Answer to Question 10
The answer to question 6 made it clear
that the general cause of Low Back Pain is civilised forms of sitting,
particularly where the backrest is shaped to provide lumbar support. Even more so
where, as in a car, the seat surface is tilted backwards which will roll the
pelvis even further backwards.
The solution must therefore be to avoid
such seats and to design seating on the principle of Pelvic or Iliac support.
This is the subject of most of the rest of
this website which has been rearranged in early 2017.
The book The Evolution of Low Back Pain
contains all the basic principles
But to correct a
problem that has already developed needs a therapy which restores the correct
shape and mobility of the lowest joints. This is what is discussed in the
answer to question 2. Experience however has shown that it takes time for the
ligaments to return to their natural length. If we are leading a normal
sedentary lifestyle, this may never happen - or only very slowly with
considerable effort.
The alternative,
and hopefully quicker, solution could be the insertion of an artificial
supra-spinous ligament surgically to restore the natural limitation in flexion
and cure the back pain. I suggested this as early as 1987 and in some detail
(1) in about 1997 but recently I discovered that this had already been done
with 100% success post operatively (maintained in 75% of cases at 7 year follow
up). (2)
In this work in the early 1990’s in Switzerland, back sufferers, without detectable pathology, had Graf ligaments inserted to restrict joint flexion with this very high rate of success.
(1) Prosthetic Supra-spinous Ligament. Document available on this website.
(2) Graf Ligament use for non-specific LBP
The Swiss paper www.ncbi.nlm.nih.gov/pubmed/7668117 (and www.ncbi.nlm.nih.gov/pubmed/12632117
for 7 year follow up.)