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How Not to Be a One-Trick Pony as a Pain Intervention

How Not to Be a One-Trick Pony as a Pain Intervention

Esther Gokhale
Date


The single focus of many back pain interventions can be described as a “one-trick pony.” Image courtesy Nikki Jeffrey on Unsplash.

Many back pain interventions could be described as having a single, dominant approach: cortisone injections into inflamed tissue, insertion of acupuncture needles to open flow in meridians, “adjustments,” medications for reducing pain, etc. Of course, each of these interventions has complexity and nuance in theory and practice, but the vast majority of existing interventions have a single focus. To put it somewhat crassly, they could be described as one-trick ponies. And I’ve wondered if this is perhaps related to why most approaches to back pain are so ineffectual (see data on HealthOutcome.org).

A three-trick pony
In our method, we’ve never been less than a 3-trick pony, the three “tricks” being intellectual, visual, and kinesthetic ways of guiding the body’s architecture and movement patterns to a more primal configuration. Does this partially account for why we are outliers in effectiveness and efficiency in helping back pain sufferers? That’s not to diminish the core insight of our program, that there is a healthier, better way to be in our bodies and that the modern day conception of the body is skewed and contributes to decline. But additionally, our multi-faceted, coordinated approach helps this diamond in the rough be accessible, persist, and bring delight.


Unlike many other back pain interventions, our “pony” has more than one “trick” in its repertoire. Image courtesy Tobias Nii Kwatei Quartey on Unsplash.

One approach to back pain that I’ve always admired is the Alexander Technique. The Alexander Technique is similar to our approach in that it works on posture and movement patterns. But it uses kinesthetic input almost exclusively. The Alexander Technique’s “one-trick” approach lacks robust use of the images we employ in our teaching, book, website, and communications. Many students and readers also experience the intellectual framework of Alexander Technique to be abstruse and inaccessible. People tell me they feel good while they’re in an Alexander Technique lesson, but they go home and have no idea how to replicate what happened in the session.

Passively viewing images or hearing theories alone doesn’t reduce pain, of course, but alongside the kinesthetic learning, they form part of a rich and textured weave Gokhale Method students take home with them. This allows students to approach the goal of reduced pain from multiple angles simultaneously. I regularly get emails from students containing posture-related images. These students have absorbed the Gokhale Method filter and carry it with them. The method takes on a life of its own. What’s more, the good feelings are replicable outside of active instruction as they go about their life exercises.


Indigenous cultures — along with non-industrialized populations and young children — are amongthe groups we look to for inspiration and the body-knowledge which informs our method. Image courtesy Jason Rojas on Unsplash.

More “tricks”
Over the past five years, we’ve added a technological trick and a research trick to our quite talented pony’s repertoire; this has expanded the range of people who have access to our work and increased students’ trust that what they are experiencing is real.

One of our difficult-to crack nuts has been how to attract alumni to Continuing Education offerings so they can integrate techniques that require repetition and practice to remain rooted in their bodies long after their initial course has concluded. In the past year, we’ve intuited our way to several additional tricks that are addressing this challenge. The new pieces include music, dance, and art in a central role. These cultural pieces have always existed in our ecosystem, but now they are part of our core Continuing Education offering. Dance, music, and art make the weave of learning and integrating so much richer and more enjoyable. Additionally, we’re discovering a sense of community and joy building in our 1-2-3 Move program. People are naturally interested in each other, and including Q&A after each session allows that community spirit to build.


Central Asia is home to rich equestrian traditions, among them horseback falconry with golden eagles, horseback archery, and horseback gymnastics. As in our method, multiple elements combine to form a complex, impressive whole. Image courtesy Lightscape on Unsplash.

We’re also recently included exercise in our programming. It’s been wonderful to be led by a knowledgeable guide in the company of dozens of people online. This makes it fun to return.

We are delighted by the response to our new directions. And as we are always adding new enrichments, there is always more to come.

Crowdsourcing Nominates Posture Modification As Best Lower Back Pain Solution

Crowdsourcing Nominates Posture Modification As Best Lower Back Pain Solution

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We’re very excited to announce recent validation of the Gokhale Method and Postural Modification by the world’s first crowdsourcing platform for medical interventions, www.HealthOutcome.org.

 


Health Outcome homepage showing the highest and lowest rated solutions for Lower Back Pain

 

On this groundbreaking website, members of the public share what interventions they have tried for a particular condition, and rate how well those have worked. Lower back pain is one of the conditions the site has highlighted and...drumroll…Postural Modifications wins by a landslide margin! The Gokhale Method was recently added to the list of interventions to be rated and we’re very proud to have a 4.9 out of 5 rating. This is a huge deal for the Gokhale Method, for back pain research, and for the public.

The Gokhale Method needs more reviews, but it is quickly becoming the top-rated solution on the Heatlh Outcome website

Says founder Ofer Ben-Shachar, “after 80 reviews are submitted for an intervention, we see the rating stabilize, which is in itself a sign of validity. The scale of the studies we are doing here is beyond anything happening in clinical trials. At 1/10,000th the cost per patient, we pool unbiased results from the public and are reflecting important truths about what works and what doesn’t.”

Some of the results are no surprise, and reflect what clinical trials have been telling us - surgery doesn’t work (rated 1.8); cortisone injections don’t work (rated 2.1). But some results are surprising - physical therapy (rated 1.8) is worsted only by spinal fusion surgery (rated 1.7). Ouch! Yoga (3.2) comes in second after Postural Modifications (3.9) after a wide margin, followed by a cluster of interventions in the 2.4-2.9 range including massage, swimming, and stretching.


A spinal fusion x-ray

Why am I not surprised?
 

This is truly the dawn of modern research in medicine as I see it. There is truth in numbers, and large numbers are reporting in at the Health Outcome website. I’m looking forward to learning about other conditions as well. Knee replacements are looking good on the osteoarthritis section, and plantar fasciitis responds to supportive shoes.

Knee Replacement Surgery rates highly on Health Outcome for knee osteoarthritis; so does Supportive Shoes for plantar fasciitis

Previous to this website, there is no patient-reported outcome data available despite over 750,000 back surgeries and over 51 million surgeries performed every year in the US. In addition, medical studies are suspect, as testified by the former Editor-in-Chief of The New England Journal of Medicine:It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” Marcia Angell


Data on medical outcomes has been limited and not trustworthy

Health Outcome is the offshoot of the healing odyssey of its founder. After suffering a leg injury in the 90’s, Ben-Shachar searched the medical literature for hints on whether to undergo the surgery he was being recommended. Frustrated by a lack of compelling data, he succumbed to assurances of a confident surgeon who predicted he would be back to running marathons within weeks. What happened instead was so debilitating, it took him five years before he was able to drive a car again. He vowed that one day he would create a website to help people get the kind of information he wished he had had at the outset of his saga. After selling his internet startup company and doing well in other endeavors, he was able to found Health Outcome. It’s a tremendous service to us all, and I hope the site flourishes and expands to cover an increasing number of conditions. People need to hear from each other, not just in anecdotes, but in numbers.

I hope the readers of this article will share their experiences and learn from others too!

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