One of the most common questions I hear as a PT is “I have back pain, so what should I do about it?” What I realize now is that there’s a lot of confusion about this and most other diagnoses.
The bottom line is that if there was one solution to back pain (or any other pain), it would have been discovered long ago and we’d be done with understanding how the body works. To my knowledge there is no single solution. This is because the body is complex, we all lead unique lives, have singular genetics, and different emotional experiences which makes for lots of variety and therefore potential causes for back pain.
This even holds true for diagnoses such as a bulging disc. I think what people need to understand is what most diagnoses are really telling you is the name of the tissue that’s complaining–nothing more. Usually the culprits lie elsewhere.
To give you an idea of what I mean, I was recently asked by an exercise instructor what might cause knee pain in her client. Well there are many potential causes of knee pain: flat or high-arched feet, tight calf muscles, poor walking patterns, rotated thigh bones, poor gluteal (butt) muscle function, a tilted pelvis, tight hip flexors, tight hamstrings, structural problems such as ligament tears, or simply poor movement habits. Notice almost all of these had nothing to do directly with the knee. By the time I got through with this list, the instructor’s eyes were glazed over (I’m sure you feel the same!). And that’s just knee pain, a fairly simple joint in the body. Just think what more complicated areas must be going through!
So diagnoses like back pain, SI joint pain, cervical/neck pain, back strain, bulging discs, hip bursitis, tennis elbow, tension headaches, migraines, sciatica, plantar fasciitis, ITB syndrome, or patellofemoral syndrome really mean very little. Basically you’re being told which tissue is hurting. Instead what we really need is a diagnosis that tells us how or why something is painful.
Part of all this confusion is that healthcare providers often fall into the trap of focusing only on the tissue that hurts. After all, your doctor said, “You’ve got a disc bulge” not “You’ve got a flat foot that is rotating your knee and thigh inward, which is dropping down that side of your pelvis and turning off your gluteal muscles, which is creating excessive arching on that side of your spine, which is causing you to have back pain”. In my experience the second explanation is the more accurate diagnosis, not to mention one that we can actually work with.
I don’t really expect other health care professionals like doctors or massage therapists to know these root causes though as that isn’t really their specialty. But it is the job of a physical therapist.
Magazines and other sources don’t help much either by trying to narrow down the solution to cute or catchy bite-sized pieces: 3 Moves to Beat Your Back Pain Now!, The Tennis Elbow Cure!, 5 Reasons Chocolate is Great for Your Headaches! and other types of articles (Did the title of this article make you look?). These give readers the impression that their solutions must be just as simple. Sometimes they are–but not often.
Can you imagine stuffing all those causes for knee pain into one article? Remember journalists for magazines or newspapers or even most bloggers are not healthcare professionals. Their job is to write an interesting article—not fix people’s pain. There’s a big difference.
A simple search on the internet shows that there are a lot of people writing about pain– these writers, however have become the gateway to your understanding of your own issues. Unfortunately many of these people don’t really have any experience helping others with pain. Therefore the answers most people are getting are usually a bit skewed.
Because understanding why pain is happening can be complicated (or at least not summed up in 250 words or less) the real reasons pain happens, never get much press. I can attest that it’s very difficult for me to get my message out to the public, mostly because it’s not simple or sexy enough (let’s face it, both of the people reading this blog might be struggling to even finish it—sorry Mom and Dad, I’ll try to make the next one shorter). It makes me think there must be others who have good answers for chronic pain but they either aren’t writers, can’t catch the ear of the media, or they can’t convey their information in a creative, concise magazine article.
I wrote my back pain book and my other books in the most concise and effective way I could. In them, you’ll find most of the roots to your own pain. One of my goals with all my books is to help you understand how your body works so you can fix it. Once you understand this, you’ll be able to manage your body and eliminate pain forever. I encourage others who have consistent success to write their books as well.
That’s my two cents. I sincerely hope you find solutions to your pain. I truly believe they are available if you look in the right places (hint: begin with my books!) and ask the right questions.