Local professor, author discusses back pain

Pain, as we know it to be, goes back to almost 5,000 years ago, in cases such as Jacob and the angel in Genesis 32:26, 32-33, where he has hip pain, or in a scene of the first act of Measure for Measure where Mistress Overdone speaks, "Thy bones are hollow," or the British epidemic among passengers called the Railway Spine in 1866, and finally, in 1932 Mixter and Barr published "Rupture of Intervertebral Disc with Involvement of the Spinal Canal," followed by Brown, Nemiah, and Barr's "Psychological Factors in Low-Back Pain."

The University of North Carolina at Greensboro Graduate Liberal Studies Program along with UNCG Health Careers Advisory Committee welcomed Nortin M. Hadler, professor of Medicine and Microbiology/Immunology at UNC Chapel Hill and attending rheumatologist with UNC Hospitals, for his lecture titled, "Backbone: Personal, Social and Policy Consequences of Low Back Pain."

Dr. Hadler attended Yale and Harvard Medical School and has been part of the facility since 1973. He has written over 200 articles, 16 books, and a series on the health care system with titles such as The Last Well Person, Worried Sick, and Stabbed in the Back: Confronting Back Pain in an Overtreated Society. Hadler has also worked with the Obama campaign and advises the White House on health care.

Ryann Hyer, a graduate student in the department of Masters of Liberal Studies, said that "the topics presented were enlightening and surprising. Dr. Hadler presented the information in a very simple and clear explanation."

Hadler had his first patient in 1973, who had an injured back and could not go to work because of the invariable pain. Unfortunately for the patient, Hadler had never heard of such issues and was unable to help the patient at the time. Hadler had to reschedule the patient and do more research. Regional low back pain afflicts working-age adults who are otherwise well and who have suffered no violently traumatic precipitant. It hinders the performance of tasks that are customary and customarily comfortable. Usually, the motion that hurts the most for that person is the motion that caused the damage.

People who have a predicament of regional low back pain fall into three different categories. The first category is the people who deal with the pain and remains a person. The second category is the person with regional low back pain who becomes a patient. Lastly, the third category is a claimant, the person who informs someone else that they are having a predicament. In the "remaining a person" category, these people seek alternative care and result in persisting predicament or become a well person. The people who fall into the patient category, work with doctors and seek medical care and will receive proven or empiric therapy and result in being a well person, or have persisting pain. Most "claimants" seek care in the workplace and contest causality, and then usually return to the workforce.

Dr. Hadler lightened the mood when he began to address myths. One myth is that "people over the age of 40 with a normal spine is getting abnormal, and the people over the age of 50 with a normal spine is definitely abnormal." Also, going one year without any back pain is absolutely abnormal. The top three reasons for pain are #1: Spine and low back, #2: Knee, #3: Shoulder. In most cases, people learn to cope with the pain until they don't remember the pain later.

Another issue Hadler addressed was patients walking into the doctor's office and telling the doctor, "Doctor, my back is killing me!" Dr. Hadler explained what we really mean is, "Doctor, I can't cope with this episode." Underlying your back pain is something else that won't allow you to take control over the pain, such as stress.

Hyer said she found that, "The notion of Regional Low Back pain and the common occurrence was very interesting. Nortin Hadler describes it as a predicament; which lessens the severity of this so-called injury. I was very interested in the idea of the social construction of medicine. The 'medicalization' of our society is a topic very different from what most of us have learned; to go to the doctor and take medicine or have surgery."

UNCG's bookstore was also in attendance so that anyone wishing to purchase Dr. Hadler's books, Stabbed in the Back: Confronting Back Pain in an Overtreated Society and Worried Sick: A Prescription for Health in an Overtreated America could do so. If you were unable to purchase the books and would like to do so, they will be available in the University Book Store. Hyer said, "I definitely plan on reading Stabbed in the Back."

Concluding his lecture, Hadler said, "All my backache patients are faculty. Take a Tylenol and a hot shower, it will cure this episode." For more information, you can contact Dr. Robert Cannon in the Biology Department at Robert_cannon@uncg.edu.