Low back pain self-diagnosis is more difficult than you think; here’s why.

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Low back pain self-diagnosis is common for those who have chronic pain.   In reality, diagnosing the cause of low back pain is more difficult than you would think for not only yourself but for most doctors as well. Some try to manage it through yoga, exercise, and other self-help methods.  Years later as these functional problems worsen, joints may have been damaged over time irreparably and are seen on imaging studies as osteoarthritis. The way we move is an adaptation to our body style, how we developed during our growing years, our overall flexibility, past injuries, our nutrition, and our activity levels. Those who grew up with a lot of activity or participated in sports may have had injuries they have adapted to. Their bodies are likely more efficient at the cellular level with a higher level of fitness but those adaptations may have consequences many years later. Sex can affect our body mechanics as well since women have wider hips which can worsen poor mechanical adaptations.  This may be one of the reasons why women are more likely to have been diagnosed with fibromyalgia which has a mechanical basis.

What is normal?

Most lower back pain is due to multiple causes that can differ depending on y9ur inherited traits. Prior to the age of 6, as toddlers, everyone is flat-footed.  By the time we are 6 years old, as discussed in the book Cheating Mother Nature, What We Need to Know to Beat Chronic Pain, we walk more like our parents. Is there a normal?   Normal is what we are used to.   Is that really normal or just normal for you?    Normal can be just my normal stiffness and tightness when sitting or standing.   While for another person, normal is that it takes a while to be able to touch my toes or my neck normally cracks. From a chiropractor's perspective, we will ask a lot of questions during our initial visit that may not seem to be related to your lower back pain, but these questions are part of a holistic way of thinking and diagnosing lower back problems.   Lower back pain is a malfunction that is usually mechanical and often results from poor adaptation or lifting improperly or both. Since there really is no normal, we are now left with your history and then how you function or malfunction which leads to chronic or acute back pain problems. Unfortunately, how we feel is personal bias.   From a physician's point of view, to accurately diagnose why you hurt, we must understand you instead of making you fit our bias or model for the symptom of back pain. Evaluating the symptom of back pain and treating the symptom with generalized recommendations or treatment protocols that everyone does is why most people with lower back problems become more chronic; they were never properly diagnosed and treated. If you developed a herniated disc, did it just happen or was there an adaptation that resulted in a herniated disc over time? A physician who uses a holistic approach to back pain is most likely to help you faster and more appropriately than a physician who ignores the rest of your body,  This is because they are looking at your body as a functional unit.  If done properly, you may find out that your neck, back, shoulder, knee, foot, and hip pain are likely one problem rather than a number of problems that all require separate healthcare providers.  It is more efficient to have one provider who understands your problem and can treat you for it than to have a team of people simply looking at an electronic record each with a different opinion or point of view.  Segmented care is expensive, inefficient, and often inaccurate in both diagnosis and treatment. In other words, keep it simple.

Why do self-diagnosis and most physicians get back pain wrong?

Imaging using an MRI machine used to be the gold standard for understanding back pain until many people had back surgeries or other interventions that made them worse and created lifelong problems. X-rays were used to wrongly diagnose back problems as being due to arthritis.  The truth is that while x-rays have some value in the diagnosis of why you hurt, they actually are more likely to show you a history of malfunction instead unless there is a more serious underlying health problem.  The good news is that serious health problems are rare. Medical physicians and most osteopaths use a medical model to diagnose back pain and fit it into their paradigm.   The truth is, they have a huge blind spot called the musculoskeletal system which is because they have little training in it.   Most back pain sufferers are either medicated which is not supported by the literature or sent for therapy to the patient's area of pain. Care is usually segmented into different people doing different things which is more complicated and more likely to result in expensive and inappropriate diagnostics and treatment that doesn't work. Looking up your symptoms on google is usually a fool's errand because your problems are unique to you and google offers very generalized information based on symptoms.  Trying to understand why you experience back pain without being able to be objective about what is happening is also frustrating.   Do we need constant medical care or a more simple solution? Chiropractors know that when you look at everything, you will see a very different clinical picture than if you look at the lower back while ignoring the parts of the body that may be affecting it.   In fact, many of the disc bulges and herniations we see on MRI are being classified as incidentalomas because they too, are a result of a history of malfunction and may be incidental to the back pain while not being the actual cause. As you can see, physician or even personal bias is often why we all get back pain wrong.   When you are in acute pain and cannot get out of bed, you are likely to do desperate things or submit to tests that may not help you find the best way to improve the way you move or recover quickly.

What causes lower back pain

Lower back pain can have many causes including

  • Upper body problems
  • Shoulder joint malfunction
  • Foot problems
  • Chronic flexibility problems
  • An old lower back injury that has been adapted to poorly
  • An acute injury to the lower back from a fall or lifting improperly
  • Of course, there are the scarier things such as a disc injury which is less common, and then of course cancer which is very rare.
Since any part(s) of the body can be responsible for why your back hurts, you need to have a generalist approach to the musculoskeletal system to understand why you hurt.   This is why a holistic approach should be used first.    The only profession that is capable of holistic primary care of the musculoskeletal system is the chiropractic profession. Using the holistic approach, you may also find out that your other problems such as sciatic pain, shoulder pain, neck pain, foot pain and even knee pain all are one problem, rather than a series of problems requiring multiple specialists. Perhaps, this is why the chiropractic profession has the best reputation for lower back pain and even sciatic pain.   Who should you see first for a lower back problem?  All roads lead to the chiropractor.   Book online here