It is rare when something comes along for it to offer both a system of diagnosis and a protocol for treatment. The painstaking work that has gone into the development of the MAST Medical, and in particular by the director Dr Hanne Albert, is very welcome.

The new MAST Medical treatment provides help for a group of patients who do not get better whatever a practitioner does to them, or suggests by way of exercises. Precisely such patients who are invariably worse at night, especially when turning over in bed, and  then worse in the morning and the evening, and worse for exercise, I would consider suitable for this form of treatment. The characteristic of this group of patients is that they all have Modic changes, which means that on MRI scan changes can be seen relating to infection. MAST Medical offers them help and the prospect of an effective outcome.

The infection gains access to the body typically following an intervertebral disc herniation or prolapse. The blood supply which develops and assists the disc to heal is also the route of access for infection. This does not mean that everybody with a disc herniation goes on to develop Modic changes; in fact it is a relative small number that do. Once this infection is established, a fairly long course of antibiotics is the only treatment that works, though the time can be reduced if laser treatment is given as well.

When I consider the profiles of my current patients, the Mast Medical treatment is not strictly relevant as it does not apply to the majority of sufferers from low back pain. In the main, the patients who come to me are better for a nights’ sleep and, usually, better for exercise, though they may have a little stiffness first thing in the morning.

As a patient, the criteria for deciding if you are a suitable case are;

• if you have pain at night
• if you are woken at night by turning over in bed
• if you are worse in the mornings and evenings, and a little better in the middle of the day
• if it hurts to bend forwards sufficiently that you would prefer not to do it
• if the pain is made worse by any sort of exercise, however gentle
• if you have not responded to treatment
• if the onset of your back pain is some months after you had a disc herniation (PID or slipped disc)
• if your problem does not show up on X-ray

Then you should consider Modic changes as the reason for your problems.

Joyce Vetterlein Osteopath
Broadgate Spine & Joint Clinic