BackBack pain—is your doctor listening to you?
The fundamentals of back pain are poorly managed by experts
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If cancer is called the “emperor of all maladies", back pain might well be the empress. Back pain might not kill, but it doesn’t let one live either. It leads to a miserable life.
The societal cost of back pain is three times higher than the total cost of all types of cancers, according to Egon Jönsson, a Swedish footballer and trainer and author of a Swedish systemic review report titled “Back Pain, Neck Pain: The Scientific Evidence Of Causes, Diagnosis, and Treatment". That holds true for India too. Back pain takes its toll not only on the individual suffering from it, but also on the family, workplace and society.
We all need to get proactively involved if we want to reduce its impact on society. There is no one big magical fix but multiple small triggers and weaknesses that we need to address.
Pain in the back and neck is by far the No.1 reason for the “years of life lived with disability", according to a paper published in Lancet by C.J. Murray. Lower back pain affects up to 80% of people at some point, and neck pain affects up to 50% of the population. These numbers have risen tremendously in the last two decades owing to drastic changes in our lifestyles.
But back and neck pain are still poorly managed—doctors don’t have a good foundation in the subject. MBBS course textbooks have less than a couple of pages on back pain and the chances of a question on back pain featuring in an examination are low, making it a topic medical students hardly make any effort to understand properly.
During postgraduation courses in medical specialities that might even be dealing with back pain, the focus now is on techniques and procedures, not on the basics of common back pain that most patients suffer from. As doctors advance in their medical careers, none of them have the time to understand the fundamentals of back pain.
People whose personal and professional lives are affected by back pain, however, expect to be heard when they see doctors specializing in back pain. Even though doctors are introduced to the art of history-taking, a majority never end up mastering the art. Effectively, then, most doctors don’t end up practising it when they see patients with any kind of ailment.
Studies have shown that doctors are known to interrupt patients often and quickly. How will doctors treat pain if they don’t let patients give complete information on what has been bothering them?
They may just be ready with formula treatments without actually knowing the details or wanting to understand the human being who sits across the table.
So if you are going to visit a doctor, watch how carefully he or she listens to your pain story before you decide to go ahead with the treatment.
And if you are a doctor, don’t be in a hurry to dish out treatment. Hear what your patient is telling you. That is where half the battle is won.
Rajat Chauhan is the founder of the Back 2 Fitness chain of clinics and La Ultra—The High, a 333km ultra marathon in Ladakh, and is the author of The Pain Handbook: A Non-Surgical Way To Managing Back, Neck And Knee Pain.
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