The back pain-industrial complex is an incredible web of interlocking interests where no part has an incentive to really cure anything long term. The canonical expose of this system is the recent book "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery"[0], where a seasoned investigative reporter surveys the entire industry in detail. She gave a nice summary on this podcast[1]. And she has a detailed section on the breakthrough ideas of Dr. Sarno, and how he was ignored for decades.

The book is in three sections. The first section is a very depressing history of back surgeries and devices attached to the back, that almost uniformly fail after a few years, leaving the patients worse than they started. The second section covers various exercise and bootcamp approaches, including the MedX lumbar extention machine invented by Arthur Jones, who also invented Nautilus machines with adjustable strength curves via cams. The MedX lumbar machine was the only device that could isolate and recruit the inter-vertebral muscles, which have been shown to be weak in patients with lower back pain. The machines came in a medical version[2] and an exercise version[3]. The back pain industry saw that the medical machine was working much too well and cutting into their income, so they had insurance companies stop paying for "exercise" modalities, and that approach died. The third section of the book is on the wide range of body manipulation techniques, like pilates, etc.

[0] https://www.amazon.com/Crooked-Outwitting-Industry-Getting-R...

[1] https://informfitness.com/podcast/50-outwitting-back-pain-ca...

[2] https://youtu.be/Ao1CkBbe2nw

[3] https://youtu.be/1Z-FyeG7pqY

For a terrific overview of the back pain industry and the scams that many places try to pull, I recommend the new book "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery"[0]. The author gave a great interview on this podcast episode[1]. She goes into the Sarno principles, among other topics. Strength training for the back is often a great help, but rarely prescribed by doctors. Most people have never heard of the multifidus muscles, much less seen the specialized machines for strengthening these muscles so critical to spinal stability[2].

[0] https://www.amazon.com/Crooked-Outwitting-Industry-Getting-R...

[1] https://informfitness.com/podcast/50-outwitting-back-pain-ca...

[2] https://www.youtube.com/watch?v=1Z-FyeG7pqY