When it comes to our health we tend to think it’s useful, perhaps essential, to have a firm diagnosis in order to successfully recover from ill-health. In many cases this is very true. In the case of certain conditions like fractures, cancer, infections and auto-immune conditions a speedy diagnosis by your doctor is important and (hopefully) leads to effective treatment and recovery.
However, assigning a label to some pains is not always helpful and can be damaging. Let me explain. Let’s take back pain, particularly the type that comes and goes or starts for no specific reason. It’s common for people to come to me saying they have been told or they are worried they have e.g. sciatica, a disc bulge, spondylosis* or any number of scary sounding diagnoses.
First things first, serious causes must be ruled out by a health professional. Once this is done the following is important to consider:
- If you are, say, over 40 then yes, it is very likely you will have a disc bulge – most of us do – but it almost certainly won’t be responsible for your back pain. See this chart for the incidence of various structural changes present in PEOPLE WITH NO PAIN. (Brinjikji et al 2015).
Therefore, a label here is virtually meaningless – most adults of a similar age are likely to have a similar looking back.
- Unlike fractures or cancer which usually respond effectively to a specific treatment, there is not one treatment for many muscle and joint aches and pains. i.e. therapists do not find the appropriate structure, fix it and send you skipping away. For recent (acute) injuries your body will, in most cases, heal very well by itself; under the right conditions. This is where a good therapist – osteo, physio, chiro – can help guide you. For more persistent pain it is usually unhelpful to focus solely on the sore bit and broader issues are important to consider (more on that another time).
- Labels instil fear and anxiety and when we are fearful and anxious we feel more pain and stop moving. This is well-documented in research and, as you can imagine, greatly slows your recovery.
- There are plenty of often well-meaning (but sometimes not) practitioners out there ready to use these labels to their commercial advantage. They may use long medical terms and scare people into believing they have a very serious condition/weakness/abnormality (when they don’t) and make them think that the only way to recover is by signing up for many weeks of treatment. This fuels fear, fosters dependency and is just wrong.
A good physical therapist should take a careful case history and complete a thorough examination; rule out more serious causes for your pain and then explain (based on current evidence):
WHY you are likely to be in pain and (if appropriate) why the pain is persisting.
WHAT you can do together to get you back in control and on the road to recovery. It most cases this should not take too long – you should certainly see improvements after a few weeks of treatment.
So, don’t let those essentially meaningless labels frighten you. Get the right advice and guidance from a health professional you trust so you can get back out there doing the things you love as soon as possible!
*I’ve given the example of low back pain here but the same scary labels apply to many other parts of the body.
Brinjikji W et al (2015) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology Apr; 36 (4) pp811-6