Why Physical Therapy Failed Him (The Vestibular Fix for Chronic Back Pain) 🧠

If your back pain isn't getting any better, maybe you just need a different approach. A lot of times people go to the doctor, they get medicine, they get physical therapy, and it might help a little bit, but the pain just lingers for a long time. Well, there's other ways we can approach pain, and that's what I do. I'm Bill Daniels from Beyond Fitness, and I've been helping people for over 20 years overcome their pain and get back to a normal, healthy, Happy life. So today I want to talk to you about a client that I had. His name was Ryan. He had chronic low back pain. He had a high-level executive job. He was fairly young, but he started to develop this pain in his lower back. He tried physical therapy and things didn't— not just get better, but sometimes they were even worse. He couldn't golf anymore. He had a hard time just moving around. He even described to me one day That every time he stood up from his desk when he'd been sitting a while, that he had excruciating pain and that he felt like he was 900 years old. And obviously, that's not the way we want to live our lives. That's not the way we're really built to live. But the doctor couldn't solve the problem, medicine wasn't solving the problem, and it was impacting his life because he couldn't do the things he loved. He couldn't even play with his kids because his kids wanted to be picked up all the time. He had young children. And that not only was difficult for him, but it scared him because he was afraid that they'd run to him when he got home and he'd pick them up, that he would end up with a huge, huge back problem, and then he'd be bedridden and things would just start to spiral. So we had to address this. In order to do this, I had to just explain to him that the back is made up of our spinal cord with the spine around it, right? The bones. And attaching all those bones, keeping them together, are all these ligaments and muscles. I mean, we have almost 2 dozen muscles attached to the lumbar spine, the lower back in itself, and then a whole bunch of ligaments, and then you've got the discs in between. Now, what ends up happening is the muscles have a certain amount of tension in them at all times. Now, if we're going to flex those muscles to move, that's one thing, but In our general day when we're sitting or standing and not even thinking about it, there's a certain amount of tension in those muscles. That tension is set by your brain, and your brain is doing that based on the information it's getting from other systems like the vestibular system. The vestibular system tells our brain which way gravity is pulling us, and then as a result, the brain says, so we don't fall over, I want this much tension in these little muscles here, and that keeps us upright with good posture. Now, what happened with Ryan was as we dug into his history, we found that he was in a really bad car accident in his early 20s, and this wasn't too long before the back pain had begun. Now, in this car accident, he said he got bumped in the head, but he didn't ever really get examined for a concussion or anything like that, so we're not sure if he had a concussion, but he did have a sustained injury to the head, however minor that was. that it was. So that led me to think, okay, well, if it happened in the head, the vestibular system's right there, the visual system's right there, what's going on? As I got more details about the injury, the way he had jolted had been very forward and kind of up, which was kind of odd the way he described it, and then bumped his head on the window right next to, on his driver's side. So I started to think, okay, maybe there's something going on with the vestibular system there. So we used the AIM system that I've created, which is assess, implement, and measure. So we assessed his back pain. We already had an idea of what was going to hurt. When he stands up from his desk, extension was hurting anytime he's trying to extend. So we were thinking, okay, extension is a part of the brainstem that is in the middle of the brainstem. That part of your brainstem helps control that movement. One of the other things that feeds into that part of the brainstem is actually the nerve that your vestibular system communicates to the brain with. So we're thinking now there's probably a disconnect there somehow. So what we decided to do was test out some vestibular exercises. I immediately went to thinking, okay, if he's having a hard time getting up and down off the— out of the chair, we need to work on some up and down movements. So, What I did was I had him stare directly at a spot on the wall, put his hands right here on his hips, and just bounce like this. And after about 10 seconds, he started to feel a little bit dizzy. So, we were immediately getting a negative response there because he was feeling worse than he was before we'd started. So, what we did instead was we slowed down the bouncing, just nice and slow. That started to make him feel better. What he found was then when he went into extension afterwards and reassessed himself, He was feeling a little bit better. There wasn't as much pain, but it was still there and it wasn't enough to really move the needle yet. So then I thought about, okay, when he hit his head on this side, was there something happening with the vestibular system on this side? So we started testing some rotation movements and those were okay, but when we turned his head, he noticed, oh yeah, my head always hurts. I don't look as far to the left when I go that way. So, I started thinking, okay, let's look at the horizontal canal in the vestibular system, because that tells your brain, hey, the head's moving in that direction. So, we did an exercise called a VOR. So, we put a thumb out in front of him and he just started to turn his head to the left, just like this, keeping his eyes on the thumb the whole time. Now, again, that started to make him feel a little bit unbalanced. It wasn't as bad of a result as it was with the bouncing. So again, we slowed it down. We just did nice and slow there and even slower on the way back. A little bit faster to the left, a little bit slower back. And we found that that started to make him again assess a little bit better. So we assessed, we implemented some vestibular exercises, and we measured or reassessed and found that those 2 things, and we tried other things, but those 2 things gave us the best results. So what we decided to do was let's put them together. So we, instead of using his thumb, because it's harder to bounce while looking at your thumb, we put a sticker on the wall and we had him bouncing nice and slow, turning his head left, and then coming back slowly. Right here, just like this. This was the bouncing VOR. Now we specifically did it to the left. Some people would need that in different directions or all directions. But for Ryan, this is what we found was the most helpful for him. What was amazing about it was we did that for about 30 seconds, he reassessed, he said, yeah, that feels great. You know what? I want to try it more. He did it a second time for another 30 seconds and he was feeling really great to the point that he sat down, stood up, and was like, that's great. Got up, started getting up and down off the floor. And started moving more than he had in quite a long time. And it was a great result for him. Now, here's what happens with that. He goes home. A couple hours later, he's like, ugh, my back's feeling stiff again. He goes and he can stand up and just put a sticker on the wall or pick a spot, it's something to look at, and just bounce and do his drill. He did that periodically for the next 5 or 6 days. And when I saw him a week later, he said, I can't believe this. I woke up this morning. Without any pain. I worked all day yesterday and got up from my chair and there was very little pain in my back. This is the best I've felt in forever. So we've started to heal, not necessarily the tissues in the back, but to regulate how all the systems are working together by picking the right exercises, testing them, and figuring out exactly what it is that works best for Ryan. So in the end, he had a happy ending. He was able to get down there, feel more confident playing with his kids. He even started to golf a little bit again, which was great, and he had no incidences there in the first couple times that he's gone out. And it's been a real game changer for his whole life. So that is an example of how this stuff can really help you. We ended up doing other exercises more specifically for his vestibular system while he was doing his traditional exercises. And That's a whole other video for another time, but there's a way to incorporate all this stuff into everything that you're doing. And if you want to learn more, I did write this book called Rewiring Pain. It is a book full of examples and my own story of when I hurt my back. It's got hundreds of drills in here of different things you can try. It'll tell you why you may need to try them. There's even a questionnaire in the back. As you can see right here, it's a few pages long, but it'll tell you exactly where to start. So if you're interested in checking this out, it's on Amazon. I'll leave a link in the description. And if you have any questions, please leave them in the comments. I'm happy to answer them. And until next time, live healthy.