Acknowledgements

iii

About the Author

iv

Introduction: A Chance Discovery

x

Chapter 1

The Low Back or Lumbar Spine

1

Myths about Acute Back Pain

5

Chapter 2

Understanding the Spine

10

Vertebrae and the Spine

10

Functions of the Lumbar Spine

12

Natural Posture

12

Mechanical Pain

13

Mechanical Low Back Pain

14

Pain Location

18

Self-Treatment

19

When Self-Treatment does not Work

19

Diagnosing Your Problem

20

Chapter 3

Common Causes of Low Back Pain

23

Consequences of Postural Neglect

23

Sitting

25

Prolonged Sitting

26

Sitting Correctly for Prolonged Periods

27

Correction of Sitting Posture

28

Forming a Lordosis using the Slouch-Overcorrect Procedure

28

Maintenance of the Lordosis

29

The Lumbar Roll

30

Regular Interruption of Prolonged Sitting

32

Standing

33

Prolonged Standing

34

Correction of Standing Posture

34

Working in Stooped Positions

34

Lifting

36

Correct Lifting Technique

37

Coughing and Sneezing

38

Relaxing after Vigorous Activity

38

Lying and Resting

39

Correction of Sleeping Surface

40

Chapter 4

Understanding the Mckenzie Method

42

The Aim of the Exercises

42

Effect on Pain Intensity and Location

44

Centralization

45

How to Know if you are Exercising Correctly

49

Chapter 5

The Exercise Program

50

Exercise 1: Lying Face Down

50

Exercise 2: Lying Face Down in Extension

51

Exercise 3: Extension in Lying

52

Exercise 4: Extension in Standing

55

Exercise 5: Flexion in Lying

57

Exercise 6: Flexion in Sitting

59

Exercise 7: Flexion in Standing

60

When to Apply the Exercises

61

When you have Significant Pain

61

When to Start Exercising

62

When Acute Pain has Subsided

65

No Response or Benefit

68

Recurrence

76

Chapter 6

When Acute Low Back Pain Strikes

77

Chapter 7

Special Situations

79

Treatment by REPEX (Repeated End-Range Passive Exercise)

79

Low Back Pain in Pregnancy

81

Low Back Pain in Athletes

84

Low Back Pain in the Over 50s

88

Osteoporosis

89

Chapter 8

Common Remedies

91

Medication for Pain Relief

91

Bed Rest

91

Acupuncture

92

Chapter 9

Emergency Panic Page

93

References

94

The McKenzie Institute International

99

Licensed Distributors

100