There she was. I’m going to guess her age to be about 75 years old.I’ll call her Mary! I encountered Mary in a CVS pharmacy.  One block from my home are 5 big box pharmacies.  I am sure they positioned themselves there having “done the math.” A cluster of high rise buildings a block away are filled with elderly residents. People who are pumped with pills to keep them going rather than showing them the path to prevention and healthy living. I’m not anti-pharma but pills should be a second choice when exercise and nutrition have failed as medicine. I was looking for deodorant when this nice woman ran right into my mission! Next to the deodorant is the section for PAIN. Mary and I met like two star-crossed lovers. Lot’s of pills in all shapes and sizes as well as pads, potions, and gels. Mary grabs a tube of some blue goop and then turns toward me.  “Hey, you look like an athlete.  Does this stuff work?  I have a back spasm!” She places her hand on my lower back.  “Oh! How’d that happen?” I replied.  Bewildered, Mary says. “I’m not sure, maybe from walking my dog out in the cold weather.  It’s been so cold the last few days and I have been out less so maybe I’m just stiff.  It could be my mattress too!” Gently, I reply. “Well, I’ve tried that blue goop and it doesn’t work– just makes your skin feel tingly.” I was hoping she would ask me what does work? Instead, she gave me a real shock and said.  “I’ll try it anyway.  I’m sure with the prescription for pain my doctor gave me will make it go away.” “Is that ALL the doctor prescribed and advised for you??”  I asked.  “Yup!” Mary replied. And then she walked away… I was dumbfounded her doctor prescribed pills to treat her back pain.  Clearly, she would benefit from a few weeks of physical therapy to decrease pain, strengthen the muscles around her spine and improve her posture. It was clear she had poor posture.  Her gait pattern wasn’t great either– placing her at risk for falls and fractures. A recent study in the JAMA Internal Medicine September 2013 demonstrated trends in the management of low back pain are worsening.  Physicians have increased the use of narcotics and expensive scans to diagnose and treat back pain.  This is driving up cost and leading patients down a path of increased expense, addiction and away from prevention. Read the study here:  http://archinte.jamanetwork.com/article.aspx?articleid=1722522 As physical therapists we know exercise works to treat back pain.  Furthermore, we know a directional preference for exercise exists in most cases.  Check out this study by Long et al where 74% of the subjects studied showed a directional preference toward extension.  http://archinte.jamanetwork.com/article.aspx?articleid=1722522. So this is for Mary in aisle 5 at the CVS. Three basic exercises to decrease her pain, improve her kyphotic posture, strengthen her spine and keep her walking strong well into her 90’s! To your health!