (of some
sort) is a normal part of being bipedal. You can't really end it, per se.
But you can change the dynamics of it quite dramatically. You can
dramatically reduce the frequency, duration, and intensity of recurring pain
episodes, for example. If you have chronic back pain, you can reduce its
intensity and (very likely) change it to periodic rather than chronic.
You have many tools at your disposal to make these improvements a reality
for you. The problem for the typical back pain sufferer is finding an expert
who can make the right diagnosis and point you in the right direction for
treatment. This is where most of us go wrong. I personally happened to luck
out by finding a chiropractor (Dr. Anderson) who has Dr. Roth's viewpoint.
Dr. Anderson sees chiropractic as one part of a much larger tool chest
and as part of a larger strategy. Most chiropractic patients see it as a
"cure" for an acute back pain episode. That's what typically gets them into
the chiropractor, but when their pain's gone they stop going. "Who is this
guy who is recommending these exercises and asking about my diet?"
About 20 years into his practice, Dr. Anderson founded Anderson Physical
Medicine, a clinic that provides a range of services (not just chiropractic
and not just for the back) and treatments. Dr. Roth discusses many of them
in this book.
But it's unusual to find someone to help you navigate the maze of
choices, and often the advice a patient gets is simply wrong. Fortunately,
Dr. Roth provides guidance on this rather large issue in the last four
chapters of the book.
This book consists of an introduction and eight chapters, spanning 226
pages. In the introduction, Dr. Roth discusses how he discovered the hidden
core. Here, he also discusses some aspects of training it, such as with the
Roman Chair and kettleballs.
The first chapter delves into the difference between health care and
disease care. This distinction is lost on nearly everybody, and most notably
with the Unaffordable Health Care Act which (in a failing way that defies
basic mathematics) addresses disease care / medical care insurance but
severely undermines health care. In this second chapter, Dr. Roth is
basically saying you don't wait until you have pain to go about taking care
of your back.
Chapter two discusses pain, and chapter three prepares you for
understanding the hidden core workout by explaining the anatomy of the back
and why things work the way they do.
Chapter four very nicely describes the Hidden Core Workout, and provides
illustrative photos of each exercise being performed. The routine is a good
one. If you gain the understanding from chapter three, you can modify this
as you see fit to keep things from getting stale.
But don't just change things without that understanding. Just to
illustrate, I sometimes travel and so visit a gym to train with weights. I
see people doing things that make no sense from a biomechanical training
standpoint and many of these things are actually dangerous. They have
changed an exercise without having a clue as to what they are doing. Don't
make that mistake.
If you're not well-versed in training principles, find someone who is. A
qualified instructor in yoga, martial arts (most of them, anyhow), or weight
training can guide you. What's critical is that you understand what exactly
you're trying to work so that you actually work it (and safely) as a result
of the form you're using to perform the exercise. You must know some anatomy
and you must understand a fairly long list of training principles, else
you're just engaging in trial and error. And it will be mostly error.
This book has a logical flow to it. The first four chapters are really
about health. That is, what you do to make your back far less prone to
The next three chapters are about medicine. That is, what you do to solve
the problems that come up despite your best efforts at health. The chapter
title are as follows:
- 5. Diagnostic: A DIY Guide.
- 6. The Nonsurgical Treatment of Back Pain.
- 7. Surgery.
The final chapter is "The Back Genome," and it's a forward-looking take
on how we might use information technology to build a sort of blueprint for
accurately diagnosing any individual's back problems and developing a
treatment plan. This would be accomplished by matching similar
characteristics of many individuals.
These characteristics include such personal data as height, weight, body
composition, age, occupation, desired activities, and so forth. These are
the characteristics that make diagnosis and recommended treatment good for
one person but bad for another.
Earlier in this review, I noted that Dr. Roth is basically saying you
don't wait until you have pain to go about taking care of your back. So this
book isn't primarily for those who have chronic back pain and want to end
it. It's primarily for those who want a healthy back so they don't end up
with back pain as a "normal" part of a miserable daily life.
I will note here that Dr. Roth's Hidden Core Workout has benefits going
well beyond creating a sort of shield against back pain. You can expect such
benefits as improved circulation, improved physical appearance (in most
cases, greatly so), and improved function of the vital organs.
This workout also helps raise testosterone, the master hormone that
signals the body to store calcium in the bones and reduce body fat. How can
anyone not want those two benefits?
Another, very important benefit is the relaxation effect. Not only is
this exercise a good way to work off stress, but it induces the release of
endorphins. So you get a double benefit.
I mentioned improved appearance. Dr. Roth doesn't go into this in any
detail. So this particular benefit might not register with some people. Have
you ever noticed that some individual in a group, say at a party, just seems
to have presence and stand out from everyone else? Take a closer look next
time. The reason (in nearly all cases) is powerful posture; shoulders back,
hips properly aligned. Exactly what you get from the Hidden Core Workout.
Burning off calories, creating a beneficial hormonal environment, flushing
your system with exercise-increased bloodflow, working your colon clean, and
all the other benefits of this kind of exercise also improve your looks.
They also improve how you smell!
That testosterone boost doesn't just trigger calcium storage and body fat
burning. It also triggers the body to build lean muscle. That's why some gym
rat who doesn't do large compound exercises like dead lifts and squats will
always have smallish arms no matter how many curls he does but the person
who does the dead lifts and squats will have admirable arms without even
Get this book. You won't regret it.