As published in Positive Health Magazine

Issue 29 June 1998

Ouch! It's My Back Again. How often have you heard that painful exclamation? Even if it hasn't happened to you the chances are that you know someone who has suffered some kind of back problem at one time or another. And it isn't always caused by something obvious like lifting a heavy weight incorrectly, or a sports injury. It can happen when you are doing something as mundane as tying up your shoe laces.      Happily, there's now a way you can help ease the pain and keep it at bay using a revolutionary new tool which gives the therapist "bionic fingers". I was privileged to be the first osteopath in the world to use this new technology, called Power Assisted Micro-Manipulation (or affectionately known as PAM). There is a growing band of osteopaths, chiropractors, sports and physiotherapists, as well as medical practitioners who see the benefits of this tool. There is nothing mystical about the treatment. It relieves mechanical back problems by increasing the suppleness and flexibility of the spine, reducing the stresses within the spine which caused the problem in the first place.

The P.A.M. 'bionic handset' incorporates 4 pads operated by 4 pneumatic pistons which are synchronised so as to operate in opposing pairs, following the line of the spine.

Back Pain – An Ever Increasing Problem

Why has back pain become a major problem? The treatment of back pain is a growth industry, yet the statistics and research indicate that the back problem is not being adequately solved, even though some therapies have gained a reputation on their successes for reducing back pain. The statistics get higher every year: 14 million visits to the doctor each year, costing the health service £480 million. £5 billion is annually lost to industry because of the 120 million days taken off sick by back pain sufferers. The results of treatment, by whichever therapy are usually short lived, because manual therapy cannot get to the underlying cause of the problem, and prognosis is similar with or without treatment.
     Using this new technology, I have found that people who have had idiopathic back pain for up to 30 years have found that their pain has disappeared. They find it very hard to believe, and think the treatment is "a miracle". They have usually tried every type of treatment. These chronic cases have often given up hope of recovery and attend the last resort – the Pain Clinic. Because the equipment exercises both the vertebrae and stimulates the spinal reflexes to stress relieve the spine, it is now possible to treat both simple and complex mechanical back problems.

A Typical History of Low Back Pain

     Most back pain builds up through years of misuse of the spine. Most readers will recognise the following stages and symptoms that occur during bouts of back pain. Traumas such as whiplash may create stiffness in certain joints, and other joints compensate and become over-stressed. This leads to the symptoms of inflammation, stiffness and muscle spasm which cause pain.
     Stage 1 – The lower back is usually the first to complain of over-stressing. The patient may experience a few twinges or the sudden onset of debilitating pain and it might occur when the patient is doing a low gain activity, like bending to pick up soap in the shower. The patient may appear to make a recovery, with or without treatment. Over time, the problem may reoccur set against a background of back-ache and morning stiffness.
     Stage 2 – Here the affected joint shows the classic signs of excessive wear and tear and disc degeneration. The joints are vulnerable at the concentration of stresses in the spine, mainly in the curve of the neck and low back. The patient may complain of restricted movement and pain. They may feel they have to give up hobbies which aggravate their condition, such as gardening, tennis, squash, golf or even their career.
     Stage 3 – The stresses in the spine continue and may result in a prolapsed disc. It may be at this later stage they go and see a therapist who might give them instant relief. However, unless suppleness and elasticity can be brought back to the spine, the relief may be temporary and the over stressing of joints continues.
     Stage 4 – The patient becomes old before their time and avoids activities that aggravate the problem. They may not be able to sit or stand for long. Life is generally full of pain and not much fun for them or their family. By this stage they may be on disability benefit.

The Solution

     To function efficiently the spine must be supple and elastic like that of a healthy teenager. Until the development of PAM there was no mechanism to restore supple elasticity in the spine. Using a combination of three modes, the therapist can work the "bionic handset" throughout the length of the spine exercising each vertebrae and stimulating the spinal reflexes. The approach is both logical and safe, and even enjoyable for the majority of patients. Even at stage 4, improvements can be made. However, treatment should be ideally commenced before there is a problem.
     As an osteopath I firmly believe in the osteopathic principle "Structure governs function." In simple terms this means, if there is something wrong with the structure of the body it will be in a state of dis-ease and therefore not function at its optimum level. If an anatomical structure such as the rib cage is unequal, this may place strain on the organs within that structure, i.e. heart or lungs. This may lead to disease of those organs. Abnormal curvatures of the spine such as scoliosis (S curve) can now be reduced using this treatment, avoiding the need for braces or surgery; whiplash can be treated immediately; the stresses in the spine which caused a prolapsed disc can be reduced. I have found that my own practice has changed, as more complex cases present themselves for treatment. Patients who have had surgery can also benefit from this treatment, as the stresses which caused their original problem in the spine will not have been removed by surgery; any fusions will cause a new stress.

Treatment with PAM.

     Each spine is different. The number of treatments required will depend on the patients age and suppleness, but on average 3-5 sessions will restore supple elasticity. As with all physical therapies, a full case history and examination of the patient is carried out to eliminate any possible pathological problems. There are very few contra indications for using PAM making it safe to use with osteoporosis, fusions or prolapsed discs.
     Treatment is carried out with the patient lying face down on the couch whilst the therapist moves the "bionic" handset throughout the length of the spine, observing the subtleties of mobility and stresses within the spine. The handset incorporates four pads, operated by four pneumatic pistons. These pistons are synchronised so as to operate in opposing pairs. The pads are spaced so as to correspond with the levels of vertebrae.
     There are three modes of operation: spasm, reflex and mobilisation. Spasm prepares the muscles and commences and ends each treatment; reflex mode stimulates the spinal reflexes which stress relieves the spine and mobilisation mode improves the mobility of the spine by counter-rotating one vertebra on another. With a combination of these modes, there are very few spines which cannot be quickly and efficiently restored to supple elasticity. The patient's responsibility is to walk tall for ten minutes a day for 10 days to exercise the postural muscles.
     As well as the reported relief of back pain, many patients have stated other benefits, such as an improved sense of well being, reduction in headaches, reduction in irritable bowel symptoms, increases in height and improved posture.

Prevention

     The ideal situation is for the patient to receive treatment before reaching the final stages of back pain. Preventative treatment should be encouraged from an early age like a routine dental check up, so that back pain is avoided in later life. A small price to pay for a healthy spine. Such an MOT may require a yearly visit. Older patients and active sports people may require treatment up to 4 times a year.
     Although this treatment is suitable for straightforward simple back problems, I have found this method particularly useful for abnormal curvatures such as dowager hump, scoliosis, pectus excavatum (funnel chest), chronic back pain and whiplash.

Conclusion

     Up until now there has been no really effective way to cure back pain, or change abnormal spinal curvatures. This new treatment brings all manual therapy into the 21st century, because many of the techniques currently used have not changed since the early 1900s, and have not got to grips with the mechanics of the problem. Power Assisted Micro-Manipulation is a simple solution for a simple mechanical problem.

About the author

Irene Phillips is a practising osteopath with a particular interest in classical and cranial osteopathy. She also has a psychology, counselling and training background. For further information about this treatment, please send sae to Irene Phillips, The Back Care Clinic, 1a Station Approach, Worcester Park, Surrey KT4 7NB. She can be contacted on Tel: 0181-335 3787

1. Minor scoliosis and neck injury.
     Patient TH, a female aged 24 presented with neck and shoulder pain which she had suffered with since the age of nine, when she fell forward off a swing and hurt her neck. She also had 1–2 headaches weekly. She had received regular chiropractic care since the accident. On her first treatment using PAM the scoliosis disappeared and her pain levels were reduced. She reported at the second treatment that she had not had any headaches and was feeling more flexible. Treatment was given on a weekly basis and following her third treatment, she phoned saying she could not believe that she was totally pain free for the first time ever.

Whiplash patient prior to treatment.

After 1 treatment.

After 2 treatments.

2. Whiplash
     Patient TC, a female aged 23 presented at the clinic with low back and neck pain and twice weekly headaches following a whiplash injury 18 months previously. She had a high level of subjective pain, limited forward and side bending, restricted cervical rotation and forward bending. She had a pronounced dowager’s hump. She had no previous history of back pain prior to the accident. She had previously received a short course of physiotherapy at a local hospital, which had mainly consisted of exercises.
      On her second visit she stated the headaches and pain had reduced. Following the second treatment, her neck length had improved once more and she left the clinic pain free. The visual change in anatomical structure was almost immediate, yet this result could not be achieved by manual methods.