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Helping clients who suffer back pain. Part 2

Begin at the beginning
Of course you would begin by referring clients back to their physicians for medical advice. While in most cases back pain indicates an isolated musculoskeletal disorder, occasionally, and very rarely, back pain is a symptom of a serious underlying disorder, such as kidney disease or cancer. Tests may be given to rule these out and to help diagnose the source of pain.

One of the difficult issues for physicians is deciding when to order which medical tests. About half of American adults report back pain every year. Ninety percent of the time the pain resolves without any special treatment. If your client sees a physician for back pain, he or she will probably be sent home with no tests, advice to take over-the-counter pain relievers, and to take it easy until the pain subsides. If the back pain does not resolve, or continues to return, then testing may begin to (hopefully) increase the accuracy of the diagnosis.

Why is back pain so hard to diagnose?
Medical tests do not always give the correct answer. In one interesting study,(1) radiologists examined X-rays, CT and MRI scans for two groups — people with back pain and people without back pain — without knowing which subjects were in which group. The radiologists found that only 36 percent of control group subjects had normal discs. The others had bulging or protruding discs that would qualify as a disc problem diagnosis. In other words, these could be considered “false positive” test results; the test would indicate there was a problem when no problem currently existed. This study has led many experts to question the usefulness of these very expensive tests.

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