Dr Paul Mason - treating back pain - an updated scientific approach (Part 1)
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- เผยแพร่เมื่อ 4 ส.ค. 2024
- Dr Paul Mason reviews historical research with proves disc injury is a key factor in what is inappropriately termed 'non specific low back pain'. Key experiments are discussed, which includes testing pain responses in conscious patients while being operated one. The value of guided injections, which are often under utilised in the treatment of pain, in both diagnosing and treating pain is discussed.
- วิทยาศาสตร์และเทคโนโลยี
Brilliant job Paul. We discussed a lot of this in the McKenzie diploma course in 1997. You have taken this to a whole new level.
God bless you! This describes my symptoms exactly after no diagnosis in almost a decade!
I have zero doubt about discogenic pain. I had a back injury as a child. I re injured my back several times in subsequent years, finally resulting in surgery in 1998. I was part of a multi-center trial for anterior interbody laparoscopic L5-S1 fusion using the BAK device (a pair of titanium cages). It was a complete success, which I knew the moment I woke up from surgery. As part of the trial, I had to undergo several unconventional tests, chief among them was the discogram. The surgeon poked and prodded my L5-S1 disk, which resulted in 24/7 extreme pain for the next several days until my surgery. I had the same diagnosis of the syndromes you listed from other doctors, but the complete removal of the disk permanently resolved the issue. I have recently lost all the weight I gained during that part of my life, and practice yoga and calisthenics on a daily basis.
In other words - spot on, my brother. My surgeon mentioned at the time that discogenic pain was controversial. It was not controversial to he or I.
Always a gold mine Paul. I would love you to discuss this further with Stuart McGill to learn what he thinks about that.
Fantastic teaching. Thank you.
I do want to mention another common form of ‘Low back pain’. Low vitamin D will cause low back pain. 85% of us are low on vitamin D-
Love this guy
Soooo how do we treat it 🥺
Ive had a lot of these problems. Lower back, middle back, neck and shoulders. Then took a job where I had to work hard with whole body. Now I'm fine. It's weakness
What kind of job…. I have the same thing on body?
My severe L5-S1 symptoms were initially treated by weekly chiropractic alignment of the sacroiliac joint. Improvement was modest and pain increased during the time between treatments. It seemed possible that the treatments were too infrequent so I undertook to align my own SI joint thrice daily. My method was to balance on crutches to brace myself while letting my hips and legs go limp until an alignment event could be felt and heard. The original Si misalignment may have caused inflammation and possibly swelling that led to my symptoms. At any rate, I eventually achieved complete recovery through thrice daily manual alignment.
Where did you hear this alignment? How long did each session take?
This is just the thing i see in my sports medicine/back and neck pain practice and have been for about 25 years. The majority of patients do have either disc og facett joint causes of their acute and chronic pain when we are able to diagnose it. Most clinics never try to diagnose this and just call it "lumbago" og non- specific back/neck pain" and then they charge the patients for the diagnosis the patient presented with; i.e i have back/neck pain! The pain pattern is actually well known as you show here and with the right tools such as the ability to test the structures we can often confirm this. Regular physical exam is not able to differentiate between most of the known causes. I does't matter how competent we think we are. And CT/X ray and MRI's doesn't show pain only "structural changes" but some changes we see better and some worse. Training and activity is important but dosen't help all and somtimes increases the problem/pain at least in the short term. I've never seen a "Piriformis" syndrome that's not something else, most often S1 ref pain or facett joint pain that you confirm by either treating/testing the joint or the nerve. We actually have studies that show that up to 30% of "Piriforimis syndrome" patients get a relieve form facett joint IA inj or MBB. "We should focus on the fire not the smoke" as we often do and i think this is why many have come to the conclusion that back and neck pain is something mysterious and doesn't behave in the same "logical" manner as other similar structures composed of bone, cartilage, connetive tissue, etc elsewhere. This is off course not the case but as long as we keep treating it with that attitute/thoughts we won't get anywhere. Greetings from the far north in - 10 gr. Celsius.
Ps it would be interesting to se how dietary changes (you know what i'm talking about) that lower the inflammation levels in the body, affects back/neck pain, including using the body's own endocannabinoids such as PEA end omega 3's and the Pro Resolving Mediators to reduce pain/inflammation. I've had some success with that.
Saved in my favorites.
Great presentation
Very often when my patients present with bilateral gluteous maximus weakness they have have a facet syndrome
This is common in adrenal stress
They have c1/c2 fixation
This accompanied usually by c7/t1 and t12/l1 fixations
This is interesting to me. I never had lower back pain until I broke my spine at t12. I have a fusion from T11 to L1. And after a decade of extremely stressful business ownership and ending one business due to supply chain issues, I have been suspecting some sort of adrenal fatigue. I just don’t react to things any more. There is a lack of call to action to things I should be reacting to.
Hey Paul can you comment on raw milk and possibly lactase enzyme?
Gotta watch this one before it disappears. The initial one mysteriously was deleted while watching it.
OMG I hurt my lower back 3 weeks ago at Crossfit! Off my tits on pain relief for 1 wk and only back at the gym this week with still some soreness. Very relevant to me to watch it. Only a few mins in!
During a laminectomy, my back surgeon decided to clean up some areas of arthritic growth and spotted a TWINNED NERVE ROOT at L5 on the right side. I assert that twinned nerve roots may not be uncommon, they are simply impossible to see with common types of imaging. Observing that the slightly smaller twin was being crushed by the larger one, my surgeon created as much room as he could for two nerve roots to coexist where there should be only one. The laminectomy was a success, but I must still rely on pain medication. I do keep the dose as low as possible. A number of symptoms and sensations occur several times every day that I believe are caused by the twinned nerve root - burning, icy coldness, endless twitching, and severe cramping in the lower leg; painful involuntary contortions in the foot; sharp pain + dull ache in the lower back and hip.
Some TTFD may help. Check out elliot Overton on thiamine.
progressive, thank you, doctor
Dr. Mason conclusively proves that physicians of the 1930s were sadistic bastards. Ha ha.
But seriously, thanks for this information, Dr. Mason. You and Dr. McGill (and Brian Carroll) are saving my back.
Did your injury come from lifting? I don't have back pain but have left lateral though numbness fun compression. Did you have any of this? If so how do you relieve it?
Just conducting experiments to see what works and what doesn't work, something doctors would never do today. They just want to prescribe you a drug instead.
If GTPS isn't releated to tendinopathy/bursitis but instead to neurogenic mechanisms you would expect to be able to reproduce pain with neurodynamic testing and or segmental testing.
In my clinical practice this happens relatively often but not exclusively. Thus one can either conclude that the tests are not sensitive enough or that other mechanisms causing nociceptive are at play. IMO you cannot conclude that GTPS has no other cause than disc/neurogenic tissues.
What about compression that causes numbers along the lateral thigh? I don't have pain but have this numbness, curious for remedies that will fix this issue?
meralgia paresthetica
Part 2: th-cam.com/video/JF9aOl0nhkY/w-d-xo.html
Please make a video on vaccines.
No point. Some people are going to have their genes altered others are not. No amount of videos is going to change that.
HeCantTouchThat3rdRail.
Smilie and wave I am!
Crushed facet joint
I advise you to use more catchy titles and thumbnails (clickable) otherwise it's shame such great content not going to be spread to millions.
I advise you to look at Dr. Eric Berg content he recently changes the strategy of thumbnails and titles and suddenly his recent videos are seen by millions.
And keep in mind it's not a clickbait as long as it's good content.
Its double edge sword in my honest opinion. On the one hand, I want his message to spread to EVERYONE, on the other hand, I fear for his safety.
Hmmmm. Dunno. What's the actual advantage? Perhaps we might ask instead, why encourage everyone to pander to the superficial? We are so "visually demanding" and novelty seeking and we also seem to be devolving back into apehood rather than evolving into smarter, wiser people. What we like to look at is not the same as what our brains need (e.g. more training in sustained concentration instead of "fast and glossy"). We seem to be turning ourselves into denizens of "The Shallows" (Nicholas Carr's book suggesting that the internet is making us increasingly dumbed-down.) Further, the increasingly glossy "Dr" Berg is a chiropractor, not longer practising, who sells a lot of stuff, and scouts the internet for fresh ideas to present in a very glossy way. And yes, he has built a great audience through his "presentation skills". But his followers seem uncritical about such matters.
Mason is the real deal.
@@T-aka-T Because Dr.Paul is the real deal he should take advantage of the TH-cam algorithm. Unfortunately the algorithm will promote good content to new audiance only if they are "clickable" (thumbnail and title).
Dr.Mason content deserve to be pushed wide not only seeked by a few.
@@fbluejay4194 Yeah, but even if you don't take the "don't pander to the shallows" view, (I just watched a Reagan-era 3-way discussion on video archives - which was visually primitive, but they could actually string sentences -- even whole paragraphs together!) ---- anyway, Paul Mason has been REALLY making an effort to upgrade his material, despite being really busy, and donating his time all over the place. (And although you were being helpful, I admit I reacted to the tone of "I advise you" -- especially in the face of all the effort I know he has been making.)
I'm always happy to take on feedback. Hopefully I can tread the line between 'intruiging' and 'click baity'.
At 63 years of age my back is now better than it was at 20 years of age.
I’d like to hear your story.
Yeah what's your secret? Spill the beans now for us youngies
@@zephyrlibs The Secret Revealed is, don't eat carbs, and watching the change in your body, muscle damage or bone damage, accompanies almost 100% deficiency in nutrition.
@@zephyrlibs The Secret Revealed is, don't eat carbs, and watching the change in your body, muscle damage or bone damage, accompanies almost 100% deficiency in nutrition.
Fuckin eh from Canada