Chronic neck and back pain often result from, or at least has a component of, weakness or injury involving the muscles that support and stabilize the spine. The paraspinal muscles act as “shock absorbers” or stabilizers of the spine. Without them, our bodies would collapse to the ground. When they are weak, they are less able to do the job of supporting the spine.
When a muscle is weak, it must work that much harder to do its normal job. This also means that it is more likely to tire or fatigue more quickly. When a muscle fatigues, though, it doesn’t “roll over and play dead.” It begins to tighten up and cramp. (This is one reason why athletes tend to cramp later in an athletic event.) The tightening (also known as "hypertonicity") starts to cause pain, most commonly a deep aching or burning type of pain that is spread out over an area. A tight muscle also begins to restrict flexibility and range of motion.
The problem with the neck and low back, however, is that it is very difficult to isolate these muscles for testing or strengthening. And if you can’t isolate a muscle, it will be very difficult to strengthen it, or even to measure how strong or weak it is. With one exception, there is no exercise machine, physical therapy program, or testing equipment that is capable of isolating the muscles of the neck or low back—though many claim they do!
Arthur Jones, the inventor of the famous Nautilus® system of exercise machines, recognized this problem. He realized that, unless you are able to restrict the motion of other parts of the body, other muscles will be recruited when trying to do neck or back strengthening exercises, and you will not be able to target the specific neck or back muscles.
After years of research and plain old trial and error, Jones developed the MedX medical machines. The MedX medical machines have proven to be the only systems in the world capable of completely isolating the neck and low back muscles, both for testing strength and for rehabilitation.
The secret is the MedX’s unique restraint mechanisms that restrict movement everywhere except the neck or low back. This allows only the cervical or lumbar paraspinal muscles to be isolated and exercised.
Patients initially undergo a strength evaluation on either the cervical or lumbar machine. The test will tell not only how strong you are, but also how you compare with other people your same age and size. The test also gives objective range of motion measurements.
Unlike other back testing machines that involve constant movement, the MedX test is a static isometric test. That means no movement is occurring during the actual strength test. This is a safer and far more accurate way to measure maximum muscle strength. The machine is set in a particular position and locked. The patient is then asked to start pushing back gently against the pad, slowly building up effort over 3 seconds to a maximum contraction, then gently relaxing. The back or head rest is then repositioned to the next testing angle and the procedure repeated. A strain gauge inside the machine measures how hard you push, and at the end of the test a computer prints out a curve showing your strength and range of motion.
If the test results indicate weakness, and your doctor determines that the MedX is an appropriate treatment, the rehab program begins at the next visit. Rehabilitation is divided into 4-week segments, and an effective treatment program usually requires at least 2, and sometime 3, segments (8-12 weeks).
Treatment sessions during the first 4 weeks are twice a week for 6 sessions, followed by a re-test on the 7th session. During the next 4-8 weeks, low back treatments are dropped down to once a week, but the cervical treatments must continue twice weekly. Testing is repeated at 4-week intervals to document progress.
Treatment is nothing more than carefully controlled weight training, and in this sense the MedX is a very elaborate computerized weight lifting machine that isolates the neck or low back muscles.
While the MedX is the only effective way effectively to isolate and strengthen the neck or low back muscles, you can maintain your gains through a simple home exercise program.
The most effective low back maintenance involves using a back extension machine (see photo). Many gyms and health clubs have these or similar. They also cost under $200 and so are affordable to for home purchase. Another option is to use a large fitness ball, as shown below.
The key with both exercises is do not squeeze or tighten your buttocks muscles! Squeezing or tightening the buttocks muscles takes the focus off the low back muscles. You’ll strengthen your butt, not your back! To keep your buttocks relaxed, think about forcing out a bowel movement—you can’t force a BM and tighten your butt at the same time. (I know it sounds gross, but it works!) Also, be careful not to arch your back backwards beyond neutral. You want to extend your back, not hyperextend it.
For maintaining neck strength after MedX rehabilitation, your physical therapist can provide an exercise device known as the Synergy® system. It consists of a head strap that attaches around the head, and a resistance exercise band that clips to the various plastic rings attached to the head strap (see photos).
The MedX has a strong body of research to support its effectiveness. In one study, over 900 patients with at least 2-year of chronic low back pain were studied. On average these people had tried and failed six prior treatment approaches, including physical therapy, injections, and surgery. They suffered from sprains & strains, disc disease, and arthritis.
They underwent MedX rehabilitation for 12 weeks. At the end of the program, 76% reported that their improvement was “good” or “excellent.” They were then instructed in a home exercise program using the back extension machine shown above. After one year, 95% were still doing well.
The MedX program can be very effective in helping to evaluate and treat chronic neck and back pain. But it is not for everyone. Talk to your doctor to see if the MedX program is right for you.