Don’t panic about your Discs!

Lower Back Pain in Dubai

 Practicing as an Osteopath in Dubai is a fantastic experience that is introducing me to people from all corners of the world. One thing that we all seem to have in common is our fair share of aches and pains, which is unfortunately a part of being a healthy and functioning human being. As an Osteopath, one of the fascinating things about working among so many different cultures is how people cope with common aches and pains, such as lower back pain.

Lower back pain is the most common complaint I encounter as an Osteopath here in Doha. It is estimated that 50-80% of adults will experience pain in their lower back at some point. The cause of lower back pain can arise from many different structures including muscles, tendons, joints, nerves and even organs, which can make it very difficult to blame any single structure for the discomfort.

When lower back pain strikes, it can be almost unbearable. The severity of discomfort can influence people to seek urgent radiological investigation such as MRI or X ray. In my short time here, I have encountered many people who have been needlessly referred or have taken themselves for a scan, as a result of lower back pain. We do not need to see a scan to provide effective manual back pain treatment in Dubai, our clinical assessment will nearly always give us all the information we need to provide excellent manual therapy treatment.

 Most episodes of lower back pain are short lasting with little or no consequence and most people who experience new episodes of lower back pain, recover quickly. That said, recurring episodes of lower back pain are common and a small number of people will experience more persistent pain .

Discs aren’t really discs and MRI’s don’t tell us what is hurting

Unfortunately what we see on MRI and X-ray does not show us what is actually causing  pain. Rarely can a specific cause of lower back pain be found, and this is why we label most lower back pain as non-specific! In fact, many of the things seen on scans in people with pain are also common in people who have no pain at all!

In the excellent pain guide book- Explain Pain, Dr David Butler and Professor Lorimer Moseley state that at least 30 % of people without lower back pain, have discs bulging into their spinal canal. The book also describes the name ‘disc’ as an unfortunate title for these structures that sit between the vertebrae of our spine. They are nothing like the neat looking discs we see in the anatomy books, and are firmly integrated between each vertebrae. They are also surrounded by super strong ligaments which ensure they are not easily displaced.

Scary words can make things worse

Scans and medical professionals often describe discs as being herniated, prolapsed, slipped, dehydrated or degenerated, which is enough to scare anyone suffering with back pain!  Such terminology also encourages patients to associate their pain with these findings, which are also found in many people without pain. To use an analogy- the changes we see on an MRI scan are like wrinkles on the inside. They are most often normal age-related changes of a healthy and active spine.

As an Osteopath here in Doha, I frequently encounter people who tell me they have prolapsed or slipped discs confirmed by a scan. As a result, they become overly concerned with the diagnosis, over precautious, and fearful of physical activity.  MRI’s cannot demonstrate whether a disc is painful or not, and there is no research that has accurately identified a disc problem as a source of lower back pain. Lots of herniated or bulging discs, resolve on their own, with no treatment needed at all.

MRI’S don’t help you recover quicker

Intervertebral discs become more relevant when there are persistent and severe nuerological symptoms such as radicular pain, which is commonly known as sciatica. This often feels worse than back pain and manifests as a lancinating or burning leg pain, weakness, tingling and a loss of sensation. Disc herniation with local inflammation is the most common cause of this radicular pain.

Having an MRI doesn’t improve the outcome of lower back pain and very, very rarely will the results of a scan change the way we as therapists treat your back pain. In addition  current clinical guidelines advise against having scans for lower back pain, with or without sciatica.

The bottom line is that lower back pain has numerous contributing factors which include stress, cultural conditioning, poor physical health, low levels of activity, and the way our nervous system processes pain. Blaming parts of our body because of what we see on a scan is unhelpful, and may complicate and prolong the recovery process. Because of what we see on a scan or a report, we can become too overprotective and fearful of using our spine normally. This often leads to the development of abnormal movement habits, deconditioning of muscles and an overall less healthy spine.

Our discs don’t just slip out of place or anything else for that matter

Neither intervertebral discs or the bones of the spine (vertebrae) slip out of place unknowingly, and are certainly not realigned by any form of manual therapy or manipulation. Things may feel out of balance and slightly lopsided at times, but unless you have suffered from some serious trauma or impact, your spine or hips do not mysteriously slip out of alignment. I have spent many a weekend on the side of a rugby pitch as a pitchside first aider, watching big guys smash into each other as hard as they can with absolutely no consequence to the spine.

One of the most fundamental prerequisites for a swift and uncomplicated recovery from lower back pain is a sense of confidence In the body’s ability to heal.

Back Pain Treatment in Dubai

So, if you are experiencing lower back pain, and have been told that your discs are bulging, dehydrated or degenerating, it is important that you continue to move your spine with as much normal movement as it can tolerate. This will promote circulation, aid any healing process that may be occurring, preserve the strength and endurance of surrounding muscles and help avoid stiffness, immobility and fear of movement.

If you are worried about your lower back, or are looking for effective back pain treatment in Dubai, come and see me at the Osteopathic Health Centre in Dubai. If not, seek help from a therapist or exercise professional who has both knowledge and experience in exercise therapy for lower back pain. Movement really is medicine in this situation, and although it may feel like the last thing you want to do, it may well save you from years of discomfort and unnecessary treatments.