Sunday, December 16, 2007

The Number One Cause of Back Pain

People with back pain often spend years in a wasted search for the "true" diagnosis of their back pain, usually in the belief that once discovered, an "accurate" diagnosis will lead to cure. The years go by and they rail at the incompetence of doctors who can't give them a diagnosis or simply add another to the growing list. Degenerative disc disease, spinal stenosis, bulging disc, herniated disc, foraminal narrowing, facet arthropathy, spondylosis, spondylolisthesis, compressed nerve root, arachnoiditis, arthritis, myofascial pain, radiculopathy, and scoliosis are just a few of the diagoses you may be given. But the reality is that the longer you have experienced back pain, the less likely that there is one overarching diagnosis. Your pain is almost inevitably "multifactoral", i.e., there are multiple factors causing, maintaining, and exacerbating your pain. Effective treatment requires attacking all the various factors contributing to your pain. From a tissue perspective, pain triggers can come from muscles, discs, nerves, tendons and ligaments, joints, bone, or scar tissue. The inflammatory process is a major culprit in maintaining back pain. Even your immune system can be a pain trigger. Another complicating factor is that as time passes, your pain triggers morph, with some disappearing, some appearing, and others waxing or waning in intensity. Back pain is an erratically but constantly moving target. Thus, there is a tremendous amount of trial and error with medical treatments and medications. Today's effective treatment may not work tomorrow and vice versa. This can be frustrating, but is as it should be. Don't shoot the messenger, whether it's me, your pain doc, or an ancillary provider.

1 comment:

albina N muro said...

The best posture device on the market is actually an exercise machine that everyone should know about. Check the link! body-aline equipment