05.08.13

Homogenizing and Color Coding Back Pain?

Posted in Back Facts (spine), Guidelines for Treatment at 2:44 PM by Dr. Greathouse

If we could homogenize back pain and then color code it, we could get more people better quicker, at less cost!

Can you homogenize back or neck pain, and how the heck do you do it?

Well, the answer to the first part of the question is yes! As a matter of fact it’s been done already. As for how, I’ll explain as we go. As for color-coding, it could be done!

We’ve all heard of homogenized milk, but what does that mean? To homogenize something means to make uniform in consistency. Now, we’re not making back pain uniform or consistent, we are identifying uniform and consisted attributes to back pain that are more likely to respond to certain types of care.  You see, a very high percentage of all back pain is heterogeneous, meaning, made up of all sorts of causal factors, of which we aren’t really able to reliably diagnose as the cause of the pain.

This heterogeneous group, better known as nonspecific back/neck pain, makes up 85% or more of all back and neck problems, and this creates havoc for people with back and neck problems.

It creates havoc because the lion’s share of the studies done on what treatment works best has been done on the heterogeneous/nonspecific group of sufferers for the past 35 years or so. So, in effect, we find that certain treatments are beneficial in some people but we don’t really know why, or how to select which one will most likely benefit from which treatment. Thus, treatment essentially remains trial & error, at the time, expense and suffering of the individual.

We can now identify certain consistent (homogeneous) characteristics of certain subgroups within this constellation of nonspecific spinal pain sufferers and get better results. This is called “clinical prediction rules” and these are now given for a variety of problems which we have difficulty diagnosing.

As for color-coding, once a subgroup has been identified, it should be coded by a matching color to the type of treatment options that are more suited for that subgroup. That’s my recommendation.

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