Chapter Two: The Humpty Dumpty Syndrome

Humpty Dumpty sat on a wall
Humpty Dumpty had a great fall
All the king’s horses and all the king’s men
Couldn’t put Humpty Dumpty together again.

When the idea first occurred to me to write a book on an often overlooked method of diagnosis and treatment of chronic low back pain, I asked myself, “How and why is this book going to be different from the many other books that have already been written on low back pain?” The answer to this question is rather simple. My experience with my own patients has proven to me that the information contained in this book will be very helpful to many, many people with chronic low back pain who have already read other books and have tried many of the other available therapies. This book will offer you valuable and practical insights into the possible causes and possible solutions of your lower back pain. With these new insights, you can begin to take control of and help direct the course of your own journey toward a pain-free lower back.

In my medical practice I treat up to 100 people per week, primarily using western medicine, manipulation, acupuncture, and herbs. Many of these people have chronic low back pain. Many have already been to primary care physicians, orthopedic or neurosurgery specialists, physical medicine specialists, physical therapists, massage therapists, sports trainers, chiropractors, naturopathic physicians, and osteopathic physicians—to “All the king’s horses and all the king’s men…,” —and they still have their chronic low back pain….”Couldn’t put Humpty Dumpty together again.” I refer to this unfortunate situation as the Humpty Dumpty Syndrome.

I have been a student of the martial arts for five years. When discussing strategy or performing a technique of the martial arts with my teacher and mentor, Grand Master Hyong Kyun Shin, he always emphasizes the following principles: “SIMPLE, EASY, EFFECTIVE.” In this book, too, I will emphasize these same principles. I will take you step by step through the necessary “thinking and doing” processes, explaining the method to you in as much “plain English” as possible. There are 140 photos and drawings to help you. You will see how simple the concepts are and how easy they are to understand. Then, after you have read the interesting case histories of real, live patients, you will be convinced of how effective the principles are in maximizing your chances of getting rid of or significantly reducing your chronic low back pain. Please don’t be frightened by the concepts or by the method. You can understand it and you can learn it. When I explain it to my patients in my office, they understand it because it makes sense to them. You will know the “whys and the wherefores.” Just take it one step at a time. If I can do it and my patients can do it, you can do it. The method really is simple, easy, and effective. Also, you will not need to come to my office for treatment. You can utilize many of the health care professionals (HCPs) where you live.

Chapter Three: Look Beyond Your Diagnosis

When a patient comes in for a first visit, I always ask for the main complaint. The patient will often answer with a diagnosis instead of what the symptoms are. For example, the patient will say, “I have a bulging disk between L4 and L5. Can you help me?” Another person may answer, ”I have degenerative arthritis in my lower back causing pain. Can you help degenerative arthritis?” The patient will frequently bring x-rays or special studies, such as a CAT scan or an MRI scan, which demonstrate such and such a diagnosis, and the patient will ask me if I can treat that diagnosis successfully. This happens quite often for the following reasons:

1. Many of my patients have already been to several other physicians and have been given one or more diagnoses.

2. The patients were told that the diagnosis is the cause of the problem.

3. The patients may have tried many different therapies in the hope of getting better and they want to know immediately if I can successfully treat that particular diagnosis.

In other words, they are sick and tired of chronic back pain and don’t want to waste any more of their time and money if I can’t successfully treat that particular diagnosis. My answer to them is very simple. I do not treat diagnoses. I treat patients. Let me give you an example of what I mean.

A patient comes into my office with a five-year history of low back pain. The patient has been examined by the primary care physician and is diagnosed with degenerative disk disease and arthritis of the lumbar spine. For purposes of explanation, let me briefly describe degenerative disk disease. Between each of the vertebrae is a disk, which can be likened to a cushion that acts as a shock absorber between the vertebrae (Fig. 3.1).

Fig. 3.1 — Side view of a skeleton model showing the vertebrae and intervertebral disks of a normal lumbar spine.

This intervertebral disk is similar to a shoe insert that is filled with gel that you might have seen advertised in magazines or on television. When we walk or run or jump, these disks provide a protective buffer layer between the vertebrae and prevent bone from rubbing against bone. As we grow older, the gel-like substance may harden and become brittle. The disk may also become thinner from the wear and tear of years of weight bearing and, as a result, the space between the vertebrae may become narrower. The disk then provides less cushion effect between the vertebrae. The end result is that weight bearing and other normal activities begin to cause pain. This is degenerative disk disease

Fig. 3.2 — Side view of an x-ray of the lumbar spine showing thinning of the intervertebral disks (narrower spaces between the vertebrae) and “wear and tear” degeneration of some of the vertebrae (bone spurs).

(Fig. 3.2). Arthritis of the spine, of course, is a condition in which the joints that connect the vertebrae with each other begin to deteriorate. The vertebrae themselves may also begin to show wear and tear. On the x-ray, bony spurs may also be seen on various parts of the vertebrae as an indication of the wear and tear (review Fig. 3.2).

Returning to our example, suppose that the patient’s primary complaint is left-sided low back pain, which occasionally goes down into the left leg. Let us also suppose that x-rays have been taken and that they do, indeed, show lumbar degenerative disk disease and arthritis of the lumbar spine. Let’s also suppose that an orthopedic surgeon examined the patient and the x-rays and has agreed with the diagnosis. Physical therapy was tried, anti-inflammatory medication was prescribed but both were of little help. The patient was then told that there was nothing more that could be done.

Now, let us also suppose that the patient does not want to accept the fact that nothing more can be done and comes into my office with x-rays in hand and says, “I have degenerative disk disease and arthritis in my lumbar spine. Can you help me?” I examine the patient and the x-rays and I discover that there are some things that are definitely treatable, so I proceed.

Let’s say that after six or eight treatments, the patient begins to feel significant improvement. After 10 or 12 treatments, the pain is gone and I discharge the patient from my care with instructions to return as needed. If we were to repeat the x-rays when finished with the treatments, would the x-rays have changed? No.

The x-rays would remain the same, showing the same degenerative disk disease and spinal arthritis that had been present before we started treatment. What does all this mean? It means that, yes, the degenerative disk disease and the arthritis in the lumbar spine are definitely there, but they are not the cause of the chronic low back pain. It’s as simple as that. Are you beginning to get the picture?

The point of this bit of humor is to illustrate that although it may be “obvious” that the patient is “not eating right,” don’t you also get the feeling that there just might be something else going on here? Something that is not quite so “obvious” that is causing him to not eat right? Similarly, with regard to you and your chronic low back pain, isn’t there a possibility that there just might be something else going on in your lower back? Something that’s not quite so obvious, something in addition to the diagnosis that you have been given, that’s causing your lower back pain? Well, there just might be! In fact, that’s what this book is about. So, please read on.

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