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Back Up: Why back pain treatments aren’t working and the new science offering hope
Back pain is one of the world’ s greatest public health challenges. It is the leading reason we visit the doctor, the leading reason we take time off work, the biggest cause of disability worldwide. Around one in 10 people will develop chronic, life-ruining back pain. And rates are growing. A multi-billion dollar industry exists that claims it can fix back pain – by shrinking discs, melting nerves, cutting spines up and putting them back together. Yet leading experts say more often than not, all this expensive medicine is making things worse. Liam Mannix is one of the many who live with back pain, and he takes his own experience as a starting point for this compelling and urgent work of investigative journalism. In the last 20 years, a new theory has emerged, born from cutting-edge neuroscience. It claims back pain often has little to do with the back or the discs or the spine. Instead, back pain is all about the brain. This new science offers new solutions – including, remarkably, evidence that just by teaching people the new theory of pain we can reduce it.
- GenresNonfiction
336 pages, Paperback
Published August 1, 2023
14 people are currently reading
115 people want to read
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Displaying 1 - 10 of 10 reviews
August 9, 2023
So interesting! Could not get enough of this.
If chronic pain, particularly back pain is of interest to you, you need to read this.
This was a spectacular book that debunked the huge number of myths surrounding back pain treatment and explored some of the new research about the best ways to actually treat it.
Every chapter taught me something new. There were so many revelations in this and I was delighted by everything I learnt.
Can't recommend enough!
If chronic pain, particularly back pain is of interest to you, you need to read this.
This was a spectacular book that debunked the huge number of myths surrounding back pain treatment and explored some of the new research about the best ways to actually treat it.
Every chapter taught me something new. There were so many revelations in this and I was delighted by everything I learnt.
Can't recommend enough!
July 7, 2023
An excellent examination of the history of back pain, why we think we have back pain and what to actually do about it (hint: it’s not surgery). Would highly recommend for anyone who suffers from any pain — doesn’t matter where — as it will truly change your perceptive on it.
September 20, 2023
Superbly therapeutic book for anyone suffering back pain.
Helpful ideas:
FlexEze heat wraps, ibuprofen, movement for acute difficulty.
New angles, flexing, bending, Pilates, running, stabilisation training, walking, riding, swimming, no x-rays, glutes/hamstrings/thighs training, visualise and affirm back as a river sound of running water “the spine is gentle and flexible”, interflexion (strength through range of motion), squats, step ups, Russian deadlifts.
Core exercises are overrated, lifting with a straight back is silly, ergonomics don’t work.
No quick fix. We need to do exercise for at least 12 months key treatment, pushing little by little into pain to turn down the brains protectometer.
Passive strategies to manage pain – meditation, relaxation, mindfulness .
CBT and act heal inhibition, creating willingness and confidence.
Helpful ideas:
FlexEze heat wraps, ibuprofen, movement for acute difficulty.
New angles, flexing, bending, Pilates, running, stabilisation training, walking, riding, swimming, no x-rays, glutes/hamstrings/thighs training, visualise and affirm back as a river sound of running water “the spine is gentle and flexible”, interflexion (strength through range of motion), squats, step ups, Russian deadlifts.
Core exercises are overrated, lifting with a straight back is silly, ergonomics don’t work.
No quick fix. We need to do exercise for at least 12 months key treatment, pushing little by little into pain to turn down the brains protectometer.
Passive strategies to manage pain – meditation, relaxation, mindfulness .
CBT and act heal inhibition, creating willingness and confidence.
December 26, 2024
Game changing.
March 5, 2024
Back Up by Liam Mannix
I picked this remarkable book up by sheer chance as I limped into the library, once again in excruciating pain from ‘putting my back out’ somehow! It was in the ‘Most Wanted’ section so my mind automatically thought it would be legitimate and excellent, as it has to be an in demand print to get onto that hallowed shelf.
I currently spend so much money on trying to avoid pain: a specialist back gym, Kieser, plus weekly massages with a myotherapist, plus regular trips to the osteopath. It’s where the bulk of my discretionary spending goes. (And still in pain, mind you!)
After reading this book I have a new view on these choices and my imagination is getting very excited by all the more rewarding things I can do with that money. A month in Greece, acting like a local, is tickling my fancy! All that delicious ocean swimming!
So I’m now resolved to move more, stretch more, relax more (breathing, meditation, yoga) and get into the water a few times a week. All things I can do without paying anyone! Wow. And … you guessed it, probably with better results!
Without destroying the punchline… our backs are not sending us pain signals but danger signals. We don’t more enough and rest too much. We don’t challenge our bodies because our neuron’s have scrambled. Pain is often neurological misfirings and the wiring has become hyper sensitive. I’m excited by what’s possible now that I know and understand these things!
Pick it up. You won’t regret it!
I picked this remarkable book up by sheer chance as I limped into the library, once again in excruciating pain from ‘putting my back out’ somehow! It was in the ‘Most Wanted’ section so my mind automatically thought it would be legitimate and excellent, as it has to be an in demand print to get onto that hallowed shelf.
I currently spend so much money on trying to avoid pain: a specialist back gym, Kieser, plus weekly massages with a myotherapist, plus regular trips to the osteopath. It’s where the bulk of my discretionary spending goes. (And still in pain, mind you!)
After reading this book I have a new view on these choices and my imagination is getting very excited by all the more rewarding things I can do with that money. A month in Greece, acting like a local, is tickling my fancy! All that delicious ocean swimming!
So I’m now resolved to move more, stretch more, relax more (breathing, meditation, yoga) and get into the water a few times a week. All things I can do without paying anyone! Wow. And … you guessed it, probably with better results!
Without destroying the punchline… our backs are not sending us pain signals but danger signals. We don’t more enough and rest too much. We don’t challenge our bodies because our neuron’s have scrambled. Pain is often neurological misfirings and the wiring has become hyper sensitive. I’m excited by what’s possible now that I know and understand these things!
Pick it up. You won’t regret it!
November 6, 2023
The book got better and better as it drew together all the threads on the poor science behind a lot of back pain treatment and the very realistic and effective solutions of exercise, physio and psychological therapy. The book has done a great job of looking at a huge breadth of research and applying it to real life situations.
It also demonstrates how stuffed our health system is, with misaligned incentives for ineffective treatments via Medicare, medical device companies, commercially oriented surgeons, and the private health insurance rules (that force them to pay for any treatment covered by Medicare even if not justified).
If a friend of family member said they were considering spinal surgery, I’d be recommending this as a first read before doing so. I’d also recommend it to all health policy makers so they can see the imperative of fixing the system (which shouldn’t be too hard).
It also demonstrates how stuffed our health system is, with misaligned incentives for ineffective treatments via Medicare, medical device companies, commercially oriented surgeons, and the private health insurance rules (that force them to pay for any treatment covered by Medicare even if not justified).
If a friend of family member said they were considering spinal surgery, I’d be recommending this as a first read before doing so. I’d also recommend it to all health policy makers so they can see the imperative of fixing the system (which shouldn’t be too hard).
August 10, 2023
Important and urgent, this book is a must read for anyone suffering from back pain and those interested in the mind-body connection.
June 19, 2025
This was a terribly written book! The author kept giving conflicting information and I am really surprised that the editors did not correct this.
So many things:
* author says pain is a danger signal but not a signal of damage, therefore you must ignore all back pain. Umm, are we sure here? I don't disagree with the basic premise that SOME back pain should be ignored, but ALL? Really?
* author says it doesn't matter what type of exercise we do as long as we do something, then says, uh ah, getting a six pack in the gym doesn't count, then says physiotherapist don't know shit, then says you should only work with physiotherapists but not personal trainers, then says he got a personal trainer for himself...
* author says people feel back pain because they focus too much on the pain, but then gives a good number of examples where people's back pain started very mild and they did not focus on it at all, but it got worse, then they tried all kinds of exercise and that did not work either
etc etc
Also some things were plain wrong, e.g. in the pharmacology section (I am a pharmacologist) he says pregabalin is toxic, but therapeutic doses of pregabalin are NOT toxic. Sure, TOXIC doses are pregabalin are toxic, but the very basic tenet of pharmacology is that everything is poison but it all depends on the dosage. Plus he also said that opioids cause massive physiological damage but that is false too. The direct effect of opioids on the body is mostly functional and one can stop after 20 years and be OK, alcohol is much worse in this respect.
So all in all this book just really cemented my overall feel about the treatment of musculoskeletal system issues - no one really knows what the hell is going on, everyone's just grasping at straws here.
So many things:
* author says pain is a danger signal but not a signal of damage, therefore you must ignore all back pain. Umm, are we sure here? I don't disagree with the basic premise that SOME back pain should be ignored, but ALL? Really?
* author says it doesn't matter what type of exercise we do as long as we do something, then says, uh ah, getting a six pack in the gym doesn't count, then says physiotherapist don't know shit, then says you should only work with physiotherapists but not personal trainers, then says he got a personal trainer for himself...
* author says people feel back pain because they focus too much on the pain, but then gives a good number of examples where people's back pain started very mild and they did not focus on it at all, but it got worse, then they tried all kinds of exercise and that did not work either
etc etc
Also some things were plain wrong, e.g. in the pharmacology section (I am a pharmacologist) he says pregabalin is toxic, but therapeutic doses of pregabalin are NOT toxic. Sure, TOXIC doses are pregabalin are toxic, but the very basic tenet of pharmacology is that everything is poison but it all depends on the dosage. Plus he also said that opioids cause massive physiological damage but that is false too. The direct effect of opioids on the body is mostly functional and one can stop after 20 years and be OK, alcohol is much worse in this respect.
So all in all this book just really cemented my overall feel about the treatment of musculoskeletal system issues - no one really knows what the hell is going on, everyone's just grasping at straws here.
August 15, 2023
This book has been life changing. I went from living in fear of re-injury and barely walking due to back pain, to now walking, moving and feeling far less pain. After reading Back Up, I’m filled with hope, inspiration and determination to regain a healthy active lifestyle. Thank you Liam!
October 21, 2023
Compelling and pleasant writing, but didn’t really cover the situations to solutions I was looking for. At times the author himself seemed to get confused between back pain and back injury, and somehow concluded at the end (after dissing it early in the book) that actually exercise and remaining calm about your injury/pain are the best approaches in the long run.
This entire review has been hidden because of spoilers.
Displaying 1 - 10 of 10 reviews