The elephant in the waiting room or why nobody else has got to the bottom of your back pain

The elephant in the waiting room or why nobody else has got to the bottom of your back pain

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We are often asked by our new patients ‘why has nobody else told me this before?’ Why has nobody else found this, got to the bottom of this problem, and given me such a clear recommendation to deal with it.

Many of our new patients have a long history of back pain, headaches, or recurring injuries. Some have been struggling with these types of problems for ten or twenty years or more. They have – they tell us – tried everything. Chiropractors, osteopaths, acupuncture, yoga, physio, different types of pain-killers. Some help a bit, some not at all. But none of them have got to the bottom of the problem for a sustained period or for good. Check out a social media support group for people with chronic back pain and you will how much people suffer and how many different strategies they try – and often fail with.

Many of our patients have had surgery before they come to us. Multiple surgeries even. And yet they are still in pain; still unable to enjoy the ‘normal’ things in life that many of us take for granted. Like sleep. Air travel. Picking up a grandchild. Even tying a shoelace.

How can it be that these patients who have consulted so many doctors and therapists over the years, can walk into our clinic to be asked questions that they’ve never been asked before, assessed in ways they’ve never been assessed before, and given diagnoses and successful treatment protocols that they’ve never been given before?

Well, there are a few reasons, but here we’ll talk about one.

Firstly, like all types of expertise, as people become more ‘expert’ in healthcare or medicine they often tend to become more specialised. You start training as a doctor, then you specialise, and eventually you become a consultant in quite a specific area of medicine – knees perhaps, or wrists. While expertise can be a great thing it can also lead to a narrowing of focus and a reduced tendency to think laterally. If your primary tool is a hammer, then you will tend to see a lot of problems as nails.

However, most chronic musculoskeletal problems – like back pain, hip pain, knee pain (or all 3 together if you’re really unlucky) which haven’t been resolved by one tool or technique – for example physiotherapy – aren’t caused by just one thing and won’t be solved by just one thing. Even the best physiotherapist in the world (or best chiropractor or best pain specialist) has a limited scope of expertise, skills, and tools in their toolkit. They may be able to help you – to an extent – but it’s only by having the right combination of expertises, skills and tools, that complex long-term problems can be resolved.

Our new patient assessments and consultations take at least an hour and often more. We take very detailed medical histories; carry out a whole range of physical, neurological and functional tests; speak to our patients at length; carry out a range of biometric tests (spinal scans, body composition scans) and more. Often patients are assessed by two or more clinicians in our team, with different expertises. Sometimes the patient’s condition is complex and it’s easy to understand why nobody has got to the bottom of it so far. But other times there is something frustratingly simple at the root of their long-history of suffering.

Why do we pick up on these things when so many other clinicians and therapists haven’t? Because we don’t just look at the place where the patient is experiencing pain, we look at the whole patient, through the eyes of different experts and we work together to build a full picture. Or, to put it another way – we see the whole elephant.


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