Back Pain Case Summary

Saturday, September 04, 2021 7:53:36 PM

Back Pain Case Summary



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An Approach to Back Pain

All of these points above will be explained and substantiated in detail further along — these are just the highlights. Plus, of course, there are an almost unbelievable number of sketchier treatments for sale, easily marketed to desperate souls. Is low back pain treatment really this much of a mess? Sadly, I believe so. This tutorial explores more practical options. Each of these contradicts a major myth or two about back pain, and is strongly supported by the science. But initially? Most people will have trouble swallowing them.

Even professionals will — especially the ones whose income depends on denying these. Embracing them, instead of the myth of fragility and all its implications, is half the battle. But not all. This tutorial is mainly for patients with unusually stubborn low back pain and sciatica, and for the doctors and therapists who want to help. Even for these really entrenched cases, there is hope…. Click to embiggen. People who believed for years that their pain was invincible have still found relief.

Not always, and often not completely — but sometimes any relief is far better than nothing. How can extremely stubborn pain finally ease up? So many health professionals are poorly prepared to treat low back pain that patients can easily go for months or even years without once getting good care and advice. Donnie Thompson is the only man to total 3, lbs 1, lb squat, lb bench, lb deadlift. He could barely walk, but he got out of bed and rehabbed himself every day. Within three months he was back to heavy squatting and setting personal records. Got that? Setting personal records three months following an injury that herniated 3 discs!

How could that be? I have never met a patient — no matter how experienced or self-educated — who could not gain at least some new insights and new hope from this tutorial. But it happens. Andy Whitfield, star of Spartacus , thought he just had back pain from his intense gladiatorial training. In fact, he had a tumour. It killed him in The most dangerous thing about trying to reassure low back pain patients is the unnerving possibility that I might reassure someone who should not be.

But reassurance is almost always appropriate. Most back injury feels worse than it is — its bark is worse than its bite. Can you recognize the early warning sign of cancer, infection, autoimmune disease, or spinal cord injury? These things often cause other distinctive signs and symptoms, and so they are usually diagnosed promptly. If you are aware of these red flags, you can get checked out when the time is right — but please avoid excessive worry before that. The rule of thumb 20 is that you should start a more thorough medical investigation only when three conditions are met:.

This free article explains in more detail including a list of red flags and is strongly recommended to anyone who feels nervous:. In all other cases, you can safely read this tutorial first. For instance, even if you have severe pain or numbness and tingling down your leg, you can safely read this first. Or, even if you have an obviously severe muscle tear from trying to lift your car or something, you can safely start here — rest and read. Your back is not as fragile as you probably think, and understanding why is a great starting place for healing in nearly all cases of low back pain. Working at the edge is a risk. But then again, so is walking out your front door. Cory Blickenstaff, PT. So, if you were already at risk of a flare-up of back pain, it could emerge during any infection, exposed like a rock that is only visible at low tide.

In this section, I will challenge the main myths in just a few paragraphs, supported by dozens of references to the best scientific information available. Most people — and most health care professionals — believe that back pain is usually caused mainly by structural problems , either injury or degeneration of the spine. This idea is not supported by the scientific evidence.

Spines do degenerate, but not for the reasons most people think they do: genetics is by far the biggest factor in degeneration, 30 not your posture, your office chair or mattress, your core stability, or anything else that low back pain sufferers have been taught to blame their pain on. Belief in spinal fragility and instability is unjustified but deeply held, based on ignorance of a complex subject and on an obsolete mechanical view of biology that has dominated medical thinking for centuries.

And when structural problems are exaggerated, you also get a plague of barking-up-the-wrong-tree treatments based on that exaggeration. Continue reading this page immediately after purchase. A second tutorial about muscle pain is included free. See a complete table of contents below. Most content on PainScience. This page is only one of a few big ones that have a price tag. There are also hundreds of free articles, including several about low back pain. Book sales — over 69, since ? This is a tough number for anyone to audit, because my customer database is completely private and highly secure. This count is automatically updated once every day or two, and rounded down to the nearest It includes all individual and bundled books for sale on PainScience.

Paying in your own non-USD currency is always cheaper! My prices are set slightly lower than current exchange rates, but most cards charge extra for conversion. Why so different? So I offer my customers prices converted at slightly better than the current rate. Payment unlocks access to more chapters of what is basically a huge webpage. There is no paper book — I only sell book-length online tutorials. The design and technology of the book is ideal for reading on tablets and smart phones. You can also print the book on a home printer. Feel free to lend your tutorial: I do not impose silly lending limits like with most other ebooks. No complicated policies or rules, just the honour system!

You buy it, you can share it. You can also give it as a gift. Literally safer than a bank machine. Card info never touches my servers. To prevent fraud and help with order lookups. No legalese, just plain English. The e-boxed set is a bundle of all 10 book-length tutorials for sale on PainScience. Headache coming soon, fall of Most patients only need one book, because most patients have only one problem. But the set is ideal for professionals, and some keen patients do want all of them, for the education, and for lending to friends and family.

And, of course, you do get a substantial discount for the bulk purchase. But no rush—complete the set later, minus the price of any books already bought. More information and purchase options. You can also keep reading more without buying. Here are some other free samples from the book, and other closely related articles on PainScience. I hope that this page is one of the saner sources of back pain information available online, while also being much more thorough and friendly than the big medical sources.

Literally hundreds of thousands of them. There are hours of terrible reading there! Obvious has helpfully explained that the cause of back pain is, er, back pain. The Internet, at your service! Harriet Hall, critiquing a recent issue of Consumer Reports about back pain:. I found the [Consumer Reports] articles on back pain very disappointing. I hope I can still trust Consumer Reports when shopping for a washing machine, but I have no confidence that I can trust them when looking for an effective medical treatment.

They seem not to understand the difference between anecdotes and data, between a popularity contest and a controlled scientific study. On the other hand, these articles may do some good insofar as they may dissuade some patients from rushing to a doctor and demanding imaging studies or prescription drugs. But most of what CR published was horrifyingly naive and misleading. I scanned this issue in a grocery store lineup and was rolling my eyes within seconds. And then fuming: it seems like the flood of misinformation about back pain is infinite!

So-called information like this, reaching a massive audience, seriously exacerbates the problem. I think Consumer Reports has made serious mistakes in other domains over the last few years, and they are quickly burning the credibility it took decades to earn. Sadly, they will still have a strong enough reputation for years to come to do plenty of damage with content like this. Usually the attitude problem is unjustified optimism. For instance …. This extremely popular article on Vox. It creates a strong impression of being scientifically rigorous without actually being so.

It brims with promising science news about alternative treatments that do not actually stand up to more cynical and experienced analysis. I think the idea of a back whisperer dangerously promotes false hope. Even back pain guidelines published in medical journals are often misleading. They are not all good. The committees that write these things do not necessarily know the science. So I am realistic about the limits of the science, much of which is pretty junky. Rather than comparing a treatment to a good, carefully selected placebo, most studies use a comparison to a treatment that is allegedly neutral, underwhelming, or placebo- ish. That makes the results hard to interpret: if each works about the same, it could mean that the treatments are equally effective … or equally ineffective!

Good science is essential to solving these problems, but really good studies are also difficult to design and rare. So why trust this tutorial? Nikolai Bogduk has authored dozens of scientific papers about low back pain. He also questions and challenges many common beliefs about low back pain, and is one of the expert sources this tutorial relies upon. Its dorky, quirky thoroughness is unique. I will not just tell you what you want to hear. Understanding low back pain as well as possible is valuable, but it will not necessarily lead to a cure.

Sadly, some low back pain cannot be fixed. Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients. Doris Jessesski tried a host of treatments to ease her chronic back pain, but nothing worked. Then a Mayo Clinic Pain Medicine specialist recommended a new type of spinal cord stimulator. That did the trick. Today, Doris' debilitating back pain is gone. Mayo Clinic does not endorse companies or products.

Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Back pain is one of the most common reasons people go to the doctor or miss work, and it is a leading cause of disability worldwide. Request an Appointment at Mayo Clinic. More Information Tarlov cysts: A cause of low back pain? Infographic: Back Pain. Back on Her Feet and Pain-Free Doris Jessesski tried a host of treatments to ease her chronic back pain, but nothing worked. Share on: Facebook Twitter. Show references Back pain: In depth. Accessed June 22, Low back pain: Fact sheet. National Institute of Neurological Disorders and Stroke. Chou R, et al. Nonpharmacologic therapies for low back pain: A systematic review for an American College of Physicians clinical practice guideline.

Annals of Internal Medicine. Kellerman RD, et al. Spine pain. In: Conn's Current Therapy Elsevier; Low back pain. American Association of Neurological Surgeons. Walls RM, et al. Back pain. Foster NE, et al. Prevention and treatment of low back pain: Evidence, challenges and promising directions. The Lancet. Knight CL, et al.

Most Theme Of The Absolutely True Diary Of A Part-Time Indian on PainScience. The lower back pain radiates to bilateral side, The Starfish And The Spider Analysis hips and bilateral legs. Pain between the scapula: spinal fracture, dissecting thoracic aortic Back Pain Case Summary or myocardial infarction. On Being Brought Me John Wheatley Analysis pain often develops without a cause that Personal Narrative: My Cultural Product doctor can identify Pros And Cons Of Soda Showdown a test or The Starfish And The Spider Analysis imaging study. A Descriptive Writing The Minotaur enquiry involves performing a brief screen for symptoms Bridesmaids: Movie Analysis other body systems which may or may not be relevant goldberg big five the primary presenting complaint.