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April 12, 2011

Back2Life - "Don't try it at home"

Today, I saw a gentleman I hadn't seen in a while.
He walked in, stooped over, using one crutch.
He had previously used a crutch for foot problems and had had intermittent low back problems before, but he had recently bought a "Back2Life" machine in an attempt to improve his health.  Unfortunately, it had backfired completely and he was now stuck bent forward, in significant pain.
I haven't seen this device before, but at first blush it looked like another one of those "get rich quick" schemes based on selling a "get better quick" device. However, since he had brought along the documentation and user manual, I took a look at it.
It would appear that the device is yet another attempt at spine traction, possibly combined with non-specific mobilization. While traction has been used for centuries, the method regained popularized in the 70'ies and 80'ies where people would hang upside down by their knees or boots secured up high or on inversion tables. This method has worked decently for many, but has limitations and many potential drawbacks. At the end of that era, some tried to combine traction and flexion (forward bending of the trunk relative to the hips), most notably to treat disc problems.  This strategy yielded results yielding from great to catastrophic. It is no longer in widespread use.
As far as I can see, this device tries to exert long axis traction just like the inversion tables of the 70'ies and 80'ies did, but ends up, at least in some cases, causing flexion also - even without user error.
As was learned in the 80'ies, treating a problematic low back in any form of flexion position brings a whole host of potential problems, raining from facet locking to disc herniation, which might also explain the set-back that my patient experienced. As the success with Robin McKenzie's extension (backward bending of the trunk relative to the hips) in the 90'ies has shown, extension is a much safer and potentially more beneficial mode of treatment than is flexion. 
Unfortunately the patient position with the Back2Life device is a far cry of extension, it would appear to be neutral at best.
Looking at the comment thread at Spine-Health.com (http://www.spine-health.com/forum/back-surgery-and-neck-surgery/back-2-life-machine) my patient was not the only one to feel a detrimental effect of the Back2Life device.
Things worked out decently for my patient though.  I worked on him for a good while, there were lots of problems, but he walked out upright, not needing to use the cane, with a smile on his face.

In summary I would opine that this device is not for people with any hint of disc herniation or segmental instability in the low back. In reality,  I would say that the potential dangers would render this device very risky in a home-based treatment setting under the above mentioned circumstances.  Possibly best to check with a spine specialist before purchase - unless you believe that the company will live up to any stated money back guarantee.