The $100 billlion per year back pain industry is mostly a hoax - an article review

"The $100 billion per year back pain industry is mostly a hoax" is an article that summarizes the thoughts and views of Cathryn Jakobson Ramin in her new book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery (read it here).

In her book, Ramin expresses that most proceedures and treatments to ease back pain are not effective and can sometimes create additional back pain. She mentions things like lumbar fusions, discectomies, opioid medication, even chiropractic adjustments. She eventually reveals that the only treatment that can reliably ease back pain is to move. Within the section discussing chiropractic, she reports that "adjustments" can temporarily decrease pain due to a rush of adrenaline, but the manipulation involves pushing a joint past it's biomechanical range which is contraindicated for many health conditions. Some chiropractors have adjusted their intervention-style. ""They have restyled themselves as rehabilitation specialists,” which means they’re training patients in effective back-strengthening exercises as a reliable physical therapist would, she tells Quartz, “and are doing a great job with it.”"

From a physical therapy standpoint, this article is great news! According to Ramin, many surgeries and proceedures patients undergo in order to ease their back pain is either not effective or, at best, have a placebo effect. As movement and strengthening exercises seems to be the most effect way to manage and heal your back pain, everyone has the ability to alleviate their pain. 

Although we don't tend to agree that subluxations and poor musculoskeletal positions cannot anatomically happen because they can't be seen on x-ray, Integrate 360 Physical Therapy has the tools you need to become pain-free including repositioning joints and musculoskeletal structures.

When we evaluate a patient whether it's their first or tenth visit, we assess how well the body is able to move both passively and actively. We look for malposition, subluxations, joint and muscle range of motion, muscular strength, etc.

Once we have finished this assessment and educated you on what is causing the pain and how we're going to work together to fix it, we get to work. We typically start with some form of "repositioning" activity. Afterward, we assess your body's ability to move again as well as your alignment. If something is still malaligned, we may choose to reposition the structure with manual mobilization or muscle energy techniques (a specific movement within a specific position where you use your muscles strategically to pull yourself into proper position - kind of like an adjustment that you do yourself). We then continue to work on restoring the strength and balance of your body. 

These interventions will likely remedy the pain in and of themselves, but sometimes we need to encourage our patients to be more physically active overall, or just like the article mentions, move more. Now that we've addressed pain, posture, alignment, and strength in our sessions, your daily walks (or whatever way you chose to move) will be much more effective and/or can be participated in as it no longer causes pain.

Let the therapists at Integrate 360 Physical Therapy help teach your body how to move correctly to eliminate pain now and prevent future pain. Call 314-733-5000 or email us at either or