As mentioned earlier, people have been suffering from back pain for a very long time. And, because back problems can be so uncomfortable (often even excruciating and incapacitating), the treatment of back pain has also been with us for a very long time.

As with every aspect of history, records go back only so far. Much of what we know, or think we know, about the medicine of any time, more than a few thousand years ago, is derived from assumptions and educated guesses. However, many of these assumptions are indeed learned. They are based on some relatively conclusive evidence, such as fossils, artifacts and a few ancient manuscripts that give anthropologists some good indications of what our forefathers thought and did.

Still, sometimes it's difficult to discern exactly what our ancestors actually knew and what was superstition. Depending on time, place and religious beliefs, scientists and medical practitioners were either encouraged or stifled. An undeniable fact of not only the treatment of back pain but all medical practice in history, is the number of patients who have died because of what doctors didn't know. Down through the ages, many a back pain sufferer has died because of so-called treat

ment. It's terrible to think about dying while being treated for something that would probably go away anyway, isn't it?

If you have back problems, you are very fortunate to be living in the 20th Century.

With that said, here is a brief history of back pain and its treatment:

Pre-Recorded History

The source of back pain has been a mystery for thousands of years. And, to a certain degree, it still is. Ancients believed that back problems and many other ailments were caused by demons and evil spirits. One of the ways in which the body was ridded of these unwanted little devils was to cut holes in the

skull to let them out. This procedure, sometimes called trephining, can be traced back to the Stone Age, and is known to have been practiced not so long ago. Perhaps as late as a 100 or 200 years, or sowhich is a little scary.

So, as you can see, surgery, no matter how peculiar this example seems, has been around for a long time. Isn't it interesting how things change? In those days trephining was a form of medical treatment. Nowadays, when we think someone odd we wonder if they have a hole in their head.

The Ancient Egyptians

Manuscripts from ancient Egypt indicate that Egyptian doctors performed certain, more sophisticated surgical procedures as early as 3000 B.C. However, the Egyptians probably did not treat back pain with surgery, because according to

History of Back Pain

surviving medical journals from that period, spinal problems were considered hopeless, or untreatable. Throughout history, surgery seems to have been a last resort for the treatment of most ailments. Before the discovery of anesthesias and antiseptics, surgery very often brought on complications that killed the patient, complications such as shock or infection that had nothing at all to do with the original condition. Even our ancestral doctors' egos suffered from killing off patients with the treatment. The Egyptians did treat certain types of back pain. For a time, some Egyptian doctors believed that alternating applications of meat and honey would help ease back pain. Probably, this procedure did little but make a big mess. The patients that did get better most likely would have done so without having a smorgasbord applied to their backs.

In Ancient Greece The ancient Greeks, whose discoveries did a lot to promote modern medicine, performed surgery on certain kinds of back problems, though not often, as far as we can tell. Traction, lying the patient on a table or rack similar to those used in medieval times for torture, and stretching the back with ropes, was used to correct spinal dislocations and other back problems. Another form of treatment entailed lying the patient on thick, heated marble slabs, a form of treatment at least the same in concept to our hot water bottles and electric hot pads.

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An early version of traction.

Ancient Autopsy gallery.

History of Back Pain

These forms of treatmentsheat, cold, traction, applying pressure to problem areasprevailed for hundreds of years, with varying degrees of success. As I've already said, in many instances those patients who got better would have done so anyway, though undoubtedly these treatments did help relieve the discomfort of back pain.

Just Last Century

In the mid-nineteenth century, anesthesia and antiseptics came along. For the next few years many surgeons would try to cure everything from insanity to the flu with a knife.

Several different procedures were developed, many of which were radical and virtually ineffectual, others not so bad. We mustn't judge our forefathers too harshly. It was all this exuberance and experimentation that ushered in the new era of medicine. One of the techniques developed for treating dislocated and broken backs during that era was the plaster of Paris body cast.

From the Orient

What the ancient Greeks did for the Western world, the Chinese did for the Orient with many developments in medicine. Now that we in the West are not so closed minded, we too have learned a lot from the Chinese.

Rather than giving you an elaborate history of Oriental back pain treatment, in this section I'll discuss briefly the contributions given to us from the Chinese, who have as far as we can tell, been treating back problems with relative success for thousands of years.

Like Western cultures, Eastern cultures have practiced medicine for a very long time. Unlike Western cultures, until just recently, most Eastern religions have traditionally been more concerned with medicine and a more complete, holistic approach to health and spirituality.

Taoism. The oldest known religion in the world, Taoism is perhaps one of the most complete approaches to spiritual and

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physical well-being available to human beings. Like many Eastern religions, its purpose is to help the believer become a more enlightened, whole human being. Part of the religion's approach to enlightenment is a system of exercises designed for self-healing. These exercises are known as "Internal Exercises".

Another form of treatment the Chinese have used for a long time4,000-5,000 yearsis acupuncture. These days, most Americans know about acupuncture and many have tried it for all different kinds of ailments. But it wasn't all that long ago that this society, including its healthcare professionals, was appalled at the idea of inserting long needles into the body. It seemed like silly, dangerous nonsense. Today most doctors realize that acupuncture is highly effective for treating certain kinds of back pain. I will discuss acupuncture and other forms of treatment in Chapter Seven.

For centuries the Taoists, Buddhists and other religions have thought about and examined extensively the effects of posture, exercise, sex and virtually everything else on the human body. Other forms of healing Orientals have utilized for a long timetechniques we in Western societies used to scoff at as hocus pocus or voodooare meditation and herbs. There are also forms of treatment that the West and East have in

History of Back Pain

Ginger root was often used to relieve pain.

Ancient massage devices.

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common. The Chinese have been using traction for back pain for at least as long as the West has, and they are still using it today.

Back surgery, where needed, is becoming more and more common in China and the rest of the orient. This merger of Eastern and Western medicine has been highly beneficial for not only back pain sufferers, but just about anybody else who needs medical attention.

The Yellow Emperor

History of Back Pain

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Ugh!

History of Back Pain

Today

Nowadays, with modern communicationsthe free exchange of information from culture to cultureand a higher degree of openmindedness among healthcare professionals in virtually all fields, back pain sufferers have the benefit of vast resources. The day of one discipline, such as neurosurgery or orthopedics, being intolerant of chiropractors or acupuncturists is almost over. Fear, superstition and ignorance have no place in the practice of medicine. Toward the year 2000 and beyond, a totally integrated approach to spine care and treatment is indicated.

We know more about relieving back pain than ever before. We know, as I've already said, that in most cases most back problems will heal themselves. But when they don't, an all new form of minimally invasive surgical techniques are available to relieve back problemstechniques that require little or no trauma to the body and cause minimal morbidity.

Using miniature instruments, lasers, and video imaging, today's surgeons can enter your spine, fix the problem, and leave without your body hardly even knowing they've been there. Where once it took two months or more to recover from back surgery, nowadays, often you can be up and around within less than an hour and back to work and normal activities within a few days.

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You will find a complete description of these minimally invasive procedures in Chapter 14. These are exciting times!

Oriental manipulation for muscular problem.