What is the Missing Piece?  Back Pain is a puzzle, and every case is in fact unique.   For many people, the thought is that their back pain is nothing more than a piece being out of place, or an inflammation, or arthritis, or disc pain.  If that were the case, then the answer would be simple, treatments straight forward and effective, and we would not have a back pain epidemic in this country.

Passive only treatments can be effective … temporarily.. And they have been a mainstay approach for practitioners from all professions for years.  But are they really effective in the long term?  From the 30,000 foot view…Nope.

For a large percentage of the population the typical cycle of low back pain goes something like this.. Back hurts, go to chiro/MD/PT or just take NSAIDs/meds. Pain goes away (usually 7-14 days), problem solved and life goes on as usual.  The cycle will continue for years in many cases.  Then at some point you go in for imaging and are told that all of your pain is coming from a degenerated disc, or arthritic change, or disc bulge, etc. This is the point where healthcare traditionally has failed the patient.  The dirty little secret is that the ugly image does not always mean that person has pain!  Yes, many people in pain show pathology on imaging, but just as many (and I would say probably more) have pathology but have no pain.

Has anyone given you a way to prevent the discomfort you experienced?  Has anyone given you a plan of action to take when the symptoms return? Has anyone showed you a progressive way to strengthen the trunk and abdominal region without creating further injury?  And by progressive, I mean more than laying on the ground doing the same remedial “ab” or “core” exercises.. Has anyone actually sat down with you and described the mechanisms as to why these issues may be coming on?  Most of the advice I have seen is unfortunately not beneficial to the patient at all, and in many cases could just be adding to the underlying problem.

So what is the point? What is the answer to the problem? What works best?

The answer is that everything works, to an extent.  Some things work better than others at some points. This is where the magic of taking a truly objective approach to patient assessment comes into play.  Having someone with the ability to sit and evaluate your movement, the joints, the tissues, the subtle variations in body language, potential systemic drivers (nutrition etc.), and giving objective feedback including advice regarding the best course of care can be a pretty powerful thing.  In my mind that is what all providers should do.  But, with healthcare in the state it is and egos potentially put on the line, you will typically get the “if I am a hammer, everyone is a nail approach”.  This can work…sometimes…for a while.

What I am advocating here is an awareness and responsibility we all need to take with our own health.  If you are suffering from back pain (or any issue for that matter), ask questions!  Take an active role in your health.  Seek answers.  And establish a PLAN!  If you are being treated, and your doctor is not giving you anything for you to do on your own…it may be time to find a new doctor.  IT IS TIME TO TAKE CONTROL OF YOUR PAIN, EMPOWER YOURSELF AND GET BACK TO THE LIFE YOU LOVE.


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