Health: Does this man understand something about back pain that nobody else knows?
Tuesday 14 October 1997
Today my mother sneezed without it hurting her for the first time in over a year; this is because she has undergone a revolutionary cure for two slipped discs. The non-surgical method, administered by a distinguished Glaswegian surgeon, involved nothing more complicated than a jab of local anaesthetic and a few brief sessions on his couch.
Alexander Walker-Naddell, a consultant orthopaedic and neurosurgeon, developed his technique after years in which he became increasingly dissatisfied with the results of conventional surgery for back problems.
At 87, he is one of Britain's oldest practising doctors, with a private orthopaedic surgery in the centre of Glasgow. He numbers Stanley Baxter, Max Bygraves and the Scottish golfing star, Craig Breedlove, among the many celebrities to whom he has brought relief from back pain.
Before her remarkably brief encounter with Mr Naddell my mother, aged 50, had undergone traction, chiropractic and osteopathic treatment for two severely slipped discs in her lower back. She had slept on hard beds, soft beds and in various contorted positions, but with no result other than continuous, debilitating pain.
She was finally told by a highly reputable neurologist that she would need surgery to remove the discs and replace them with metal plates in an operation known as a laminectomy. She could look forward to a six-month, bed-ridden convalescence with less than a 50 per cent chance of successful recovery. For a woman who lives for and thrives on physical activity, the prospect of never being allowed to garden or to take long walks in the countryside again was both terrifying and depressing.
There was even a risk of paralysis, which sometimes results from a vertebral column operation. As a family we ended up discussing her will over dinner and what action she would want us to take if the operation was to go wrong. Then enter Mr Naddell and, as if by magic, today my mother has just charged off up her favourite hill without even a twinge of pain.
Mr Naddell developed his technique at Glasgow Royal Infirmary nearly 40 years ago, after spending a decade dissecting bodies in the hospital's pathology department. "I didn't accept the anatomy of the spine as it was presented to me in the books," he comments, "so I had to find out for myself".
His research led to an astounding discovery. "I studied thousands of bodies and found that many of them did not have any vertebral discs. I then contacted their families and found that 90 per cent of the deceased had never experienced back problems. We do not need our discs; they are not an essential part of one's anatomy."
Mr Naddell maintains that the discs are not, as is commonly thought, the shock-absorbers of the spine, but the vestigial remnants of a primitive structure seen only in the foetus. The shock-absorbing role referred to is actually played by the fibrous ligaments surrounding the discs. These are made up of rings of cartilage which act as a coil or spring between the opposing vertebrae.
A slipped disc can be caused by constant wear and tear or a sudden strain on the back.It is the protrusion of the jelly-like substance which forms the disc through a tear in the ligament, which causes pain if it strikes a nerve root. By removing the disc, the pain is eradicated.
Mr Naddell's technique is simple. His consulting room is small, cosy, and festooned with military medals and he welcomed us in a relaxed manner with a smile. He required no X-rays or description of previous diagnoses made by other consultants, informing us that "I must make my own investigations or I wouldn't be giving it my best shot".
During his investigations and the whole of his treatment, my mother never even had to remove her shoes; she simply had to hold up her jumper so that he could examine her back. Then, using the largest, fleshiest thumb that I have ever seen, resulting from Mr Naddell's days as a champion student boxer, he proceeded to diagnose the condition using only touch, describing the symptoms that the neurologist and orthopaedic surgeons had required scans to detect.
The only instruments that he uses other than his thumbs are a hammer to test reflexes, aiding his diagnoses, and a syringe to inject a local anaesthetic into the affected area. "There does not need to be any fuss. It seems to me an unfortunate medical practice that, in order only to confirm a diagnosis, one should actually aggravate the condition one is about to try and clear up. I don't believe it is necessary to cause further pain to the patient with my diagnosis and treatment."
The treatment involves slow strong pressure on the disc with his fleshy thumb. By using the jagged edges of the ligament through which the disc is poking, he simply breaks off the protruding piece of vertebral disc. Now cut off from its food supply, this will then waste away.
Next, on an orthopaedic couch disguised by a tartan rug (her shoes still on), he begins to gradually straighten out my mother's spine, through manipulation of her leg and pelvis. Throughout the treatment Mr Naddell chats about the weather: although it is raining, he comments "the sun is shining somewhere", and we leave the surgery after only 30 minutes.
We return for five more 15 minute sessions over three days, but my mother's spinal pain has disappeared after only the second session. Between the treatments, she has to undertake specific exercises four times a day to encourage any remnants of the discs to slip out of the ligaments so that Mr Naddell can break off the protrusions, until all the offending discs have been removed. She is then given a training programme to carry out for at least two weeks after the treatment.
The treatment seemed so painless and undramatic that it has taken some time for my mother and I to be finally convinced that it has worked. But the continuing lack of pain and the file full of letters from patients thanking Mr Naddell for his treatment substantiate his claims of a high success rate. "I've been practising for nearly 40 years now and my very first patients are still fit and healthy. I have letters of thanks here from thousands of patients from the four corners of the globe. I rely wholly on word of mouth and my reputation because the medical profession are not allowed to advertise."
He remains, however, disheartened that his technique has not been more widely taken up. "I have said to many surgeons, `show me a perfect, surgical result as good as mine and I'll change my methods' - and they never have. I don't know why they won't listen to me. They continue to put this ironmongery into people's backs. Bone and metal just don't mix."
As proof, Mr Naddell thrusts a letter at us from a reputable Glaswegian orthopaedic surgeon which states that, following examination of one of Naddell's patients, "there is no indication for any surgical investigation or intervention at this stage. Indeed, if I had operated upon this patient myself I would regard this as a very good result." Many other surgeons have shown an interest in Naddell's work but as yet there has been no scientific trial of his simple technique.
He will not give up, however. As we leave his consulting room for the last time, he promises, with his usual beatific smile: "I will never retire. When I go, I will go with my boots on."
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