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Book Review: ‘The End of Back Pain’ by Patrick A. Roth, M.D.

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Oh my aching back! How many people do you know who have uttered or screamed those words? Who among us hasn’t suffered with back pain at some time in our lives? Not many, would be my non-expert guess.


Those who have suffered even a day or two with a pain in the back know how difficult it is to get around or even get up out of bed. A new book, The End of Back Pain Access Your Hidden Core to Heal Your Body by Patrick A. Roth, M.D., offers explanations of the different kinds of back pains and a ‘stackable’ exercise program to help relieve the pain.

Dealing with Back Pain

Dealing with any kind of pain can be a haunting experience. Dealing with back pain is especially challenging because troubles with your back can limit just about any kind of movement from standing to walking to sitting to bending to living a normal active lifestyle.

Dr. Roth’s new book offers “plenty of rational information about pain, your reaction to it, your perception of it, and you innate ability to be a person of action, especially when in pain.”

He writes, “Back pain is not the problem. How we deal with back pain is. While a sobering 80 percent of us will suffer from back pain at some point—and nearly 50 percent of us have experienced back pain in the past year—treatment for back pain has been found largely ineffective when scrutinized by modern, evidence-based medicine.”

Hidden Core for Back Pain

Roth introduces readers to the ‘hidden core’ or the muscles of the back. His research shows that the back muscles have “too often been overlooked.” His Hidden Core Workout is meant to strengthen the core to end back pain.

Roth writes that his book is about learning not to be preoccupied or overwhelmed by the pain but instead to exercise the core. He approaches back pain by addressing readers’ bodies and minds.

The Hidden Core Workout is a stackable program where you add exercises to a workout each week. It is designed to “build strength, working your back muscles first, to catch up to your more developed abdomen.”

Roth provides 13 exercises that are illustrated in the book. He also provides additional, more advanced illustrated exercises along with a recommended schedule for doing them.

Noteworthy Features

In addition to the Hidden Core Workout plan, Roth includes sections called ‘Hidden Truths’ and ‘The Gist’ that act as chapter summaries. He also provides a lot of medical information in chapters such as ‘The Anomaly and Anatomy of the Back’, ‘Diagnosis: A DIY Guide’, ‘The Nonsurgical Treatment of Back Pain’, ‘Surgery’ and ‘The Back Genome’.

The back pain sufferers I know are desperate for relief and scared of undergoing back surgery. This book could provide a lifeline for those ready to give up.

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  • Dr Joseph S Maresca

    There are things physical therapists can do to help alleviate some pain and reduce the amount of kyphosis from the bending of the spine. For instance, utilizing light weights while lying flat will oppose the direction of the kyphosis and may help to some extent along with building up the abdominal muscles. (Kyphosis is the forward bending of the spine so that the head cannot touch the examination table while lying down flat.)

    The thing that can’t be cured is the presence of the calcification dimension throughout the various back planes like the cervical, thoracic and lumbar. The calcifications essentially restrict movement in every direction. The osteotomy may help with the cervical area; however, this surgery is complicated. Laser surgery may help but the hospital costs might be difficult to get covered by insurance. The emcell transplantation is still in an early stage of commercialization. There is a clinic in the Ukraine that does the emcell implantation but the costs are in the area of $100,000. or more over a period of years plus transportation costs . There could be complications which cause death or brain damage in under 10% of patients.

    The other problem is the secondary symptomatology like extensive diverticular issues,
    as well as, other conditions of the gastrointestinal tract like Crohns and inflammatory bowel issues. Some spinal disk issues can be helped by surgery or physical therapy.
    There is no known cure-all for back pain except for a combination of things like
    conventional medicine and complementary medicine in an attempt to get the best of both worlds.

    Dietary changes may reduce spasms for people with severe gastrointestinal issues.
    Things like alcohol elimination and reducing the consumption of food that aggravates allergies may be helpful in some patients. For back pain, the Rheumatologist is the physician specialist of choice to do the MRIs and blood tests like the C-Reactive Protein and SED rate to get better data on the progression of the condition. The Schober range of motion test is the gold standard for understanding the restrictive aspects of the underlying disease and range of motion restrictions.