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The End of Back Pain

Book Review of: The End of Back Pain

Access Your Hidden Core to Heal Your Body

Avoid Back Surgery

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Review of The End of Back Pain, by Dr. Patrick A. Roth, M.D. (Softcover, 2014)

(You can print this review in landscape mode, if you want a hardcopy)


Any book on this particular topic is likely to get a two or three star rating and is nearly guaranteed to max out at a four. The reason? Most authors on this sort of topic follow the "if you have a hammer, everything looks like a nail" approach. They have a particular expertise, and it makes a lens through which they see the problem. Their particular take on the subject may be very effective for some people, but it's incomplete. It may help in some other situations, be useless in some, or maybe even do more harm than good.

So how did Dr. Roth manage to pull off a five star rating?

By not doing what most authors on this sort of topic do. He repeatedly states he does have his own bias, so you might expect him to laud the virtues and superiority of allopathic medical treatments. Drugs, surgery, and not much else. But he doesn't do that.

The core concept of the book is "developing your core," a concept that most elite athletes have embraced for many years because a weak core has negative implications for your athletic performance.

But it's also a concept germane to physical health. The "normal" decline we see in strength, mobility, and general vigor doesn't need to invariably begin in our mid-twenties. It can, through proper diet and consistent, programmatic training of the body's core, be delayed for two, three, or even four decades. As can the chronic aches and pains (mostly of the back) that afflict so many people.

So, OK, a surgeon prescribes a cohesive exercise plan. Unusual, but still not a balanced approach. For example, what about chiropractic? Dr. Roth covers that, also. In fact, he describes its benefits as "amazing". But as with the many other treatments he discusses, he puts it into context rather than claiming to have "the" answer to back pain. Yes, programmatically working that core to keep it strong and supple is his main "cure" but he puts that into context also.

I discussed this book with a retired medical professional. Coincidentally, she had seen Dr. Roth on The Dr. Oz Show. She's had two spinal fusions, a surgery that Dr. Roth performs. She said she'd been able to delay this surgery for quite a few years, using many of the treatments and techniques described in this book. Notably, she didn't do the core training. Maybe if she had....

Very early in the book, Dr. Roth makes it clear that back pain (of some sort) is a normal part of being bipedal. You can't really end it, per se. But you can change the dynamics of it quite dramatically. You can dramatically reduce the frequency, duration, and intensity of recurring pain episodes, for example. If you have chronic back pain, you can reduce its intensity and (very likely) change it to periodic rather than chronic.

You have many tools at your disposal to make these improvements a reality for you. The problem for the typical back pain sufferer is finding an expert who can make the right diagnosis and point you in the right direction for treatment. This is where most of us go wrong. I personally happened to luck out by finding a chiropractor (Dr. Anderson) who has Dr. Roth's viewpoint.

Dr. Anderson sees chiropractic as one part of a much larger tool chest and as part of a larger strategy. Most chiropractic patients see it as a "cure" for an acute back pain episode. That's what typically gets them into the chiropractor, but when their pain's gone they stop going. "Who is this guy who is recommending these exercises and asking about my diet?"

About 20 years into his practice, Dr. Anderson founded Anderson Physical Medicine, a clinic that provides a range of services (not just chiropractic and not just for the back) and treatments. Dr. Roth discusses many of them in this book.

But it's unusual to find someone to help you navigate the maze of choices, and often the advice a patient gets is simply wrong. Fortunately, Dr. Roth provides guidance on this rather large issue in the last four chapters of the book.

This book consists of an introduction and eight chapters, spanning 226 pages. In the introduction, Dr. Roth discusses how he discovered the hidden core. Here, he also discusses some aspects of training it, such as with the Roman Chair and kettleballs.

The first chapter delves into the difference between health care and disease care. This distinction is lost on nearly everybody, and most notably with the Unaffordable Health Care Act which (in a failing way that defies basic mathematics) addresses disease care / medical care insurance but severely undermines health care. In this second chapter, Dr. Roth is basically saying you don't wait until you have pain to go about taking care of your back.

Chapter two discusses pain, and chapter three prepares you for understanding the hidden core workout by explaining the anatomy of the back and why things work the way they do.

Chapter four very nicely describes the Hidden Core Workout, and provides illustrative photos of each exercise being performed. The routine is a good one. If you gain the understanding from chapter three, you can modify this as you see fit to keep things from getting stale.

But don't just change things without that understanding. Just to illustrate, I sometimes travel and so visit a gym to train with weights. I see people doing things that make no sense from a biomechanical training standpoint and many of these things are actually dangerous. They have changed an exercise without having a clue as to what they are doing. Don't make that mistake.

If you're not well-versed in training principles, find someone who is. A qualified instructor in yoga, martial arts (most of them, anyhow), or weight training can guide you. What's critical is that you understand what exactly you're trying to work so that you actually work it (and safely) as a result of the form you're using to perform the exercise. You must know some anatomy and you must understand a fairly long list of training principles, else you're just engaging in trial and error. And it will be mostly error.

This book has a logical flow to it. The first four chapters are really about health. That is, what you do to make your back far less prone to problems.

The next three chapters are about medicine. That is, what you do to solve the problems that come up despite your best efforts at health. The chapter title are as follows:

  • 5. Diagnostic: A DIY Guide.
  • 6. The Nonsurgical Treatment of Back Pain.
  • 7. Surgery.

The final chapter is "The Back Genome," and it's a forward-looking take on how we might use information technology to build a sort of blueprint for accurately diagnosing any individual's back problems and developing a treatment plan. This would be accomplished by matching similar characteristics of many individuals.

These characteristics include such personal data as height, weight, body composition, age, occupation, desired activities, and so forth. These are the characteristics that make diagnosis and recommended treatment good for one person but bad for another.

Earlier in this review, I noted that Dr. Roth is basically saying you don't wait until you have pain to go about taking care of your back. So this book isn't primarily for those who have chronic back pain and want to end it. It's primarily for those who want a healthy back so they don't end up with back pain as a "normal" part of a miserable daily life.

I will note here that Dr. Roth's Hidden Core Workout has benefits going well beyond creating a sort of shield against back pain. You can expect such benefits as improved circulation, improved physical appearance (in most cases, greatly so), and improved function of the vital organs.

This workout also helps raise testosterone, the master hormone that signals the body to store calcium in the bones and reduce body fat. How can anyone not want those two benefits?

Another, very important benefit is the relaxation effect. Not only is this exercise a good way to work off stress, but it induces the release of endorphins. So you get a double benefit.

I mentioned improved appearance. Dr. Roth doesn't go into this in any detail. So this particular benefit might not register with some people. Have you ever noticed that some individual in a group, say at a party, just seems to have presence and stand out from everyone else? Take a closer look next time. The reason (in nearly all cases) is powerful posture; shoulders back, hips properly aligned. Exactly what you get from the Hidden Core Workout. Burning off calories, creating a beneficial hormonal environment, flushing your system with exercise-increased bloodflow, working your colon clean, and all the other benefits of this kind of exercise also improve your looks. They also improve how you smell!

That testosterone boost doesn't just trigger calcium storage and body fat burning. It also triggers the body to build lean muscle. That's why some gym rat who doesn't do large compound exercises like dead lifts and squats will always have smallish arms no matter how many curls he does but the person who does the dead lifts and squats will have admirable arms without even doing curls.

Get this book. You won't regret it.


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