The Most Frequent Diagnosis and Causes of Back Pain

The most frequent diagnosis for back pain is ‘non-specific low back pain’ (it used to be termed ‘simple back-ache’ but, as we know, it is far from ‘simple!’). The maxim that you can’t treat a patient without first knowing exactly what’s wrong with him or her doesn’t hold up in the field of back care.

Most people never find out the cause of back pain, and they get well nevertheless. For example, a 60-year-old construction worker who saw a noted orthopedic surgeon received a diagnosis of severe osteoarthritis of the lumbar spine – very specific. But after a few weeks of bed rest and exercise therapy, there was no improvement. A lesser-known orthopedic surgeon then diagnosed the problem as a general weakness of the lower back – not very specific. But the result of his approach to treatment was successful.

If you look at any schematic of the back and spinal area you will see that each nerve supplies both muscles and joints in the back. This can make it very difficult to pinpoint the exact causes of back pain in different parts of the back, which partly explains why it’s often so hard to get a specific diagnosis.

You Need a Diagnosis That Rules Out Serious Medical Conditions

causes of back painWhen you’re dealing with persistent back pain, it is essential to evaluate underlying medical causes of this pain. The chances are 95 in 100 that nothing of great consequence will be discovered.

But if you have severe or chronic back pain, don’t take chances. Any disease or disorder, literally from your head to your toes, can cause back pain. And far too many people needlessly suffer back pain for years because no practitioner makes a thorough effort to identify the tangible – and treatable – cause. One writer’s neck pain caused him great anguish for five years. In all that time, no doctor tried systematically to rule out a tangible cause of his pain.

The practitioners he saw talked continually about stress as a major causal factor, until the writer himself wondered whether the pain was ‘all in-his head’, or at least mostly caused by stress. Finally, relatively common diagnostic measures revealed a large but non-malignant tumor. When the tumor was removed, the pain eventually went with it.

A businessman who owned his own company spent years seeing virtually every famous back specialist in the US. He was repeatedly told that the problem wasn’t physical but that he needed psychological help. Crippled with pain, depressed and obsessed with thoughts about suicide, the patient tried one last specialist. A treatable neuromuscular disorder was discovered. In six months a prescribed drug brought him a 90 per cent recovery. In a year the patient was fully recovered.

Colitis, an inflammation of the colon, turned out to be the cause of back pain for a secretary. She went to a general practitioner for a complete medical examination after years of chiropractic care failed to control her chronic back pain. Appropriate back pain medication quickly solved her problem.

Perhaps the most frustrating story about needless suffering with back pain comes from a publishing executive who was warned by an osteopath that he would have to live in a wheelchair for the rest of his life. A ‘crooked spine,’ the osteopath said, “Was combining with spondylolisthesis to produce incapacitating and irreversible leg pain and numbness.’

short leg syndromeBut after ten years of agony, the last two of them disabling, the executive saw a chiropractor who diagnosed the cause of back pain as short-leg syndrome. The real culprit, again, was the lack of a thorough examination. The chiropractor prescribed a built-up shoe, and the patient was fully recovered in two months.

Finally, another of the causes of lower back pain, for older men, can be un-diagnosed prostate cancer. A UK based sufferer wanted others to know this: ‘My back pain started about 15 months ago and started to get more and more serious. After three months the GP decided to take a blood test and my PSA [Prostate Specific Antigen] level was almost 60! I was rapidly referred to the local hospital and prostate cancer, which had spread to the spine and other bone areas, was confirmed.

I was immediately placed on hormone therapy and the back pain soon disappeared. . . I am bringing this to your attention as I was never aware that lower back pain could be a symptom of prostate cancer and feel that this fact deserves a mention, particularly for the over-sixties who, I believe, should have a PSA test if the pain cannot be related to anything specific. In fact, a PSA test at least once a year for the over-sixties would be desirable. In my case it could have picked up the prostate cancer before it had spread to the bones. I am now 70 and feel very positive with my treatment. Regular massage helps to control “ageing” aches and pains in the back and elsewhere.’

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