Do we always understand neck and back pain?Do we always understand neck and back pain?

Given all the complaints of misdiagnosis, maybe it’s no surprise to hear from me, that in about 10-15% of cases, spine specialists are not sure why the person is having neck or back pain. We typically look at x-rays and MRI scans of the painful area. And, often, we see something that looks like a probably cause of the patient’s neck or back pain. But in about 10-15% of cases, we seen fairly normal looking x-rays or MRI scans, with the expected amount of degeneration for the person’s age, and without a problem that looks bad, or worse, than other areas, and we just don’t know the patient is having their pain.

In these circumstances, it’s not necessarily a problem. We can help most of these people by trying various conservative treatments, and they’ll usually get better. But in some of these patients, we try treatments and they just get better, which is, of course, disheartening to both the patient and the doctor. Such is life.

In this video link, I’ll explain this phenomenon and tell you my experience with patients and other doctors in dealing with this unfortunate reality.

I well remember graduating from chiropractic college and feeling diffident about my competency. So I went to work at an orthopedic clinic and stayed for 18 years. It was a high-volume, clinic and I learned a lot. That’s what it takes to become a good doctor, among other things. It takes experience with many people having many kinds of problems. You need to see all many of people, problems, injuries, degeneration, etc. And it takes quite awhile to become at ease and confident in learning and taking on other people’s problems. In fact, when I am attended by other doctors and healthcare professionals, I am reminded of the sanctity of this profession. There is no greater act, honor and privilege than to care for another human being in need.

Back to this theme. Doctors have each other to share with, and consult with, when serious problems arise. But many problems are not serious. They are benign. They won’t kill someone, although chronic pain, without a diagnosis or relief can be a real biopsychosocial problem for people. Sometimes, and thankfully not often, I can’t help someone, and I’m at a loss to be able to recommend someone who can help. And that’s the reality in 2022. We’ll get better but we don’t have an answer for every problem.