Medical Diagnosis Necessary

With my personalised treatment approach to treating low back pain and sciatica, i am a great believer in not getting too carried away with any specific medical diagnosis you may already have been given (if I may just hasten to add, that is not to say you should not go to see a health professional to have the low back pain or sciatica you are suffering with assessed, as this is important, especially if your signs and symptoms are getting no better). The reason I say this is because any medical diagnosis you are given may not actually be the cause of the low back pain or sciatica you are suffering with, as more often than not it may be just a normal sign of the ageing process we all go through as we, well… get older!

If I ever treat someone who tells me they have been given such a diagnosis, I often tell them (after I have carried out a full assessment obviously to make sure there is nothing else going on which may indicate further medical attention/investigations) to more or less ignore the diagnosis. The reason I say this, is because it is more than likely there are plenty of people walking around who would be given a similar diagnosis were that to have the appropriate investigations, yet they will be suffering with no low back pain or sciatica whatsoever. The most important diagnosis we need to concentrate on is what I refer to as the ‘functional diagnosis’ i.e. the diagnosis given after taking the history of the problem, listening to the individuals typical daily activities and assessing how they move and checking for any muscle imbalance which may be present.

A few classic examples of medical diagnosis which can be a bit mis-leading are:

Facet Joint degeneration (wear and tear of the joints in your back)

Degenerative disc disease (wear and tear of the discs in your back)

Facet Joint Arthropathy (basically, there is something wrong with the facet joints, normally wear and tear!)

Herniated Disc (this means there is a disc bulge present, and while this is not necessarily a sign of ageing/wear & tear, it is something that many people walking around with no pain at all would be diagnosed with were they to have the appropriate investigations)

Ideopathic Low Back Pain (it is not known why you are suffering with Low Back Pain. This could just as readily be called ‘I do not know low back pain’)

Lumbar Spondylosis (medical jargon for changes which are taking place, typically as a result of… wear and tear)

I am sure you can see where I am going with this, these diagnostic terms describe ‘problems’ identified following further investigations, such as an X-ray or MRI scan, which may well be picked up if someone who is suffering with no low back pain or sciatica at all were to undergo the same investigations!

When I explain this to a patient, it is sometimes met with a degree of scepticism. I fully understand this as I can relate to someone thinking that if, for example, an MRI scan shows they have a Herniated Disc and they are in pain, then it is thought that this must be the cause of their pain. However it is not always the case and can be a red herring. Mind you, I may not be so understanding when a fellow health professional believes that just because an X-ray or MRI scan picks up something, that this is definitely the cause of the pain.