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JFK’s Back Pain and Physiatry

A Look into the Fascinating History of President John F. Kennedy's Back Pain and Physiatry's Role in Developing New Treatments

August 2021

John F. Kennedy’s back issues probably started at the age of 20 when playing football, but their exact cause is unknown.

He was rejected from both the Army and Navy during WWII because of his bad back. However, his father’s political connections enabled him to join the Navy.

While serving in the military, he faced a traumatic combat incident. Two of his crewmates tragically died in the event. He managed to save a crewmate, but this heroic act likely further injured his back.

President Kennedy presented a healthy and energetic appearance to the world. In reality, he was a man in constant pain.

An Era of Limited Back Treatments

Unfortunately, John F. Kennedy, our 35th President (commonly called JFK), lived in an era with limited medical options. These options were often experimental and extreme.

Due to his status, Kennedy had access to the best doctors and medical facilities available. Before becoming President, he underwent two major and two minor back surgeries that were advanced for the time. However, in hindsight, it’s possible they made his health problems worse.

John F. Kennedy gives a speech from the resolute desk in the White House.
President John F. Kennedy gives a speech at the resolute desk in the oval office.

Medication Mismanagement

Further complicating the situation, a physician named Max Jacobson was used to provide injections to ease Kennedy’s back pain. This doctor was known for his famous clientele and was popularly called ‘Dr. Feelgood’ and ‘Miracle Max.’

Dr. Jacobson treated the President with shots containing vitamins, hormones, and methamphetamines. The last ingredient was considered innocuous in the early 1960s. It wasn’t until later in the decade that many realized the medical usage of methamphetamines was hard to justify.

Fortunately for the President, he decided to look beyond pain medication for his lower back issues.

Restoring Mobility and Pain Relief from Physiatry

Dr. Hans Kraus, a physiatrist, was then sent to evaluate Kennedy in 1961. Kraus was a leading expert in the newly evolving fields of physiatry and sports medicine.

Dr. Kraus originated an approach for treating lower back pain that remains widely used today. He used it with President Kennedy as well as his other patients.

His concept started with an in-depth evaluation to guide a comprehensive rehabilitation program. This approach used trigger point injections very selectively. But the key for Kraus was to combine those injections with therapeutic exercises focused on flexibility. This was further coupled with strength exercises to rebuild muscle.

Kraus determined that Kennedy’s postural muscles were weak and stiff during his initial assessment. He also realized that the different regimens of Kennedy’s other doctors were working against what he was trying to achieve. He asserted complete control of all medical treatments for the President’s chronic back pain care.

This concept of orchestrating a patient’s treatment is a significant part of physiatry today. Physiatrist doctors frequently lead in coordinating individual patient treatment plans across multiple medical disciplines and providers beyond physiatry alone.

Dr. Kraus’ medical records reveal his success in treating Kennedy’s back pain. When we lost the President, this physiatry-oriented approach had nearly cured him.

Dr. Kraus’ Medical Legacy

Dr. Kraus attended medical school at the University of Vienna in the 1920s. This was a period of growing demand and higher quality standards for physicians and hospitals. Surgeons like Dr. Kraus were motivated to discover better treatments and therapies than the long-accepted status quo.

As Kraus built his early medical practice, he discovered a connection between the healing of fractures and exercise.

In the 1930s, Kraus authored a study of several hundred patients with wrist fractures and casts. He asked half the group to do a simple set of exercises that he developed. Some of these custom exercises were as basic as shrugging the shoulders.

Dr. Kraus then observed that the patients that did the exercises healed far faster than those who did not. These improvements with exercise were evident even with more severe injuries. Those insights established the foundation of his treatment philosophy that he followed for the rest of his life.

As Germany set its eyes on Austria in 1938, Kraus fled to New York with his family. He ended up at New York-Presbyterian Hospital in Manhattan, becoming a U.S. citizen in 1945. He continued his research at New York-Presbyterian, building on his understanding of the connection between exercise and health.

This all led him to become one of the pathfinders in developing the physical medicine and rehabilitation, and sports medicine medical specialties. His work on managing and avoiding musculoskeletal injuries continues significantly to impact the field of physiatry today.

An Epilogue on Dr. Kraus’ Treatment of President Kennedy

The severity of President Kennedy’s back pain and the impact on his life was significant. When he was out of view of cameras or the public, the President often used crutches to move around. His condition was a well-guarded secret.

Given that, how do we know about Dr. Kraus’ treatment of our 45th President? Ten years after Dr. Kraus’ death, his widow donated his White House medical records to the Kennedy Library. Two medical school physicians, T. Glenn Pait, MD, and Justin T. Dowdy, MD, reviewed those records in depth.

In 2017, they published their findings in a paper in the Journal of Neurosurgery. Details on that document and a link to download it can be found here:

Article Link: John F. Kennedy’s back: chronic pain, failed surgeries, and the story of its effects on his life and death.

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