I've been hearing this "80%" figure for as long as I can remember and I
doubt it will ever change. Bigos' classic study of thousands of workers at
Boeing concluded that the same percentage of patients had "no anatomical
reason" to hurt.
I honestly think that this figure is a reflection of the percentage of
people who hurt without displaying any *pathology*. As long as the notion
that painful problems must include a positive finding for relevant disease
processes or visible breaks in normal tissue continuity, the "80%" figure
will continue to haunt us. When are we going to consider the non-pathologic
problems of neural tension (which undoubtedly include pain and restricted
mobility) that will never coincide with a frank lesion demonstrated with
traditional testing?
As far as I'm concerned, this is not so much a psychological issue as it
is an issue of ignorance on the part of those doing the diagnosing.
Barrett L. Dorko P.T.
<http://qin.com/dorko>
At 12:33 PM 3/6/00 -0600, you wrote:
> Dear Charlie,
>
>The surgical study you presented supports my thinking- not all chronic back
>patients have psychological issues- some get better from surgery & other
>treatments! I believe that Di stated that chronic patients fall into 2
>groups- both with some sort of psychological issues- she left no room for
>this 3rd group who recover eventually once their mechanical problems are
>corrected or compensated for. I agree, however, especially depending on
>your setting, that many, possibly most chronic patients no matter what the
>patho or joint involved have some psychological component in addition to
>physical.
>
>As far as not knowing much diagnostically, in the past few years, a research
>article reported that 80% of back patients do not have a specific diagnosis.
>I don't consider this a high point for the medical community. (I'd be happy
>to look up the reference.)
>
>Finally, someone on this list stated that they ask patients questions if the
>rehab is not going well. Great idea, but be careful of what you're asking.
>Patients are not idiots- they know what you're getting at, and may feel
>offended if you go to far (they do not consider us to be psychological
>professionals- so I wouldn't do any diagnosing!!).
>
>Jill K
>
>
>
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