I have been in clinical practice since 2001, and what that means is just that I have spent my work days seeing patients. People come to me with problems and I help them with solutions. Unlike a traditional medical doctor, most of what I offer is not covered by insurance, which means that people have to pay me directly for my services. Now some things are covered and of course there are exceptions but basically I am a cash for service doctor. Immediately I get haters for that, people say things like, "If it's not covered by insurance it can't be any good". Not true. Not even close to the truth. In reality, medical insurance is the biggest scam ever created (more on this later). But as mentioned I have been in practice since 2001, so if I was not very good at solving problems you could assume I would have never lasted more than 20 years. In fact, I have never been sued and in 20 years I can only remember one person that was ever very unhappy with me, and I gave him back all his money. Later I found out his dissatisfaction had nothing to do with my care, but regardless there are going to always be these weird exceptions. So my point is that I do know something about helping people and in fact I would say that in all my experiences the one thing that I am certain of is my ability to fix people with back pain. In my busiest days, working in Battle Creek, Michigan, I would treat over a hundred patients per day, five and a half days a week. I have seen and treated everything related to back pain and I even had my own personal experience with severe back pain, which I wrote about extensively in the book, The Philosophical Physician. So today I want to write a few pages about what I have learned and how you should approach back pain if you or a loved one is suffering. Let's dive in!
It seems that as humans, we are plagued with back problems. Many theories exist, but I believe it has to do with the fact that our original design is based on four legs, not two. In the evolutionary process of standing up, the spine develops several curves to maintain the head over pelvis. These curves act as springs in a coil to reduce mechanical forces in the body but they also place additional stress on the spinal joints and discs. While this is only a theory we don’t see spinal conditions like scoliosis (lateral curves) in any other mammal.
The spine is 24 bony vertebrae that encase and protect the more delicate the spinal cord. These vertebrae are separated by spinal discs that act as a shock absorber while allowing for the safe movement. The spinal cord runs down through the vertebrae like a telephone cable, branching out through small holes between the bones called foramen. Nerves exit the spinal cord and travel throughout the body controlling your muscles and organs. Damage in the spine will routinely cause illness and dysfunction in the organs; for example, a spinal injury can cause bladder problems or even high blood pressure. Back pain is a systemic problem.
In 1996 doctors Vert Mooney, MD, Jeffery A Saal MD, and Joel S Saal, MD, published the Evaluation and Treatment of Low Back Pain. In this, the doctors identified the leading causes of back pain as follows, the spinal disc was responsible for 85%, the facet joints 10%, and the sacroiliac joint 5% with muscles, fascia, and metabolic factors acting as contributors to each of those cases (1).
At 85%, you can almost certainly assume if you are having back pain it is a disc problem. But most laypeople do not automatically think disc; instead, they think muscle. When someone presents in my clinic, that’s the most common thing I hear, “Oh, it’s just a pulled muscle.” And they are right, but only partially. Muscles are usually involved in all cases of back pain but only as a secondary cause. The muscles will often spasm to brace the spine from further injury, but the underlying cause of the problem is the spinal disc. The disc can tear under stress and squish out into the foramen where it will irritate the nerve and cause pain, weakness, numbness or even organ dysfunction. Damage to the spinal disc is cumulative, and over time repeated injuries cause degeneration and stenosis.
The disc itself is active tissue that contains significant mechanisms for self repair (2). Under a published study proper treatment can correct 88% of people who have back, neck or sciatica pain (3) and in a 4 year post treatment follow up study those who got better stayed better (4). Take a moment and let that really sink in, especially if you have a bad back because it means you can likely end your pain and avoid drugs, needles and surgery.
The spinal disc is an essential structure in the human spine, but it is avascular. Since there are no vessels to feed blood and oxygen to the disc directly, it must get its nutrition from diffusion. Small blood vessels branch to the surface of the spinal vertebrae and poke through the endplates where they sit under the discs. Like a sponge, the disc draws blood up through these vessels, and then when under pressure, like a sponge, the disc releases waste. This process is called the pump mechanism of disc nutrition.
This pump mechanism is a natural process that occurs through the movement of the spine. When injured, the body automatically can limit spinal motion and, in the process, prevent the pump mechanism. Without the pump, the spinal discs cannot receive vital fluids needed to repair and regenerate. Overtime waste products will build up in the tissues, and the disc begins to degenerate. Clinically I have seen injuries that happened many years ago, where someone hurt their back, and the initial pain went away, but the pump mechanism is not restored. Now years later, that same person has severe arthritis and degeneration of the spinal discs and does not know why. Luckily, even in these chronic cases, once the pump is working correctly, the spine will begin to heal. Restoration of the pump mechanism is the main focus of treatment.
To assist the spinal discs in regeneration, you must create a negative pressure from within the structure. This pressure difference will produce a slight vacuum that will draw in bulges and herniations as well as vital fluids that will stimulate the repair process. The suction from the vacuum also stretches the small blood vessels that feed the endplates, causing controlled stress that overtime stimulates the body to meet that stress by growing new blood vessels. This mechanism of building new blood vessels is called angiogenesis.
Before continuing lets take a moment to understand the significance of spinal disc pressures. Simply put more pressure is bad and less pressure is good. Pressure puts the spinal disc under stress that can lead to injury and premature degeneration. When the disc is hurt we want to maintain a lower pressure environment, which will assist natural healing. Normal pressure is about +75 mm/Hg, when we lie down and raise up our legs we can reduce it to +45 mm/Hg but with decompression therapy we can lower the pressure to -150 mm/Hg, enough to create a suction effect.
My first experience with this specific treatment approach was in a student clinic at Logan College of Chiropractic. The school had community outreach locations throughout the city where people could get reduced Chiropractic care administrated by students in their final year of study. Despite being a student clinic, the quality of care was still very high because experienced doctors carefully supervised everything. Most of the time, things went smooth in the student clinic, and I would adjust people, many times, whole families without any problems. One Saturday morning, I was doing my shift, relaxing, and finishing my second cup of coffee. Saturdays had a more relaxed atmosphere that offered more one on one time with the supervising doctor. I was at the front desk making small talk with the receptionist when I noticed two men helping an older gentleman get out of his truck. As they carried him towards the clinic, I wondered what I was going to do to help this man. He was obviously in severe pain and doubted if I would be able to adjust him. After taking some x-rays and ruling out any red flags that would require a medical referral, I discussed the case with my supervisor. The working diagnosis was a damaged spinal disc, maybe a bulge or herniation. He would need an MRI to confirm the extent of the damage, but for now, we needed to reduce his pain. The patient’s back was in spasm, and he was bent forward, unable to straighten up. I doubted I would be able to get him on my table, and I certainly was not confident I could adjust him.
The clinical director looked at the x-rays one more time and then turned to me and said, “You need to get the pressure off his disc, you need to decompress him.” We led the patient to the back of the clinic past all the traditional Chiropractic adjusting equipment and into a small room that contains a funny-looking bench with a hinge in the middle. “Set the table in flexion,” the doctor instructed me. “Now sir, slowly lie down but do not try and straighten up, use your arms to keep the pressure off, that’s it, slowly now, take your time.” As the injured man assumed his place on the table, he immediately started to relax, he was able to maintain his bent position but with support. The pain was quickly reduced. Again my mentor led me through the process, “Now unlock the table and gently distract the spine, slowly, carefully use a pumping motion while supporting his spine with your other hand.” I could hear the patient moaning slightly, “Are you alright?” I asked. “That feels better, he reported.
After about 15 minutes of treatment, I was able to reduce the swelling on the patient’s disc enough that he could get up from the table with 50% less pain. Next, we braced his spine with a lumbar orthotic and instructed him to wear it for the next two hours with an ice pack in place for the first 20 minutes. The gentleman was able to walk to the front desk by himself, where he made an appointment for a follow up on Monday morning. Before leaving, he turns to me and suddenly hugged me with tears in his eyes, “Thank you, doctor, you saved me.” It was the first time anyone called me a doctor, and it was my first experience with decompression treatment.
Fast forward, how is all this going to help you? Well here's the good news! A friend of mine, John Lee was so impressed with this story that he designed and patented a do it yourself version of this decompression treatment. This is a decompression belt that is manufacture by his company DDS. John and I have been friends for over 10 years and I have prescribed his decompression belts for just as long. At our last count John told me I have ordered almost 2,000 belts. The success with this treatment rate on reducing pain is almost 100% but more impressive is that more than 44% of those scheduled for back surgery cancelled the operation after using this device (5). Now I wrote an entire article just on this device alone and I encourage you to check it out (HERE) but in the meantime just realize that by using this belt you can reduce the pressure in your spine and help your back heal. Better than any inversion table, you can walk around with this on and heal while you move. The minimum requirements are you must wear it for 2 hours per day for 30 days. Most people feel improvement after the first 2 hour session.
Now let's talk about our friends the plants. Of course there several plants that can really help fix our bad backs. Many of these I covered in my article on general pain which you can read (HERE) however, in cases of back pain the one single plant you must use is Gotu Kola. This herb promotes angiogenesis (blood vessel growth) and tissue regeneration. Honestly it helps with any type of healing but works dramatically with spinal discs. You can take it in tablet form as Goto Kola Complex #M1313 2 tablets, 3x a day or in a powerful liquid extract #M7060 taking 5 ml a day, adjusting dosage based on your size.
Another winner is Turmeric Forte #M1448. Turmeric is a miracle herb that reduces inflammation better than any other product. The problem is that turmeric is poorly absorbed. This product is different in that it combines the turmeric with fenugrek thus allowing the powerful medicines of the curcuminoids to pass into th eblood stream and be used by the damaged tissues. Here is a ridiculous but true statement, turmeric forte by Mediherb is the only product in the world that does this. Honestly, it is perhaps one of the top 3 most useful herbs I prescribe.
Finally, if you are just really having a hard time with the pain, and this is common when you are dealing with problems like sciatica (this is when the sciatic nerve is being pinched by a bulging spinal disc) you need willow stem bark extract, Saligesic #M1395. This is a great non addictive pain reducer that is safer than Advil. I recommend using then "as needed" because they are super expensive but they really work great on difficult back and sciatica pain.
So now you have your Decompression belt and your Plant Medicine, here are some final tips. First don't use ice, use heat. Buy a nice moist heating pad and apply it for 20 minutes every 2 hours. Remember it is all about blood flow, we don't want to constrict the flow with ice. I know what you have been told about ice but heat is the king to healing. Ice will numb the area and reduce your pain temporarily however heat will increase the circulation and promote healing. Use heat. Secondly, move around every 2 hours. The ideal situation is that you get into a pool and wade around floating on a pool noodle, again 20 minutes every 2 hours. If you don't have a pool get up and force yourself to walk, slowly and carefully for no more than 20 minutes every 2 hours. This promotes circulation and keep your muscles from spasming. Thirdly, you must sleep to heal. Take afternoon naps if you can and if you are not able to sleep at night I recommend either Valerian Complex #M1452 (to stay asleep) or Kava Forte #M1345 (to go to sleep). Again Kava is a powerful plant, expensive and very strong, it will literally knock you unconscious if you take to much. Use it with optimistic caution.
Hey wait a minute? What about Chiropractors, lasers, massage, acupuncture and all those treatments? Ya, they can help, but do you own a laser? These recommendations are simple and affordable. Try them out and let me know how you do. Back pain is a serious problem and in some cases you may need surgery but if at all possible you should try everything possible before making that sort of commitment, remember back surgery has a 74% failure rate (6).
1. Evaluation and Treatment of Low Back Pain Vert Mooney, MD; Jeffery A Saal, MD; Joel S Saal,MD Clinical Symposia Vol. 48 Number 4 1996.
2. Humzah MD, Soames RW: Human intervertebral disc: structure and function. Anat Rec 220:337–356, 1988
3. Efficacy of Vertebral Axial Decompression (VAX-D) on Chronic Low Back Pain: A Study of Dosage Regimen Ramos G., MD, Journal of Neurological Research, Volume 26, April 2004
4. VAX-D Reduces Chronic Discogenic Low Back Pain- 4 year Study Odell R., MD. Ph.D, Boudreau D. DO Anesthesiology News, Volume 29, Number 3 , March 2003
5. The following patient survey results are a combination of a survey performed by Disc Disease Solutions, Inc. in late 2011 and again in early 2014. DDS, Inc. mailed out a multi-page questionnaire to all patients who received a DDS 500 LSO Brace within the time period of 1/1/2009 and 12/20/2013 and who had returned to DDS the enclosed warranty card that is included within the product packaging. The total amount of questionnaires returned was 879.
6. Spine (Phila Pa 1976) 2011 (Feb 15); 36 (4): 320–331
Hello, I am Dr. Stephen Stokes, my patients call me Dr. Steve, and my friends call me Steve. So what can plants do for you? Well, the short answer is everything! Keep an open mind and discover what you have been missing. Please share this information with everyone you know.