Guest Author - Anne Asher

While many computer users complain about wrist pain, back pain is certainly not to be discounted from ergonomically created injury. For example, sitting is a prime culprit in the creation of back problems, and most computer users spend hours upon hours sitting.

Back Pain Solution
While there is no one solution to all types of back pain, one author has come quite close. Jim Johnson, a physical therapist specializing in low back problems has written The Multifidus Back Pain Solution. The main thrust of the book is a simple, well-justified exercise program for chronic low back pain sufferers. Because Johnson is licensed health care professional this book is research-based, offering reliable background information as to why the program works, as well as fueling decisions about treatment with examinations of anatomy, the nature of painful conditions and how the medical community determines the efficacy of specific treatments. Add to this core knowledge base a friendly, yet competent writing style, and you have a handy resource that should sit on your desk along with your keyboard, mouse and other components!

The Book's Justification
The program suggested in the book is not reached until the 4th chapter, but the wait is well worth it. In the first 3 chapters, Johnson sets the foundation by explaining the spine, types of back pain and the multifidus muscle.
The author believes that the multifidus muscle, while not a panacea, is a "significant piece of the back pain puzzle�1. He provides numbers for:

• a strong link between an abnormal multifidus muscle and the presence low back pain
• a normal multifidus muscle in conditions which are commonly associated with pain, but where there is none.

In his explanation of the multifidus muscle, Johnson discusses why this muscle is significant in the presence and absence of back pain. While most back muscles extend across several vertebral levels, the multifidus, in some places, spans only one. This gives the muscle more power over the movements of the spine in that area; it also makes that particular segment more vulnerable to dysfunction.

Specific Conditions and the Multifidus Muscle
Johnson also covers conditions found to be affected by the multifidus muscle. This includes for example,

• spondylolisthesis
• back pain due to pregnancy
• post back surgery back pain
• herniated disks

Ever the scientist, Johnson�s explanations address the activity of the multifidus muscle as revealed by EMG and/or ultrasound studies in each of these conditions. The conditions, themselves, are well-explained, providing excellent background information. Johnson also classifies back pain by the length of time the pain has presented itself.

Scientific Basis for Back Pain Treatments
The book provides a review of the scientific research on the multifidus and its role in back pain, especially exercise as treatment. It includes a discussion of how the medical community brings forward scientific proof that individual medical treatments work. The main reseach categories discussed are:

• natural history studies
• anecdotal evidence
• randomized control trials.

This provides insight not only into the rationale for the exercise program, but also for becoming an educated consumer of back pain treatments.

The Exercise Program
In describing the exercise program, Johnson gives the basics of strength training guidelines, including definitions for reps and sets and a discussion of intensity and time, all for the purpose of implementing the program according to standard fitness protocol. He also talks about what you can expect once you have embarked upon the program, and how to progress and maintain the program.

Interestingly enough, Johnson�s program consists of only 3 exercises (and variations meant to progress you as you become stronger). The exercises are excellent and can also be found in the Pilates repertorie, as well as other systems. The exercises have been adapted to target the multifidus muscle as it affects back pain. He instructs to do the exercise in the neutral position, but does not offer a lot of explanation has to how to establish, maintain and recognize that position.

Related Information
The book has 2 chapters dedicated to related information about treating back pain, as well as suggestions for further reading.

All in all, this is an excellent reference for anyone who suffers with low back pain, and for those of us who wish to prevent it. You can purchase the book by clicking on the image:

Bibliography
1 Johnson, Jim. 2002. The Multifidus Back Pain Solution.
Oakland, California: New Harbinger Publications.