It is clear to me that we do not know enough about back pain.
One morning a long-time patient whom I hadn’t seen in a while asked if he could talk to me about a problem he had for over eighteen months.
At first, he stated that he had back and hip pain. Before our appointment, he went to the orthopedic doctor who prescribed physical therapy for the back; however, his back felt worse after the treatment. (He was doing a whole range of back and hip exercises.)
He then received a series of cortisone injections in his back and hips. The injections did not help, but in fact, aggravated the pain, making it worse. Even walking up and down stairs was problematic.
I examined him which included discussing his symptoms, like what type of pain, where did it hurt, how does it hurt, what makes it hurt and what makes it feel better. Once I had an idea as to what might be the problem, I performed a few orthopedic tests to help me confirm what I thought the problem was.
I determined that the primary issue was his hip, which was causing pain, but also causing a problem in his lower back. He had a physically demanding job, and it has taken a toll on his hip, and because of this, his back was also affected.
I directed treatment to his hip, which only helped a little, so I then suggested an MRI of both hips. The MRI revealed that he had a tear in the ligament supporting his hips. One was worse than the other. He needed surgery.
It is hard to say, but if the issue was figured out eighteen months before his visit with me, chances are his hips would not have been as bad.