We are excited to bring you another thrilling book review as part of our Flowly Book Review Series! This week, we invite you to join us on an exploration of Back Mechanic as Christine, a valued member of the Flowly team, takes us on a journey through its pages.
The views expressed in this blog are solely those of the reviewer and do not necessarily reflect the opinions or position of Flowly.
Why did you choose to read Back Mechanic?
Like everyone in the United States, I've been following the news regarding Brian Thompson, United Healthcare CEO, and Luigi Mangione since our team first heard the news. When we heard about Luigi's experience with chronic back pain and discovered that he read and reviewed some books about back pain, we immediately decided to read them to see if there was any applicable advice we could pass on to our heroes.
I picked Back Mechanic to read first because Luigi's review stated that this book was more useful than Crooked.
What’s it about?
In a world filled with countless back products promising quick fixes, a comprehensive guide to self-assessment and recovery is crucial. Back Mechanic offers a step-by-step approach to identifying the causes of your pain and provides strategies to avoid setbacks in your recovery journey. The book features a progressive exercise program designed to strengthen and rehabilitate your back. Developed by spine specialist Prof. McGill, this guide is built on over 30 years of research and clinical expertise. Through this evidence-based resource, you’ll gain the tools to take control of your back health and become your own advocate. Richly illustrated, Back Mechanic empowers you to rebuild your life.
What are the main takeaways?
While this book is a great starting point for those with back pain on maintaining healthy physical back health, a lot of Dr. Stuart Mcgill's understanding of nonstructural back pain is severely outdated. A lot has changed since he first penned this book in 2015, and I'm disappointed that there isn't an updated version to reflect these changes.
However, I thought it was really interesting that our philosophy at Flowly and his intention to write his book are similar. We also don't think that people with chronic pain should go through surgery or be prescribed heavy pain medication to be able to live their lives pain-free. We also know and agree with him that the healing journey won't happen overnight, nor will it be easy for the patients. It's a lifelong journey. And, like Dr. McGill, we at Flowly try to give our heroes all the tools they need to have better days than bad.
-Outdated Info #1: Dr Stuart McGill believes that there is no such thing as nonstructural pain (aka nonspecific or psychosomatic pain). He believes that all back pain has a cause that can be addressed. The self-assessment he provides is geared towards pinpointing structural pain and would not apply to our heroes with nonstructural pain whose pain is asymmetrical, varies in intensity throughout the day, migrates to different locations, etc. If we had our heroes go through this self-assessment, many would not be able to pinpoint their cause because it would not apply to their situation.
His opinion on talk therapy is that it doesn't do much for pain. We agree. Traditional talk therapy was not meant to help people with their chronic pain. Since 2015, there have been significant advances, and we now have pain-informed therapies like pain-reprocessing therapy (PRT) and emotional awareness and expression therapy (EAET). This new pain-informed therapy goes beyond what Dr. McGill considers to be psychotherapy as the focus is on addressing the root of the pain and not on the "Psychosocial issues, such as whether or not an individual likes their job, or whether or not a patient is neurotic."
-Outdated Info #2: Dr Stuart Mcgill's opinion on alternative modalities for back pain treatment (physical therapy and Pilates) is based primarily on his experience prior to publishing this book in 2015. For example, he considers physical therapy as a "passive treatment" where something is being done to you vs. an "active treatment" that requires the patient to participate in some manner that works towards the cure. Since writing his book in 2015, there have been significant strides and innovations in the physical and occupational therapy vocations. I would argue that most PT/OT are now more active, where patients are relearning how to move and use their bodies correctly instead of getting the treatment done to them. I can see this on social media where PT-content creators share exercises with their followers vs. showing passive treatments to sell through their services.
At Flowly, we're partnering with physical therapy clinics so that we're approaching pain from both sides, where our heroes not only shift their relationship with pain but also learn how to move in a way that doesn't cause physical stress and inflammation to their bodies.
Additionally, as someone entering her fifth year of doing Pilates consistently, it's clear that Dr Mcgill's expertise in Pilates is limited to what he's been exposed to in 2015. When he's talking about how pilates encourages "flattening of the neutral spine," which can amplify back pain, he's mainly referencing classical pilates. Contemporary pilates emphasizes maintaining the neutral spine much more and incorporates elements from physical therapy, yoga, etc.
-Outdated Info #3 (and the biggest, in my opinion): The medical landscape has changed significantly since he wrote this handbook. We see now that there are more working in the healthcare industry who also believe that surgery or opioids are not the best - or only - answers to chronic pain. There's an overwhelming number of new research that I hope he includes if he ever writes an updated version.
How did Back Mechanic affect you?
I think it's reaffirmed my belief that I need to continue to maintain healthy physical habits so that I can continue to have a healthy back and spine as I get older. While I believe the book is outdated in context, his content (e.g., his plan) is timeless and applies to anyone wanting to learn how to maintain good spine/back health. I will be incorporating some of his guidelines and strategies into my life. (For those who want to know what they are, the top two I'll be implementing are daily brisk walking to help unload the pressure on my spine and improving my posture during my daily activities).
Who should read Back Mechanic?
Anyone who has structural back issues and wants a clearly written, thoughtful guide on improving their physical back health should read this book.
While not everyone in our community has chronic back pain, the plan he outlines is a great starting point for our heroes who want to slowly incorporate more movement into their lives. It's a great plan for them to work on improving their back health since our core is so essential to our everyday activities.
Additionally, if any of our heroes are considering if they need movement therapy, the self-assessment in this book is a great starting point for evaluation.
However, I would like to stress the importance of remembering the time period in which this book was written and coming to your own conclusions about the other modalities he mentions in this book, as they may no longer be applicable to you, your situation, or in general.
Have a book you would like to review and share with the Flowly community? Send us an email at contact@flowly.world.