BackWords

If you’ve read my book, there is a section about how little things can have a big effect on your back pain. I tell the story of a time when I went to a car auction with my father and witnessed someone repair a million dollar car with the twist of a dime used as a makeshift screwdriver.

Little things can have a huge effect- If you don’t believe me, try wearing your wristwatch (if you wear one) on the opposite hand you usually do. Notice how many times you lift the wrong arm to tell the time, and how soon you get exasperated by this. Pay attention to how many times you bang your watch on a door jam. You wil be surprised how much this small change can affect your day.

This came up last week when working with a new patient who had low back pain for the past few years. He had already had a million dollar workup from another physician, including an MRI and a course of Physical Therapy. He noticed his pain started when he began working at a new law firm in the city. He had a longer commute- so we discussed his car ergonomics. Then we reviewed the ergonomics of his desk chair.  Then his workout- we pretty much reviewed everything- and there was no clear cause for his pain. I looked over his MRI- and there was nothing special there. Upon physical examination, he had nothing really remarkable- a little low grade spasm in his low back on the left side, and a small dysfunction in his sacrum. I fixed this, and it provided him relief- but this relief only lasted about an hour.

This was a frustrating situation, and I decided to order a standing plain film x-ray. What this showed was that he had one sacroiliac joint nearly a quarter of an inch higher than the other. He didn’t examine this way in the office. How could this be? I brought him back in and checked again- his sacrum was level. I looked at the bottoms of his shoes to see if perhaps one was significantly more worn than the other (I usually do my initial examination barefoot), and when I turned his shoe over, his drivers license and a small stack of bills (about a quarter of an inch high) slipped out from under the insole…

It turns out that when he took the job in the city, he found that one of his office mates had been mugged in a parking lot going back to his car after hours, and in an effort to hide a few bucks and spare himself the aggravation of losing his driver’s license, and to have some emergency cash- he started stashing them in his shoe. Stuff out of the shoe, and that day his pain resolved.

This one little thing caused him 3 years of pain and annoyance. The moral of the story is that if you are experiencing back pain, it can really be beneficial to  pay attention to even the small things. When you see the Tip o’ the Day here, it may be something small, but its’ effect can be huge.

Be well!

-Andy

I bet orangutans do not get back pain…