Original Article

A New Look To The Natural History Of Back Pain

S Rezaian

Citation

S Rezaian. A New Look To The Natural History Of Back Pain. The Internet Journal of Minimally Invasive Spinal Technology. 2006 Volume 1 Number 1.

Abstract


Aim: Based on the personally management of 13,356 patients with back pain, the author present the exact cause of common back pain. Therefore the dilemma of "Idiopathic Back Pain (Bianchini, K.J. et al, 2005, Kim D. Het, 2005, Fritz J. Metal 2006) must be left to the history". If we know the exact cause of back pain, the right treatment could be utilized. The economic and scientific important of this research could not be over emphasized.

Introduction: The bureau of Labor and Statistic reported in 1998 estimated 1.9 million industrial back pains with approximately direct expenses 418 billion dollars and indirect cost about 837 billion dollars (Melhorn, J. Mark, Spine 3, 411-416, 2003). The exact cause and natural cause of back pain is not known in medical literature. The author has reviewed the literature and present a new look to the natural history of back pain. The economic and the scientific points of this clinical research could not be emphasized. Method: Firstly, How Low Back Pain Leads to Leg (sciatica) pain?


1. History. The most patients particularly so called the blue collar laborer after the injury report something snapped or popped or disrupted on my back. But medical literatures are silent to describe what anatomical structure initiates the back pain. This author believe inter spinal ligament is a thin, non stretchable fails in first instant and causes back pain.
2. Clinically, there is tenderness, sometimes gap as the results of rupture of inter spinal ligament. If it is incomplete it will be relieved in time, but if it' is complete, will cause spinal instability and later sciatic pain, secondary to herniated disc. If we inject 2 ml. local anesthesias between the tender spinal processes, the patients pain temporarily completely will relieve. This proves the theory subjectively.
3. Radiology. A flexion and extension x-rays will show an increased gap between the 2 spinal processes with injured ligament and objectively confirm the diagnoses. This is one of the most important point which leads to litigation with extra, stress and expenses. The patient originally complains of back pain/sprain and later develops leg pain (herniated disc). The insurance authorities accept the responsibility for the back pain but refuse to authorize treatment for the leg pain. This is one of the important point of litigation and consequences.


Secondly, How Low back pain produce neck Pain? This important point is concerning the physio-pathology of cervical, thoracic and lumbar curvatures. This author had found these curvature acts as inter connected water tubs. We read in high school, if one tub fills up with water, it will affect the rest of the tubs. Similarly if we do not treat well the herniated disc of lumbar spine on time it will produce hyper-lordosis lumbar spine. It will affect thoracic spine produce hyper-kyphosis; in turn it will produce cervical hyper lordosis and eventually neck pain, and pain also on the upper extremity (ies) as result of herniated disc. These are the natural history of back pain by one injury. The reverse may happen; a simple whiplash neck injury due to affect on spinal curvature may lead to herniated disc in lumbar spine. The denial of such claim is very common.

Materials: This new look to the natural history of back pain, is based on personally taken the history; diagnosed and managed 13,356 patient since January 1985 to January 2005. Every patients back pain was really diagnosed and treated on these groups of patient. We treated over 92% of these patients (good or excellent) with conservative management. We did not find even one back pain caused as result of psychiatric disorder.

 

References

Author Information

S. Rezaian, M.D., Ph.D.
International Spine Institute

Your free access to ISPUB is funded by the following advertisements:

Advertisement

 

Close

Enter the site

Login

Password

Remember me

Forgot password?

Login

SIGN IN AS A USER

Use your account on the social network Facebook, to create a profile on BusinessPress