We will be starting a series titled: Medical Myths.  It has been sparked by a great book about medicine: Hippocrates’ Shadow by ER doctor David Newman.

Myth #1: Back Pain.  Back pain is no myth, but its treatment is.  Back pain is one of the most common complaints seen by doctors.  Thankfully, it is usually self limiting (gets better on its own).  

The myth is that we know what causes it.  We don’t, or at least, it is not clear.  Many people with back pain seem to want an answer ASAP.  They request xray’s which are not helpful, or now many patients want an MRI as soon as they get their first bout of pain.  

“But there’s a secret about MRIs and back pain: the most common problems physicians see on MRI and attribute to back pain herniated, ruptured, and bulging discs are seen almost as commonly on MRIs of healthy people without back pain. This means that herniated and bulging discs, and most of the other findings that radiologists report seeing on MRIs of the back, usually have nothing to do with back pain.”-Dr. Newman, Hippocrates’ Shadow

Besides “I want an MRI” requests, the other request is: surgery.  But surgery doesn’t seem to work.  The only time you want anyone taking a knife to your back is if you have a neurologic deficit i.e. weakness.  

“Surgery to fix or remove a disc is usually performed in the hope that a herniated disc is compressing a nerve and causing the pain, but it carries a poor overall success rate. Even after the nerve is decompressed, or freed, by removing the disc surgically, half of the time the patient’s low back pain is unrelieved.”-Dr. Newman, Hippocrates’ Shadow

We will ALL suffer from back pain in our lives.  The best treatment? no one knows.  Prevention is important: Don’t do things that are going to put you at risk for injury. 

The good news–most of the time back pain will get better in time.