Today I shall talk a bit about an irking bit of my job. As a doctor, I have vowed to educate patients as part of my profession; as most chronic conditions like arthritis involve an understanding from the patients’ end to understand the sometimes less then fast-acting treatment strategies like physiotherapy and lifestyle modifications.

On most clinic days I find myself engrossed in lengthy conversation about the basis of the disease of cartilage, bone, nerves and ligaments; only to get faces twisted in bafflement. On occasion, I even get an interjection like “ah ok, the nerve” when in reality we would have been talking about a tendon all along.

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Let’s talk a bit about back pain. This has to be by far the most common orthopaedic complaint. So the literature has it that about 80% of the population will have back pain at some point in their life. That is close to being as common as the common cold.

Here is the low down on what we need to realize:

Most, but not all back pain is what we call mechanical. This means that the pain is arising from muscle spasm or from the little joints in the back of the vertebrae. This is benign and usually resolves with activity.

Radicular pain is the pain originating from the back BUT actually running down the leg. This is usually due to a pinched nerve somewhere along the course of the sciatic nerve, which incidentally coins the term sciatica. (more…)