Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery

by Cathryn Jakobson Ramin

Overview

The acclaimed author of Carved in Sand—a veteran investigative journalist who endured persistent back pain for decades—delivers the definitive book on the subject: an essential examination of all facets of the back pain industry, exploring what works, what doesn't, what may cause harm, and how to get on the road to recovery.

In her effort to manage her chronic back pain, investigative reporter Cathryn Jakobson Ramin spent years and a small fortune on a panoply of treatments. But her discomfort only intensified, leaving her feeling frustrated and perplexed. As she searched for better solutions, she exposed a much bigger problem. Costing roughly $100 billion a year, spine medicine—often ineffective and sometimes harmful —exemplified the worst aspects of the U.S. health care system.

The result of six years of intensive investigation, Crooked offers a startling look at the poorly identified risks of spine medicine, and provides practical advice and solutions. Ramin interviewed scores of spine surgeons, pain management doctors, physical medicine and rehabilitation physicians, exercise physiologists, physical therapists, chiropractors, specialized bodywork practitioners. She met with many patients whose pain and desperation led them to make life-altering decisions, and with others who triumphed over their limitations.

The result is a brilliant and comprehensive book that is not only important but essential to millions of back pain sufferers, and all types of health care professionals. Ramin shatters assumptions about surgery, chiropractic methods, physical therapy, spinal injections and painkillers, and addresses evidence-based rehabilitation options—showing, in detail, how to avoid therapeutic dead ends, while saving money, time, and considerable anguish. With Crooked, she reveals what it takes to outwit the back pain industry and get on the road to recovery.

Product Details

ISBN-13:	9780062641793
Publisher:	HarperCollins
Publication date:	05/08/2018
Edition description:	Reprint
Pages:	432
Sales rank:	227,911
Product dimensions:	5.20(w) x 7.90(h) x 1.10(d)

About the Author

Investigative journalist Cathryn Jakobson Ramin is the author of Carved in Sand: When Attention Fails and Memory Fades in Midlife, published by HarperCollins in 2007. Her new book about the back pain industry, Crooked, will be published in April 2017.  She’s written for many national magazines on topics that include healthcare, neuroscience, business, public policy,  travel, art, design and culture.  A popular speaker, these days, she’s booking lectures that enlighten patients,  health care practitioners, corporations and medical facilities about how to manage back pain. Cathryn is married to Ron Ramin, a music composer. They have two adult sons, Avery and Oliver, and a Jack Russell-Daschundt mix dog named Dasch, after the punctuation mark, which he resembles. She divides her time between Northern California and New York City. Facebook: http://bit.ly/fbcrooked . Twitter: @cjramin

Table of Contents

Introduction: A Terrible Affliction: When I Went Looking for a Solution, I Found a Much Bigger Problem 1

Part I Problems

1 Back Pain Nation: How We Got Into This Mess 7

2 A Tale of Two Tables: Why Back Patients "Fail" Chiropractic Treatment and Physical Therapy 19

3 Hazardous Images: Why You Do Not Need-Or Want-To Have an MRI 45

4 Needle Jockeys: How Epidural Steroid Injections Can Go Wrong 55

5 The Gold Standard: Why Lumbar Spinal Fusion is Never Your Only Remaining Option 73

6 Google Your Spine Surgery: The Truth About "Cutting-Edge" Procedures, as Advertised Online and on TV 103

7 Replacement Parts: Why a Bionic Lumbar Spine is not in the Cards 132

8 The Opioid Wars: How Chronic Opioid Therapy Keeps You in Pain 153

Part II Solutions

Introduction to Part II 177

9 Head Case: What Your Brain has to Do with Your Back 179

10 The Back Whisperers: How to Find a Rehabilitation Partner 219

11 The Right Kind of Hurt: How a Much-Maligned Machine May Still Change Everything 260

12 The Posture Mavens: How to Make Gravity Your Friend 284

Conclusion: Six Years Later 325

Acknowledgments 331

Notes 335

Bibliography 379

Index 385

Editorial Reviews

[Crooked] details the nature and results of virtually every current approach to treating back pain.” — Jane Brody, New York Times

“Written by veteran investigative journalist and back pain sufferer Cathryn Jakobson Ramin, Crooked highlights how traditional treatments such as chiropractic, surgery and injections are largely ineffective. Ramin argues the psychological impact of back pain… is so severe that people are compelled to pursue any possibility of relief.” — New York Post

“Ramin decided to deploy her skills as a journalist and investigate the $100 billion back pain industry. She went on to write Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, an incredible tale of back pain and its treatment, published last May.” — Vox

“Ramin offers a thoughtful and heartfelt way … to treat one of humankind’s most debilitating disorders–chronic back pain. A remarkable guide from someone who unfortunately had to make the journey, and found her way out.” — Paul A. Offit, MD, author of Pandora’s Lab: Seven Stories of Science Gone Wrong

“I see back pain patients who have undergone invasive procedures before they go through evidence-based rehabilitation. In a most engaging way, Cathryn Jakobson Ramin tells it like it is. Whether you’re a patient, a physician, or a public policy wonk, you should read this book.” — Vijay Vad, MD, sports medicine specialist at the Hospital for Special Surgery, and author of Back RX

“Ramin has written a riveting and disturbing account of a sector of American medicine that’s gone very wrong…. Politics, science, history–it’s all in there, along with concrete advice for fellow sufferers. Policymakers can learn from this book, and patients can, too.” — Jonathan Cohn, author of The Untold Story of America’s Health Care Crisis and The People Who Pay the Price

“[A] thoroughly reported first-person take on the back-pain industry . . . Buyer beware! This cautionary book ends on a high note with the once-hobbled-by-back-pain author standing up straight and hiking a 13,000-foot trail in the Peruvian Andes.” — Booklist

“…[A] well-researched and fascinating read detailing the heart-wrenching experience so common to millions of back pain sufferers. Ramin exposes the devastating financial and emotional cost of back pain…Ultimately, her in-depth research lights the way to a better path for healing.” — Miranda Esmonde-White, New York Times bestselling author of Forever Painless

“For most people, the key to preventing—and relieving—back pain is to simply keep moving, says Cathryn Jakobson Ramin, author of Crooked… An investigative journalist and chronic back pain sufferer herself, Ramin shares what she learned after six years of researching solutions for this common complaint.” — Shape

“Crooked weaves together her compelling personal story and those of compatriots in back pain of all ages.” — Quartz

“This is one of those books where you will keep reading parts aloud to your partner—and sending copies to your loved ones. Don’t miss it.” — Spirituality and Health Magazine

Ramin, an investigative journalist by trade, published a book in May examining the back pain and spine surgery industries… Crooked is based on… Ramin’s experience managing chronic back pain. She describes spending money on unsuccessful treatments and pairs her personal narrative with statistics and interviews with spine specialists. — Becker’s Spine Review

“In her book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, Ramin exposes the motive behind frightening diagnoses and the influence of pharmaceutical companies. In addition, she shatters assumptions about surgery, chiropractic methods and spinal injections.” — the Waking Times

“Ramin’s search for better treatments, paired with four decades as an investigative journalist, resulted in her latest book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery. The book’s conclusions are a sweeping indictment of a $100 billion industry.” — MarketWatch

“Ramin’s new book, Crooked, pulls back the curtain on the back pain industry and provides strategies for navigating the plethora of treatment options.” — KQED Radio

“Herself a back pain sufferer, [Ramin] chronicles her odyssey, touching on virtually every option, conventional and alternative, for back pain.” — Ronald Hoffman, MD, Intelligent Medicine

From the Publisher

Ramin offers a thoughtful and heartfelt way … to treat one of humankind’s most debilitating disorders–chronic back pain. A remarkable guide from someone who unfortunately had to make the journey, and found her way out.

Paul A. Offit

Ramin has written a riveting and disturbing account of a sector of American medicine that’s gone very wrong…. Politics, science, history–it’s all in there, along with concrete advice for fellow sufferers. Policymakers can learn from this book, and patients can, too.

Jonathan Cohn

Written by veteran investigative journalist and back pain sufferer Cathryn Jakobson Ramin, Crooked highlights how traditional treatments such as chiropractic, surgery and injections are largely ineffective. Ramin argues the psychological impact of back pain… is so severe that people are compelled to pursue any possibility of relief.

New York Post

For most people, the key to preventing—and relieving—back pain is to simply keep moving, says Cathryn Jakobson Ramin, author of Crooked… An investigative journalist and chronic back pain sufferer herself, Ramin shares what she learned after six years of researching solutions for this common complaint.

Shape

Ramin’s search for better treatments, paired with four decades as an investigative journalist, resulted in her latest book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery. The book’s conclusions are a sweeping indictment of a $100 billion industry.

MarketWatch

Ramin’s new book, Crooked, pulls back the curtain on the back pain industry and provides strategies for navigating the plethora of treatment options.

KQED Radio

Crooked weaves together her compelling personal story and those of compatriots in back pain of all ages.

Quartz

Ramin decided to deploy her skills as a journalist and investigate the $100 billion back pain industry. She went on to write Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, an incredible tale of back pain and its treatment, published last May.

Vox

Written by veteran investigative journalist and back pain sufferer Cathryn Jakobson Ramin, Crooked highlights how traditional treatments such as chiropractic, surgery and injections are largely ineffective. Ramin argues the psychological impact of back pain… is so severe that people are compelled to pursue any possibility of relief.

New York Post

I see back pain patients who have undergone invasive procedures before they go through evidence-based rehabilitation. In a most engaging way, Cathryn Jakobson Ramin tells it like it is. Whether you’re a patient, a physician, or a public policy wonk, you should read this book.

VIJAY VAD

Herself a back pain sufferer, [Ramin] chronicles her odyssey, touching on virtually every option, conventional and alternative, for back pain.

Ronald Hoffman

This is one of those books where you will keep reading parts aloud to your partner—and sending copies to your loved ones. Don’t miss it.

Spirituality and Health Magazine

…[A] well-researched and fascinating read detailing the heart-wrenching experience so common to millions of back pain sufferers. Ramin exposes the devastating financial and emotional cost of back pain…Ultimately, her in-depth research lights the way to a better path for healing.

Miranda Esmonde-White

[A] thoroughly reported first-person take on the back-pain industry . . . Buyer beware! This cautionary book ends on a high note with the once-hobbled-by-back-pain author standing up straight and hiking a 13,000-foot trail in the Peruvian Andes.

Booklist

I see back pain patients who have undergone invasive procedures before they go through evidence-based rehabilitation. In a most engaging way, Cathryn Jakobson Ramin tells it like it is. Whether you’re a patient, a physician, or a public policy wonk, you should read this book.

Vijay Vad

In her book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, Ramin exposes the motive behind frightening diagnoses and the influence of pharmaceutical companies. In addition, she shatters assumptions about surgery, chiropractic methods and spinal injections.

the Waking Times

Ramin, an investigative journalist by trade, published a book in May examining the back pain and spine surgery industries… Crooked is based on… Ramin’s experience managing chronic back pain. She describes spending money on unsuccessful treatments and pairs her personal narrative with statistics and interviews with spine specialists.

Becker’s Spine Review

[Crooked] details the nature and results of virtually every current approach to treating back pain.

Jane Brody

04/17/2017
Veteran journalist Ramin (Carved in Sand) spent six years researching her latest topic, conducting 600 interviews for this comprehensive investigation. She also personally explored a number of back-pain solutions—as human lab rat, the author took notes while being examined in her underwear (a first, she observes, “in over three decades as an investigative reporter”) and observed disc surgery while cloaked in scrubs. Although she experienced chronic back pain herself, her personal story isn’t shared until chapter 10; the book’s first half is instead a riveting exposé of the back-pain industry, critiquing such common treatments as lumbar spinal fusion, epidural spinal injections, and opioid prescription. Though Ramin asserts that she knew very little about the back-pain industry when she began her research, she soon realized that she was delving into a checkered subject with “twists, turns and corrupt characters” worthy of a Le Carré novel. Ramin offers two approaches to her text: readers may begin with a chronological study of various medical techniques and their efficacy (or lack thereof), or they may jump into part two (“Solutions”) first, where they will encounter a much more optimistic exploration of back rehabilitation, exercise, Iyengar yoga, tai chi, and other nonoperative approaches. This book will be of particular interest to back-pain sufferers and health care professionals. Agent: Michael Carlisle, InkWell Management. (May)

Publishers Weekly

[A] thoroughly reported first-person take on the back-pain industry . . . Buyer beware! This cautionary book ends on a high note with the once-hobbled-by-back-pain author standing up straight and hiking a 13,000-foot trail in the Peruvian Andes.

Booklist