A back pain tale…

You wake up one day and realize that your back pain has been gradually increasing over the last few months. You decide to make an appointment with your doctor.

You visit your doctor and have an MRI done and its shows you have a minor disc bulge. You have no physical signs of disc bulge, which include a lateral shifting of your pelvis, or immediate pain upon bending forward, no pain during coughing or sneezing, or any major symptoms that would indicate a disc bulge, however, your doctor is convinced that your pain is coming from the bulge. By the way, no movement testing was done.

Your doctor first recommends that physical therapy may help. A prescription is written and you’re on your way to the therapist. The first day, your therapist does some general flexibility testing, takes a list of your symptoms, and some notes. From that day on, you meet with the therapist’s assistant when you visit to do a general back pain program that every patient gets. After doing physical therapy for 8 weeks, 3 times per week and doing exercises and back stretches, ice or heat and muscle stimulation with electrodes, you feel a bit better, but the pain keeps coming back, particularly if you miss a therapy appointment. You decide its time to re-visit your doctor to get another suggestion.

Your doctor then refers you to an orthopedic surgeon, who reviews your case, and your MRIs, and additional relevant information. The surgeon then recommends one of the following options; you can do nothing and see if it goes away on its own, have an epidural, or schedule surgery to repair the disc. Again, no movement testing was done.

So, first you decide that an epidural is the least invasive option, and your back is really bothering you, so maybe it will give you relief, and surgery doesn’t sound good to you. After receiving the epidural, you experience a minor reduction in pain, and wait a few weeks to see what develops. Over the next few weeks, you feel pretty good, and have noticed that the pain has calmed down a bit. You go back to your own daily routine. After a few more weeks, you notice that your pain levels are starting to rise again, and visit your surgeon for a follow up visit.

Once in your surgeon’s office to find that the exact same options are all that’s available to you. Surgery is still not enticing to you. What do you do now??

99.9% of chronic back pain cases are stuck RIGHT here!

So, what’s WRONG with this scenario??

Right now, let’s get something out of the way. I am NOT anti-traditional medicine nor am I against medical doctors. Medicine absolutely has its place, and we are all so blessed to have a doctor around should we break an arm, get an infection, or need a specialty operation or medication to help overcome an immediate health challenge.

However, in the context of chronic back pain, the truth is, most medical care is not effective. There are many reasons for this, but the biggest reason is that assisting patients in overcoming chronic back pain takes time, patience, a number of visits, and effective systems for assessing and treating all aspects of health that contribute to back pain.

Think about the last time you visited your primary healthcare provider. First, how long did it take to get a visit? How long was your appointment? How much time did you ACTUALLY SEE your physician? How much time was used to visit symptoms, complete history, physical assessments of multiple muscles and joints, nutritional analysis, and creating an itemized list of potential contributing lifestyle stressors?

Bottom line, it’s not the doctor’s fault. Overhead costs of running a medical practice are immense, and insurances just don’t pay for spending that kind of time working with patients. They do what they have to do, which unfortunately, unless you have an acute episode of back pain that must have a surgical procedure done, or you really need pain pharmaceuticals to make it through the day, isn’t much of anything.

The other challenge with seeing your medical doctor about back pain is that the majority of MD’s are not specialists in movement therapy. Very rarely, if ever, are physical assessments done on patients in that setting. In order to effectively rule out certain causal factors of back pain, these forms of testing MUST be done. Unfortunately, the majority of MDs don’t know how to perform or interpret them.

So, how does an MD generally diagnose back pain?

That leaves visual tests to lead to a diagnosis. These tests can include MRI, CAT, or X-ray, amongst some others. There are MANY reasons why visual diagnostic tests can be misleading and can overlook the actual reason why backs hurt.

One of them is that these images are taken when you are lying down. Most chronic back pain sufferers don’t have pain when they are on their backs. Pain on standing or moving means that the problem is based on your body’s interaction with gravity, and how it stabilizes itself during motion. A visual diagnostic test may not reveal these issues.

Very simply put, if I were to bend over and pick up something from the ground, and my back goes out, then wouldn’t it make sense to assess the position of the body, and the activity of the muscles in this position? (or at least what they were SUPPOSED to be doing!)

With this use of visual diagnostic tools, the END result of the back problem is actually being assessed alone, may reveal how to treat the symptoms, but will not reveal the real root cause of the problem or how to treat the person so that it doesn’t happen again.

So, what are the primary treatment options? Pharmaceuticals or surgical intervention are commonly the only offered. Many ask and pose the question to experts to establish if these two options are in fact valid treatments. That is indeed a very good question. To answer that, the following references are provided by quite well-known and respected physicians, as well as industry journals for medical professionals.

Imaging studies overestimate the problem, resulting in an increased number of unnecessary surgeries, yet thousands of medical doctors and osteopaths don’t know this. Surgery is the last resort.

90% percent of MRIs read as abnormal.

Pretty scary stuff, eh?

–Sam Visnic