Prior to drawing blood, saying a word to patients that suggested pain increased the likelihood of them experiencing pain. You might think of this study as just another example of the importance of “Bedside manner”- the awareness of the importance of the behavior and speech of the physician or other care-takers, on the feeling of well-being of the patient. Eugene Bauer, M.D., a Viennese physician, said in 1931: “A word in the mouth of a physician is as important as the scalpel in the hands of a surgeon”. Words can cut, soothe, and rattle. How you are approached by a doctor is determined not only by their personality but also by the beliefs concerning your problem.
Archive for June, 2013
Bedside Manner and the power of suggestion in back pain
Sunday, June 30th, 2013 at
6:30 PM
Obesity, poverty, and community influence- back pain
Sunday, June 30th, 2013 at
6:28 PM
Obesity is more prevalent in neighborhoods with a high incidence of poverty. A study in the New England Journal of Medicine showed that encouraging families to relocate to higher income neighborhoods could lower the rate of obesity and signs of diabetes. This finding may lead to a better understanding of how we can combat the obesity epidemic. Read the rest of this entry
“Doctor, My Back is Killing Me!” – Chapter 1, Part 3 (#endbackpain)
Wednesday, June 26th, 2013 at
2:23 PM
In the last part of Chapter 1 from End Back Pain Forever, we turn to the story of “Stephanie”. Please review this blog for the complete chapters 1 and 2 from my book.
“Doctor, My Back is Killing Me!”, Part 3
Take the case of a patient whom I shall call Stephanie. She is a married attorney who in 2004 began to experience stiffness whenever she she got up out of a chair. She also had problems straightening up if she bent over. This was bothersome, but it was nothing compared to her first attack of spasms in her low back, on the right side. The spasms were incapacitating. She couldn’t walk and had to lie in bed for four days, taking painkillers and muscle relaxants. When the spasms broke, she still felt an inkling of discomfort that would frequently and unexpectedly morph into repeat episodes of painful spasms.
“Doctor, My Back is Killing Me!” – Chapter 1, Part 2 (#endbackpain)
Wednesday, June 26th, 2013 at
2:21 PM
Here is Part 2 of Chapter 1 from my book, End Back Pain Forever. Click here for Part 1.
Chapter 1
“Doctor, My Back is Killing Me!”, Part 2
“I can put you on strong medication to dull the pain,” says the doctor. “It may be that your spine is the problem.”
“Does that mean surgery?”
“It could. Surgeons do a million spinal operations a year.”
Surgery on your spine is the last thing you want to do, but your back pain is horrendous. And, of course, you want to get better. So you say, “Can’t we do an MRI or a CT scan to see if there’s anything wrong with the spine?” MRI, or Magnetic Resonance Imaging, is a picture generated by magnetic fields, while a CT (computed tomography) scan is a picture generated by X-rays.
When you are shown the test results, the doctor points out that the images of your spine show that you have, say, a herniated disc (in which the cushion between two bony vertebrae is either protruding or has ruptured) or spinal stenosis (narrowing of the spinal column that houses your spinal cord), or some other spinal anomaly–and that, apparently, is the cause of your pain.
But if it were true that the abnormality on the MRI or CT scan was indeed the cause of your pain, I wouldn’t have written this book–because almost no one has a “normal” MRI or CT scan of the lower spine, and what is read as abnormal is frequently not the cause of your pain.
“Doctor, My Back is Killing Me!” – Chapter 1, Part 1 (#endbackpain)
Wednesday, June 26th, 2013 at
2:16 PM
Where to begin? In the first two chapters of my book I explore a variety of issues related to the difficulties in evaluating and treating patients with back pain. I am posting these chapters as a means to share my perspective which developed over more than 40 years as a pain medicine physician in the US and the UK. I wrote End Back Pain Forever to open up a discussion on back pain and provide insights on effective treatments.
Chapter 1
“Doctor, My Back is Killing Me!”
You felt a twitch in your low back, then a heaviness and a sudden stab of pain. It struck without warning — when you were crossing the street, stacking the dishwasher, jogging, whacking a golf ball, lifting a baby, swatting a fly, carrying groceries, bending over, getting out of a car, or just turning on a faucet.
Now you’re afraid to move. You’re locked in place. You feel a belt of pain pulsing across your back from hip to hip. You wonder, what’s happening? What did I do to get this? You feel as though you’re cut in half as the pain seems to separate you from your legs. Will the pain go away? Will it stay? Gingerly you start to move, but the pain only strikes harder. No, it’s not going away, not at all. And if — this is a big “if” — the pain does not ease off in a few days or go away in a couple of weeks, without proper treatment it is certain to return because your back is a target waiting to get hit again.
Newly published study showing positive muscle treatment results
Wednesday, June 5th, 2013 at
9:15 AM
Dr. Marcus and his colleagues just published a 2 part long-term muscle treatment outcome study of lower back pain patients who were originally diagnosed as having pain in the spine and nerves exiting the spine (i.e. herniated disc, facet arthropathy, spinal stenosis, lumbar radiculopathy). The first large group of patients had been treated unsuccessfully with one or more of the following: spine surgery, facet blocks, radiofrequency ablation, trigger point injections and prolotherapy. The second small group were scheduled for back surgery. Both groups responded to a muscle treatment protocol with significant reductions in pain intensity and improvements in level of activity. Three of seven pre-surgery patients, identified with painful muscles, had their surgeries cancelled. Results were maintained at > 14 months follow-up. This second published study of his muscle evaluation and treatment protocol suggests that improved treatment and cost of care could result if muscles were routinely evaluated and treated in all patients with lower back pain. Click here to read the study document.
END BACK PAIN FOREVER
by Dr. Norman Marcus
If you or someone you love has been suffering with back pain, this book could change your life.
