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Back pain happens to everyone and for some is a life-changing occurrence. The causes are as many as there are structures capable of producing pain; and every tissue in the body is capable of giving us pain. Help from the health care profession is sought when the pain is severe enough to interfere with activities we need, or want to do. What happens next depends on who you choose to consult. There are many health care practitioners who treat back pain - the family doctor, chiropractor, physiotherapist, massage therapist, acupuncturist, orthopaedic surgeon, neurosurgeon, anesthetist, rheumatologist, psychiatrist and psychologist to name but a few. Each approaches your problem from a very different perspective, which is based on their formal training and their clinical experience. Their training/experience helps them to develop models some of which are based on scientific principles and some on long time common thought.
Back pain has been subjected to scientific research, so what does the research tell us. First of all consider the questions we have asked in the research. It's important to understand the question because it ultimately directs the answer. If one is interested in understanding "What structure is responsible for an individual's pain?" then the research will focus on specific anatomical parts capable of generating pain. Entire models for both assessment and treatment of the low back have been developed following this line of questioning. Highly sophisticated imaging techniques and surgical procedures have been developed to address this question - "What is hurting"? This would be useful clinically if only one structure was responsible for an individual's pain. Unfortunately, multiple structures are often the problem and it is not possible to identify them individually. So we see diagnoses such as 'non-specific low back pain". In other words, the pain is not specific to any identifiable structure however, your low back pain is acknowledged. Even if we did know what structure was responsible for the pain, this would not help us in treatment unless all we wanted to do was cut it out or numb it with an anaesthetic - sometimes this is necessary but rarely is this all that is needed.
What information would be gained if the initial research question was "Why is the low back or pelvis painful?" "Why is the back no longer able to sustain or transfer the loads, stand, sit, lift or twist?" To answer these questions, the research must explore how the region functions in order to appreciate why breakdown and pain have occurred. Much research has been done with these questions in mind and today we have a new model (The Integrated Systems Model (Lee & Lee)), which considers both function and how emotional factors such as stress and anxiety can influence the pain experience. Download this article to learn more about the approach we use at Diane Lee & Associates to treat back & pelvic pain.