PREFACE

As a specialist in Physical Medicine and Rehabilitation, I have seen thousands of patients suffering from back pain over the years.  During the first several years of my practice, I followed the current update from medical journals and seminars in addition to the previous textbooks and teachings of my professors for diagnosis and treatment.  Even with my best effort, I was unable to cure back pain, leaving me and my patients very frustrated.  This bothered me quite a bit.  I just could not accept the notion that back pain is incurable in this high-tech modern era.  So I took a step back, trying to figure out why back pain is such a tough problem.  I soon suspected that back pain must have come from muscles instead of spine or nerves.  I then redirected my focus and started treating muscle injury, consistently obtaining satisfactory results, even cure in some cases. 

 

Having many questions, yet little knowledge and no books or teachers for guidance regarding muscle injury, I had to search alone in the dark for answers without knowing where to go and what to look for.  Relying on common sense and keen observation, I learned a great deal from carefully examining and treating my patients.  I analyzed many medical writings with skepticism as well as verification.  I also experimented with nearly all the available treatments.  I began to see some light through the inner working of pain.  I was able to break the myths, one after another, and eventually come out of the maze.  After considerable experience, I was finally convinced that back pain is actually derived from soft tissue injury, not bone spur, disc herniation, pinched nerve, sciatica, arthritis or other spinal conditions as written in the medical books.  Therefore, I determined: Soft tissue injury is the culprit of back pain.  A diagnosis with no regard to soft tissue injury is deemed to be a misdiagnosis; a treatment with no regard to soft tissue injury is deemed to be ineffective

 

I unknowingly stumbled into a new field of “soft tissue injury”.  I was surprised and shocked to find how primitive and uncultivated the field is in modern medicine.  No wonder there are numerous errors in the diagnosis and treatment of back pain as well as other pain-related conditions.  In diagnosis, the cause of pain is often misleading, non-specific or unknown, not pointing to the real source.  In treatment, based on a misleading diagnosis, it is understandably out of focus, ineffective, and largely symptomatic relief at best, but no cure.  Thus, so many pain-related conditions remain unresolved for years despite all medical resources.  Patients have suffered so much for so long, still longing for a cure.  How unfortunate it is, but how wonderful it will be to have a cure!

 

 So I set out to search for a cure, charging forward with determination and diligence.

 

 In my early efforts, I treated only the injured muscle and managed to soften its tight nodule.  Before long, I realized that its attachments must also be treated and tried a slightly lighter technique to treat them.

 

 Later, I understood the relationship between injury and muscle strength and that muscle strength is a key element in the diagnosis of pain.  Pain interferes with muscle exertion and limits the output of strength; thereby most of muscle weakness is actually muscle strength limited by pain.  Once pain is removed, strength returns to normal immediately.  Thus, muscle strength can be utilized as a reliable factor in the diagnosis as well as in the measurement of the efficacy of treatment. 

 

Then, I also learned that exercising an injured muscle often irritates and worsens its injury causing further weakness.  To restore muscle strength, injury must first be resolved but not with exercises.  I always treated the injury without any strengthening exercise.  Furthermore, most soft tissue injury actually comes from exercises; I realized that there is too much risk and little benefit in exercise.  I hereby advocate suitable activity instead by downplaying the importance of exercise while alerting the risk of its harm so as to reduce or even prevent the occurrence of soft tissue injury.           

 

In addition, I found that fascia plays an essential and utmost important role in pain.  This new concept was monumental!  It helps clarify various pain-related conditions.  I devised an effective way to treat fascia injury.

 

It has taken me quite some time, through trial and error, to find ways of identifying the precise source of pain and the optimal method of curing pain.  All these years, I have been sharpening my skills to master the simplest, most effective and efficient techniques to cure pain.  Initially, I applied vigorous massage trying to break down tight muscles, based on physics.  Although still somewhat effective, it hurt my patients and my hands.  There is also the limitation that massage cannot be done to certain small parts of the body.  I attempted various existing and creative methods searching for a better solution for years in vain.  My “eureka!” aha moment came one day (Easter Day 2005) when I tried light touch on a patient (my niece, Alice) who was horrified of pain and could not tolerate massage on the injured site.  I was surprised to feel the injured tissue immediately softening under my fingertips until no more pain or tightness.  By accident, I discovered a previously unknown and unutilized physiological phenomenon that light touch elicits body response for self-healing reversing the injured tissue to its normal state, and thus pain disappears.  Light touch works very well on the muscle and especially the fascia.  It can be applied to soft tissue injury of any site and size.  I have since replaced physics with physiology so that painful injury can be quickly resolved and there is little pain hurting my patients or my hands during treatment.  This simple, low-tech, highly efficient and truly effective method has become a terminator of pain and the very tool to cure injury. 

 

The same principles of diagnosis and treatment can be successfully applied to pain anywhere in the body, even extending to other pain-related conditions. 

 

Little by little, over a forty-year span, I have cumulatively established the theory and application of The Precision Method using Touch-and-Hold & Stretch-and-Hold techniques for soft tissue release.  With this method, injured sites are precisely identified and effectively treated toward a cure.  Any pain-related condition can definitely recover in a very short time without recurrence, regardless of new or old, mild or severe, tiny or large, body part or location.  There is no risk or side effect.  Costly tests, medications, injections, surgeries as well as tools, devices, machines are not needed, thus medical expenses can be greatly reduced.  I am excited about this breakthrough and eagerly reaching out to bring good tidings to those in need.  

 

This book is written entirely based on my personal understanding and clinical experience and for the first time to introduce “The Precision Method”.

 自序

筆者係物理復健專科醫師,幾十年來看過腰酸背痛的病人,不知凡幾?少說也有上萬。早先數年依照所學之醫學教科書、教授之授課及臨床指導、醫學期刊與學術研討會的新知,循規蹈矩地作診斷與治療;即使精心盡力,總是難以根治,效果令人失望,病人懊惱,我也十分困惑,何以在這高科技時代竟仍治不好?我的個性偏不信邪,不認為腰酸背痛真的應該如許難纏,便退而檢討解析。不久,我懷疑腰痛極可能來自肌肉傷,而非脊椎或神經的問題。於是,改以檢查肌肉,果然又緊又痛,按摩治療之,概皆成效良好,有些甚至得以根治。

 

起初,面臨許多疑難,苦於對肌肉傷痛所知有限,在既無書又無師的情況之下,獨自摸黑找答案,茫然不知從何著手,也不懂在搜尋什麼,唯有借助常識辨析及觀察體驗,從臨床診療中學習,仔細檢測,審慎探究,潛心研討各種論述,不斷質疑求證,並實際試驗幾乎所有的現行療法,逐漸尋出脈絡,一一破除迷思,擺脫窠臼,儲積了足夠的經驗,終於柳暗花明,啟開奧秘。從此確認,腰痛原來是筋肉傷所致,絕非書本所言的骨刺、椎間盤突出、壓迫神經、坐骨神經痛、關節炎或其他脊椎病變。總結言之,腰痛都是筋肉傷惹的禍。診斷若不檢查筋肉,便誤入歧途;治療若不及於筋肉,就徒勞無功。

 

如此無意間闖進「筋肉傷」的嶄新領域,驚見現代醫學在這方面的知識,渾沌未闢,一片貧瘠,因而錯謬百出,難怪對諸種疼痛病症的診斷,含糊迷歧、偏差離譜,始終未搔到癢處;診斷既已錯失,治療遂不對症,落得揚湯止沸、治標不治本,甚至胡為盲撞,療效極差,終成久醫不癒的無解難題。患者多遭誤導去做無益的檢驗與無效的治療,浪費金錢、時間、心力、醫療資源,而沉疴猶存,依舊捱痛嗷嗷待救。實在太冤枉!太可惜!若能根治,該有多好!

 

於是,我矢志尋求根治之方,全力以赴。

 

首先,我用按摩治療受傷的肌肉,設法鬆開硬塊,很快就察覺到骨頭表面的肌肉附着處必須兼顧才行,便以較為輕緩的手法試之。

 

我漸漸搞懂了肌力與筋肉傷的關係,傷痛阻礙肌肉的運作,力道變弱,肌無力(使不上力)多係肌肉受制於疼痛之故,一旦治傷袪痛,肌力立刻恢復正常;肌力對疼痛的診斷頗具關鍵,乃是檢查傷處及驗證療效的要素。

 

後來,我體會出操練肌肉會刺激傷處使之惡化,肌力不增反減,要恢復肌力,必須先療傷,不能靠運動,治療時我刻意排斥強肌運動。更爾,絕多的筋肉傷乃是運動所造成,我深悟並認清運動的好處太少、壞處太多,在此呼籲,吾人必須貶低運動的重要性,同時強調運動的危害性,代以適當的活動,俾能減少甚而預防筋肉傷。

 

此外,我發見筋膜在疼痛中扮演極其重大的角色,這個新觀念是瞭解各種疼痛相關病症的一大轉機,我也逐漸揣摩出筋膜傷的診治。

 

許多年裡,由失誤中學習,從挫折中探討,致力尋找疼痛的確切根源與對症療法;在技巧上持續改進,精益求精,希望鑽研出最簡易、有效、快捷的治療方法。初期依物理原則,用力壓揉緊硬的肌肉,按摩予以鬆開,稍具療效,但是病人喊痛,治療者也手痛;況且按摩有其局限,隱密及細微處無從下手。我用心嘗試各種傳統與創新的療法,一直找不出更好的方法。某天(二ΟΟ五年復活節)轉捩的契機忽地臨門,一位病人(甥女張亮芳)極為怕痛,不肯按摩弄痛傷處,我只好改以輕按代替壓揉,不期然竟感覺到,指尖下緊痛的傷處即刻反應,漸趨鬆軟,至於不緊也不痛,令我萬分驚訝,驀地恍悟出一個現象:輕按傷處能啟動人體的自癒功能,病變迅速復原,疼痛隨即消失。這是身體原本就有的生理功能,歷來沒人知曉,也不懂得應用;我意外地發現了除痛的奧妙,恰是「終日尋春不見春,芒鞋踏破嶺頭雲,歸來笑拈梅花嗅,春在枝頭亦十分」,果爾「踏破鐵鞋無覓處,得來全不費功夫」,不啻天賜的奇蹟!輕按對筋肉(尤其是筋膜)傷的療效特佳,無論大小、部位,甚至沒法按摩的細密處,皆可治之而癒。我乃放棄物理原則而改依生理原則,輕按治療時病人不痛,治療者的手也不痛。這種低科技的徒手療法,對筋肉傷的鬆解與痊癒確具實效,簡便容易又快速,儼然成為疼痛的剋星、療傷的利器。

 

腰痛之外,引申到全身各部位,及於諸種疼痛疑難雜症,一概適用不爽。

 

筆者耗費時日四十年,一點一滴累積知識與經驗,終於開創出以輕按候住及輕拉候住手法專治筋肉傷的精準療法(Touch-and-Hold & Stretch-and-Hold of The Precision Method),建立其理論與實際,完成體系。此法可精確找出傷處,疼痛不管新舊、輕重、大小、部位,短期內便能輕易根除,而且治癒之後,不虞復發。不必吃藥、打針、開刀,無需工具、儀器、器械,沒危險性、副作用,既省事、省時,也省大筆醫療花費。筆者慶幸有此重大的突破,爰立下心願,將之推廣,盼能帶給疼痛患者,根治的佳音。

 

本書完全根據個人對治療疼痛的認知心得和臨床經驗而寫,並介紹筆者首創的精準療法。

 

 * 本書比照筆者的英文原著:《NO MORE PAIN》All Pain Considered—A Breakthrough 2020年最新增訂版而寫。