| In part one, we discussed how back pain is an | | | | time is spent on consulting and examining. |
| epidemic with seemingly no end in sight. And that | | | | Combine that with the fact that most medical |
| despite huge investments in research, there | | | | schools spend a miniscule amount of time training |
| seems to be blockages to a cure for lower back | | | | students in the diagnosis and management of |
| pain. We suggested chief among theses reasons | | | | physical ailments and in particular lower backs and |
| was medical physicians unwillingness to change. | | | | you have a situation where doctors provide |
| Despite evidence suggesting things like drugs and | | | | inadequate examinations. |
| bed rest are abject failures they continue to be | | | | The proper diagnosis of a back problem requires |
| the mainstay of medical lower back treatment. | | | | the doctor to understand all the possible causes |
| In this article we will discuss the delicate issue of | | | | of back problems and how each presents clinically. |
| misdiagnosis as a reason why peopel with back | | | | It may appear to a layperson and even to a large |
| problems cannot find a cure for their lower back | | | | percentage of general doctors not versed in the |
| condition. | | | | specialty of lower back issues that "back pain is |
| There are many causes of a painful lower back: | | | | back pain." |
| - Strains and Sprains (traumatic and postural) | | | | There are, however many variations of |
| - Emotional stress | | | | symptoms from a back condition that must be |
| - Subluxations (misaligned spinal bones) | | | | distinguished. |
| - Arthritis (osteoarthritis is the most common, but | | | | Believe it or not, a ligament in your back presents |
| many other forms exist) | | | | with a unique pain pattern that is different than |
| - Degenerative disc disease | | | | say a degenerative disc. Likewise, a degenerative |
| - Herniated discs | | | | disc can present with a totally different pain |
| - Disc bulges | | | | pattern than a bulging or herniated disc. The |
| - Spinal stenosis | | | | doctor must understand this. |
| - Fractures | | | | All too often, generalist doctors and even some |
| - Tumors | | | | specialists perform a cursory exam and then rely |
| Often, back sufferers have more than one | | | | on imaging such as x-rays and/or MRI. They allow |
| condition contributing to their pain. This makes | | | | a structural finding on a film to dictate to them |
| arriving at a clear diagnosis difficult at times. | | | | what is functionally wrong. That is not always the |
| Doctors must use their clinical judgment as to | | | | best method of diagnosing a complex problem. A |
| which condition is likely to be causing certain | | | | disc that is degenerative on film may not be the |
| symptoms. Sometimes a condition is present, but | | | | culprit causing the back pain. Likewise relatively |
| has very little to do with the patients' pain. This | | | | benign MRI finding does not mean that the |
| requires great skill and experience on the doctor's | | | | patent's condition is not serious. |
| part to discern. | | | | Finding a cure for lower back pain is difficult, but if |
| And therein lies the problem. | | | | your doctor is open to newer technologies and |
| Our medical system forces doctors to see ever | | | | performs a careful and specialized examination, it |
| increasing numbers of patients each day. Less | | | | is possible to achieve in many instances. |