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Giresh Kanji knows a lot about bad backs. He has been a musculoskeletal pain specialist for almost 20 years and has treated many injured and sore people over that time at practices in Wellington and Auckland. So, when he had an accident at the gym – Kanji was crushed by the 200kg he was leg-pressing – he knew exactly what he was facing.

Prior to that, he had been highly active, kayaking most days, playing hockey, cycling and crafting wooden furniture in his spare time. Now he was among the one in five New Zealanders suffering from persistent pain.

“I experienced back pain every day for two years,” he says. “The pain was a six or seven out of 10, with pins and needles down the leg. And I was waking at 2am with severe pain.”

As he searched for ways to ease his discomfort, Kanji started re-examining everything he understood about lower-back pain. He went through hundreds of medical articles to find the best way forward. In the process, he has developed a philo sophy about the management of chronic pain that is focused not so much on the brain – as with most other modern approaches – but on the site of the initial damage.

For most spinal problems, surgery should be a last resort, says Kanji. Often it will solve a problem only in

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