Catching the Deadliest Advice (From 5/30/14)

I LOVE the show Deadliest Catch. I absolutely cannot get enough of it. If you have never seen the program, it is about 6 or so boats that travel the Bering Sea fishing for various types of crab. The show is now in its tenth season, and I still like it just as much as I did in the beginning. The arctic environment the fishermen work in is extremely harsh, and there are often injuries on the boats. Broken fingers, sprained joints, bruises, cuts, and back pain are just a few of the common maladies suffered on the show.

However, I was watching last night and one particular injury caught my attention. Scott Campbell, Jr., the captain of the Seabrook, has been suffering from severe low back pain for most of the king crab season. Last night his condition finally got the best of him, and he was forced to leave his boat to seek medical attention.
Junior spent much of the next two days lying in bed, as his pain got steadily worse. Finally, he has an appointment with his physician, who promptly schedules an MRI. After some time following the drama with the Saga, we return to the doctor’s office where Junior undergoes a makeshift physical examination, and is informed he has several severely herniated discs and a vertebrae that is “out-of-place”. His father and his wife begin to cry as they say, “you may never be able to go crab fishing again!”

As much as I love this show, the things shown in last night’s episode frustrate me. Unfortunately, I think many people who suffer from back pain have similar beliefs and receive similar care. The bad thing about this is that these beliefs and ideas are based more in anecdote than in science. Here are some hard facts about back pain:

  1. Herniated, bulging or “slipped” discs do not cause back pain.
    2. Vertebrae do not often get out-of-place, or alignment
    3. Bed rest and activity avoidance are the WORST things a person can do for back pain
    4. Back pain does not mean you will never be able to return to your previous level of function

However, the above facts are the opposite of the conventional wisdom. The beliefs that pinched nerves, herniated discs, and displaced vertebrae are the causes of back pain is not based in science. Several studies have now shown that bulging discs are likely normal changes associated with aging, the same as wrinkles in the skin. A vertebra cannot displace, because besides being physically impossible, it would paralyze a person if it did. Bed rest is the old standard treatment for back pain, but in the majority of cases, the pain will worsen immediately (Junior is a perfect example of this: two days bed rest = great exacerbation of pain). Anyone who would restrict a person’s function, or the level of activity that they can return to in the future, has already given up on their ability to recover.

These myths are perpetuated by pop culture, bad information on the internet, and the stories old grandpa tells you
about that time he “threw his back out.” So if this has been scientifically proven, then why do the myths persist. The answer is simple: convenience. It is easier for a patient to hear that they have pain because of a slipped disc. It is difficult for a patient to accept that the causes of back pain are unknown. Physical therapy can often be difficult, but it is one of the ONLY ways a patient will make a full recovery. Everyone wants the instant relief from their pain. So the convenience of slipped discs and pinched nerves gratify them, as they head toward bed rest, and disability.

Deadliest Catch and Discovery Channel just helped continue the public misinformation last night. Realistically, if Junior is treated correctly, he should be able to make a full recovery and return to captaining the “Seabrook”. It just frustrates me that I see this everyday in our pop culture, and I know the mental damage it can do to my prospective patients. I want them all to recover, but with so much bad information, that is only becoming increasingly difficult. The fact is, many are being detoured away from our clinic by this. The opposite of physical therapy is bed rest. Unfortunately, this is also what causes disability, lost work, and increased back pain.

I hope that if I stand on my soapbox long enough, maybe the tide of public information will shift in a direction that can actually help patients.

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