The Problem With the Article Claiming Back Pain Is a Result of 'Idleness'

I really didn’t think I could be this upset by a piece in the paper. I thought that this kind of rage was reserved for things that upset my family, or threatened the planet. But here I am, having canceled my subscription to The Times of London and so annoyed I can barely stop trembling.

The Lancet has recently published a study that says that many cases of lower back pain are badly treated by doctors, and that back pain is generally poorly misunderstood. Amen, say I. Everything in my personal experience tells me that scans don’t show everything, that there is a long wait for physical therapy compared to writing a prescription for painkillers and that, despite their name, painkillers don’t actually stop anything hurting for me. I have had back pain since 2011 and my spine is now held up by a couple of metal rods due to kyphosis, so I’ve been through a few specialists of widely ranging competence. I have also had at least four physiotherapists and see my osteopath every 10 days. That backs are complex and that the medical profession can’t cure them all really isn’t news to me.

This study was written up in The Times last week in very general terms, and I
commented that the conclusion they emphasized – that physical therapy was likely to be more useful than painkillers for all sorts of back pain – was a generalization. Like a lot of people, I have tried physical therapy and still stay active, and it has been useful to some parts of my back, but not others. In one instance it actually made a lower back problem worse. I take painkillers every three to four hours day and night because nothing sorts out some backs, and the suggestion that a bit of Pilates is a universal cure is unhelpful. Many, many comments made it clear that a lot of people think that what cured their back should cure everybody’s.

Why should the chronic pain community care about this? The opinion of these people matters because they might be our employers. They might have family members with persistent back pain. They might be the people who have decided that we didn’t deserve unemployment benefits. We are at the mercy of these judgements all the time. Lots of people think that, because swimming helped their sciatica, they are not only qualified to suggest the cure to others – which at least is helpful in intention – but to doubt others who never seem to be able to sort out their pain in the longer term. They got better, so why can’t we?

A few days later there was an opinion piece by a journalist I used to greatly respect entitled: “If we weren’t so idle we wouldn’t have all this back pain.” The title says it all, really. Basically, we all know that we should be more active, but we aren’t, and that’s why so many backs hurt. Nowhere does it mention any exceptions to this rule. Nowhere is there an acknowledgement that persistent back pain can hit someone who is running after a preschooler and a toddler, and thus is definitely not inactive. Nowhere does it mention that genes, bones and so on might determine one’s back pain. Nowhere does it acknowledge that physical therapy might be hard to undertake in pain. Nowhere does it even mention that The Lancet study is only about the lower back. Back pain happens because we don’t move enough these days and because we stop the physical therapy too soon, because we’re lazy.

I quote: “What works far better is appropriate exercise, determination and keeping flexibility on the move.” For some people it does, I’m sure, but this lady – who has no medical qualifications – fails to mention that this does not apply to everyone. In my case, persistent chronic pain started in someone who was fit, and who has largely remained determined and active in the face of horrible and continual pain.

I have made a complaint, but even in the event that it is upheld, which seems most unlikely, the damage is done. Thousands of brains have registered the thought today that back pain is the preserve of the idle. I thought the physical pain was enough to be going on with.