"Why Don't They Believe Me??"

"Sure, your back hurts. Mine does too. Now get back to work!!"

Have you heard that when telling your supervisor that you can't go to work? I know I did, multiple times. You try, you really do try. You take a couple Advil, Motrin or Aleve, hoping that they'll take the edge off just enough to allow you to get out of bed, get dressed and head to the workplace. But it doesn't happen, does it? So why do those closest to us, either in our family or at work, think we're faking this horrible pain that back pain brings?

Let's go back to my first or second post for a moment. Eighty percent of adult Americans experience some form of back pain every year. Of that group, the cause for about 80% of them is muscular in nature. That means that they have strained or "pulled" a muscle in their backs. Most will see out a medical provider, as some of those injuries can producer a significant amount of pain. The "cure" most often recommended is 2-3 days of bed rest and moist heat, several times a day and a couple of OTC (Over the Counter) pain relievers, as needed. Additionally, after each heat treatment, perform some light stretching exercises. This will often help alleviate the pain and allow the muscles to loosen and not cramp up.

So what about the other 20%? If you're reading this blog, you're a member of this group like I am. Our pain is much deeper and much more difficult to ascertain and to cure. Some of us will never see a cure, only mitigation (a lessening of the pain level). This pain come from a skeletal deformation, either congenital or due to accidental injury, the causes parts of the body structure to impinge on a nerve or nerves. Often, this pain in debilitating and excruciating, needing medications much more powerful than an OTC and treatments much more elaborate than warm, moist heat, even surgery.

We've all seen scenes on television or perhaps in real life where someone has ridden a horse for the first time and dismount, rubbing their butts. However, if you've never ridden a horse, how can they explain to you what they feel so that you'll understand?

Luckily, I've been with the same PCP (primary care provider, whom I'll call, "Joe") since 1986. First his late father took care of me and when Dad retired, he took over. We've been family friends as well for all that time. And it actually was his father who was taking care of me when my disc first popped in 1992. So Joe knows all about my back pain. As a matter of fact, I even worked in Joe's office for almost 12 years as his Administrator and all during that time, I was only able to work part-time due to my pain.

For a long time, Joe tried to understand what I was going through. "Where was this pain" he asked. "How much does it hurt?" I explained until I was "blue in the face," and while he was very sympathetic, he never quite got it. I said to him, "You really can't appreciate this intractable pain unless you've had it." He agreed and we moved on.

However, just about two years ago, Joe experienced severe back pain. Pain that was so severe, there were days he couldn't make it to his office for his appointments. And that was very much uncharacteristic for him. As you can imagine, every time we saw each other, Joe wanted to know more and more about my pain and we'd discuss his symptoms. Finally, he reached a point and through a thorough exam by an excellent neurosurgeon, Joe was forced to undergo back surgery for a herniated disc.

He tolerated the procedure well and was hopefully on the road to recovery. He did well for several months. Then one day, while simply standing in the pool at his apartment complex, he experienced excruciating pain. The pain was so bad, he couldn't walk in the water. He sent someone up to his apartment to retrieve the walker he had used after his surgery and using that, he was just able to make it back upstairs and into bed.

Initially, he thought that it couldn't be related to his initial injury. It had to be something else, quite temporary and coincidental. As we've all heard, doctors make lousy patients. Joe was stubborn and pushed himself through the pain to get to the office to see his patients. Yet, after numerous injections and other minimally invasive procedures, another MRI showed that certain pieces of the original disc had not been seen (thus not removed) during the initial surgery. It was back to the surgical table for Joe.

I visited him in the hospital and I remember him finally caving in and admitting that he never had been truly able to comprehend the depth of my pain over all those years, until he experienced it himself. Thankfully this time, Joe has made a full recovery and is backing seeing zillions of patients every weekday, being the outstanding physician he is. And that's why your boss doesn't believe you when you complain about severe back pain. Unless that is, he/she saw you run over by the inebriated fork-lift driver and pinned to the bale of scrap paper.

However, it is imperative for you to know that you're not alone. Let me know what you think!