My mission is to inform, enlighten and empower people to take control of their health and I would hope after people read this they would question everything they are told for every medical condition. The scope of this article deals primarily with my past and recent experience of the NHS in their handling of a ten year lower back problem.
I attended my local NHS hospital about ten years ago after a period of chronic lower back pain and was diagnosed by an orthopaedic consultant, with scoliosis of the spine and degenerative disc disease in my lumber region (L3, L4). I asked him for an MRI or X-ray, but he was adamant on his diagnosis and said I did not need either. “There was nothing he could do, it was wear and tear”.
Consequently I was sent packing with the feeling of helplessness and thoughts of whether I could ever jog, exercise fully or perform some normal day to day tasks again.
I spent £2,000 on an osteopath over a year to help alleviate the pain as well as taking Vioxx for two years; Vioxx was banned in 2004 for causing deaths and heart valve damage and was the subject of a multibillion dollar lawsuit.
I lost a job as a business adviser because I simply could not function properly on a daily basis; the pain was so debilitating and I also suffered bouts of depression.
In the past year I started to suffer pain in my hip joint and heel and therefore decided to request a consultation with a different hospital.
On arrival at the hospital last month, the first thing the consultant did was to take an X-ray and to my shock horror deduced that I did not have both the conditions previously diagnosed ten years ago. I was then referred to the hospital’s orthotics technician to be fitted with a back brace. I probed and prompted the orthotics technician with various questions and theories and eventually the penny dropped; he surmised I had short leg syndrome and proceeded to do a quick, albeit crude test on my pelvic alignment. I was then given a heel insert for my right shoe and asked to come back at the end of September.
Although I have not been for the second appointment, since wearing the insert (six weeks), my back has never felt better and the hip joint and heel pain have also subsided.
If I had resigned myself to a life of pain and limited mobility, my quality of life would have been much less than hopefully it will now turn out to be, because I took the step to re-visit the NHS, but only after being forced by the added pain from my hip and heel (two classic symptoms of short leg syndrome) rather than questioning their diagnosis..
Here is some research I managed to dig out from the States.
Frieberg1 has determined that about 50% of the population have uneven leg length, but found that of the low back pain patients, 75% had leg length inequality of 5mm or more. Giles2 has demonstrated that there can be a 75% reduction of low back, hip, and sciatic pain in the short leg cases of less than 10mm by placing a lift under the short leg.
Kakushima3 found that patients who have unequal leg length due to disorders in the lower extremities are at greater risk of developing disabling spinal disorders due to exaggerated degenerative change. Therefore, treatment for leg length discrepancy may be helpful in preventing degenerative spinal changes.
In the United States there are approximately 300 million people. Nachemson4 states that 88% of the population are back pain patients at one time or another. Of that 248 million people only 60% will seek professional help.
Consequentially, there are about 148.8 million back pain patients that will look for professional help. By using Nachemson’s reasoning, one could assume that approximately 111 million people with lower back pain could possibly receive a great deal of relief if not total elimination of their back pain just by placing a heel lift of a predetermined thickness under the heel on the side of the short leg.
Unfortunately, there are very few practitioners in the healing arts who treat back pain, that fully understand the use and application of heel lifts. It is projected that approximately 3 million heel lifts were dispensed to the healing arts in 2005. Heel lifts are usually given to patients in multiples of 4.
Therefore about 750,000 back pain patients or 0.005% of the back pain population received heel lifts as part of their regimen of care.
But according to Friberg, in his study, there probably should have been 111 million people receive a heel lift as part of the treatment of their lower back pain.
So if you want a more accurate diagnosis of your back problem, then you will need to try and do some research of your own, not to offer a complete self-diagnosis, but rather to show an inquisitive attitude and arm yourself with some knowledge in the hope that a consultant respects your efforts to bring some sense to the situation.
Also you are sending a signal that you won’t be palmed off with “there is nothing we can do, it’s just wear and tear” or “you have mechanical back pain and sometimes there is no definitive reason for it”.
I spoke to an NHS physio recently and he was not surprised to hear my plight and also stated that “these so called specialists can be blinkered or trained to think in a certain way”. They can also be aloof, complacent and beyond criticism; a dangerous cocktail.
I realise many people have a sacrosanct attitude towards the NHS. However once you scratch under the surface you realise all is not well. With a budget of £130 Billion, there has to be more accountability and improved quality of service delivery.
1Friberg, Ora. “Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality” Spine 1983
2Giles, L.G.F. Leg Length Inequality Spine 1981: Sept. 6 (5): 510-518
3Kakushima M, Miyamoto K, Shimizu K. Departments of Orthopaedic Surgery, Hirano General Hospital, Gifu, Japan. 2003
4Nachemson AL; Low Back Pain -its Etiology and Treatment Clin Med 78:18-24, 1971 Sept. 8(6):643-651