“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.
That bears repeating: when an MRI shows a herniated disc, it does not necessarily mean that the disc is causing your pain. Many people have a herniated or degenerated disc as a consequence of aging, and yet they have no back pain. Furthermore, it certainly does not mean that surgery is needed.
Actually, studies have shown that patients who get imaging tests increase their chance of undergoing invasive treatment such as surgery or spinal nerve injections. Studies have also shown that when an MRI or CT scan for back pain indicates that something is “wrong” with the spine, patients are left to believe they will never truly be “normal” again, regardless of whether their pain is ever reduced or eliminated through any form of treatment. And bear in mind that as many as half of all spinal operations fail.
In fact, the primary source of 75 percent or more of all back pain is from the muscles, not the spine. In 2001, a study of more than twenty thousand patients at outpatient medical clinics in the United States found that sprains and strains of muscles and other soft tissue accounted for 70 percent to 80 percent of all back pain. This is strikingly similar to the findings of a study of three thousand patients with back pain conducted at Columbia Presbyterian Medical Center in New York City in 1946, which revealed that weak and stiff muscles were the source of pain in 83 percent of the participants.
It is truly astonishing that so many physicians who treat back pain have failed to make use of these findings. For years, medical schools have paid very little attention to the muscular system, even though muscles account for approximately half the weight of the body. Medical practice in recent decades has relied increasingly on high-tech imagery for diagnosis. Although high-tech imagery is certainly of great value–as is surgery, when required–neither X-rays nor MRIs nor CT scans are designed to detect the subtle nuances associated with muscle as a source of pain.
In a later section, I will discuss this further with the case of a lady I shall call Stephanie, a married attorney who in 2004 began to experience stiffness and debilitating spasms.
Tagged with: back pain
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