Almost on a daily basis, someone will ask ‘Is my back out?’. This is sometimes accompanied by a terrified look on their face. This can be a tricky question to answer as everyone has a different understanding of what this phrase means.
At Heavitree Osteopaths, we try not to use this term with our patients, as it isn’t usually a true representation of what is actually going on with the body. We thought, as many people have different views of what this means, it would be easier to discuss what it doesn’t mean.
“A bone or disc has gone out of place”
The idea of a bone or disc moving out of place is something that goes way back into our culture. Many Hollywood films show somebody cracking their spine “back into place” and this has also been stated in the history of my profession. Practitioners used to (and still do) tell people that they have put their back out of place, a disc has slipped or something is out of alignment, which is the cause for their low back pain.
Osteopaths even used to be called ‘Bonesetters’ as people believed we put bones back into place when they had slipped out. This is because sometimes during treatments we manipulate joints resulting in an audible “Crack”.
A joint slipping out of position and causing pain is a model which is very simple to get your head around. The likes of science and engineering have facilitated a mechanical way of understanding the world.
We have an understanding that each individual part is separate from another. The body is not so simple; it’s less like a car or machine which may be built from thousands of different components, but more like a garden, an ecosystem. An ecosystem is self-regulating, repairing, and regenerating, whereas a machine relies on outside intervention, not just for its construction and assembly, but also for its maintenance and repair.
“The body is not so simple; it’s less like a car or machine which may be built from thousands of different components, but more like a garden, an ecosystem”
In our modern way of thinking, particularly with advances in medicine, we often have an expectation to be passive in the repair process, machine-like and dependent on others. The majority want to take medication despite simple lifestyle changes being a solution, we’re looking for somebody to perform a technique or procedure to fix the problem.
By having adopted the mechanical perception of the human condition, when pain suddenly erupts in the back, we presume some part must be out of place or something has gone really wrong. The majority of back pain is actually classified as a lumbar strain, which could mean a pulled muscle, joint, ligament or disc.
The idea that a vertebra can move out of place is not representative of what is actually going on. The bones of the spine are bound together with incredibly strong ligaments and lots of them. The model of misalignment of the spine is used by some practitioners who believe in models that are not supported by modern science and is therefore an outdated model.
The development of an acute onset of back pain can be pretty scary. You could find yourself in huge amounts of pain, standing off-centre and not being able to move much at all. It is important to speak to a healthcare professional to make sure nothing too serious has happened.
Once that is established and you have discussed a plan of action with your practitioner, spinal manipulation may be used as part of your treatment. Manipulation can often result in the joint making a clicking noise – this is gasses being released from the joint. This can increase the movements in the spine, allowing for a potentially faster recovery.
It’s not putting your spine back into its correct position.
June 5, 2022. Billy Challis, Osteopath