Ultimate Neck Pain, Back Pain & Sciatica Relief Strategies

The Truth About Back Pain and Diagnosis Bias!

Are You a Victim of Neck Pain, Back Pain, and Sciatica Diagnosis Bias?

Diagnosis bias is a real issue in the medical community, one not often discussed, openly or in private. In fact, diagnosis bias is one of those ”dirty little secrets” only recently addressed; and then, only in closed door conferences and at a few of the more progressive medical schools in the country.

Chronic fatigue and chronic to chronically acute neck pain, back pain, and sciatica are among the most difficult conditions to diagnose and treat. A great deal of the reason, or reasons, for the difficulty in properly diagnosing and treating chronic pain and chronic fatigue, to include chronic neck pain, back pain, and sciatica is because while pain is a very real symptom of an underlying condition, and the underlying condition may be recognized and treatment initiated, it is also an abstract concept.

Pain as an Abstract Concept: Difficulties in Diagnosis and Treatment

When I state that pain is an abstract concept, I mean pain in any of its guises, in any and all of its manifestations, is as different from one person to the next as personality and/or fingerprints are. For this reason, and a myriad of others, neck pain, back pain, and sciatica create a number of challenges for medical practitioners, not only in the diagnosis phase but in subsequent treatment.

Value Attribution, Diagnosis Bias, Neck Pain, Back Pain, and Sciatic Nerve Pain (or Sciatica)

When dealing with neck pain, back pain, and sciatic nerve pain (sciatica) complaints doctors, like most people, will often make an initial assessment based on value attribution. Value attribution, in this instance at least, is a first impression of the medical kind! Unfortunately for the individual suffering from chronic fatigue or chronic neck pain, back pain, and/or sciatica the medical practitioner will often stick to that attribution when making even a critical diagnosis, even in the face of contradictory evidence.

Value attribution and diagnosis bias occur for a myriad of reasons, most of all because doctors are human. Medical practitioners are subject and susceptible to the same biases and prejudices the rest of us are. Interestingly, this bias, once set in place, will often shape the medical practitioner’s future perception of a patient’s complaints, once again, even when confronted with contradictory evidence, and will shape the treatment received…or not received.

Value attribution and diagnosis bias are covered extensively, and quite well, by Brafman and Brafman in their book Sway: The Irresistible Pull of Irrational Behavior. I recommend it for anyone who would like to understand why we do the things we do and make the decisions me make…and are forced to live with. This book is particularly appropriate for anyone who feels he or she may have been a victim of diagnosis bias.

The Video, Chronically Acute Back Pain, and Diagnosis Bias

I have first hand knowledge of diagnosis bias as it applies to neck pain, back pain, and sciatica and I discuss the situation and its eventual outcome in the video below. It should be an eye-opener for many, for others living through it at this time, it may give you what you need to press on and fight back, fight against the diagnosis bias that nearly took my life and ultimately robs many neck pain, back pain, and sciatica sufferers every year of the life they could have if only someone took them seriously…or just took them differently!

Chronic Fatigue, Chronic Pain, Empathy, and Abstraction

In fighting chronic fatigue, and chronic pain, one very often goes through the same battles to be heard and taken seriously. Many times even friends and relatives just don’t understand. How could they, pain is such an abstraction and if they have never experienced it themselves? Again, how could they!

Given the above, one would still hope the medical community, and particularly specialists trained to deal with chronic fatigue and chronic neck pain, back pain, and/or sciatica would be somewhat immune from value attribution and diagnosis bias. Yet we know that, in fact, some are and some aren’t!

The Good, The Bad, and The Misdiagnosis

Just as there are good physicians and bad ones, there are good chefs and terrible ones, there are good pilots and bad ones…and they all make mistakes. The trick here is to not allow others to lump you into a category before an adequate diagnosis has been made. Whether the condition is a chronic one, one that is chronic and acute or
is relatively new and still very much in the acute phase, do not allow your medical pracitioner to make an attribution, a diagnosis, based on a bias and without all the facts. As stated above, pain in any and all of its guises is a symptom and it is their task to uncover the cause and treat it effectively.

Do Not Take No for an Answer!

And do not take “I don’t know” for an answer! Press on until someone, somewhere provides you with a legitimate diagnosis and the quality care you deserve, care we all deserve. There is a life on the other side of any chronic fatigue and/or pain condition, do not allow anyone to rob you of even one day of your life…much less your life in total, as almost happened to me!

Best wishes in health!

John

Professor John P. J. Zajaros., Sr., The Bad Back Guy
216-712-6526
216-539-7412 (bus)
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

PS, If you would like to take matters into your own hands and grab control of your life? If you would like to achieve a neck pain, back pain, and sciatica free life? Simply click here and you will be on you way, one step closer to neck pain, back pain, and sciatica relief…once and for all!

Treating chronic neck pain, back pain, and/or sciatica is always problematic. The condition may lead to debilitating pain and, ultimately, to disability!

Most people, at some point in their lives, experience some type of short-lived back pain. This is usually a relatively temporary occurrence that doesn’t interfere with daily life in a major way. But, for an unlucky percentage of the population, back pain is a chronic problem that’s debilitating physically and emotionally. To make matters worse, treating and managing chronic back pain tends to be a frustrating process because not all causes are totally understood. The first step to treating and managing chronic back pain is finding a doctor who specializes in back disorders, an orthopedic surgeon or a neurologist. This doctor will be able to diagnose what type of pain you have and, hopefully, determine what is causing it.

Neck pain, back pain, and/or sciatica may be muscular or nerve-related. It may occur in the upper or lower portion of the back. (Lower back pain is the most common type, and some studies indicate that its prevalence is on the rise, possibly due to a higher percentage of the population being overweight or obese.) It may be the result of an injury or it may be age-related. Common causes of chronic back pain include herniated discs, arthritis and sciatica.

Conventional treatments for chronic neck pain, back pain, and sciatica include oral medications, injections, weight loss and surgery. If you have tried these options without success, or if the cause of your pain has been diagnosed as ‘non-specific,’ it may be time to consider alternatives such as physical therapy, reducing stress, getting more and better sleep, changing your diet, getting acupuncture or acupressure treatments, going to a masseuse regularly, using an inversion board, or getting chiropractic adjustments.

Physical Therapy

If your back pain is caused by muscular stiffness or inflammation, physical therapy may be helpful. The purpose of physical therapy is to loosen and work muscles to improve your mobility. You may be able to independently perform flexion (bending forward), extension (bending backward) and other stretching exercises. Or, you may need to go to a specialist to help you perform the needed movements (possibility in conjunction with apply heat/cold treatments and/or electrical stimulation).

Stress Reduction

High levels of stress intensify the body’s sensitivity to pain. Therefore, reducing stress is one way to reduce neck pain, back pain, and sciatica. Consider visiting a mental health care specialist to develop a plan of action for reducing stress in your life. Managing stress through the use of regular meditation or deep-breathing exercises can be helpful as well. You may prefer to practice such exercises on your own, or as part of a guided group.

Improving Sleep

Not getting enough sleep, or having poor-quality sleep, can be both a cause and a symptom of chronic back pain. If you feel tired in addition to having back pain, or frequently wake up at night in extreme discomfort, consider spending some time addressing this aspect of your overall health. Of course, sleeping on a comfortable mattress that properly aligns your spine is important. But ruling out disorders like sleep apnea is a smart idea. No matter what, if you’re as rested as you can be, you’ll be likely to experience less pain and be better able to deal with the pain you do have.

Dietary Changes

It’s probably pretty obvious that eating a healthful, varied diet and maintaining a consistent, healthy weight is vital to overall well-being. But other, more specific changes to your diet might help reduce back pain and sciatica. For example, you may have food allergies or sensitivities that you’re not aware of, deficiencies in specific nutrients or vitamins (like Vitamin D), or undiagnosed digestive problems (like celiac disease). Elimination diets, allergy testing and other diagnostics can help you determine if a diet-related problem is causing or exacerbating your back pain.

Acupuncture and Acupressure

While not totally accepted in the U.S. nor confirmed to be effective, this practice is gaining popularity. It involves inserting thin needles into the skin at specific points on the body to unblock ‘Qi’ or ‘life-force’ channels. Studies have confirmed that acupuncture may be effective in reducing neck pain and back pain if combined with other treatments. Some practitioners use the same principle to perform acupressure, in which pressure (rather than needles) is applied to specific points on the body.

Massage

As with physical therapy, if your neck pain, back pain, and/or sciatica is caused by muscle tightness, massage may help. Massage may be general in nature, or more specialized as with ‘rolfing,’ a practice that involves loosening the fascia (tissue covering muscles) in the back through the use of strong pressure.

Inversion Therapy

If you have back pain and sciatica caused by a compressed disc or sciatica, inversion therapy (a form of ‘traction’ treatment) may provide short-term relief. It involves hanging upside down by the ankles or tipping upside down in a special table, which allows gravity to stretch the spine, decompressing nerve roots and discs in the process. This isn’t a long-term solution to chronic pain, but might be helpful in combination with other therapies.

Chiropractic Treatment

This type of treatment involves physical manipulation of the spine and/or surrounding tissues to alleviate neck pain, back pain, and/or sciatica. It is performed by chiropractors and osteopathic physicians, and may be helpful but shouldn’t be used if you have certain conditions such as compressed spinal cord or inflammatory arthritis. Check with your primary doctor first.

In most cases, the options discussed here represent ways to manage chronic back pain rather than cure it. One or more of these options may temporarily eliminate or alleviate your pain, but it’s quite likely that you’ll need ongoing treatment to maintain a pain-free or pain-reduced life. Exercise, weight loss, and any one or several of the above strategies, when applied in concert will alleviate and possibly eliminate neck pain, back pain, and sciatica once and for all!

I hold degrees in history and anthropology. Graduating summa cum laude, I was awarded a doctoral fellowship to study for my PhD as a fellow at one of the nations top consortiums for physical anthropology, made up of Columbia University, NYU, CUNY, the American Museum of Natural History (AMNH), and others. I commenced my doctoral studies and researched the spine and sacroiliac joint, reviewing and categorizing more than 15,000 modern and pre-Columbian skeletons to understand the age-progressive phenomena affecting humans as we grow older. Having had 14 major surgeries on my spine, I am in a unique position to understand the “back pain complex” as few others can, from the perspective of patient and scientist/researcher. I hope my articles help you better understand your “bad back/back pain” issues.

Chronic Treatment-Resistant Neck Pain, Back Pain, and Sciatica: Psychosomatic Back Pain…It’s Not “All in the Head!”

Science has demonstrated that there is an incredibly powerful link between the mind and the body. In many instances, the underlying cause of neck pain, back pain and sciatica, also referred to as the back pain complex, may be psychological. Many times, when an individual is in pain and told that the pain may be psychological or psychosomatic, the patient immediately becomes defensive, often stating, “It is not in my mind, the pain is real!” The fact is, the pain is indeed very real, regardless of whether the pain is labeled as psychosomatic or not. When dealing with treatment-resistant, chronic pain the mind/body link must be explored, so it can be ruled out. In this article, we will discuss psychological pain, psychosomatic pain, and chronic psychological back pain. While discussed in a previous article, we will also address, once again but briefly, the link between chronic back pain and depression. Chronic pain, in any form, can be the most insidious, debilitating, and disabling of any medical complaint. In order to fully treat the condition, underlying causality must be explored and diagnosed thoroughly. It is true that most cases of neck pain, back pain, and sciatica are or have their basis in an actual pathology or other physiological condition. However, psychological back pain is quite common and in fact is one of the primary causes of treatment-resistant chronic pain.

“I’m Not Crazy!”

Unfortunately, when an illness is labeled psychosomatic there is often an immediate stigma or negative perception associated with it. Very often, when an individual suffering from neck pain, back pain and/or sciatica hears the term psychosomatic, they immediately respond defensively. When a condition is labeled as psychosomatic the connotation attached is that the condition is “all in the mind” or somehow “imaginary.” There is even a mental illness stigma attached, with the patient protesting, “I am not crazy, this pain is real!” Even people close, at times members of the individual’s own family, will say unkind things like, “I knew he was faking it” or “I knew she was just trying to get attention, I felt sorry for her!” For these reasons and others, the resistance to a psychosomatic diagnosis is considerable, often socially and culturally based.

Stress, Back Pain, and Depression

As discussed in a previous article, there is a powerful link between stress and psychosomatic illness, in this case neck pain, back pain, and/or sciatica; or treatment-resistant chronic back pain. Additionally, the link between depression and psychosomatic illness, particularly as we age, is often quite powerful. Individuals suffering from psychosomatic illness may experience incredible pain or other physical manifestations or symptoms, with no physical diagnosis. Paradoxically, there are a number of physical conditions, such as brain injuries and vitamin deficiencies just to name two, which may exhibit profound psychological symptoms. However, it is often the case that many individuals exhibiting treatment-resistant chronic pain, with no underlying medical diagnosis, may have a psychological or psychosomatic condition.

The Pain is Real!

Contrary to commonly held beliefs, pain that is the result of a psychosomatic condition, of an emotional or psychological process, is actually quite real. Psychosomatic pain, in this case treatment-resistant chronic back pain, is not imaginary, it is not “in our heads,” it is not the result of a delusional or a sick mind, and it is not the consequence of mental illness. The fact is that anyone suffering from tension headaches, ulcers, colitis, tension backaches, and a myriad of other stress-related illnesses has a psychosomatic condition. Clearly, all of these individuals are not “crazy.” I suppose the best way for an individual to understand just how real psychosomatic pain can be is to have them think back to their last tension headache and ask a single, quite simple question: “Was the pain real?”

Psychological, Psychosomatic, Stress-Induced Back Pain

Psychological back pain is simply another name for psychosomatic back pain and is sometimes referred to as stress-induced back pain. Once again, pain associated with this condition is indeed very real. While the pain may ultimately be linked to the mind/body link, the physical expression of pain, whether the pain is neck pain, back pain or sciatica, may be debilitating and disabling. Consequently, dealing with psychosomatic, treatment-resistance chronic pain is often difficult, if not close to impossible, without effectively dealing with the underlying condition. As a noted evolutionary scientist once pointed out, psychosomatic pain may be considered an evolutionary anomaly but it is completely human and utterly normal. As our system, and that includes our mind, becomes overloaded, it seeks to alleviate or eliminate the problem as quickly and efficiently as possible. Unfortunately for the patient, it does this by shifting focus away from the actual cause, the real danger, expressing it in a very uncomfortable, often intense fashion; and, in this case through chronic treatment-resistant back pain.

Failures of Modern Medicine

Psychosomatic pain is the most frequently diagnosed and least understood form of both acute and chronic back pain. Significantly, most treatment-resistant chronic back pain sufferers, those with unresolved back pain, meaning that there is no clear diagnosis, by definition suffer from an underlying and misdiagnosed psychological ailment or condition. While medical schools are beginning to address this very significant medical issue, psychosomatic illness has long been relegated to the back burner of medical education. Consequently, medical practitioners are simply not prepared for or able to understand, much less treat, this condition. As a result, many individuals are misdiagnosed with this “scapegoat condition,” leaving individuals with very real physiological, structural, and medical conditions undiagnosed.

Impact and Consequences

Unfortunately, while solutions are available, they are still relatively unknown. As the medical community begins to educate itself, so they can be better prepared to deal with this condition, we are beginning to see the first steps towards a holistic approach to this problem. Psychosomatic medicine has been talked about for centuries, even Sigmund Freud was fascinated by it in his time, yet it is only in the last few years that we see a real movement to deal with this ongoing epidemic. Treatment-resistance chronic pain sufferers, particularly those individuals with an extended history of unresolved and undiagnosed pain, are most likely to exhibit a myriad of medical complaints to include ulcers, colitis, and depression, just to name a few. The combination of unresolved neck pain, back pain and/or sciatica and depression leads to profound consequences for the individual, the family, the community, and even the state. The impact of this poorly understood and often misdiagnosed condition or set of conditions ripples throughout the system with consequences far beyond those of a medical nature.

Bad Back Treatment Strategies

Ultimately, and until such time as the underlying condition has been diagnosed, treated, and eliminated, symptoms must be recognized and alleviated. For this reason, it is advisable for the individual to begin a wide-ranging, individualized, and medically supervised program to deal with both symptoms expressed and causality yet undetermined. Exercise, in and of itself, will have a remarkable and immediate impact on most individuals. Not only will an exercise program, properly administered and supervised, do wonders to alleviate stress, it will also serve to improve self-esteem and self-confidence. With exercise, particularly until the musculature adapts and adjusts to the new routine, certain other measures will need to be taken. The additional treatment strategies to be initiated, along with the exercise program, should include a stretching program, 2 to 3 times a day (see: “Simple and Easy Program of Exercise for Sciatica Relief… Part I & Part II”). Self-education, both individually and in a group setting, will also enhance understanding, self-knowledge, and self-esteem. Most importantly, either individual or group therapy should be initiated in order to comes to grips with the underlying issues contributing to the unresolved and/or misdiagnosed psychosomatic pain condition. The concert of bad back strategies will do wonders to alleviate symptoms, ultimately leading to a resolution when used along side of a solid therapy program to understand underlying stressors which resulted in the back pain complex of neck pain, back pain, and sciatica.

These are some of the “Ultimate Bad Back Strategies” I recommend. I hope they help you as much as they helped me!

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