LIVING WITH BACK PAIN PART 1

How to avoid misdiagnosing the cause of back pain

Did you know that even if your back is killing you, even if the pain is clearly coming from that area and you can barely move, the cause of the problem may be elsewhere? And that treating the source of the pain might be the worst thing for you?

WHEN IS BACK PAIN NOT BACK PAIN?

The latest research in pain shows that it is a signal by the brain that something is not working properly in the body. In short, pain in the body works very much like the red engine dashboard light in a car. When the engine is not functioning properly, then the light on the dashboard lights up. When it lights, up, we naturally assume something is wrong with the car, therefore we take it to the mechanic. They help fix the engine and that stops the red dashboard light.

When you suffer from back pain, it is the same thing – the red dashboard light is in the back. To fix the light, we have to fix the engine. The engine is the whole body. In the past many sufferers from back pain have thought their problem is in the lower back and most treatment has occurred there. Yet in as many as 75% of cases the problem occurs elsewhere, other than the back. In only 25% of cases does the problem occur in the lower back, thereby causing pain there.

Understandably, many people will selfdiagnose their pain or, even worse, make an Internet diagnosis. They then become attached to that diagnosis – this can go on for months or even years, preventing them from receiving correct treatment.

Those who wisely see a professional often fail to get a second opinion when treatment isn’t helping. My rule is: you should expect progress in three sessions or fewer – if there’s no progress then proceed to a second opinion. It’s easy to become resigned to your fate and prolong your suffering.

BELIEVING THAT A HEALED INJURY IS STILL TROUBLING YOU IS A COMMON TRAP.

But it all starts with misdiagnosis.

The ‘big three’ misdiagnoses which mislead back pain sufferers are:

1. Believing it’s a disc problem: Debilitating disc problems are less common than people think. Around seven out of 10 people, if checked using an MRI, would show disc issue. Disc bulges are incredibly

common, yet don’t necessarily cause pain or discomfort.

People are quick to believe it’s a disc. But with proper analysis they often find it’s something completely different, such as gluteal tightness, nerve spasm, lower spine joint tightness or even stress.

2. Sciatica: It’s easy to assume a shooting ‘nerve-like’ pain emanating from the back is sciatica – it’s one of the top selfdiagnosed complaints. But it’s massively misdiagnosed – nine times out of 10 sciatica is not the issue.

Many problems masquerade as sciatica, including lower back biomechanical issues, hip pain and even knee issues. None will improve while you wrongly mistake these complications for sciatica.

3. Stress fractures: Stress fractures in the back can be debilitating. They commonly impact sportspeople and those performing physical manual labour. But a funny thing happens to people who suffer from stress fractures – they fall into the easy routine of blaming any other body issues on the stress fractures, even after it has healed. Meanwhile, they are missing other issues such as shoulder pain, knee problems or neck pain.

Believing that a healed injury is still troubling you is a common trap. It’s almost

always something else, even if it appears to be mimicking that old familiar pain of a previous injury.

READING BACK PAIN’S SIGNS AND SYMPTOMS - THERE ARE THREE PHASES:

First: the person notices tightness or stiffness in the lower back – but tend to ignore this.

Second: the body continues to warn the person by then making the movements apprehensive. For example, a person who wants to bend forward and tie their shoelaces, will feel uncomfortable to move down quickly into the position they want. This is apprehension and is usually ignored as a symptom.

Finally, it is pain. This is when people usually realise that something is wrong. By this time, they are further down the injury path, but the good news is, it might not be too late to find a solution for them.

KEY POINTS:

• Pain is often misunderstood and the cause of your pain may originate from somewhere else in the body.

• Lower back pain is a case in point – only one in four cases are actually caused by a problem located in the lower back.

• Most common misdiagnoses of back pain include ‘slipped discs’, sciatica and stress fractures.

• Understanding some simple signs and symptoms can give you some pre-warning of back pain.

See Part 2 in next months’ issue of Great Health GuideTM, where I discuss what to do when it’s genuinely a back problem, including some exercises and treatments.

Kusal is an experienced physiotherapist who consults via his clinic, Elite Akademy Sports Medicine. He has authored books including: Low Back Pain – 30 Days to Pain Free; 3 Minute Workouts; and co-authored Natural Healing: Quiet and Calm, available via Wilkinson Publishing. When not consulting, Kusal is a lecturer, consultant & mentor to thousands of physiotherapy students around the world.