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November 15, 2016

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What are the long term consequences of back pain?

May 10, 2016

 

Most people tend to think that once a problem stops hurting then that’s the end of the problem. Its healed. All done. Let’s move on. Likewise, prior to having pain, there was no problem. Everything was perfect.

 

The reality is that in most cases (barring a direct trauma like a fall or tackle gone wrong) the problem existed long before pain came along. And once the pain resolves, there are consequences that can be long term if not corrected.

 

So let explain with an example;

 

Peter aged 36 is your normal kind a guy. Exercises a bit here and there, has a 45 hour a week deskbound job. Eats reasonably ok.

 

One day, Peter wakes up in the morning and notices his lower back feels a little sore and tight. He tries to loosen it up with a hot shower before work but it doesn’t do the trick. Slowly over the day his pain starts to increase until about 2pm when it becomes sharp and spasmy.

 

Sounds like a common story. I hear it a lot.

 

The problem is most people want a reason why their back hurts so they will attribute to the closest causal factor they can think of; “the gym yesterday, that must have done it!” or “I did all that work around the house on the weekend!”. In some cases they can be right, but a lot of the time it isn’t the only reason why.

 

So in Peter’s case, once we do a bit of digging we find out that Peter had a nasty fall about 5 years ago when he fell off a ladder on his bum. Back was a bit sore but felt fine after a day or two. What Peter didn’t realise is that even though the pain went, the damage done to his back and the alteration to how his lower back worked (joints and discs) has stuck around and adapted and adapted over that 5 year period. That combined with his right foot that has become pronated after recovering from a twisted ankle 7 years ago which has caused a rotation in his pelvis, has all combined to make Peter’s back not as adaptable to stress and load as it should be. Now fast forward to today when Peter’s back is in spasm and we take an xray, we can see that there are long term physiological changes to the joints and discs of the lower back that didn’t happen overnight. We can see a distorted pelvis that took years to get that way. It now functions in a way totally different than it did 7 years ago.  He is now has visible osteoarthritic changes to the spine and its joints as a consequence of the fall.

 

Over time, the body decays; that’s life. But particular to the spine, if it is aligned well, it will distribute weight and work evenly so that the natural degeneration that occurs over time is even. You shouldn’t develop visible arthritic changes in the spine till you are 70+. I am seeing it in 30 year olds. Falls, accidents, long term postures (like sitting or staring at your iphone) lead to changes in the way the spine works which in turn speed up the processes by which it wears away. And wear and tear is a one way street.

 

So falls, accidents, sporting injuries are important to get checked. Even if the pain goes in a day, it can still have long term consequences, which can sometimes be irreparable.

 

 

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