Yes, this is about self-help, and maybe the worst kind of self-help: medical self-help. Some editions of this book are probably stocked on shelves next to books on the ill effects of radio waves, or on the use of crystals and rocks in dealing with cancer.

Yet, in the spirit of Illich’s Medical Nemesis, and the desperation induced by a few years of recurrent sciatica, I have decided to wade into the ocean of no-publisher, no-ISBN books, in order to reclaim some pieces of knowledge I usually give up to white coats wearing people and medical PhDs having people. Bien m’en a pris.

(McGill is one of the white coats/MD, and runs what appears to be a successful clinic. Also, his book does have an ISBN. So we still are quite away from the crystals.)

I won’t try and summarize here what amounts to medical advice. He has (what looks like) pretty reasonable ideas and doesn’t overpromise.

Quite simply, he considers that :

• Patients are ill informed about their body and backs. He provides an extensive description of back mechanics. The most striking idea I got from this was the differentiation between limbs and torso. Limbs move while the torso takes the counter-movement in. Meaning : good posture is about maintaining a straight back/torso, and not letting the back be over-swayed by the limb movements. In line with this, he advocates for endurance training rather than strength training: because this is what the small but continuous effort provided by the back and torso calls for.

• Most medical professionals do not diagnose precisely enough back issues. Their prescription is too generic (the usual “be more active, do yoga, build more muscle”) to be efficient. He demonstrates a few self-administered tests to better identify where (which vertebrae) and what the problem is (nerve, disc, muscle…), and provides specific exercises as well as advice on proper form.

• Worse than inefficient exercises are the ones that can worsen a condition. A large part of the book is about them (notably, the back on the floor, knee-to-chest "relief" posture), as well as a short list of safe exercises (notably demonstrated in videos under the tag, "The Big Three"), and a program including walking and some endurance training.

• Back issues are about health as much as about pain management. He relies on the gate theory of pain (gain control theory): if the sensory checkpoints can be overloaded with non-painful sensations, then the pain won't be felt as much. Hence the importance of "finding and repeating pain-free motions in your back (that) will cause the remaining painful activities to hurt less".

• Surgery is an option, but there are some criteria and questions to be answered before - he shares them and offers tips to navigate that part of the medical field.

Reading this is another confirmation that medicine is more art than science, and that this is the worst part of society to behave like a passive consumer.

It reinforced my desire to build a personal medical bookshelf, and maybe stop relying so much on inefficient practices born out the inflation of medicine at the expense of general health.

Also, I have been sciatica-free for three weeks now.