Back pain: macro impact

Back pain is the #1 reason for disability in the U.S. The cost is high enough to have Macro impact.


**Why Americans Spend More on Back and Neck Pain Than Any Other Health Issue**
**by Christopher Curley, Healthline, March 3, 2020**


**From 1996 to 2016, back and neck pain were the costliest in aggregate, accounting for $134 billion in care paid out-of-pocket expenses as well as by public and private and insurance companies.**

**All told, treatments for lower back and neck pain cost nearly $77 billion by private insurance, $45 billion by public insurance, and $12 billion out of pocket by patients themselves, the new research from the Institute for Health Metrics and Evaluation (IHME) shows. ...** [end quote]

Musculoskeletal pain actually costs more than the next two costliest health problems, diabetes and ischemic heart disease. That’s kind of amazing, since the latter two are potentially fatal, while musculoskeletal pain just…hurts.

I’m sure that many (if not most) METARs have experienced back pain at one time or another. I have.

A new study shows that “graded sensorimotor retraining” (teaching people how to move and then telling them to exercise for 30 minutes, 5 times a week at home) significantly helped.

**Graded Sensorimotor Retraining Improved Chronic Low Back Pain**
**— Randomized trial shows that guided movement sessions can lessen pain**

**by Elizabeth Short, Editorial Intern, MedPage Today August 2, 2022**

**"What we observed in our trial was a clinically meaningful effect on pain intensity and a clinically meaningful effect on disability," said McAuley in a statement. "People were happier, they reported their backs felt better and their quality of life was better. It also looks like these effects were sustained over the long term; twice as many people were completely recovered. Very few treatments for low back pain show long-term benefits, but participants in the trial reported improved quality of life one year later."...**

**The intention of graded sensorimotor retraining is "to help people in pain understand that it was safe and helpful to move (step 1), feel safe to move (step 2), and experience that it was safe to move (step 3) as they progressed toward re-engagement with meaningful functional goals."...**

**The intervention consisted of graded premovement treatment sessions spanning 12 to 18 weeks with an exercise physiologist or a physiotherapist, which included sensory precision training and mental rehearsal of movement, as well as a home-based component that participants were encouraged to complete for 30 minutes 5 times per week.....** [end quote]

The participants were taught back exercises and told to do them at home. Not surprisingly, they improved!

The controls had several sham “treatments” – sham noninvasive brain stimulation, sham laser, and shortwave diathermy for the lower back in hour-long sessions over the course of 12 to 18 weeks, as well as a sham cranial electrical stimulation device, which they were encouraged to use five times a week in 30-minute sessions. This is cool because these sham treatments are actually used by practitioners who charge for them. Any benefit is pure placebo effect – not to be sneezed at because about 1/3 of people can benefit strongly from a placebo effect.

Personally, I exercise my back by stretching and strengthing every day. I was taught yoga by a chiropractor 30+ years ago and continue to practice daily. Otherwise, my back would hurt. I exercise my back even after surgery since my back is finicky and insists on daily exercise. Even my younger sister, who has severe scoliosis and osteoporosis, exercises her back muscles (carefully and with special exercises).

Americans have a great burden of back pain due to a high rate of obesity and lack of movement.

Ironically, with few exceptions, anyone can adapt standard back exercises (including yoga and Pilates) to any level of ability. And they are absolutely free and non-invasive, with none of the side effects of drugs or surgery.

The new study proves this well-known fact with a small but significant data set.




Earlier versions of the same fundamental insight are Alexander Technique and Feldenkreis Method, and both are well worth more than a look by anyone suffering from back and any other chronic pain disabilities.

I am deeply indebted to Alexander Technique, and my Mom claimed it “makes living into my nineties worth it” as she kept hiking and climbing.

david fb


Earlier versions of the same fundamental insight are Alexander Technique and Feldenkreis Method, and both are well worth more than a look by anyone suffering from back and any other chronic pain disabilities.

Aldous Huxley used and benefited from the Alexander Technique.

Here and Now!
Aldous Huxley, Consciousness and The Alexander Technique


The core is the foundation for a strong, mobile body. Bridges ( also called planks ) are a very
low impact way to strengthen your core. Improve balance and strengthen core by doing bridges with 1 or 2 opposite limbs not having contact with the floor ( ie balance on left arm and right leg in a bridge position ). there are many variations that can be done, and you can definitely test your limits
from the comfort of your living room floor if desired. From the yoga that I’ve done, it seems very similar to doing bridges, of course different poses work different parts of the body, not just the core. A strong core will probably help alleviate back pain that people suffer from, if it is not a nerve or disc issue.

Did a kayak float yesterday with 4 friends, they all complained of back soreness afterwards.
But they don’t do much to strengthen their core, even though it is a pretty easy habit to
get into. But I give them credit, they made it down a pretty challenging river with no mishaps.
4 of us were in our 60’s, one is 70 years old.

I see quite a few very fit people in their 60’s and 70’s, they all seem to make
a real effort to put their bodies in motion daily, they are lucky enough to be healthy
enough that it’s a way of life for them. I know not everybody is that lucky, don’t mean to sound
like it is just a choice to be made. For some, genetics makes the choice for them.

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UNJ For some, genetics makes the choice for them.

Its not only genetics, or one’s personality or commitment and will power to maintain a “healthy” body.
See Wendy’s Autoimmune Psychosis thread

A virus/pathogen induced arthritis is as painful as a wear-and-tear arthritis as a genetic arthritis.
Graves, and some muscular dystrophy are apparently “pathogen or virus” related.

The physical injuries one experiences: a car wreck, with undiagnosed/untreated stress/strain damage, for example; falling and a head injury neck or other injury, etc.
Snake bite that atrophies a major muscle group.

Fybromyalgia, chronic myofacial pain. AFAIK, the cause is as yet unknown. But the myofacial pain is tough to get passed?

Sometimes, that “slob” doesn’t have a lot of “choice”.

To bring this back to the thread topic - some back exercises application that work for me (YMMV):

I mounted an 80 cm handicap bar vertically on a living room wall.
I have some of the wide stretch bands hanging off it, with the bar as anchor. Each day, as I pass by it, I’ll do some stretch band exercises which work the Back, abs, and core.

YTWL - it, there are many “versions”. Some you’ll recognize from yoga postures, some from weight lifting, etc. stretch band exercises, too.

An example of the stretch bands.…

I also do various ab exercises with the same rig.
My rig aint perfect, but, it is good.

I do these exercises sporadically throughout the day, all in my living room, at my leisure, and LOW impact.

Exercising, like diet, is very individual and must be something that is doable longterm.

ralph thinks squats are as important as “back”.

I do chair squats, deep squats, and a variety of other squat actions. I find the deep squats and Asian Squat are especially useful for hip, knee, and ankle flexibility.


"Sometimes, that “slob” doesn’t have a lot of “choice”.

Ralph, I never referred to anybody as a “slob”, not sure where that is coming from.

Exercise is great, if your body doesn’t have debilitating issues. Not everybody is
that lucky, does not make them a “slob”.

Hi Joe. I apologize. I didn’t intend to imply that you had called any body a slob. That was my word.


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Dr Bob and Flyerboys,

It made my day to see you both reference the Alexander Technique. I enrolled in teacher training many years ago and found it very helpful for myself and clients. My first teacher was Marj Barstow who was in the first class that FM Alexander taught to be teachers. She was actively teaching into her 90s!

I remember her saying “we do what we do regardless of what we are doing”. We carry our patterns into any activity we do. If those patterns are faulty and go unaddressed, we are just reinforcing them by exercising and thereby risk just adding to the problem.

Anyway, thanks for calling attention to the work!