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Back Pain – From This Side, and That Side of the Therapeutic Relationship. A Practitioner’s Personal Story.

Going from expert to expert, and get different answers made me wonder if anyone knew what they were talking about.

I had persistent mid-back pain for about 5 years. It was pretty bad. It drove me bananas (2006-2010). It was through this experience that the wheels really fell off the ortho bus for me. It was through this experience that I got turned on to some pain science, and the BPS model (thanks to reading Rehabilitation of the Spine – A Practitioner’s Manual, by Craig Liebenson).

I got treatments from practitioners who are well known and supposed to be the best in my field, and many others who are supposed to be great practitioners in theirs.

My response to every treatment was exactly the same. Nothing. It didn’t feel good. It didn’t feel bad. Just nothing. Zero effect, except cleaning out my wallet. I was a believer then, too. You’d think I would have gotten more of a placebo.

  • Acupuncture
  • Electric Acupuncture
  • TCM (herbs, supplements, moxibustion, cupping etc)
  • IMS
  • MFR
  • SDTT
  • PT (exercise, needles, manual stuff)
  • Chiro adjustments
  • End range loading
  • CST (apparently my thoracic inlet was screwy)
  • Graston
  • ART
  • “Functional” and “rehabilitative” exercise
  • DNS

During that time, I must have seen about 20 different practitioners, had imaging and been given about 40 different reasons for my “problem”.

  • Rib subluxation
  • Muscle weakness
  • Muscle imbalance
  • Muscle tightness
  • A million fascial adhesions everywhere
  • Hypermobility
  • Misalignments everywhere
  • Postural problems (too much torsion)
  • MFTPs
  • The 20-year-old injury to my wrist (The scar tissue. The way my wrist moves differently – the regional interdependence quackery)
  • The 25-year-old scar from a minor abdominal surgery
  • kissing spines
  • DJD
  • Vertebral misalignment (actually used the term “train-wreck”)
  • Facet irritation

Those are just the ones I can remember.

I was scared. Nobody could treat this problem, and I was becoming increasingly anxious because all these “experts” seemed to have an answer, but *nothing* was working.

You know what I wish someone would have told me??? Something like this (said slowly, in a quiet and gentle tone, conveying compassion, understanding, knowledge, and a desire to be there for me. I’m not suggesting that this verbiage or approach would be best for everyone):

“Dude…… I’m really sorry that you’re going through this. I know it sucks”.


“I can see that finding a reason is really important to you. I’ll tell you the uncomfortable secret though: we don’t really know very much about why people hurt all the time. I think that you have probably figured that out by now, seeing as many great practitioners as you have, and getting all this treatment. It’s not as simple as if you were playing soccer, and twisted your knee. This just seemingly came out of nowhere”.

(validating my experience)

“Nothing in you is broken. Nothing in you is misaligned, adhered, weak or tight. Everyone on the planet is misaligned, weird, tight, crooked etc, so that clearly can’t be the reason. Let’s take a look at a little bit of everything, and approach from more angles: sleep, stress management, what treatments you seem to respond well to, because *you’re the expert* on what helps you feel better”.

(Actually know what’s up, and stopping with the silliness modality worship, and propping up theories on the broken foundation of outdated models with zero credibility. Also, putting *me* in the driver’s seat, making me the expert on what works best for me, taking away the mystique and delusion I had of the guru with the magic modality. Every time treatment failed…you can imagine how the anxiety got worse. The power imbalance and the modality worshipers were hurting me. Side by side, and let me lead, would have been better than top-down).

“In the meantime. Please, just leave it alone. Let’s just for a while stop poking it, stabbing it, electrifying it, kneading, foam rolling, stretching, using balls etc”.

(Addressing the increasing anxiety, and the likelihood of driving my own peripheral sensitization by thinking it’s all in the tissues)

Things like this often come on for no identifiable reason, and will probably go away on it’s own. Let’s just leave it alone for a bit, and I’m here for you to see if I can help take the edge off in the meantime”.

(Reassure, and actually just be there for me)

That’s my story of chronic pain.

If you’re wondering, I have zero pain now. I feel awesome most of the time. I found my medicine in unexpected places, but that’s a side convo. I just wanted to share how I wish I’d met a BPS practitioner with some relevant knowledge then.

If you’re looking for better treatment strategies than modality worship, and busted old theories check out Eric Purves and Richard Mcilmoyle‘s course! Here’s a link to Achieve Health’s courses. Evidence-based, and stressing the BPS.

ABOUT TAYLOR JAMES / / / Taylor James (TJ) Laviolette is the owner and founder of, an online learning platform for healthcare professionals. He helps professional manual therapists (RMTs) maintain and develop their skills through his accredited coursework. Reach him at or visit Taylor James for a complete list of available courses.