Dr. Patrick Roth is calling on doctors and patients "to be better" by embracing the "soft skills" of narrative-based medicine in spite of conventional, evidence-based medicine. He is pleading for a slower approach, one that requires active listening, compassion, introspection, humility, and sharing on both parts.
This, he believes, will restore the critical role of the patient’s own story in the healing process. This, he believes, will better our healthcare system by reducing misdirection and overtreatment by doctors.
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Patrick Roth M.D. believes that most of what you have been told about back pain is completely wrong. In The End of Back Pain, Dr. Roth introduces a novel way of both conceptualizing and treating back pain.
Pain is explored within the context of a dynamic brain/body relationship. A method of treating back pain by strengthening a set up muscles referred to as the “hidden core” is introduced which features the use of kettlebells. The book also features a diagnose yourself section, a surgeon’s perspective of conservative and surgical treatments for back pain, and a prediction of how back pain will be treated in the next decade.
After reading the book you will understand why:
Your back should be straight when its bent
Pain medications cause more pain
Surgery is merely a preparation for physical therapy
You will also learn about:
The brain’s judicial function
The placebo effect, and its partner, the nocebo effect
The anatomy and physiology of the core
How to exercise with kettlebells
The “back genome”
Author of WHEN and DRIVE
"THE END OF BACK PAIN offers a rare opportunity to peer into the heart and mind of a neurosurgeon, one who uses both his humanity and his hands to treat patients. You’ll finish this remarkable book more optimistic about the future of health care.”
Alan R. Cohen, MD
Professor of Neurosurgery, Oncology and Pediatrics / Chief of Pediatric Neurosurgery The Johns Hopkins University School of Medicine
A passionate, incisive, fascinating behind-the-scenes exposé of today’s flawed healthcare. The Me In Medicine reveals how doctors and patients have automatically bought into a ‘system’ that appears sound and yet disappoints. This is a must-read for doctors and patients alike—and everyone who cares about getting back to the heart of good medicine today. Sir William Osler reminded us that ‘the good physician treats the disease; the great physician treats the patient who has the disease.’ Likewise, the good surgeon learns how to cut; the great surgeon, like Patrick Roth, learns that the tongue may be sharper than the scalpel.
Carl Heilman, MD
Chairman and Professor / Department of Neurosurgery Tufts University School of Medicine
Dr. Roth delivers an intriguing and entertaining review of the complicated flaws present in our current healthcare system. With compelling perspectives from history, philosophy, science and literature, Roth clarifies how we have gotten here, and where we are headed. This is a story about us, physicians and patients, and what we can do together on the ground to transform our most fundamental connections. An interesting and thought-provoking read!
Dean and Professor of Pediatrics / Seton Hall-Hackensack Meridian School of Medicine
A thoughtful and thought provoking book… regarding the critical aspects of being a physician: the patient-doctor relationship. Through this lens, Dr. Roth explores the richness and power of this relationship...A beautifully written book…Health professional and patients alike will learn so much.
Danielle Ofri, MD, PhD
Author of What Patients Say, What Doctors Hear
A call to arms to reaffirm the humanity of medicine for both doctors and patients alike. While not shying away from the high-tech innovations that advance medical science, Roth reminds us that we can’t lose sight of the primary focus of medicine: compassionate healing.
Chair / Neurosciences Hackensack University Medical Center
Patrick Roth’s book is important and timely. He provides incisive, real-life perspective and advice to patients and health care providers based on his decades-spanning track record as an academic neurosurgeon. He articulates what makes a physician tick. For Roth, the successful patient embarks on a journey of autonomy during which physicians and patients form a partnership. To this end, physicians must reflect on their patients’ narrative. Only then can test results be placed in the clinically relevant context. Spine surgeon Roth’s bread and butter are patients with back pain whose MRIs show disk prolapses or bulges. But association does not imply causation, post hoc non propter hoc. As Roth explains, this misconception is the root of countless unnecessary back surgeries, poor outcomes, prolonged post-op recovery, avoidable but tremendous cost to the health care system, unimproved quality of life and dissatisfied patients. Behind this misinterpretation stands a natural but ultimately counterproductive yearning for simple explanations to complex problems because besides disk disease, back pain is also linked to sedentary lifestyles, lack of exercise, depression and obesity, all issues for which the solutions must originate with the sufferer, not the doctor.
Roth explains persuasively what patients should seek in a good surgeon. His views rest on a keen understanding of human nature. It is not just the technical brilliance, the attention to pre- and post-op care, but also the empathy, ability and willingness to understand patients’ narrative, the sine qua non of linking a patient’s problem to the procedure and the condition for a rewarding outcome. And it is the combination of modesty and confidence that allows the doctor to admit to uncertainty and ambiguity.
I expect people who embrace Roth’s thoughts and advice will become better prepared as patients and health care providers.
Edward Benzel, MD
Chairman of Neurosurgery, Cleveland Clinic
Patrick Roth courageously addresses the chronic pain epidemic/crisis head on. Chronic pain consumes 1/4 of our healthcare expenditures in North America. Why is this so? Well, physicians treat these patients as if they had acute pain. They operate, they do procedures, and they prescribe narcotic medication — all of which are doomed to failure in this patient population. Dr. Roth offers a solution and provides not only a rationale for dealing with chronic back pain, but also provides structure for orchestrated recovery. Bottom line, this is a GREAT BOOK. Must reading for anyone with a back.
Mark Bilsky, MD
Chief of Spine Surgery at Memorial Sloan-Kettering Cancer Center
Pat Roth has done a masterful job describing the complex mechanisms that create back pain, a leading cause of morbidity and disability in the United States. Spine surgeons have developed sophisticated techniques to treat back pain, but Dr, Roth elucidates exercise techniques to strengthen core muscles that will hopefully keep the majority of us off the operating table and out of pain. The book is a phenomenal treatise on the management of back pain by a cutting edge surgeon who sees the bigger picture.
Michael Kelly, MD
Chairman of the Department of Orthopedics, Hackensack University Medical Center
As a busy orthopedic surgeon, my chronic low back pain has been an obstacle to enjoying a pleasant day for many years. I have been treated with a variety of exercise programs, injections and pain medications. The unique approach so clearly presented in Dr Roth’s The End of Back Pain is an outstanding and simple way to conquer your pain and improve your quality of life. Understanding and treating your “hidden core” will assuredly help you as it did me.
Walter Bortz, MD
Clinical Associate Professor of Medicine at Stanford University School of Medicine
Dr. Roth’s book addresses one of the greatest embarrassments of American Medicine, treatment of back pain. The current system rather than helping this epidemic condition actually acts as a co-conspirator through wrong counsel and practice. Dr. Roth’s book is the antidote to this mal-practice.
Carl B. Heilman, MD
Chairman of Neurosurgery at Tufts University School of Medicine
Dr. Roth’s ‘stackable’ exercise program is designed to strengthen the muscles on all sides of the spine, providing an inner support structure to minimize exacerbations of back pain. If patients with chronic back pain are willing to put forth the effort Dr. Roth prescribes, most will be able to take control of their back pain future.
Steven Kirschblum, MD
Medical director at Kessler Institute for Rehabilitation
For those suffering from low back pain, Dr. Roth offers a unique program that combines the body and mind in a clear, thorough, and meaningful way.
Richard D. Guyer, MD
Chairman of Texas Back Institute
I highly recommend this book to any back pain sufferer who is interested in controlling their back pain. In fact I will make this required reading for spine fellow surgeons that train with us every year.
John Du Cane
CEO, Dragon Door Publications
As the co-founder in 2001 of RKC, the world’s first kettlebell instructor certification system—and as the originator of the modern kettlebell movement—I have long championed the skilled use of kettlebells to help reduce or prevent back pain. I therefore applaud Dr. Roth for his compelling, well-reasoned and eminently practical explanation of how the diligent application of this core-strengthening tool can have a profound impact on back health. Accessible medical science vindicates ancient exercise wisdom in Dr. Roth’s impressive contribution to a healthier, safer world.