Personal Problems Become Back Pain

Science seems to be bursting with promise, if you believe what you hear and read -- but the reality is slightly more grim. Seems like science can't help anyone escape their own psyche.

Details of the very latest developments in diagnosis and treatment find their way into the headlines of print media and the features of broadcast media. We are told to expect cures.

All of us respond with bated breath. But then, problems persist that challenge our own sense of well-being and invincibility because, frankly, they seem simple but we can't beat them.

Backache is an object lesson.

The following is what modern medical science currently understands about the most common kind of low back pain, the backache that bedevils working-age adults who are otherwise totally well. This is a pain that does not involve the legs -- unlike many back pains -- and that comes on for no apparent reason.

What Science Can Explain...

It's not normal to be back pain-free for a long time. Low back pain happens. It's one of life's many recurring predicaments, like heartburn and heartache. To be well is not to be pain-free, but to have the strength of spirit enough to to cope until the pain goes away, cope so well that the episode is not even memorable.

Low back pain is related to posture and movement. It doesn't hurt as much when reclining, but hurts more when sitting slouched forward in a chair or propped up on pillows, and hurts even more when bending over.

One is forced to choose between being an invalid or being in pain. Compelling science says that the pain relief of being an invalid isn't worth the risk of feeling useless. Feeling useless just enhances the suffering without making the pain heal any faster. Science says, take an over-the-counter analgesic and get on with life as best you can.

Dr. Nortin M. Hadler is a Professor of Medicine and Microbiology/Immunology at the University of North Carolina at Chapel Hill and Attending Rheumatologist at University of North Carolina Hospitals in Chapel Hill, N.C. Low back pain will go away, but seldom overnight. The pain will more likely take weeks -- sometimes months -- to recede. But, one should never despair, nor should one feel so desperate as to grasp at miracle cures that sound too good to be true, and probably are.

Keep in mind that, despite all their jargon, there is no one who can reliably pinpoint the cause of your pain. There is no magic theory or "modality" that can be applied specifically to you. All these helpful people, frankly, are taking advantage of you -- engulfing you and your pain in their belief system.

You will no longer suffer alone. But, despite their promises, you will not return to your prior state of well-being any faster.

In fact, you will probably not return to your prior state of well-being at all. The treatments you underwent taught you new ways to think about yourself, your back, and your vulnerabilities. You will greet any recurrence of the back pain with a different mindset. Nearly all the information that is purveyed reflects the beliefs of the purveyors and withstands scientific testing very poorly.

If all this is a pleasing prospect, go for it. But do so informed.

For some of us, the pain overwhelms the ability to cope. Certainly, that could reflect the severity of the pain. But science suggests that it is not the pain, but other aspects of life that blunt our coping skills. Problems with life at home or work may be hurting our ability to cope with physical pain, no pun intended.

What to Do?

If you cannot cope any longer, find someone trustworthy to discuss the possibility that the pain is a reflection of some other assault on your coping skills. In all likelihood, you coped with similar predicaments in the past.

If you can't open up to the possibility that something in life is more painful than the pain in the back, you run the risk of feeling so desperate that you submit to pills, potions, magical thinking or ineffective surgery before you come to grips with your psychosocial adversity.

Dr. Nortin M. Hadler is a Professor of Medicine and Microbiology/Immunology at the University of North Carolina at Chapel Hill and Attending Rheumatologist at University of North Carolina Hospitals in Chapel Hill, N.C. Don't let the pain cloud your thinking. Don't let preconceived notions lead you astray.

That's low back pain, 2006.

Dr. Nortin M. Hadler is a Professor of Medicine and Microbiology/Immunology at the University of North Carolina at Chapel Hill and Attending Rheumatologist at University of North Carolina Hospitals in Chapel Hill, NC.