Is ‘wear and tear’ causing my back pain?
At the clinic we often see people coming to our clinic in pain stating that they have been told that ‘it is due to their age’ or ‘wear and tear’.
In this article I want to discuss why this often simply isn’t the case.
What is ‘wear and tear’?
‘Wear and tear’ is a layman’s term for Osteo-Arthritis (OA) which is the normal process of degeneration that’s occurs in all humans as we age. This process occurs for several reasons. A normal joint can be exposed to abnormal loads such as trauma or repetitive activity OR a joint which is not functioning correctly can be exposed to normal everyday forces.
How is OA diagnosed?
OA can only be diagnosed with the use of medical imaging, most commonly X-ray’s.
Under medical guidelines it is inappropriate to diagnoses OA without the use of an X-ray as symptomology is simply not accurate enough to formulate a diagnosis as we will discuss later.
On an X-ray, OA will be seen at the joints of your body where two bony surfaces meet and is often classified as mild, moderate or severe.
How and when does OA occur?
OA has been shown by many studies to be seen on X-rays in most people from the late 20’s to early 30’s and may slowly progress in severity as we age. Interestingly there is a large evidence base to suggest that the severity of OA is poorly related to the level of pain experienced by a patient meaning you can have a small amount of OA and lots of pain or large amounts of OA and little to no pain.
Putting it all together:
OA begins to develop in your late 20’s to early 30’s as a result of trauma or incorrect joint function which both place increased stress into the joints. As there is no correlation between the severity of OA and the amount of pain you experience it is logical to suggest that you could have as much or more pain for OA in your younger years than you may as you age which begins to dispel the myth of Ageing= increased pain.
Now consider this also. We now know that a vast percentage of the human population over the age of 30, when imaged, will show some signs of OA. We also know that most people who have an X-ray of their lower back do so because they are in pain. What happens now is a case of ‘guilty until proven innocent’, the OA is often blamed for the back pain because it is at the scene of the crime at the time the crime despite the fact it may have been there before the back pain and will definitely be there after the pain has gone! This begins to challenge the view that ‘wear and tear’ is always the cause of the back pain when nothing else is seen on the imaging.
The far more likely culprit is the trauma or incorrect joint function which is cause the OA to occur…