Bruce Reid begins his lecture by painting a rather dark picture: Back pain is rampant, expensive, and very difficult to diagnose and cure. He says that $86 billion is spent a year on back pain treatments in the U.S., with 1 out of 14 patients going to the hospital with back pain complaints. He says that back pain is over-treated, citing a case of an ineffective spinal surgery. Reid raises the very important point that, though we know spinal surgery is not helpful to most people, the performance of complicated spinal surgeries is on the rise.
Reid admits something about his profession: Doctors generally don’t know what to do about back pain. For this reason, it is important for patients to assume some responsibility for their treatment. The more you can learn about your specific pain, the better able you are to steer your doctor in the right direction.
Bruce Reid, MD, provides an informational lecture at The Wellness Center of URMC. The first part of the lecture can be viewed here:
After detailing the frequency of back pain and the difficulty of treating it, Reid offers hope. He says that most instances of back pain develop out of improper posture and positioning as well as a lack of physical fitness. Reid has participated in projects that address the ergonomics of workplaces and prescribe exercise programs. The results showed less back pain among those who exercise and work in an ergonomically-inclined environment.
Maintaining fitness and overall health is one of the best ways to avoid or even correct back pain. Exercise keeps the muscles that support the spine strong. Stretching keeps blood flowing through the muscles, ligaments and tendons. It also helps muscles to maintain elasticity and joints to maintain flexibility.
Ergonomics, the science of adjusting an environment to the needs of the human body, ensures that the spaces we work in are not designed in a way that encourages us to overextend, lift while twisting, slouch while sitting or standing, or assume any other positions that are unnatural and harmful to our bodies. The discs of our spine can be damaged by improper lifting or by sitting in a way that distorts the natural curvature of the spine. Muscles are also strained by these activities.
Other risks of back pain Dr. Bruce Reid mentions are being overweight and smoking. More weight means more load for the spine and muscles to support. Smoking disrupts the diffusion of nutrients into spinal discs, causing them to dehydrate prematurely. Emotional stress can also manifest in the muscles of the back, especially the lower back.
Lastly, Reid warns against rushing to a diagnosis without knowing for sure what the problem is. He cites the overuse of the term ‘sciatica’ as an example. Many people feel a pain shoot down the leg and think it is sciatica; some doctors do as well. True sciatica is felt in the lower back and shoots down the nerve path, at least below the knee. Muscular problems can cause pain to radiate from the back to the buttocks and legs, so a diagnosis should be done carefully. Sciatica, leg pain and muscular pain are treated differently.
Dr. Bruce Reid gives us a very honest picture of back pain and the medical profession as an insider. He emphasizes the importance of cautiousness when issuing or accepting a diagnosis. We can also take away from this video the important role that self-care can play in preventing and correcting back pain. Keeping in shape with an exercise program that offers a balanced workout goes a long way in back health. Reid reminds us that we have the power to help ourselves, and that our personal efforts are often more productive than what our doctors can do for us.