7 Quotes From Experts That Will Change How You Look At Back Pain
Is it time to rethink how we approach back pain?
Americans are spending more money than ever to treat low back pain, but as a chiropractor in Brookfield WI, I can tell you that our spine problems – collectively – aren’t getting any better.
That’s the conclusion of a report from The Journal of the American Medical Association, which found that Americans spend an estimated $380 billion every year treating spine and joint pain. That’s more than twice as much as we spent 20 years ago. The use of MRI scans, narcotic painkillers, injections, and invasive spine surgery have all grown by several hundred percent. Even so, the percentage of people with impaired function because of back problems has drastically increased over the past two decades, even after controlling for an aging population.
Author Marni Jackson scrutinized our poor return on investment in treating pain conditions in Pain: The Science and Culture of Why We Hurt.
“Has nobody noticed the embarrassing fact that science is about to clone a human being, but it still can’t cure the pain of a bad back?”
– Marni Jackson
The JAMA report is the latest to suggest that the nation is losing its battle against back pain, and that many (if not most) popular mainstream medical treatments are ineffective or overused. Case in point: surgery has recently been completely dropped as a recommendation for lumbar disc herniations by NICE; so have corticosteroid injections.
That’s why experts like NYU Professor John Sarno have questioned why these surgeries, injections, and pain medications are still so widely prescribed for low back pain.
“There is probably no other medical condition which is treated in so many different ways and by such a variety of practitioners as back pain. Though the conclusion may be uncomfortable, the medical community must bear the responsibility for this, for it has been distressingly narrow in its approach to the problem.”
– John Sarno
Unfortunately, many of the mainstream medical approaches to treating back pain are minimally effective at best, and may actually be doing more harm than good. Author Richard A. Deyo, MD, summed it up nicely in Watch Your Back!: How the Back Pain Industry Is Costing Us More and Giving Us Less.
“There is a combination of side effects and unnecessary treatments and labeling people as being fragile when they’re really not. The combination of those kinds of things may actually be in some cases doing more harm than good.”
– Richard A. Deyo
A major part of the problem is that, in the majority of cases, mainstream medical practitioners aren’t even able to figure out what’s causing their patients’ pain. Reviews have shown that a definitive cause is only identified in about 5-15% of people with back pain. The rest is all labeled as “non-specific”.
Even Dr. Alf Nachemson, one of the pioneers of spinal orthopedic surgery, admitted at the end of his career that even he didn’t know what really caused back pain.
“I’ve been studying low back pain for the last 50 years of my life and if anyone says they know where low back pain comes from, they’re full of s**t.”
– Alf Nachemson
Personally, I don’t share the same defeatist view, but it’s saying something about the state of modern medicine’s approach to treating back pain when one of the most-respected minds in orthopedic surgery makes that statement.
As a result, mainstream healthcare practitioners have skewed toward a reductionist approach in which every back pain condition fits into a neatly defined category, with treatment dictated by flowcharts and guidelines.
“For decades we have scanned, screened and tested. Spines have been cut, carved and fixated. However, on our seemingly never-ending quest to find the pathoanatomical ‘Holy Grail’ of pain, we seem to be forgetting something: Our patients are not cars. And we are not mechanics.”
– Jørgen Jevne
As a Brookfield chiropractor who’s treated back pain every day for the past decade, it’s clear that the unique complexities of every individual’s body don’t fit into neatly defined boxes. We need to assess and treat the human body less like a machine and more like an ecosystem where multiple factors influence patient presentations and outcomes.
Of course, a paradigm shift like that is easier said than done. Gordon Waddell, in The Back Pain Revolution, lays it out simply.
“It is all very well to say that we use science and mechanical treatment within a holistic framework, but it is too easy for that framework to dissolve in the starry mists of idealism. We all agree in principle that we should treat people and not spines, but then in daily practice we get on with business.”
– Gordon Waddell
It’s not just your doctor, either. Author and blogger Todd Hargrove, in Healthy Movements for Human Animals: An Evolutionary Perspective on Exercise, points out that we all tend to simplify the causes of back pain.
“When back pain suddenly shows up, we are tempted to blame it on the last minor stressor that affected it, such as a soft bed in a hotel. This is like blaming your bankruptcy on the last latte you bought before your account finally went into the red.”
– Todd Hargrove
The Bottom Line On Back Pain
The message to the public and to health professionals is clear. Pain is highly complex nuerobiology that involves many different factors, and treating it needs to take the full picture of the individual patient into account. The reductionist approach of attempting to fit every patient into a neatly defined box, writing a prescription for pain meds, surgery or spinal injections and calling it a day just doesn’t work. There’s no magic bullet.
So what’s the solution? Your first line of defense is to find a healthcare provider who’s up to date on pain science, is going to take their time to fully figure out what’s going on, and treat you as a partner – not just a patient. That means taking into account physical, psychosocial and lifestyle factors that may be contributing to a patient’s pain. Unfortunately, finding the right doc isn’t easy, but they’re out there.
Second, it’s important to maintain your locus of control when it comes to your health and not catastrophize. You’re not fundamentally broken, you’re not going to feel like this forever; everything is going to be okay. Just take one proactive step at a time.
Suffering from back pain, or have friends or family members that could benefit from what we do at Ascent Chiropractic? Looking at the excellent clinical track record of what we do, it’s an easy decision. To get started, make an appointment at Ascent Chiropractic in Brookfield by calling 262-345-4166 or with our online scheduling app.