Have you been experiencing pain for one week, one month, or over a year? Maybe over 10 years?? Maybe you know someone in your family that has been suffering with the same injury for what seems like decades.
Have you (or they) been to countless physician appointments, taken prescription medications like it's your job, and possibly even undergone surgery?
Maybe you're afraid of that cycle because you've seen your Aunt Bessy go through it and you're afraid that you're going down that same destructive path.
First thing to note:
Our healthcare system is broken.
The days of speaking with your MD or Specialist are over. Now we have become reliant upon assistants and other practitioners. That's not to say that they don't do a fine job. However, physicians are now in charge of seeing their patients and overseeing the patients of PAs (physician assistants) and NPs (nurse practitioners).
You can see how it would be easy to overlook someone's problem or unintentionally let people slip through the cracks. I don't blame the practitioners for this.. I blame the insurance companies and greed - but that's a topic for another day.
Let's get to my point:
Low back and neck pain are key contributors with the rise in opioid use. Many will go to specialist after specialist, undergo countless imaging and testing, along with injections... without any relief in their pain. For many people, their pain actually INCREASES.
And this is where it starts.. for many, it may have started at the very beginning. Their physician gives them a prescriptions for anti-inflammatories and pain killers. When that doesn't work then they start with the injections over the course of several months which then eventually leads to surgery.
Throughout this entire process, physicians continue to prescribe pain killers because what else can be done? Might as well try to help them numb the pain until it can be "fixed" with surgery, right? And don't forget about their caseload.. alot of practitioners don't have time to think about anything other than referring a patient to a specialist or performing surgery.. when was the last time you spent more than 10 min with your physician?
After surgery, the pain still continues... then what happens?
Typically they will refer these patients to other "specialists"..
and so the cycle begins...
I have a BIG problem with this cycle..
First of all.. IT NEEDS TO END.
Secondly.. How do we do that?
We have to determine the underlying cause of the pain. Pain doesn't happen randomly and for no reason.
This is our body's way of saying.. "I'm not a big fan of what you're doing here.. something's just not right!" If not, then we would continue to do further damage without knowing it.
That's EXACTLY what our painkillers are doing..
They kill the pain. Quite literally.
You might be thinking to yourself, "Well I'd rather not be in pain so what's the harm in taking them for the time being?"
Because it's disrupting your body's normal alarm system. It's quieting it down or shutting it off completely. And just because the pain goes away (or is decreased) that doesn't mean it's getting better. Many times, you'll end up doing more harm because you can't feel what you're doing.
You won't feel the pain when sitting at your desk at work. You won't feel the pain when picking up your kiddo or grandkiddo. You won't feel the pain when picking something up off the floor.
Eventually, you will have to take more medication to have the same effects and that's when it can become scary.
The people getting addicted to opioids aren't the men and women who are living on the streets...
It's the average person trying to get by. Trying to continue working without going on disability... Trying to tackle all of the responsibilities of being a parent... Trying to live an active lifestyle... You get my point.
What needs to happen is the first line of access should be seeing a Physical Therapist
If you don't know one.. then find one! Do your research. Don't just go to the Physical Therapist that is the closest to your work or home.
Finding a true Musculoskeletal Specialist that isn't bogged down by all of the paperwork as well as being overworked and underpaid may be difficult, but it's not impossible.
But you would do this when researching a Neurosurgeon.
You wouldn't pick the first one that pops up on Google or one because they have a hospital closest to your home.. at least I hope not! :)
I understand that surgery on the spine can be very dangerous so you'll want the best! And I'm not saying Physical Therapy comes with the same precautions as surgery. However, if you see a PT that doesn't perform a thorough comprehensive assessment and establish a treatment progression based on YOUR specific needs then you will slip through the cracks unnoticed and be on the track for surgery.
And get this.. you may have surgery on something that ISN'T the primary cause of your pain. You complain of back pain and symptoms down the leg.. then go in for an MRI to show horrid things.. "oh my! I have degenerative WHHAATT? Well of course I need surgery!"
Let me break it down.. just because you have signs (or actually have) degenerative disc disease or joint disease does NOT mean that you automatically HAVE to have surgery. And just because someone says your joint is "bone on bone" doesn't mean you HAVE to have surgery!
Does it mean that you will never require surgery?? Of course not.
But why not give the conservative route (AKA Physical Therapy) a try? What harm could it do? You can ALWAYS have surgery..
And most importantly, I have helped many people return to active and healthy lifestyles without requiring surgery.. And . yes, these are people who have been told, "You have the worst spine I've ever seen" and "You're bone on bone. There's no way you'll be able to play with your grandchildren".
So there is still hope!
Musculoskeletal Specialists will provide you with a comprehensive total body assessment
This will involve a detailed history of YOUR PAIN. Each session should be 45-60 minutes long and should be heavily manual based.. meaning they work on your _____ fill in the blank by using manual techniques.
Through their assessment, they should be able to develop a plan of care that tackles the underlying cause of your pain.
Remember that children's song.. "The leg bone's connected to the knee bone, the knee bone's connected to the thigh bone..?"
Well, its true!!
Your body is a kinetic chain.. meaning that everything works TOGETHER.
When one part moves, the other part stabilizes. Therefore, if you have an injury or source of pain in one area of your body.. then you'll certainly develop aches and pains in other areas of your body.
And when you add painkillers into the mix you can see how that can be a toxic concoction.
One thing that I do want to note is that if you are currently dealing with pain and are discouraged.. DON'T LOSE HOPE!
I have seen, firsthand, how resilient the body is. Just because you've been told, "that's the worse (insert body part) I've ever seen" or "it's bone-on-bone" or even "you have degenerated discs and joints, you shouldn't do xyz.." doesn't mean it's true!
I have had MANY people overcome pain that they thought they would have to deal with the rest of their life.. Is it easy? Heck no!! Is it possible? Heck yes!!
Now depending on how long you've been dealing with the pain and how many body parts are involved, it might take longer than you like. Unfortunately there are no quick fixes in life.
If someone tells you they can fix something in one session then you might want to walk the other way. That's not real life.. However, if you are dedicated to overcoming your pain and will do anything to get back to a healthy and active lifestyle then, by golly, you can!!
Where to go from here?
Over the next few weeks I will be discussing common injuries (starting with back pain) and ways to treat them!
If you're local to the Nashville area, I provide FREE Discovery Visits and Phone Consultations. I would love to talk with you and explain how I can specifically help YOU and YOUR pain.
I also offer Money-Back Guaranteed after 2-4 sessions if you're not completely satisfied with the results. I 100% believe in what I do. I have seen people's lives transformed by making minor modifications to their daily routine. You will be surprised what the body can overcome if you are able to address the real reason behind the pain.
And please subscribe to my newsletter to get email reminders for my upcoming posts! I'll also send you my FREE Back Pain Guide!
I would also love to hear any questions that you may have! Please email me directly at firstname.lastname@example.org or comment below!
Dr. Katie Spruell, PT, DPT, CSCS
KS Fitness + Co, LLC
Dr. Katie Spruell, PT, DPT, CSCS
I am a licensed Physical Therapist and Certified Strength & Conditioning Specialist practicing in Nashville, TN. I started a small private practice - KS Fitness + Co, LLC - in April 2018. Recently I moved my practice to Knoxville, TN.