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.
I've had chronic sciatica for over 2 years now and i can tell you that I only started slowly getting better when I finally stopped avoiding spine flexion (pulling knees to chest and bending over) and stopped doing forced spine extension (cobra pose, etc). I'm glad you found relief with McGills approach, but It's just one of many viable approaches. I feel like many people get recommended this book early on and get indoctrinated into never trying anything else. There's somewhat of a cult surrounding this book. I still haven't got around to actually reading it though. I guess if I don't completely heal, I'll eventually get around to it.
Oh you're right: it's not the sole approach I have used, but it got me to be more aware of the way I moved, and gave me tools for immediate and long-term relief. Actually, the Sarno approach (somatic/tension related) helped too: at some point, a lot of my pain was coming from the anticipation of it and the bracing seemed to cause unnecessary painful tension. Just knowing it helped me relax and get out of it.