What do your bowel movements have to do with back pain?: Q&A with Chiropractor, Author, and Inventor, Dr. Todd Sinett
Published June 15, 2021
| Written By
SpineNation Editorial Staff
| Medically Reviewed by
Jerry Nichols, MD
Dr. Todd Sinett, an expert in applied kinesiology and pain, is a chiropractor, founder of Tru Whole Care, inventor of the Backbridge, and author of The Good Sh*t, 3 Weeks to A Better Back, and The Back Pain Relief Diet, among other titles.
Dr. Sinett is a second-generation chiropractor, following in his father's footsteps. He is a graduate of New York Chiropractic College.
Dr. Sinett sat down with us to discuss the connection between our digestive health and inflammation in the spine.
Dr. Sinett is a second-generation chiropractor, following in his father's footsteps. He is a graduate of New York Chiropractic College.
Dr. Sinett sat down with us to discuss the connection between our digestive health and inflammation in the spine.
Dr. Sinett, how did you become the poop expert? How did you come to be known for that, and how did that become an area of expertise?
My father was a chiropractor for about 15 years. In 1975, he bent down to pick up a tennis ball one day, and his back went out. His back pain became so severe that he was bedridden for nine months. No one could help him.
He went to every known profession, including his own, and the consensus was they had no idea what was going on. He was having severe back spasms, but it wasn't clear why. Finally, one doctor recommended exploratory surgery, which was not a very good option.
He wound up going to this doctor with a very different approach. This doctor really wanted to get to the answer to why my dad had this back problem in the first place.
This doctor surmised that my father's diet was filled with sugar. Back then, the belief was that you could eat anything you wanted, and you were healthy as long as you were thin. So, his theory was that the sugar was upsetting the digestive system. And then his digestive system was reflexing, affecting the muscular system, putting his back into spasm.
My dad had the choice of changing his diet or having exploratory back surgery, which wasn't a very difficult decision. So, my father changed his diet and had some manual (chiropractic) adjustments done by this doctor, and lo and behold, his pain was 100% cured in two weeks.
This was sort of the beginning of the correlation and linking of digestive function and back pain. I will tell you that this is the largest missed opportunity to help people, where no one is talking about the linkage between diet and back pain.
The only linkage that people have come up with is that if you are heavy, you carry around more weight, putting more pressure on the discs or your back, so you want to lose the weight. But that's a flawed model; it's not the additional structural weight; it's the gut inflammation and irritation that affects the muscular system.
He went to every known profession, including his own, and the consensus was they had no idea what was going on. He was having severe back spasms, but it wasn't clear why. Finally, one doctor recommended exploratory surgery, which was not a very good option.
He wound up going to this doctor with a very different approach. This doctor really wanted to get to the answer to why my dad had this back problem in the first place.
This doctor surmised that my father's diet was filled with sugar. Back then, the belief was that you could eat anything you wanted, and you were healthy as long as you were thin. So, his theory was that the sugar was upsetting the digestive system. And then his digestive system was reflexing, affecting the muscular system, putting his back into spasm.
My dad had the choice of changing his diet or having exploratory back surgery, which wasn't a very difficult decision. So, my father changed his diet and had some manual (chiropractic) adjustments done by this doctor, and lo and behold, his pain was 100% cured in two weeks.
This was sort of the beginning of the correlation and linking of digestive function and back pain. I will tell you that this is the largest missed opportunity to help people, where no one is talking about the linkage between diet and back pain.
The only linkage that people have come up with is that if you are heavy, you carry around more weight, putting more pressure on the discs or your back, so you want to lose the weight. But that's a flawed model; it's not the additional structural weight; it's the gut inflammation and irritation that affects the muscular system.
What does this mean for our back pain?
To have a good functioning back, you need a good functioning digestive system. To have a good functioning digestive system, you have to have good functioning bowel movements. So whenever I'm talking about diet and nutrition, I'm actually talking about a good-functioning gut.
Having a good functioning gut is not just determined by the food you're eating. It's really based on the quality of your bowel movements. Not everyone experiencing back pain is ingesting a lot of sugar or alcohol. Many of my patients with back pain actually eat what is considered a fairly healthy diet.
After experimenting with my own diet and eating "healthy" foods daily as a New Year's resolution, I came to an understanding and belief that not all food is good or bad for everyone. Within three days of changing my diet for my resolution, everything changed. My mood changed, my muscular system changed, my back pain changed, and it got to the point where my neck and shoulders were as tight as could be.
I was having alternating bouts of diarrhea and constipation. So I went back to the original way I was eating, which was still fairly healthy but more varied. That calmed down my digestive system, and my bowel movements began to change. When my bowel movements changed, and I became healthier, I began to feel better.
So, that was the beginning of my understanding that we are chasing the wrong end regarding diet. I always say that everything we know about diet and nutrition is bass-ackwards.
Using the Scientific Method, our food or what we are eating is our theory or the hypothesis. Our bowel movements are the results of the conclusion. A good, healthy bowel movement tells us that our digestive system is functioning well. Likewise, a good functioning digestive system is vital for a good, healthy back.
Having a good functioning gut is not just determined by the food you're eating. It's really based on the quality of your bowel movements. Not everyone experiencing back pain is ingesting a lot of sugar or alcohol. Many of my patients with back pain actually eat what is considered a fairly healthy diet.
After experimenting with my own diet and eating "healthy" foods daily as a New Year's resolution, I came to an understanding and belief that not all food is good or bad for everyone. Within three days of changing my diet for my resolution, everything changed. My mood changed, my muscular system changed, my back pain changed, and it got to the point where my neck and shoulders were as tight as could be.
I was having alternating bouts of diarrhea and constipation. So I went back to the original way I was eating, which was still fairly healthy but more varied. That calmed down my digestive system, and my bowel movements began to change. When my bowel movements changed, and I became healthier, I began to feel better.
So, that was the beginning of my understanding that we are chasing the wrong end regarding diet. I always say that everything we know about diet and nutrition is bass-ackwards.
Using the Scientific Method, our food or what we are eating is our theory or the hypothesis. Our bowel movements are the results of the conclusion. A good, healthy bowel movement tells us that our digestive system is functioning well. Likewise, a good functioning digestive system is vital for a good, healthy back.
Why do you think there is an epidemic of back pain in the U.S. and elsewhere?
We have this back pain epidemic because we are missing the cause; it takes a philosophical approach. Back pain is primarily studied in the orthopedic model. It is based on the MRI (Magnetic Resonance Imaging), which is a flawed model. We see things like [spinal] disc degeneration, muscular weakness; this model focuses on structural issues.
But Stanford University proved that emotions and stress is the number one factor contributing to back pain. And the other factor that no one is talking about is the role of diet and nutrition in back pain. So any orthopedic website, book, approach, etc., is at best limited. Quite frankly, while it can do some good, it's only presenting one-third of the information.
So, we have this back pain epidemic because we are missing two-thirds of the data and two-thirds of treatment modalities. So, that's why we act as if back pain is normal when it's not.
But Stanford University proved that emotions and stress is the number one factor contributing to back pain. And the other factor that no one is talking about is the role of diet and nutrition in back pain. So any orthopedic website, book, approach, etc., is at best limited. Quite frankly, while it can do some good, it's only presenting one-third of the information.
So, we have this back pain epidemic because we are missing two-thirds of the data and two-thirds of treatment modalities. So, that's why we act as if back pain is normal when it's not.
Let's talk more about MRIs. Doctors told me that nothing showed on the MRIs to justify the pain and other symptoms I was experiencing in my health journey. It turned out that a spinal disc rupture was crushing my spinal cord (among other issues), and I needed four neurosurgeries.
The MRI is not only outdated, but it is also harmful. In 1994, researchers put 198 people in an MRI machine, and two-thirds of the participants showed a [spinal] disc bulge. Twenty-six percent of the participants showed disc herniation. But these people had never had back pain.
Research shows that MRIs are harmful because studies show that MRI leads to higher specialist consultations. More specialist interactions such as surgeries, injections, etc., result from these consultations. And all of this takes place without better patient outcomes.
You can have the brightest orthopedic surgeons, give them five different MRIs, and tell them that two people have back pain and three people don't. They won't be able to tell you which two are in pain.
Research shows that MRIs are harmful because studies show that MRI leads to higher specialist consultations. More specialist interactions such as surgeries, injections, etc., result from these consultations. And all of this takes place without better patient outcomes.
You can have the brightest orthopedic surgeons, give them five different MRIs, and tell them that two people have back pain and three people don't. They won't be able to tell you which two are in pain.
Frequently as spine patients, we are told to eat an anti-inflammatory diet. How does that jive with your research?
How do you know what diet is for you?
It's based on the quality of your sh*ts.
That's it?
That's it.
So, what is good sh*t versus bad sh*t, as you discuss in your book, The Good Sh*t?
We want to look at how it's coming out, what it looks like, and its color. It should come out looking like a sausage. It should be light brown in color, and it should come out easy and smooth. So, if it comes out in hard pellets or pieces, your body tends to be more constipated. Suppose your sh*t is coming out much looser. In that case, you are likely eating irritating things that impact your digestive system or are moving through you too quickly.
After we look at your sh*t, we want to look at your diet. If you are eating a lot of sugar or having a large amount of caffeine, we may want to change those things. If you're a person who eats a lot of vegetables and green drinks, we may like to change that. You want to look at your eating habits and patterns in conjunction with your bowel movements.
After we look at your sh*t, we want to look at your diet. If you are eating a lot of sugar or having a large amount of caffeine, we may want to change those things. If you're a person who eats a lot of vegetables and green drinks, we may like to change that. You want to look at your eating habits and patterns in conjunction with your bowel movements.
Is there value to having yourself evaluated by a professional for a recommended diet? What about being checked out for food allergies?
Yes, there's value to having your diet evaluated. However, we often go straight to step 10 without doing steps 1-9 first. In the case of your diet, you need to do steps 1-9 before step 10, which is seeing someone to evaluate your diet.
Steps 1-9 include food journaling and tracking the quality of your bowel movements; finding repeatable patterns in the data. Come up with theories of your own and play with your diet a bit. Then, if you're still having issues with your bowel movements, see a nutritionist, get some guidance.
If the nutritionist isn't really helping you, maybe you'd see your primary care physician for some blood work to see if anything shows up there. Then perhaps you see a gastroenterologist, then an allergist. Isn't it crazy that your medical doctor only gets a couple of hours of nutritional training? You can't talk about diet and nutrition with your regular doctor; they don't know anything about it.
Steps 1-9 include food journaling and tracking the quality of your bowel movements; finding repeatable patterns in the data. Come up with theories of your own and play with your diet a bit. Then, if you're still having issues with your bowel movements, see a nutritionist, get some guidance.
If the nutritionist isn't really helping you, maybe you'd see your primary care physician for some blood work to see if anything shows up there. Then perhaps you see a gastroenterologist, then an allergist. Isn't it crazy that your medical doctor only gets a couple of hours of nutritional training? You can't talk about diet and nutrition with your regular doctor; they don't know anything about it.
Is there anything that is universally true for everyone regarding diet, such as the importance of hydration?
I don't think there are any universal truths. The idea that we should have eight glasses of water per day to be hydrated is, in my opinion, outdated and incorrect. We as a society are not good at listening to the language that our bodies speak. Your body knows if it's hydrated, you can tell by the color of your pee.
If your pee is quite yellow, you're dehydrated, and if it's quite clear, you are hydrating properly. The body always needs to be in balance. If we drink too much water, it can have deadly consequences. Too much of a good thing is never a good thing; we want to stay right in the middle and balanced.
If your pee is quite yellow, you're dehydrated, and if it's quite clear, you are hydrating properly. The body always needs to be in balance. If we drink too much water, it can have deadly consequences. Too much of a good thing is never a good thing; we want to stay right in the middle and balanced.
This concept reiterates the idea of going back to basics when caring for the human body.
The human body is a self-regulating, homeostatic machine. It either does it, or it signals us to pay attention to whatever is out of balance. If you're hot, the body is going to sweat to cool you down. If you're cold, your body will tell you to put on something like a sweater.
It's the same with our bowel movements or urine output. Our bodies speak to us. We just have to listen. If you have balance in your structural, emotional, and digestive or nutritional systems, you will get rid of your back pain. If you don't, you never will.
It's the same with our bowel movements or urine output. Our bodies speak to us. We just have to listen. If you have balance in your structural, emotional, and digestive or nutritional systems, you will get rid of your back pain. If you don't, you never will.
It's common for those living with spine conditions and back pain to also live with conditions like depression and anxiety. In addition, many of us are on medications needed for our quality of life but can interfere with how our body functions.
How often are you seeing patients on medications that may be causing digestive upset or constipation who aren't making that connection? How do you advise them?
You want your patients with mental health conditions, such as depression, who are taking medication to know: Yes, that medication may be disrupting your bowel movements.
But you also want them to know that their back pain can be very much emotion-based and can be digestive or diet-based. You can't be just a spine patient.
As doctors, we have to do everything we can to reduce the inflammatory response in our patient's body from stress and emotions—the same thing with the digestive system. It's infuriating to me that so many people are suffering because they aren't receiving 66% of the information needed to reduce their back pain and balance their bodies.
But you also want them to know that their back pain can be very much emotion-based and can be digestive or diet-based. You can't be just a spine patient.
As doctors, we have to do everything we can to reduce the inflammatory response in our patient's body from stress and emotions—the same thing with the digestive system. It's infuriating to me that so many people are suffering because they aren't receiving 66% of the information needed to reduce their back pain and balance their bodies.
Do you have advice for patients on how to best advocate for themselves when running into doctors or specialists who discount their pain or other symptoms they're experiencing?
The first thing is education, which impacts the perspective and mindset of the patient. There are a couple of types of back pain sufferers. If you've been diagnosed with things like degenerative arthritis, degenerative disc disease, or spinal stenosis, you've basically been branded as a lifelong sufferer of back pain. But this doesn't have to be true.
There are plenty of people with degenerative disc disease or spinal stenosis, etc., who don't experience chronic pain. It's not about convincing your doctor that you're suffering. If you have to convince them, they're not the right doctor for you, and you should find a different doctor.
If
you haven't already, definitely check out 3 Weeks to a Better Back. It will help walk you through monitoring and tweaking your diet to keep your body well-balanced and reduce your back pain. In addition, there are recipes included, a food journal, and other helpful tools to help you achieve your best quality of life and bowel movements!
There are plenty of people with degenerative disc disease or spinal stenosis, etc., who don't experience chronic pain. It's not about convincing your doctor that you're suffering. If you have to convince them, they're not the right doctor for you, and you should find a different doctor.
If
you haven't already, definitely check out 3 Weeks to a Better Back. It will help walk you through monitoring and tweaking your diet to keep your body well-balanced and reduce your back pain. In addition, there are recipes included, a food journal, and other helpful tools to help you achieve your best quality of life and bowel movements!BONUS GIVEAWAY!
SpineNation and Dr. Todd Sinett have teamed up to giveaway 3 BackBridge products. Enter now for your chance to win!
Three winners will be drawn at random. Participants have until 11:59 pm on June 30, 2021, to enter. We just need to collect some basic information.
Three winners will be drawn at random. Participants have until 11:59 pm on June 30, 2021, to enter. We just need to collect some basic information.
Updated: June 15, 2021
Disclaimer
Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.
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Jerry Nichols, MD is board certified in Physical Medicine and Rehabilitation with Carilion Clinic.
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