Back pain, more than a clinical symptom
I was glad to see the growing cooperation amongst various professionals especially in the hospital setting in the management of neck and back pain at a conference jointly organized by Hong Kong Physiotherapy Association, Hong Kong Association of Rehabilitation Medicine and the Orthopaedic Rehabilitation Subspecialty Board of the Hong Kong College of Orthopaedic Surgeons. Dr. Ping, Chairman of the Orthopaedic Rehabilitation Subspecialty Board, gave an enlightening welcoming speech that is well worth sharing: Back Pain is not only a clinical symptom. With a yearly prevalence (frequent) at 50% of the population and lifetime prevalence at 80%, it certainly qualifies as a national health issue for all countries around the world. Chronic (long-standing) pain more often than not, "hits home", affecting family life as well as vocational life, thus turning into medico social and medico legal issues. Back Pain is not as deadly as a malignancy. However, it certainly costs more for the society than malignancies. The Society pays to treat it, to compensate for the work absence and disability entailed. It pays ultimately for the lawsuits involved and the welfare required. Is back pain the leading cause of disability in our society? Of course it is. The overwhelming prevalence of back pain over CVA (stroke), spinal cord injuries, heart diseases and so on, ensure its top positions in the minds of health care planners. Back pain has never been the issue of a single discipline. The workload and the complexity of it could not be rest upon the shoulders of a single specialty. Back pain involves clinicians of many disciplines, including those working in the field of alternative medicine. Publications from their efforts have been overwhelming. Yet, like the quantum physicists, despite advances in technology since our last century, we have yet to obtain an "Universal Theory" that enlighten clinicians on the pathophysiology of "non-specific back pain" that modern technology can show nothing "specific". However, like the quantum physicists, despite the seemingly futility of this pursuit that discourages many, many more still persistently work hard for a solution that could only come, not in a quantum leap, but bit by bit.