Severe lower back pain can be a life-changing experience for anyone who experiences extreme symptoms. In medical surveys, low back pain consistently ranks number one in terms of the misery it produces, the functional limitations it creates and the fear that persists even once the symptoms have subsided.
Severe lower back pain is currently the second most common explanation given for a doctor visit. This is ironic, since the medical establishment seems to be regressing in its effectiveness in treating virtually all varieties of dorsalgia. Numerous studies have now decisively proven that patients who avoid seeking any type of diagnosis or treatment for low back issues fare much better over the short term and the long term, compared to patients who seek any type of medical or complementary medical care.
Although we write on many topics at The Cure Back Pain Network, we are still acutely focused on the common variety of low back pain that affects the vast majority of our regular readers. This is because we have recognized certain treatment trends over the last few decades and are shocked at the direction in which treatment continues to head, despite its abysmal results.
This critical essay explores the occurrence of severe lower back pain symptoms from human and medical perspectives. We will provide our analysis of the major problems in the current back pain therapy sector and provide some simple solutions that could get the entire industry back on track, if only doctors had the courage to become more objective and less financially-motivated. No, we are not holding our breath for this to actually happen any time soon...
We completely understand the misery of severe lower back pain. Many of us at The Cure Back Pain Network have experienced, and continue to experience, symptoms ourselves. We are empathic to your dire situation. People who have never had severe back ache simply don’t get it. They think, "So what? What is the big deal about a little pain in the lower back?" If and when the pain finally comes to them firsthand, they change their tone rather quickly.
There is simply no other common health issue that causes the type of agony inherent to lower back symptomologies. There is no more disabling condition than acute lower back pain. There is certainly no type of pain that creates the levels of anxiety and fear we see in patients who suffer recurrent or chronic discomfort. Extreme lower back pain is truly in a class by itself when it comes to the consequences it enacts on victim’s lives.
Why is this lumbar variety of severe lower back pain so affective? Why does it strike us in an area of our anatomy that is so vital for all movement and physical function? Is this a coincidence? Is it because the lumbar region is an area of the spine that is actually weaker than the rest? Is it due to bad posture, a poor diet, too much sitting, too much standing, too much exercise, not enough exercise or some seemingly insignificant injury, as is often theorized?
In most cases, the answer is no. Most cases of severe lower back pain are not structural and this absolute truth has been proven countless times in research studies dating back almost 70 years.
Research has shown no correlation between the most commonly suspected causes of lower back pain and the actual expression of symptoms. Can you understand the profundity of this statement?
Let’s say it again, in slightly different wording to let the message really sink in: The most commonly diagnosed spinal structural issues have never been proven to be the cause of any low back pain.
These diagnoses include herniated discs, spinal stenosis, degenerative disc disease, osteoarthritis, scoliosis, lordotic and kyphotic curvature abnormalities, short leg syndrome and spina bifida occulta. All of these diagnoses represent a structural "problem" in the spine, since the anatomy is not considered textbook perfect. However, this is like saying someone with a larger or smaller nose, ears or eyes has something wrong with their face, since they do not conform to extremely narrow anatomical proportions and attributes. It makes no sense. It has never made any sense...
Of all the conditions listed above, as well as in many more which are less often diagnosed, there is simply no evidence of a pathological process at work that might actually be responsible for pain. Vast numbers of people have severe lower back pain with no obvious structural explanations. Meanwhile, similarly vast numbers of people demonstrate all of the above diagnoses, but have no pain whatsoever.
This fascination with Cartesian medical philosophy has irreparably broken the back pain treatment sector. We are so focused on structural aberration that we discount the scientific conclusions of an objective diagnostic process. Doctors speculate every day on the cause of pain without any evidence of the verdict being correct or even logical. They simply image the spine, look for anything that looks "different" in the affected general area and then arbitrarily blame the structural irregularity as the true cause, without symptomatic correlation or evidence-based data. This reckless diagnostic process has led to the misdiagnosis of far too many people to ever be counted. We are talking in the hundreds of millions or more, worldwide.
We have no problem with blaming a structural "problem" for causing pain when the "problem" can actually be definitively linked to the symptoms through the scientific process. However, we rarely witness this degree of diagnostic evaluation. Typically, the process is largely unscientific and focuses on moving past (time consuming and largely unprofitable) diagnosis as quickly as possible and getting the patient into (much more time efficient and money-making) treatment.
In some cases, structural issues in the lumbar spine can surely create pain. This we know. However, in these cases, the process of generated symptomology can be correlated accurately to the causative condition through objective scientific methods. In our decades of experience, we estimate that somewhere between 2% to 5% of chronic lower back pain patients actually receive accurate structural diagnoses. The rest are given inaccurate explanations for their pain or have their pain blamed (fairly or unfairly) on nonstructural issues or anatomical issues that reside outside the spine.
This is our twelfth year of actively fighting the injustices of the back pain diagnostic arena as a formally organized network of care providers and medical researchers. Individually, we have been working to better the treatment results for tens of thousands of patients for many more years than this. We are sad to report that our efforts simply can not match the powerful, greedy financial motivations held in such high position by many doctors and therapists who treat these same structural issues without any evidence of them being the true cause of pain.
We have made great headway in reaching doctors on a scientific level and have seen our efforts rewarded in many studies that support our work and research conclusions. Doctors are slowly moving away from old and incorrect models of pain, but are still looking for substitute solutions that will guarantee profitable careers treating "something", regardless of what that "something" turns out to be or the accuracy of the diagnostic presumptions. It has become a case of replacing yesterday’s mistakes with all new blunders today, in many scenarios... New diagnostic conclusions have emerged to explain many types of pain and these too are suspect in so many patient profiles: thoracic outlet syndrome, piriformis syndrome, sciatica as a separate diagnosis, and the dreaded fibromyalgia. Meanwhile, logical diagnoses, such as tension myositis syndrome, are virtually unknown in the mainstream medical community.
We do have more hope than ever before. Many young doctors are leaving behind the old ideas that have proven themselves to be incorrect through their inefficacy. These young doctors see the logic in many nonstructural and mindbody models of pain and are slowly developing their own treatment parameters to combat these pain syndrome that have up-until-now, fallen through the cracks.
We hope that this trend will continue and that the lower back pain epidemic will subside. We just hope that when it does, whatever health issue becomes the newest manifestation of internalized tension will be recognized for what it truly is, and not misrepresented as yet another structural issue that must be dealt with through endless drugs, barbaric surgery and other risky and anatomically-punishing interventions.