False Beliefs About Your Health That Are Holding You Back
The things we cover in today’s article are ideas that we hear EVERY DAY from our actual patients. It’s important that we address many of the false beliefs that are so prevalent in the pain and injury world. Things that their doctors, family, and friends have repeated to the point that they accept them as fact.
False beliefs are what keep us stuck. When these false beliefs are accepted as fact, they keep us from taking any action to improve our health because they give the idea that there’s nothing we can do. In this article we want to address three of the most common false beliefs we hear from patients in the clinic and provide some clarity that will get you unstuck and on a path to better movement and health and to keep you doing what you love.
False Belief #1: Arthritis Is the Cause of Your Pain
We hear this one A LOT. A patient went to their doctor and got X-rays. The X-rays showed degeneration or arthritis in their spine, and the doctor concluded that their arthritis is the source of their pain. Here’s the truth: degeneration on X-rays is extremely common in anyone over 30 and is not the cause of your pain. Most people over 30 have some form of degeneration in their joints and experience no pain. On the other side, there are many people who have lots of pain – and their X-rays show no degeneration.
This idea is backed up in the research. A recent systematic review (summation of multiple studies on the topic) concluded, “Imaging findings of spine degeneration are present in high proportions of asymptomatic (no pain) individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain.”
In fact, they found that even a third of people in their 20s had some form of degeneration (arthritis). Here’s a breakdown of the percentage of people studied who had some form of arthritis with no physical pain:
People in their 20s – 37%
People in their 30s – 52%
People in their 40s – 68%
People in their 50s – 80%
People in their 60s – 88%
People in their 70s – 93%
People in their 80s – 96%
What to take away from these numbers? Some level of arthritis is common (even in younger populations) in people with no pain — meaning that arthritis is not the CAUSE of pain.
Source: Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2014;36(4):811–816. doi:10.3174/ajnr.A4173
False Belief #2: Bulging Discs Are the Cause of My Pain
Taking it a step further, many of our clients have opted for an MRI that has shown they have a “disc bulge” and have been told that this bulge is the cause of their pain. Just like the X-ray, the presence of a disc bulge in the spine has no correlation with the amount of pain we experience. It’s 100% possible to have a disc bulge and have no pain. It’s also 100% possible to have back pain with no disc bulge. Just like with the X-rays, studies have shown that MRI findings were not related to the intensity of pain and do not explain the cause of a patient’s pain.
Worse yet, studies have shown there is so much variability in MRI reading among radiologists that where you have your MRI read will have significant impact on your diagnosis and the type of treatment you receive.
There are plenty of instances where imaging is needed and necessary. Chronic and age-related pain is not one of them. The finding of an X-ray or MRI rarely identifies the cause of such pain, and placing too much emphasis on them damages patients’ expectations and has a negative impact on how they recover.
False Belief #3: Surgery Is My Only Option
Another major issue with these image findings is they are then used as justification to get patients under the knife. Spinal degeneration? Let’s just fuse everything together. If we can’t move, we will stop irritating our tissues, right? Knee arthritis? Let’s go in there and “clean it up.” Bulging disc? Let’s go in there and take out the injured part of the disc — that should do the trick.
Stuart McGill, the leading expert on treating back pain (and who has a PhD in treating low back pain), states in his book, Back Mechanic: The Secret to a Healthy Spine Your Doctor Isn’t Telling You, that 95% of the patients he sees DO NOT need surgery, even though many were told it was their only cure. He explains that surgeries often work in the short term, but studies have shown that after a few years a surgical patient’s status is comparable to those who chose the non-surgical option. One reason is that surgery doesn’t correct (and also contributes to) the underlying movement and strength deficiencies that lead to tissue breakdown and pain. Beginning to see a pattern here?
Another thing to consider when you’re looking into surgery is that it truly is an “all in” approach. You’re not just “fixing” the injured area; you’re cutting though muscles and nerves, you’re removing areas of bone or cartilage that does not grow back, and you’re starting a scarring process that can entrap nerves and lead to chronic pain. Basically, there’s no going back from surgery. It’s an expensive and potentially debilitating treatment option whose long-term effectiveness has yet to be proven. Is that really a risk you want to take with your life?
When we look at all these false beliefs together, a pattern starts to emerge. They create an idea that the pain we experience is out of our control and we need someone or something to fix us. An approach that keeps doctors, orthopedic surgeons, and chiropractors/physical therapists very busy but still leaves patients limited in the activities they love.
We discuss more of the false beliefs that hold us back in our new book. If you’re interested in learning more, grab your copy today!
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