The Conundrum of Pain

Restore24 Blog #1       3/15/2022

The Conundrum of Pain

What is pain? Well, I could give you the Webster’s dictionary definition- Noun: Pain; physical suffering or discomfort caused by illness or injury. Mental suffering or distress. The definition doesn’t quite give the word, the concept, the condition that is PAIN the justice it deserves. Pain is more like an animal, a caged animal, constantly gnashing its teeth fighting to get out. If you have, or currently suffer from daily pain then you understand. Back pain is one of the most common reasons to visit a doctor. According to the Mayo Clinic who analyzed data from 2005-2009, back pain came in 3^rd behind osteoarthritis/joint disorders and skin disorders, 2^nd and 1^st respectively. Back pain is very common and data from the World Health Organization indicates that 60-70% of people will experience back pain in their lifetime.  With the boring stats covered let’s talk about the problem, back pain.

Imagine, you wake up in the morning with plans to exercise to start the day out right. You get your shorts and shirt on, head to your home gym stopping on the way to get your water for hydration. Sit down and bend forward to put your running shoes on and BAM!! Your back seizes up and suddenly you can barely get back upstairs to your room. Nothing helps; sitting, laying, and standing…nothing. You feel it may be a spasm and attempt to stretch, ice, heat, a tennis ball, a fist shoved in the spot…nothing. Fidgeting around constantly, trying to get comfortable…nothing. This was me recently and thankfully I fully recovered in a few days, however not all are that lucky.

Now here’s the big problem, back pain is difficult to diagnose. There can be multiple different causes. It could be any number of spine related issues such as disc herniation, disc degeneration, spinal stenosis (narrowing of the spinal canal) or facet (joint of the spine) mediated pain. It could be from a muscular or other connective tissue source, sacroiliac (SI joint) generated pain. The pain could be due to abdominal or pelvic causes. Potentially it could be vascular. I have to say that in most cases the cause does emanate from the spine. I used to work in the Emergency Room and I recall a patient who came in due to mid back pain that had been present for a few days. He sat in the waiting room for a while and was eventually seen by the physician. An x-ray followed by a CT scan showed the patient had a large thoracic aortic aneurysm and this was the source of his back pain. Unfortunately this patient did not survive his condition.  Currently I work in a spine surgery practice and some years ago saw a patient in clinic complaining of severe low back pain. He was a prior surgical patient who felt his pain acutely changed and was only made better by a hot shower. X-rays failed to show any obvious cause for the recent change in pain. He was eventually diagnosed with a bowel abscess, was treated for the abscess and the pain resolved.

The bottom line is that back pain or pain in general is a complicated condition that may require a Sherlock Holmes & Watson bit of detective work to figure out. Be patient and don’t disregard the possibility that your back pain may not be a back (spine) problem at all.