Taking control of back pain offers long-lasting results with ‘Back in Shape’ programme: writing exclusively for the Hippocratic Post, Consultant Osteopath Michael Fatica shares the innovative ‘Back in Shape’ programme which he conceived during lockdown to alleviate back pain misery for his patients.
The impact of lockdown at the height of the pandemic was, of course, felt far and wide. For me as an osteopath, I was faced with the challenge of how to help my patients without being able to see them face-to-face. Needless to say, my personal frustration was nothing compared to the actual pain they were having to suffer, including many with acute long-term back issues.
It was during this period that I set about finding a way to support my patients remotely, and the result was the ‘Back in Shape’ programme – an online, interactive back rehabilitation programme. It was devised to provide support to my patients when the only option was digital, but the results quickly exceeded my expectations and have transformed my philosophy to effective back pain treatment.
The ‘Back in Shape’ programme is based on the idea that the patient takes explicit ‘ownership’ and control of their back pain. What surprised me was the speed at which patients who would have been ‘challenging’ cases in the clinic were able to make progress at home, when given the right support.
A home-based programme, which reduces reliance on a clinician, can encourage patients to commit more consistently to appropriate exercise and general lifestyle improvements, leading to enhanced overall physical and mental wellbeing.
One of my patients, Annie, a GP from Halifax, had suffered from back pain for years, and experienced a bad episode at the start of lockdown when lifting something particularly heavy. This led to months of intense pain and the development of sciatica. At its worse, it left Annie unable to walk, feeling very weak and prone to frequent falls. Annie felt completely out of character, becoming moody and very despondent about her situation. However, after being guided through the first phase of the programme over a three-month period, Annie’s pain had reduced significantly. As the weeks progressed, she could function much better and her mood was lifting. By July 2021, 10 weeks after starting the programme, Annie was competing in the ‘parkrun’, where she completed 5km in 40 minutes. She can now do it in 32 minutes!
Of course, every patient case is unique and there is not a ‘one size fits all’ in terms of treating back pain. But, the common thread of the programme can benefit everyone, no matter their individual circumstances and obstacles. In a world where we now expect everything at the click of a button, this also now seems to be the case with back pain, where an obsession among many to find ‘quick fixes’ persists. This actually leads many sufferers into a permanent cycle of failed treatments.
There is also a tendency for people to rush blindly into treatment for back pain without ever trying to fully understand why the problem developed in the first instance, and this prevents them from finding a lasting solution. The fact is that for most people, the best long-term rehabilitation for their back issue is one in which they actively participate. It takes patience and persistence, but the rewards will be far greater and the chances and severity of re-injury will be dramatically reduced.
There are three key pillars which everyone can follow to maintain a healthy, pain-free back: core strength; diet; and good habits. These are the focus areas for the ‘Back in Shape’ programme.
Another of my patients, Sam, a former Consultant Epidemiologist from Suffolk, had been plagued by back pain for most of her life. Like Annie, she suffered an injury at the start of the pandemic and in the immediate aftermath was left stuck on all fours and screaming out in pain. When an MRI scan showed several disc prolapses and one of Sam’s vertebrae out of alignment with the rest of her spine, she decided to eschew her previous treatment ‘routine’, which consisted of pain killers and physio appointments, and instead joined the programme to take matters into her own hands.
Key for Sam, as for many patients, was to develop a better understanding of the spine and how intricate and complex it is. She quickly recognised the need to start afresh to get the root of the problem.
After eight months on the programme, Sam felt that her back issue were finally resolved. This was the first time in her adult life that she was ‘pain-free’. There was no back stiffness in the mornings and no trouble getting out of bed. She felt like a ‘normal’ person for the first time in years.
My advice to those with back pain is to take personal ownership of it. The last two years has highlighted to me how most patients just need the guidance and confidence to take control of their issues. By getting to the root cause of their back pain, they have been able to take the steps necessary to prevent it. By equipping patients with the right education and support, we can prevent back pain from becoming a chronic – and often expensive – condition that many feel they simply have to ‘put up with’.