#5 May Edition - Treat the patient not the scan

Hi, everyone! 🌟 Back pain—it's something we've all experienced at some point, isn't it? As we dive into May, it's been top of mind for many of my patients. In fact, just this past week, I had four patients rush in for scans due to acute back pain. This got me thinking about a fascinating study by Brinkji et al. in 2015, where thousands of individuals without back pain underwent scans to see if any findings emerged.

Understanding Back Pain and Imaging

Our ability to use advanced imaging techniques like MRI and CT scans to explore the source of discomfort is truly remarkable. They offer us detailed insights into the spine, often uncovering conditions like disk degeneration or disk protrusion. 🕵️‍♂️🔍

The Surprising Truth

But here's the kicker: Many of these changes are found in people without any pain! Yes, you read that right. It's more common than we think. 😲 (See chart below for some eye-opening stats!)

What Does This Mean?

Even in young adults, these changes can appear, suggesting they might not be the primary cause of discomfort. It's a revelation that challenges our traditional approach to interpreting these scans. 🤔💭

Key Takeaways

So, what does all of this mean?

1. Pain Doesn't Always Correlate: The amount of pain we feel does not always correlate with the severity of the injury. The worse the disc bulge doesn’t mean the worse pain we will feel! 📉🤕

2. Normal Aging Process: Disc degeneration, disc bulge, etc. are all part of the normal aging process! Just like wrinkles on our face—think of these changes as wrinkles of our spine. 🧓👵

3. Use Scans Wisely: Scans are not the answer, just part of the puzzle that may add information but this is very much a case by case basis. As you can see, they are not as reliable as we thought. 🩺💡

What To Do If You Wake Up With Back Pain?

1) Consult with your doctor for appropriate pain medication: Managing pain is important because if you have less pain you will be motivated to move. Movement is vital for recovery.

2) Consult with a healthcare professional for stretches and exercises: When it comes to back pain, any form of movement will help - so don’t feel bad if you can’t stand pilates.

3) Eat, sleep, hydrate: Do your best to eat healthy, drink lots of water (2.7L for females, 3.7L for males) and try to get some sleep. I know sleep can be challenging especially when having a flare up.

4) Only 5% of back pain is serious: Try not to worry, there is a really good change that your back pain is not serious but consulting with your doctor or healthcare provider can screen this out with some specific questions.

5) Try not to stress on the why: Pain is complex, it can present because you did too much too soon, did something your body is not used too, a spike in life stress, poor sleep, not exercising enough, or going through a period of unhealthy habits. It will pass, especially if managed well from the beginning.

Wishing You a Fantastic Month Ahead!

Stay health smart and have a wonderful May, everyone! 🌟🌈

Warm regards,

Kosta Ikonomou 😊