 Hey guys, it is Dr. Nathan Cashin at Natural Family Health Clinic again with another book review. This is gonna be a quick one, not a five lessons learned from the book. Because number one, this is a very short book and there's basically one lesson, but also because I just haven't had the time to prepare the five lessons from the book. So the book that I'm gonna talk about today has all to do with the low back pain and it is called Treat Your Own Back and it's by Robin McKenzie, and this is really a almost a patient handout. It's only a hundred pages and that's including all of the excess text, the appendix and everything else. But this is a book that really changed how I approach patients with low back pain and I'll just tell you the story of Robin McKenzie was a PT in, I want to say New Zealand, might be Australia, but pretty sure he's in New Zealand and he had a patient with acute low back pain who had been coming in and the routine was he'd be taken into room by one of the assistants laid on a table and then the PT and McKenzie would come in and in the rush of this particular day the patient was taken and laid down on the table and about five minutes later Robin McKenzie comes in horrified to see that the table, which was a what I'm assuming was a flexion distraction table, one of those tables that will bend in the middle was actually bent to where there was some lumbar extension and the patient was lying face down on this table with his low back arched like this for at least five minutes and when he checked in with the patient Robin McKenzie was surprised to find out that the patient said he'd never felt better that this was the best he had felt in months so this led to a curious question. Why would a patient with low back pain in such a position that was assumed at the time to cause problems be feeling so much better and led him to do some further kind of testing and playing around with this approach as well as quite a bit of research and so the McKenzie approaches a well researched and a technique supported by the evidence and the basic idea is what I've talked about a lot in some of these videos here at the clinic so if you're if you're watching on my page go head over to natural family health clinic and check out some of the videos I've done there where I've described the disc in between the bones of the low back How pressure on that disc can cause irritation leading to back pain and spasm and a number of those things so the approach with Treat your own back or McKenzie is to take pressure off of that with some very simple exercises But before I get to those There's a good section about myths about back pain where he talks about how acute back pain is short term now The evidence shows us two things number one patients with first time acute low back pain tend to get better in about two to three weeks doing nothing at all Patients with low back pain whether it's the first time or not about 85% of them get better within six weeks so the truth is that this aggressive care that we're so used to Isn't really necessary to get rid of that first bout of back pain however We do find is that this type of pain is likely to come back and so it oftentimes I think it's somewhere about 50% of patients with acute in About of acute low back pain about 50% of them Could go on to have chronic pain So why does that happen and how can we fix it? That's Part of the issue about seeing a specialist a PT or a chiropractor who's well trained It's really about producing stabilization in the low back and learning how to move properly But we do want to treat those acute cases even though They're likely to get better on their own within two to six weeks There are things that we can do to still get you back to activity More quickly than just sitting and waiting and potentially Make it move a little bit faster Myth number two spinal manipulation is the best and most effective treatment for back pain And this is a myth because it depends on the type of back pain in most cases Well, I guess you could say about 40% of cases manipulation is not needed There are basically four types of back pain or for causes. There's disc nerve joint and muscle and so it's only that joint cause that really needs the manipulation The other issues can take the approach found in treat your own back So just quickly show you some of the examples here of the exercises that you can do He talks a lot about posture talks a lot about What the goals are? Which is when you have that pain that goes down to the leg commonly known as sciatica It may not go all the way down the leg may go just to the thigh or the buttock And you may not have that at all But when you do have that pain we call that peripheralization of pain So it's pain that goes peripheral to the low back and the ultimate goal is to bring that pain back up towards the low back so there's a nice diagram here if I can find it that shows the concept of Peripheralization as you go down the leg and then Centralization is when that pain comes back up to be centralized in the low back and so Really what this book shows you is how you can? test your own back and how you can find out whether you would respond to this approach and I'm just trying to get to the good stuff here So there's an exercise program and it starts out with this simple movement of lying face down and Pressing up to create that extension like Robin McKinsey found his patient On your own and you can do this at home as long as you don't have Shooting pain down to the foot or the leg that's causing any muscle weakness Or loss of sensation if you do have those please come into the clinic and go find a Physiotherapist or a medical doctor But if it's pain this was localized that's right in the low back or maybe down to the buttocks This is something you can try at home. You can do it standing as well and what you might find is that you need to start With a little bit of a side bend and I'm just trying to find here so if it is a Lateral disc problem, then you might need a side bend to achieve the same effect And again the whole goal as you do this and the picture of that side bend There or there The whole goal as you do this is to pay attention to the sensations that you are feeling and so if you have Achydole pain or if you have shooting pain down to the thigh or the buttocks pay attention to where that pain or that Sensation is whether it comes closer to the back Whether decreases in intensity what you might find is the low back pain increases, but as long as we're getting that centralization Then we're making an effect Another thing that I really like about this book is that at the very back? There is an emergency back pain page, and so this is what you should do if you have a flare up if you have an acute onset some things that you can do on your own to Get that to settle down and to take care of it in the short term if you're not able to get into the clinic during that time Again, this really changed my approach really changed how I look at patients with acute low back pain and How I can help them to find solutions that they can treat their own back pain So the link is down below. I hope you enjoy this review of the book, and I hope it's helpful It's actually quite affordable. I believe it's less than ten dollars on Amazon So the link below will take you to Amazon where you can purchase it I recommend it definitely for patients because it's written for patients, but again for me as a budding clinician at the time it really changed my approach so even chiropractors and Students should really check out the Mackenzie approach because we hear a lot about it But oftentimes we don't get the description of the how and the why and what is going on so that we can think about it Clinically that is my book review for this week if you enjoy this Please give me thumbs up like it down below share your comments. Let me know if there's a book that you think I should review I'm going to be adding this to a list on the web page of recommended books for patients about low back pain So thank you very much for following click the follow button down below so you get notifications when I go live Thanks a lot