Back pain musings

Back pain is a complex affair. I often say to would be osteopaths that if you want to understand what is happening most of the time don't even think about my job. There are so many variables from the shape and quality of the bones and joints, the health of the surrounding tissues and the past experience of injury and pain. Now we all like to have a diagnosis. Apart from anything else it's easier to say to your boss, yes my sciatica is bad today. But of course 'sciatica' is a description of the sciatic nerve being painful. It doesn't explain why this particular nerve is causing a line of unrelenting pain down your leg. The reasons for its dysfunction could be simple but difficult to treat (a severly herniating disc for example) or complex but readily amenable to osteopathic treatment and a change in lifestyle (ie different shoes, postural change or exercise advice). Often my diagnosis/evaluation will evolve over a period of time, and I feel like a detective piecing ideas and facts and experience together. Sometimes I'll think I know exactly what's going on only to find thatI have just grasped one piece of the puzzle. However it's the acceptence and willingness to keep thinking and learning which makes my job so interesting. (Just on Friday afternoons it would be nice if things were straight forward)