Low Back Pain, Section 1

Over my thir­ty years of expe­ri­ence as a doc­tor of chi­ro­prac­tic, I’ve helped many peo­ple with low back pain.

Part of my job is mak­ing sure they under­stand how the low back works and what pain means.  This com­mu­ni­ca­tion chal­lenge has been made more dif­fi­cult because the typ­i­cal med­ical test­ing process for low back pain is mis­guid­ed. The process can actu­al­ly dis­tract peo­ple from the fun­da­men­tal issues of low back health.

So here, in one place, is some of the impor­tant infor­ma­tion I wish my patients under­stood.

Keep in mind that I’ve nev­er exam­ined or treat­ed you.  I have no idea what the specifics of your sit­u­a­tion are.  This arti­cle is for infor­ma­tion­al pur­pos­es only — to broad­en your think­ing process.  There’s no sub­sti­tute for con­sult­ing your own doc­tor.

Freedom from back pain

Free­dom to move

1. Pain is an expe­ri­ence that takes place in the brain, not in the mus­cles, joints, or discs. This doesn’t mean that pain is “all in your head”.  Pain has a tan­gi­ble basis in the sig­nals that are com­ing in from your body.  Change the sig­nals, and the expe­ri­ence of pain will change.  Or change the way the brain process­es the sig­nals, and the expe­ri­ence of pain will also change.  Even bet­ter, change both: the input and the cen­tral pro­cess­ing of the input.

2. The brain cre­ates an inter­pre­ta­tion of pain based on all the sig­nals com­ing from the body – all the mus­cles, joints, lig­a­ments, organs, etc.  What that means is that only rarely is there a sin­gle site in the body you can point to and say “Aha!  There’s the cause of the pain.”  Instead, your body “com­putes” that you’re in pain based on the total pic­ture.

3. Doc­tors often iden­ti­fy the inter­ver­te­bral disc as the source of low back pain. This vio­lates prin­ci­ple #2 in the para­graph above.  But it’s not entire­ly crazy, either.  Discs are sub­ject to a lot of stress, and they’re rich with nerve end­ings – nerve end­ings that can send pain sig­nals into the brain.

4. Near­ly every­one over 30 – those with low back pain and those with­out — has some wear and tear of the inter­ver­te­bral discs. And if you have an MRI, you’ll see it.  The radi­ol­o­gist might call it degen­er­at­ed, her­ni­at­ed, or bulging, or use some oth­er term.

Bulging Disc Impinging on Spinal Cord

5. Since near­ly every­one has some disc dam­age, the appear­ance of your discs on an MRI doesn’t cor­re­late well with the amount of pain you’re in. It’s a tricky diag­nos­tic sit­u­a­tion.  You can have real­ly bad discs but lit­tle pain, or only slight­ly dam­aged discs and a lot of pain.  You can also have pain on the side oppo­site to your disc bulge, or at a spinal lev­el above or below your worst disc.  The MRI shows the archi­tec­ture of the disc, not the dynam­ics of move­ment or how your ner­vous sys­tem copes.  It has lim­its as a diag­nos­tic tool.

Move on to Low Back Pain, Sec­tion 2: research sta­tus


Deepen Your Body of Knowledge

Low back pain, Sec­tion 2: Research sta­tus

Why sit-ups, curl-ups or crunch­es can do more harm than good

Free copy of Dr. Lavine’s Report: Top Five Exer­cis­es for Your Low Back


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty five years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website, askdrlavine.com, provides more information about his approach. Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.
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