Why your Back Hurts And Why your Health Practitioner Can’t Tell you Exactly Why you Feel Pain
“More than 80% of the adult population suffer from back pain at some point in their life”
Why can’t my health practitioner tell me exactly what’s going on with my back?
Our minds have developed in such a way, that we require an answer to our questions, or we can become very frustrated. We have also come to believe that the health service is able to play God and has the answer to all physiological imbalance. Doctors and health specialists are just people. Very well educated people, that deserve more credit then they are often given but still, well educated people, making educated guesses.
So when they look at your MRI, they are making an educated guess as to why you feel pain or discomfort but it isn’t always straight forward and obvious, here’s why:
We all have wear and tear on the spine, it is part of the ageing process. But not all wear and tear will cause pain or discomfort.
If we looked at an MRI of a 27 year old spine and that of a 50 year old spine, they can look very similar, with wear and tear showing in the same places. Yet only one of these people may feel back pain and it isn’t necessarily going to be the 50 year old.
The reason is that we have these wonderful shock absorbents between each spinal vertebrae, called ‘Discs’ they are technically ligaments that allow for movement. Discs are a little like jammy donuts and the substance that makes the donut squishy (and therefore a good shock absorber) is Glucose Amino Glycon (GAG), because of this, the disc acts as a cushion. But GAG is mostly liquid in nature, and dries up as we age. The discs therefore shrink, narrow and stiffen.
When we are young and ‘bouncy’, the nucleus (jam) is more mobile, so more likely to prolapse due to disc compression which happens when we jump about, trip and fall. Imagine this happens when you are in your 20’s. You fall and form a tear in one of your donuts (disc) and the jam (nucleus) then seeps into this tear. You don’t feel any discomfort because you have lots of GAG and the donut is nice and squishy still. Then you age and slowly, the donut dries up (just like a donut would if you left it out for a few days) with the jam in the ‘wrong’ place, outside of the centre. And at 50, you bend down to tie your shoelaces and ‘boom’ -You feel something you did in your 20’s.
Doctors are not typically trained in low back pain pathology. They might order an MRI and then send it to an orthopaedic or neurosurgeon who make their living doing.. Surgery.
And you will probably be put forward for a procedure of some kind. But consider this..
“In a study of 600 people, all were given an MRI. 60% showed pathology that required surgery, according to the radiologist that read it.
The interesting thing is, that they were ALL healthy people who did not experience back pain, so really none of them required surgery.”
As a side note: Sometimes surgery is necessary, and surgeons don’t offer surgery as an easy way out. It is their training and skill, so that is what they have to offer. It is worth seeking the advice of other professionals first if you want to avoid surgery.
What is back pain?
There are two types:
Non-Specific- Tension, soreness, and/or stiffness and the specific cause of pain is not specified.
This type of back pain, is usually from formed incorrect movement patterns and incorrect posture that we just pick up through life for one reason or another.
Specific- Accident, injury and often localised (one area).
Usually the trauma heals and then becomes a non-specific pain (above) and we continue to blame the accident or injury. However, in a lot of cases, the body heals within a few days and it is the continued use of adapted incorrect movement patterns and compensatory posture due to the initial pain that maintain the feeling of discomfort in the body.
EXAMPLE: Getting up and down for sitting. Anyone with back pain will adapt a very rigid position when trying to sit down or stand up. They stop bending at their hips- but their hips are fine! It is the body’s way of protecting itself. (which ironically, is unnecessary and results in the real problem).
So whether you have had an accident (specific pain) or not (non-specific pain) the treatment is the same.
As a Movement Therapist, it is really helpful for me to have information about falls and accidents and know MRI results, but what I really want to know is exactly where you feel pain, exactly where you feel discomfort and in what activities you feel this, and what time of the day.
This helps me to work out how to balance your body to take away the pain. It helps me to see where there is movement avoidance and where we can reduce overuse of compensating tissue (all caused by pain).
Where to go from here
As with any pain, comes low or high level trauma, so I hope this helps you understand that you can let go of anything that happened to you, it isn’t important. Including how it has unfairly changed your life. What is most important is how you feel now and what we do about it- now.
Holding on to fear of movement and the memory of what happened, so you don't do it again is going to exacerbate the problem.
If you do have a tear in a disc, you can rest in the knowledge that it is normal and it is okay. Movement avoidance will exacerbate the problem so we need to get you moving confidently in every day functional activities, such as getting up and down for sitting and putting on a pair of trousers- We build you up from there. I find with all of my clients, that once these two very normal activities have been achieved without pain, there is no stopping you.
So, this is where will will pick up next time.
Charlette x