Recently, research has focussed on the psychology of lower back pain and they have found that one big hurdle faced is when patients fixate on a particular diagnosis from a scan they recently had done.
“I’ve got a bulging disc mate! I shouldn’t be doing that!”
“3 bulging discs! I won’t be able to go fishing again!”
But there is one missing link which his crucial when talking about lower back pain and scans! Health professionals often fail to point out that degeneration and different changes are a normal part of ageing and do not necessarily mean any pain!
I always think of it as wrinkles – do wrinkles mean anything? No! it just means I’m getting wiser! It doesn’t mean cancer, or a kidney disease, or anything! It just means I’m getting wiser!
It’s easy for us as humans to fixate on a diagnosis which results in limiting ourselves from doing certain activities because we are scared! Did you know that research shows, when patients see a scan which shows a disc bulge, they are less likely to get better simply? We just think, ‘that’s it! I will never recover from this!’
This is why the Australian Physio Association (APA) warns against unnecessary imaging for patients presenting with back pain. Scans definitely have a crucial role in management of the patient with lower back pain, but the health professional must use his medical reasoning to decipher whether this is necessary or not!
If you have a look at the table below, there was a huge research paper done (3,100 participants – huge!) on patients which had no back pain whatsoever! Literally nothing! And they had a look at their scan results and concluded with these figures!
So if you have a look at this in their 30’s, 52% of them had disc degeneration but still NO lower back pain whatsoever! Those in their 20’s, 30% of them had disc bulges and again NO lower back pain whatsoever! And obviously the stats increased as we age!
1. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. 2015 by American Journal of Neuroradiology.
BUT WHAT DOES THIS MEAN? THIS MEANS 3 MAIN THINGS:
1. The amount of pain we feel does not correlate with the injury! The worse the disc bulge doesn’t mean the worse pain we will feel!
2. Disc degeneration, disc bulge, etc. Are all apart of the normal ageing process!
3. This one is for the health professionals – we should be very picky with the amount of scans we ask for! Those with red flags, or chronic pain – may be good candidates for scans.
At Agape Physio, we listen to you! And then with all the information you have told us, we then thoroughly and accurately assess everything to make sure we have a clear picture and comprehensive treatment plan specifically for you! So we can get you back to living you best life! What are you waiting for?
