I love this question. It is a question I answer everyday in practice. It is a very simple answer with complicating factors. Let’s begin with a question.

How does a cavity start? If you ask your dentist this question he/she will tell you about sugars, bacteria and acid formation or something to that effect. In other words he/she would have a straight forward answer.

Ask a MD, DO or DC about how back pain begins and watch out! You will get so many different answers that you will not be able to draw one conclusion with all the information given.

So, are you ready for my explanation?

Well, before I give my answer I was told in a very nice way today that I get preachy, opinionated with a touch of anger in my blogs. I apologize. This is my soapbox and I love to vent! You of course could give your opinion at anytime.

The answer= disc or inter-vertebral disc damage is were back pain begins.

What? Think of it this way. If you buy a new car right off the lot what is the first car part you will most likely have to replace? Tires. Think of your inter-vertebral discs as tires. Does your tire just explode when you drive it off the car lot or even if you drive them 5,000 miles? No, it better not. If your tires do get damaged or blow out is it not due to a pot-hole or because they have worn down treads? If you drive on gravel or pavement(environment) would this effect those tires?

This is a very simple analogy to what occurs with ligaments and the inter-vertebral discs of the spine. Today many of the cars we drive have sensors that will tell you if your tires are going bad, going flat or need to be replaced. Your car does this through computer pressure sensors. Well guess what also has pressure sensors? Your inter-vertebral discs. The sensors in your body are nerves that connect the outer third of the disc to muscles, skin and ligaments. These sensors send information to your spinal cord and brain.

When your discs show signs of wear and tear (degenerative disc disease) they send an alarm and alter function to your body in the form of symptoms. The small nerves that innervate the disc with connections to muscles, skin and ligaments send signals of; stiffness, aching and/or sharp pain. The pain can be radiating (really all nerve pain is radiating) or “localized”. The signals from the “bad” disc will also change contractility of muscles or shut them off completely.Why? To stop further damage I presume. Just like a cavity stops you from chewing on the bad tooth. Disc symptoms or degenerative discs are silent just like a cavity until blow out time.

When you get a cavity in your mouth does it just cause shooting pain in your jaw all at one time? Or in one day? No. First, you notice your cavity when you bite down or with hot or cold. Same thing with the inter-vertebral disc innervation.

These disc symptoms are often first diagnosed as a sprain or strain (muscle/ligament problem). Again, these “muscle problems” are really nerve problems from a disc going bad telling the body to stop moving around. While I do consider the disc tearing a sprain. I also recognize that it is a sprain with neurological repercussions also known as a chiropractic subluxation. Did I mention that the small nerves from the inter-vertebral disc supply signals and function to the muscles of the back? Ever heard “you got a weak back.” Is it weak or flaccid? see earlier blog on core strength.

At what age to most people have back surgery? In their late 30′s early 40′s. When does degenerative disc disease show up? About late 30′s early 40′s.

Man, should have gotten my tires checked sooner! What is the average patient of mine? About 40.

WARNING!!! PREACHY PART COMING…….

Just because your “doctor” says, “You can’t have a disc problem, because if you did your leg would have pain, be numb and your foot would tingle.” Does not mean that you don’t have a disc tear, herniation or both.

If you have a tingling foot, numb leg or loss of function in your leg you hardly need an educated doctor to diagnose that problem. I could get your diagnosis on WebMD pretty quick. Of course there are other differentials and I am not suggesting you just use WebMD for your diagnosis. What I am saying is do you want to take medical advice from someone who is reactive or proactive with your back pain?

Do you want to rotate your tires or just wait until they blow? I know what you are thinking. How can a chiropractor help a disc or soft tissue problem? As I just defined how back pain starts, I do have the solution.

I just don’t have the energy to answer that question today. Maybe some other time.

Dr. Trenton Scott D.C.