Back pain is a leading cause of disability worldwide. In the United States, SRDs are an expensive disease — costing the economy $87.6 billion while taking third overall behind Diabetes ($101 billion) and Heart disease ($88.1 billion).
Despite rising costs ($87.6 billion in 2013 vs $30.4 billion in 1996), people aren’t getting better. Patient outcomes have declined while spine related disability has increased.
Part of the problem is what many in the profession refer to as the “spine supermarket“.
When a patient develops neck or back pain, there are a myriad of choices available. Chiropractor, physical therapist, primary care doctor, pain management, surgeon, orthopedic specialist, neurologist, yoga, Pilates, get an x-ray, get an MRI, get an injection, walk more, swim, don’t sit, stand at work, get a new bed, change your shoes…there’s more, but you get the point.
All of these choices, just like the foods in your supermarket, are all the right choice… when indicated. Just like you wouldn’t have a steak after your ice cream, if you stretch your hamstrings after herniating a disc, you will probably end up worse off.
While all forms of back pain hurt, back pain comes from different sources. Herniated discs, compressed nerves, strained muscles, joint dysfunction, sprained ligaments, trigger points and more. Each problem is associated with its own unique characteristics and, by extension, its own unique treatment.
When patients come to my office frustrated with pain or a problem they’ve had for a while and they say “well, I’ve already done physical therapy” or “I got adjusted and it didn’t fix it”, I often will explain that our method is different.
In order for a treatment to work, it has to be aimed at the right problem. For example, chest pain also has many causes; Heart attack, acid reflux, rib dysfunction, anxiety and more. Antacids are great for one of those conditions — BUT — if we prescribe them to all of our chest pain patients, it will perform poorly. Similarly, just going to physical therapy (or any treatment for that matter) without being classified and getting general back pain exercise/treatment, will also fail in the majority of cases.
The University of Pittsburgh, known for its outstanding medical programs and renowned for the best physical therapy and rehab program in the country, created a certification process to train professionals to fill this role.
Similar to your primary care doctor, your primary spine practitioner is trained to diagnose and treat all things spine-related. The majority of the problems are easily handled by the PSP — but more importantly than being well versed in treatment, your PSP also knows when to order X-rays or MRIs, when to refer you for medications and coordinate more invasive treatments (injections all the way up to surgery) when indicated.
In short, your primary spine practitioner’s job is to fix you; But, if that can’t be done in house, they will guide you through the “supermarket of back pain”, answer all of your questions, refer you to specialists and see you through to resolution.
Live young. Have fun. Be your best!
-Dr. Timothy Kennedy