A Consultation With the Back Doctor

I discovered Dr. Hamilton Hall by accident six months after the onset of what is apparently a herniated disc. I'd been through two months of physical therapy and then two months of diligent core strengthening exercises. I'm very fit to begin with and was getting a much stronger core but I wasn't seeing an improvement in my condition, wasn't able to sleep well, and I was frustrated. Dr. Hall's book was a godsend. After untold hours of trying to understand what I had and the merits of various exercises and stretches, and having given up vigorous strength training and ice hockey, both which I so enjoyed, I was profoundly pessimistic.Dr. Hall's book changed all of that for me within three days. His is the first SYSTEMATIC explanation I'd found of how to classify and treat back pain, based on his more than 40 years of work as an orthopedic surgeon focused on treating spinal maladies. If I could recommend one thing to read for back pain sufferers on Day One this would be it. It will make a tremendous difference by giving you power and understanding about what is happening to your body and how to conquer it. And it will make you an informed consumer of care in a field that seems infested by poor, conflicting sources of information and outright quackery from those seeking to profit from our pain and fear.This book is the only source I've found in six months that gives a systematic explanation of how to assess back and neck pain, and that can make a sufferer a truly informed consumer of orthopedic, chiropractic, and PT treatments. He assesses the pros and cons of these avenues of treatment (as well as acupuncture and others), the scientific evidence of efficacy, and the reality of practical treatment.Dr. Hall's Four Patterns of Pain are easy to understand and led me clearly to see what my PT had never bothered to diagnose (check out his YouTube videos of a seminar he gave in Vancouver in 2013; this is what led me to buy his book.) I bought the book and read it within three days. I skipped over the neck material as it didn't apply to me. I could quickly narrow down my diagnosis to back-dominant pain classified as Pattern 1 - Prone Extension Positive. I could see how some of the exercises that my PT had given me that involved even minor flexion in fact exacerbated my condition.The best part of the book for me (after the explanation of the patterns of pain) comprised the final two chapters on basic exercises. My PT had given me upward of 20 different exercises to do. No one has time for that. After I finished my course of PT I had to use my own judgment which six or seven to focus on. But these didn't seem satisfying. Much to my delight I found via Dr. Hall's book that by adopting a simple regimen of controlled sit-ups, crunches (no, they really don't hurt your back if done correctly and are, in fact, the fastest way to build strong abs), wall sits, and oblique side raises I was able to reduce my pain swiftly. Part of this, no doubt, is that as a middle-aged man six months out I'm beginning to heal. I'm convinced, however, that had I encountered this book at the end of month one when I first sought treatment, I would have saved myself at least 2-3 months of misery and wheel-spinning in trying to figure out which exercises to focus on in order to reduce my pain. I would have also felt much more optimistic about my recovery.The final bit of exercise advice that cheered me was that back extensions done on a Roman table, which I'd done until my pain commenced and had given up during PT, are actually the best and most effective back-strengthening exercises one can do. I dove back into those and saw quick results.In my opinion, the most important concept for those of us suffering from back pain is Dr. Hall's explanation of "pain-focused behavior." This is a mindset that one develops by assuming, mistakenly, that the back and spine are delicate things and that one should curtail physical activity when injured. The most important thing to do, after an initial acute phase of incapacitation passes, is to resume activity and work on strengthening the back. Reflecting on my experience in months 2-5 I saw myself having succumbed to this mindset, which is why I had become discouraged having shied away from activity. The minute I told myself that getting back to my weight training was important for my physical and psychological health I saw an improvement in my condition. A month later, I'm back to doing heavy squats, overhead presses and kettlebell swings, and nearly five of seven days are largely pain-free. On days when I feel pain I use the appropriate exercises for my condition (extension, not flexion; hip flexor stretches; "sloppy push-ups") and I see improvement quickly.I contrast this book with John Sarno's mind-body diagnosis of back pain, which I also studied. Dr. Sarno is definitely on to something regarding how the unconscious can lead the mind to constrain the body. His books are interesting. However, he's steering people away from pain-focused behavior by telling them that there's nothing physically wrong with them, that their minds are starving their tissues of oxygen leading to spams and pain. The mind, however, is only part of the problem. There IS something physically and mechanically impairing people having back pain that time, activity, strengthening, psychological tenacity, and disciplined adjustments to posture and musculature will help heal. Medical research clearly demonstrates this. Ignoring all of that is not going to make us better.Dr. Hall has a marvelous approach. He advises not to have an MRI, CT scan or X-ray initially, unless a clearly dire situation exists (indicated by the loss of bladder or bowel control) requiring emergency surgery or if cancer is indicated. Otherwise, diagnosis of the proper Pattern of Pain leads to a prescription for physical activity that will facilitate healing. The false positive rate on MRI's, he cites, are upward of 60-90% where back maladies are concerned. Having one of these shortly after the onset of pain leads to demonstrably worse treatment outcomes than not having them. He notes that only around two percent of back pain sufferers really need or can benefit from surgery. Such surgery is rarely advisable early on after the onset of pain.As I said earlier, if I could recommend one thing to read for back pain sufferers on Day One this would be it. It will make a tremendous difference by giving you power and understanding about what is happening to your body and how to conquer it. And it will make you an informed consumer of care in a field that seems infested by poor, conflicting sources of information and outright quackery from those seeking to profit from our pain and fear.

Good straight forward writting by the author, making understanding protocols developed through experience and time easier to grasp and apply. Those suffering from back and/ or neck pain should have access to this book for its practical and common sense approach for pain relief of the spine.

I liked the four simple patterns of back pain and was able to immediately ease a lot of the fear I was feeling due to a compressed nerve. Also it was good at pointing out which treatments were mainly placebo. It easy to read and very helpful. I feel like I have gained a better understanding of my back and how to prevent future problems.

I have the original Back Doctor book that this doctor wrote. It's at least 40 years old, and well worn since I have loaned it to many people. A friend was going into the hospital and I thought I would look for the original - when I found an updated version I was happy to order it and send it to him. Back surgery is frightening and I hope it answered some of his questions. His surgery just happens to be today that I am writing this.

I friend with servere back problems recommend this. What a gift. After a month with less than 2 hours sleep in a row, I'm now back (no pun) in controlTwo MD's diagnosed ligament tear in the leg. Take drugs, you'll be fine.With this book and my questioning the disc problem was found. Simple exercise has it under control.Don't be a victim of back pain. Read the book and get on with life.

Liked his first book, several years ago, much better because it had much fewer stories and got right to the point, telling you what really causes back pain and how rare it is that you really need surgery, and how it's diagnosed. Too many people head straight for the knife, when normally there are many things you can do to avoid pain and to manage it for what are normally non-permanent injuries (and yet can last for months).

A practical non-surgical solution to chronic back and neck pain. It is refreshing hearing from a physician that admits a battery of test and procedures are not the first line of defense for back and neck pain.

This book's focus is too broad. It has some very good information. In trying to be all things to all people many pages and chapters become irrelevant to all readers.