Where to begin? In the first two chapters of my book I explore a variety of issues related to the difficulties in evaluating and treating patients with back pain. I am posting these chapters as a means to share my perspective which developed over more than 40 years as a pain medicine physician in the US and the UK. I wrote End Back Pain Forever to open up a discussion on back pain and provide insights on effective treatments.
Chapter 1
“Doctor, My Back is Killing Me!”
You felt a twitch in your low back, then a heaviness and a sudden stab of pain. It struck without warning — when you were crossing the street, stacking the dishwasher, jogging, whacking a golf ball, lifting a baby, swatting a fly, carrying groceries, bending over, getting out of a car, or just turning on a faucet.
Now you’re afraid to move. You’re locked in place. You feel a belt of pain pulsing across your back from hip to hip. You wonder, what’s happening? What did I do to get this? You feel as though you’re cut in half as the pain seems to separate you from your legs. Will the pain go away? Will it stay? Gingerly you start to move, but the pain only strikes harder. No, it’s not going away, not at all. And if — this is a big “if” — the pain does not ease off in a few days or go away in a couple of weeks, without proper treatment it is certain to return because your back is a target waiting to get hit again.
Back pain can be your personal bully. It can readily become chronic, enduring for months, years, even a lifetime. It may become so intense and disabling, that your life can change dramatically, for the worse. It can strip you bare financially, isolate you from family and friends, leave you anxious and depressed. It can banish even the mere thought of sex. The curious thing about pain is that the more you think about it, the worse the pain becomes. Preoccupied with your pain, you lose interest in hobbies and sports. Your decreased activity may lead to obesity, which in turn can cause diabetes and heart disease. You watch in despair as you decline physically, mentally, and spiritually.
This book means exactly what the title No More Back Pain says. I have written it so that you can end your back pain once and for all and avoid a life of despair. I say this as a physician who has treated some 10,000 patients in 35 years of private practice and as a past president of the American Academy of Pain Medicine, the medical society that represents physicians practicing a multi-disciplinary approach to the treatment of pain.
I have seen many patients so wracked by pain that they wished they were dead and some who actually attempted suicide before they saw me. So I am aware of the helplessness that you and millions like you feel when you first hobble into the doctor’s office and exclaim, “Doctor, my back is killing me! I can’t go on like this!”
Let me describe a not uncommon scenario: After some pokes and prods, the doctor says, “Go home, take an aspirin, lie down, and rest.”
You do as the doctor says. But it does no good and two days later, having missed work, you see the doctor again. “Well,” says the doctor, “you have a case of nonspecific low back pain. We see a great deal of it.”
It sounds scientific, but it leaves you completely baffled and still wracked with pain.
“What does ‘nonspecific low back pain’ mean, doctor?”
“It means that we don’t know the cause.”
“You don’t know the cause?”
Should you ask more, you’ll learn that nonspecific low back pain, also known by the acronym NSLBP, is so baffling that an entire chapter devoted to it in Functional Pain Syndrome, published in 2009 by the International Association for the Study of Pain, draws the frustrating conclusion that “it is exceedingly difficult to identify specific pathology underlying NSLBP” which is no help to you or to anyone else.
Tagged with: back pain
Filed under: back pain posts
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