Chiropractor/ San Francisco/ Dr Kai Tiltmann/ FDChiropractic

This article is from Prof. Stuart McGill delivered in his monthly newsletter. I find it important because many low back pain individuals read the Back Mechanic and watch YouTube videos and are surprised why their back pain is not going away. This is why McGill Method Master Clinicians spend 3 hours face to face with their patients to appropriately coach them. In this case, finding the tipping point where the lumbar muscles start to activate and relax is very importation and...Continue reading

Low back pain from 7/10 to 0/10 in 10 minutes. A 27-year-old, fit female presented with a 3-year history of non-traumatic, intermittent, severe low back pain and occasional right sciatica, but at the time of the exam, she reported having no pain. After careful history and examination, it was determined that three lumbar discs were involved (L3/4, L4/L5 and L5/S1). No MRI was necessary. Extensive prior treatment did not resolve her problem. First visit consisted only of histor...y and exam, no treatment was provided and she left the clinic without pain. Patient returns the next day with 7/10 low back pain, radiating pain down the right leg to the knee and difficulty walking. Based on the information gathered on the first visit, I placed the patient in a prone (face down) position, placed a bolster under her feet, placed a wedge under each thigh near the top to create mild lumbar extension and had her support her chin with one fist on top of a flat hand. She was instructed to relax, breath deeply and let everything settle down. Within 10 minutes her pain resolved going from 7/10 pain to 0/10 pain. I showed her how to get up and how to walk based on her low back findings from the prior exam. No other treatment was provided. One of her problems is that she is flexion intolerant. Then she reported that the night before she slept on her back with a pillow under her knees, which creates spinal flexion. This is what flared her symptoms, but now she know better. I did not fix her, and she has a very long way to go, but she is starting to understand the importance of proper spine movement.

This is a testimonial from a patient who has family members, many of whom received low back surgeries and he desperately wants to avoid following in their foot steps. "Dr. Tiltmann is a back expert, coach and teammate all rolled into one. I came to Dr. Tiltmann after noticing that folks with surgically repaired backs often end up requiring additional surgery into the future. This is not a pattern I am keen to join. It’s been a week since my McGill Method assessment and I feel... confident I have the knowledge/tools to make a full recovery and stay off the operating table. One thing that stands out is how invested Dr. Tiltmann is in my recovery. Because the assessment is a three hour allotment of time, Dr. Tiltmann is able to listen, diagnose and educate without cutting corners. He listens to every detail of your back history and helps you to understand the mechanics of back issues. I left knowing much more about the various back issues that exist (and those that I have). Knowledge is central to recovery in the McGill Method. Dr. Tiltmann performs an extensive array of tests to identify your pain triggers as well as positions to alleviate pain. The idea is to establish a knowledge foundation for how we will modify our movements in the future. Dr. Tiltmann was incredibly patient as I sometimes struggled to quantify pain levels. However, I now have a much better understanding of what aggravates my pain and which positions are more comfortable for me. Unfortunately, before the session I was practicing some pain inducing postures in my well-intentioned attempts to heal my back. Finally, Dr. Tiltmann coaches you through everyday movements and rehabilitation exercises. Some of these moves are foreign and require a bit of practice. Dr. Tiltmann was patient and helped every step of the way. Even going so far as to record me on my phone (with his voice over) moving correctly. He worked up an exercise regimen tailored around my specific pain triggers. I think the McGill Method assessment with Dr. Tiltmann is great value. Back problems are complex and personal, it requires time and effort to get a diagnoses/plan of attack correct. The three hour allotment (while reflected in the price) is necessary, and for this reason good value. Have you ever had a medical professional’s attention for three solid hours? I came to the session with a notebook full of questions but by the time we got to the Q&A at the end, virtually all had been addressed already. It’s a lot of information for a three hour period. Fortunately, Dr. Tiltmann provides a detailed report of the session for your reference. The videos regarding movement, exercises are helpful to ensure you continue to move correctly once you’ve left the office. And in case you forgot to ask a question or encounter challenges in the real world a follow up conversation is included. I’m very happy to have worked with Dr. Tiltmann and have already recommended him to family and friends. Best Ben"

McGill Method Testimonial 43-year-old male with low back tightness for 14 years but flared 5 years ago after having 1st child and moving poorly. Review is 4 months post McGill Method. Hi Dr. Tiltmann,... I am much improved, and only notice back tension when I do something physical without paying full attention to my form. In my normal day-to-day now I almost never notice any back tension. The most recent time when I noticed some back tension was while doing maintenance on a car that required me to be in an awkward position for over an hour, but that resolved pretty quickly! I have kept up with daily walking (I'm up to 60 minutes a day) and I am doing exercises, but not exactly the big three. I found that the curl-up continued to tighten my neck muscles, even after trying the neck exercises recommended in Dr. McGill's book, so I have switched to doing dead-bugs, which are much easier on my neck and shoulders (which are chronically tight from typing on a computer all day, every day). I have added glute bridges, which have made a big difference as well. I still do planks, and I do both side and front planks now. I did the bird dog for a couple months, and have now switched to doing step-ups on a 1.5 foot high step. I spent about two weeks just practicing good form, doing one step at a time as slowly as possible, and I find that it really helps with training my abs and glutes to work together. I've included answers to your questions below: 1) Did you receive a thorough history, examination and coaching session, which were later provided in report form? Absolutely. Your examination is one of the most thorough and comprehensive I have ever received in any context. 2) Was Dr. Tiltmann able to elicit your pain triggers as well as positions that alleviate the symptoms? Yes. 3) Did Dr. Tiltmann provide a better understanding of your back condition, how it became symptomatic, how to avoid aggravating it, and guide you on your path to recovery? Yes. The most valuable parts, for me, were the examination of my anatomy, including my hip depth, and the specific instruction for managing my specific problems. That information is in Dr. McGill's book, but even after a couple readings, I found it significantly more enlightening to have the examination. For example, I had done the "self test" recommended in the book, but had come to a different set of conclusions than Dr. Tiltmann did in his examination. His conclusions made much more sense than mine, of course. 4) Was Dr. Tiltmann able to answer your questions in a way that you understood? Yes, Dr. Tiltmann is a gifted communicator and teacher. 5) Did you find the McGill Method a good value and would you recommend it to family and friends suffering from chronic low back pain? Yes! I already recommend it to everyone I meet who has any sort of back pain. Charles

On 9/20/19, I performed a 3-hour McGill Method for chronic low back pain in San Francisco. Here is a quick recap. I will be in New York City next week where I have 5 McGill patients scheduled. I’m really looking forward to it. 31 year old male, 161 lbs. reported injuring his back in July 2015 lifting a fallen 600 cc motor cycle. He felt pain right away in central low back. Over the past 4 years, he was seen by multiple doctors and physical therapists, through Palo Alto Medica...l Foundation and Stanford Health Care. He was diagnosed with low back pain secondary to spondylolisthesis reported on MRI. This is an under diagnosis at best but really a missed diagnosis. The Spondy is simply an incidental MRI finding. Treatment was generic, ultimately ineffective and causing additional spine damage. After 4 years, he was told that there is nothing they could do expect symptoms relief with medication or injections. He was not considered a surgical candidate. Based on my history and physical exam findings, patient has lumbar instability at L3/L4, L4/L5 and L5/S1, intolerance to spinal extension > flexion, and has a neural underhook (when extending is neck in cobra position pain increases, when flexing his neck in cobra position pain reduces). His prognosis is excellent but he will require time to heal, perform the correct exercises correctly, and most important of all, use his spine and move in a spine sparing way. All this was coached and video taped in his 3 hour session. No further follow up visits are required. For more info; see www.fdchiro.com or backfitpro.com

There is a way to cure mechanical low back pain, and it’s not waiting for it to get better. And you can’t get it done in a 15 min. doctors visit. How about a 3 hour doctors appointment? Is that revolutionary? Actually figuring out why the patient has low back pain instead of masking the symptoms with meds. I work in San Francisco and New York city. Yesterday, I provided the McGill Method for a patient, with a 1 year history of chronic low back pain, that bent over to get some...thing out of the fridge. Her back pain flared-up, she fell to the ground and could not move, but she cried. Her McGill Method appointment, which she had scheduled August 8th, was later that day. She called and wanted to cancel because of her severe pain. I told her to come in and see me. She was 10 minutes late because her and her fiancé, who proposed at Burning Man, were selecting an engagement ring. She did all she could to contain her back pain while looking at rings. I spend 3.5 hours with her. At the end of our visit, I had her totally pain free and performing core exercises including; bird dog, side planks and curl ups. She thanked me, hugged me. We parted ways. I gave her the tools she needs to let her spine heal. It will take 1-2 year to re-stabilize her spine, which she damaged with Pilates. She has a 2 level spinal instability, L4/L5, L5/S1, she is flexion > extension intolerant. She will make a full recovery without further treatment. There are 4 McGill Method providers in the USA. www.backfitpro.com. We did not have an MRI and she didn't need one. https://www.salon.com//the-problem-with-mris-for-low-back/

Dr. McGill discusses lumbar herniations in this video clip. More info at www.fdchiro.com and backfitpro.com https://www.youtube.com/watch?v=3WAQ0q8iYX0&feature=youtu.be

Dr. Tiltmann is now licensed to practice in New York State. With so many people with chronic low back pain he wants to help those suffering, in the greater New York area, to have access to a 3-hour McGill low back assessment. These assessments are designed to be an encompassing single visit where the history, examination and movement coaching are all completed in a single 3 hour visit. Typically, chronic low back pain sufferers has seen a multitude of therapy providers, so they are usually not lacking from insufficient therapy. For more information about the McGill assessment or if you know of someone who is in need of an assessment, please reach out to us at (415)781-2225. Here are some links for additional information: www.fdchiro.com, www.backfitpro.com

"Chiropractic Eases Low Back Pain in Military Members" - Spine Universe Article. https://www.spineuniverse.com//chiropractic-eases-low-back

29 year old male patient with 4 year history of chronic back pain sends thank you note after 3 hour McGill assessment. If you need to schedule an appointment, please call the office at (415)781-2225 or visit our website at, www.fdchiro.com

Chronic low back pain discussed at One Medical in San Francisco. Dr. Kai Tiltmann talks about the Stuart McGill method of low back assessment. www.fdchiro.com, www.backfitpro.com https://www.youtube.com/watch?v=Ud7Y0F7cSVQ&t=53s

Don't let the tech neck epidemic wreck your spine. Learn how doctors of chiropractic can help manage your pain and improve overall posture. If you need to be seen and want to schedule an appointment, please call the office at, (415) 781-2225, or visit our website: www.fdchiro.com