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Every back pain is not spine pain.

November 15, 2017

Everyone has experienced back pains some time in  life. The pains range from simple occasional discomfort which at times only attracts your attention to pains severe enough to disable one for long time and knock of from work. Each time back pains arises, the fear factor about spine disorder comes into mind and then vicious cycle continues. 

 

With advances in imaging technologies and reduction in cost of imaging, most of the time I see patients walking into my OPD with MRI films in their hand along with big question on their face. 

 

As we all know, with advancing age, the process of ageing occurs all across body, especially in the the axial skeletal system or spine. So anyone who has no back pains at all, if gets his/her MRI done, he/she is bound to see some changes of ageing on MRI. Report of the same are usually written like "C5-6 disc prolapse or L4-5 disc prolapse with compression of subarachnoid space". 

 

Almost 70% patients undergoing MRI of cervical or lumbar spine are going to read same lines in their report.  Google has added to confusion by explaining only the meanings of the words but not the clinical correlation of MRI findings and patients symptoms. So many times patients do not know whether the findings mentioned on MRI report are troubling them or its something else?

 

My opinion in such situation is, get yourself clinically examined from a clinician. I am purposefully avoiding using word neurosurgeon or spine surgeon as basic clinical examination remains same for everyone, from MBBS to post graduate level.

 

After careful examination, I dismiss almost 70-80% patient's claims saying that they have muscular pains which are going to get cured with exercises alone.  These patients, who are either labelled or got themselves labelled to have spine problem usually have simple muscular mechanical pains which need exercises, changes in lifestyle and health diet. 

 

I had delivered a talk on Doordarshan about the same, a year ago, Its in Marathi language. I will try to dub it in english so that it can be helpful to larger group of people. 

 

 

After going through this video, one will be able to understand that MRI reports or MRI film along are not the key towards diagnosing the problem. Clinical examination is a must before undergoing any treatment. 

 

I will write about RED FLAGS in back pains which are very important signs which point towards underlying spine disorder, in another post. 

 

 

Happy reading. 

 

 

 

Regards, 

 

Manish Sabnis

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