Is Your Back Pain All in Your Head?
There has been an alarming amount of research recently stating the best practice for low back pain is through the biopsychosocial model. (Lancet vol. 391, issue 10137, 9-15 June 2018) So, what does that mean? It means to fix your back pain, you should follow an educational program to return to normal exercise and activity regardless of pain. If your symptoms do not improve the next step is to enroll in psychological programs.This type of model is dangerous to say the least. Low back pain is a huge economic burden for our health care system.To simply state that the best way to fix it is through exercising and talking to someone about it is short-sighted. The vast majority of people suffering with lower back pain have pain during exercise or their daily activities.
Does that make sense to continue to do something that is causing pain? That would be like driving your car with the check engine light on, ignoring it, and expecting it to get better the longer and harder you drive. It’s just not going to work. Period.
I do want to make one thing clear, I am not saying psychological stress manifested as physical pain doesn’t exist. It does. But, to have entire schools of thought and practitioners only using this model is not fair to the patients. What is fair to the patient first and foremost is a complete diagnosis. A skilled physician should have the ability to rule in or out all possibilities of your pain.
What if there was something out there that could help physicians find the source of your pain? Would you want to know? Would you want to go see them instead?
Pain can be categorized into 4 possibilities and, thankfully, Dr. Brady of Integrative Diagnosis created a tool for us to use. These 4 categories are:
Functional (muscles, tendons, ligaments, nerves)
Structural (spine, bones, joints)
Metabolic (diabetes, high blood pressure, celiac, etc)
Psychological (stress, depression, anxiety, etc.)
The acronym is FastMap. We utilize cutting edge technology along with expert clinical knowledge to discover the cause of your pain. It should be widely adopted for those of us who practice manual medicine. This allows the doctor to determine the true source of your pain, not automatically putting you in the psychological category because you’ve had pain for 6 months or more.
Image courtesy of Integrative Diagnosis
Over 95% of our cases have had pain longer than 6 months prior to seeing us. We did not dismiss the functional or structural components. Likewise, we also don’t ignore any metabolic disorders or psychological component. FastMap allows us to paint a realistic picture for each of our patients. That ensures they completely understand their problem and have action steps if they need to follow up with other specialists.
If you have been told your pain is all in your head or it has been over 12 months and there is nothing you can do about it, there is. You can find an Integrative Diagnosis provider who will look at the entirety of your problem, put you through FastMap, and guide you in the right direction.