Well, here we are another year under our belt. How is your back pain doing?

You know I have this terrible habit of being cynical and tough on professionals and lay people on their back pain issues. Someone very close to me pointed this out. I guess I am just the Andy Rooney of chiropractic. You Gotta love it. So, I started to ask myself, “Trenton why does treating back pain drive you crazy?” Why does it make you cynical?

I thought about my day-to-day routine and how many lower back pain patients I see in a week, month and year. Hundreds!

Now, let’s say for the sake of argument that you write software for a living. You do this eight hours a day five days a week. You have done this for 16 years. Beyond seven years of schooling you have gone to numerous outside training sessions and even wrote a book on writing software. You are the expert!

Everyday people come in to your software-writing job with problems with their software not running correctly on their computers.

These people have never written software they just know how to put it into their computers and run it. Now they agree to your services to help correct their software problems.

So you start to dissect the software issues they are having, when all of a sudden they tell you that you are wrong and they won’t take your advice! They explain that some of their friends with the “same” problems just struck their keyboards with their fists really hard and that this fixed their software issues. When you ask if their friends are software experts they state, “no, but they did stay at a Holiday Inn last night!”

You cannot simplify back pain. It is a very, very difficult problem that has many facets to diagnose and treat. If you doubt this get the book, “The Spinal Engine” by  Dr. Serge Gracovetsky PhD. It will take you a while to get through it trust me.

Dr. Gracovetsky PhD. speaks about the healthcare professionals that treat the spine should be compensated at a high rate due to the extreme complexity of diagnosing problems with the spine. No wonder I love him, if only it were true.  I will point out that Dr. Serge is a physicist not a medical or chiropractic doctor. He also has studied the human spine over 30 years.

Not to be cynical but most of what is on TV and talked about with back pain is very simplistic and incomplete. When people ask me if their back pain is permanent I have two ways to answer.

The happy not-quite-so true answer that everything will be great with some exercises and yoga or the more cynical correct answer of, “you are going to have to take care of this problem because it is permanent. “

This does not mean that back pain does not change. It means that once you have a system failure in your spine YOU are going to have to listen and learn from the experts about your particular diagnosis. What do I mean with “system failure?” It means that normal physiology of the spine is altered. Most often this occurs at the end plates of the vertebral bodies and discs. When the spine is altered for a period of time it fails. When your spine fails you experience pain.

People are shocked when I express they have permanent spinal damage (to one degree or another). Like it just fell from the sky! They are forty years old and have had minor back pain for ten years, now severe lower back pain. I tell them, “this pain will get better but it is permanent” and they look at me like I have gone mad.

They will also accept the trainer’s advice at the gym that they have back pain because their stomach muscles are weak. The patient may rationalize why they have back pain and now they want to lose weight and exercise. Little late. It’s like eating tons of sugar until age forty you end up getting diabetes and you say, “well I will just quit eating sugar.” System failure.

Some people may think, well you cannot compare diabetes (organ failure) to back pain. Oh, yes you can! When your back fails it affects three systems, organ (via nerves), neuro-muscular system (again nerves) and the nervous system itself. Ask someone who has lost function of a leg or arm due to nervous system shutdown from a disc herniation. These people will be more than happy to explain real pain and system failure to you.

Why do patients take simplistic advice or irrational explanations to back pain?  I guess we swallow this advice because we as Americans love a quick, easy and cheap “fix”. We also don’t want to be responsible or be blamed for the pain we are having. I guess we don’t like getting old.

Most of the trainers that are handing out simple treatments without understanding the problems of the spine also are usually in their twenties. I can’t blame them. They are just trying to make a living. They are buff and good-looking, so they must know what they are talking about, right?  Guess what, they don’t have back pain they’re in their twenties! How’s that for cynical.

Let me ask you a question? Do any persons you know in their late sixties to late seventies complain of back pain (all of them)? Do you think this pain is due to weak core muscles?

No, you would tell me they have arthritis in their back and that is why they have back pain.  You would be correct but do you get arthritis when you pass fifty years of age? No, you don’t. You acquire arthritis from early on in life. I have seen studies that show disc damages begins as early as age 15.

I wish I could in clear conscience just tell my patients that my magic chiropractic adjustments will take away their back pain forever, they will lose weight and catch a unicorn. I would be lying (all except the unicorn, several patients actually have caught one).

Everything in treatment works on back pain to one degree or another. Yoga, chiropractic, massage, physical therapy, acupuncture, Pilates, athletic training, inversion machines, spinal traction, medications, spinal surgery, spinal injections, core strengthening, qi machines, gua sha, nutrition, the list goes on and on.

You just need a doctor like me to help you find your diagnosis, understand everything listed above and get you the help you need. If I can do this then call me cynical but please do not simplify back pain. It is really hard work.