Gerry's Story of Back Pain & Dr. Visits...

Let's look at 2 ways this common complaint could play out.

There is always choice. Sometimes we don't know what exists, sometimes we are too worn out from our persistent pain to even think straight, which affects our ability to advocate for ourselves.

I've also mentioned that our medical system in Canada is seen as a gold standard, that our medical doctors know all and can provide us the best outcome... and that system is flawed, no fault to the doctors. Apart from the state of our medical system in general right now, the amount of information that is out there, it is impossible for any one person to stay up to date without a team behind them.

So where does that leave someone with persistent pain? We know pain is complex, and our ingrained & taught go to is finding MSK (musculoskeletal) issues.

Join me for a story about Gerry (fictional person). Gerry has had back pain on and off for a number of years. Sometimes it is long lasting, sometimes it is just a nagging ache, every so often, it is exhausting. Gerry grew up a competitive athlete and had the occasional injury affecting their knees, shoulders and neck. This back pain though... staying active, massage, acupuncture, even their physiotherapist that they've been seeing for years. Nothing has really solved the issue, so the next choice is their medical doctor.

Let's jump ahead (as is common, Gerry has walked away from the first 3 appointments over a year with a prescription in hand), the doctor sends Gerry for imaging, a basic xray panel.

At the post xray appointment, Gerry is told that there is severe osteoarthritis in the facet joints, previous compression fractures in the lower thoracic spine, and disc degeneration in the lower lumbar spine. That sounds pretty serious to Gerry and this language (and lack of explanation) sets Gerry up with a foundational sense that their spine is now fragile and is only going to get worse with more movement & activity. Gerry can now visualize how painful all those joints are when there is movement. We all know the story of 'wear & tear' well, and with the competitive history that Gerry has, it is no wonder... this is ALL about 'wear & tear'.

Since Gerry has tried all of the manual therapies prior to heading to the doctor, now all thoughts steer toward the only 'seemingly' possible fix... surgeries, injections, and prescription drugs to manage the pain. Since it takes 6-18 months to get into the next specialist, Gerry continues one prescription after another... Tramadol, Naproxen, Cymbalta... nothing quite helps and since Gerry now sees the spine as fragile and at the point of breaking, the activity level of life has now disappeared and with the fear of such a different lifestyle and level of fragility, the back pain is so much worse.

Let's stop here and imagine a different situation...

Yes, the back pain is still there, but the doctor has a different approach and at the very first appointment asks 3 simple questions to learn more. One of the first things asked of Gerry is what stress has affected their life over the last few years. Between the stress of raising young children, a not so communicative life partner (they were overworked for a solid couple of years), a stressful promotion at work, a house renovation, and the loss of a parent last year, Gerry tells of a few issues. When asked if any back pain flare ups have occurred around those same stressful times... a pattern arises that gives the doctor some solid information. One more question to ask. Have there been times in the last few years that the back pain hasn't affected your life and you've felt strong and active? Yes, answers Gerry, during and after an amazing vacation where there was lots of relaxed cycling, no work load... and a handful of other times.

Now, instead of the doctor sending Gerry for xrays, there is a referral to a Kinesiologist that specializes in persistent pain. Work is done on reprocessing pain, calming the nervous system, movement rehab to build confidence, and teaching skills that will help Gerry with flare ups.

Within 3-6 sessions with the specialist, Gerry is back to building strength, getting back to life, and feeling so much better! Yes, the pain is still there, but there is confidence in the path back to wellness and the energy to live life once again.

Now... I'm bias. Fully admit this. Which way would you like your doctor to approach your pain? Yes, there is a time for xrays, surgery, injections. In the first scenario, there were findings on the xrays, but were they findings that would have affected the process of work with the Kinesiologist? Did the findings have a negative affect on Gerry and how the pain was visualized? What if the findings were read in a way that created a sense of awareness but normalcy. In the way that those things are related to aging, like saying they are 'wrinkles on the inside' (thank you to Greg Lehman for that phrase).

Here's the deal, the results of the xray... my results. Yes, I've had radio frequency nerve ablation and it helped a little. You know what helped more... learning that the sensations I was experiencing were not 100% tissue damage, but my nervous system trying to protect me and get me to change certain ways I was dealing with my life. I've learned lots, and I am still learning. Good thing I love learning. :)

So where does that leave you? If you are experiencing persistent pain, let's get some work done! Message me, let's chat.

Are you a doctor, physio, manual therapist, fitness trainer, yoga instructor that would like to learn more about working with patients and clients in pain? Message me, let's chat!

Let's change the way we treat persistent, chronic pain.