Back pain is one of the leading reasons people seek medical care in America. However, per this article, a staggering number of people will continue their lives without seeking professional help for their issue possibly causing further harm later on down the road. Often, people come to see us for their back pain and I just love it when they say, “my back is out and I usually just go to the chiro and they put it back in.” I used to get wide eyed and shocked at this statement. I would often respond to the patient, “what do you mean your back is out? It looks like it’s inside your body.” Sometimes I would get a chuckle, other times I would get a look of disdain from my rebuttal. I just thought that it was a silly thing to say out loud to another person that something that is inside of you is now outside of you and someone has to put it back in your body. Especially something like your spine. Use of these terms often come with the fear that doing anything active will cause further damage but they have been walking around and doing ALL of the things up to this point without their signs and symptoms worsening.
Take a look at this picture:
The first slide shows obvious discogenic issue and compromise to the nervous system. The picture next to it are the effects of effective, physical therapy intervention without surgical intervention performed. And no one had to put the back “in” for this to happen. Even more shocking is that this patient was still working out with minimal discomfort and intermittent lower extremity signs and symptoms. After feeling some low back discomfort, this person decided to seek medical attention and had this imaging study performed only to reveal this. Imagine the instant fear from looking at that first pic. Remarkable isn’t it?
I know, I know. You are probably reading this and saying to yourself, “good for that person, but my back goes in and out all of the time and my case is different.” Absolutely correct about the latter, your case is different. But to use terms like “my back is out” or “I was told my disc slipped out” seems to be misleading. The message trying to be delivered here gets muddled. Your body is injured. It’s important as clinicians to use effective verbage to describe what is happening inside your body. Often these “pictures” just show one side of the story anyway. It’s a still shot of what may be causing your pain. I’d much rather see how you move first, improve that dysfunctional movement pattern and teach your body to adapt to something like this. Often this will allow the body to do what it is supposed to do which is heal itself. Think about that scratch on your arm that scabbed up. Your skin isn’t out and you don’t have epidermal prolapse. (Doesn’t that sound like a hot mess?) You have an injury and your body, when put in the correct environment, will heal itself. That’s why scabs go away and you have normal, healthy skin after awhile.
By now you are probably saying, “Ok, fine. My back isn’t out. But I do have pain so what does that mean?” It means you’re normal just like the rest of us. Congratulations, you have an injury! How can you manage it? Well that is where we come in. Let’s sit down and talk about it. Let us see how you got here and how we can get you back to a happy place which is moving pain free and going back to the activities you want to do without pain. Let us help you get your body back into a position to heal properly, move better and get stronger! We understand that pain can definitely be annoying and limiting, but always remember, “Pain is inevitable. Suffering is a choice.”
Tommie J. Baugh, PT, FAAOMPT
P.S. This blog has some interactive hyperlinks in it. Feel free to enjoy them!