John Henning Schumann in NPR:
A woman in her late 20s came to see me recently because her back hurt. She works at a child care center in town where she picks up babies and small children all day long. She felt a twinge in her lower back when hoisting a fussy kid. The pain was bad enough that she went home from work early and was laid out on the couch until she came to see me the next day. In my office she told me she had “done some damage” to her back. She was worried. She didn't want to end up like her father, who'd left his factory job in his mid-50s on disability after suffering what she called permanent damage to his back. Back pain is common. I see someone with back pain almost every day. Nearly all of us have at least one episode in our lives, and two-thirds of us will have it repeatedly. If you've somehow lived into your 40s and never suffered low back pain, congratulations! You're what doctors like me call an outlier. In my patient's case, I was confident that her back pain wasn't serious. A minor injury was the clear cause. And nearly all back pain like hers from a simple mechanical strain gets better on its own. I wanted to reassure her. I told her to go about her daily life. Keep exercising, but try to take it just a little bit easy until she felt better. At a minimum, I said, she should be walking 30 minutes a day. Also, try some ibuprofen, which helps with inflammation and doesn't require a prescription. But she wasn't buying it. “Don't I need an MRI, or at least an X-ray?” she asked. “My father had three herniated discs and wound up with two back operations. He still never has a day without at least some pain.” I upped the ante. I told her I could refer her to physical therapy, one of the few things shown to be truly helpful for low back pain. No dice. She insisted on an MRI just to be sure. A test like that wasn't warranted, in my opinion, because it would neither change her treatment nor the course of this first-ever bout of back pain. She would just get better.
To convince her of this, I had to resort to my secret weapon: I showed her an 11-minute educational video created by Dr. Mike Evans of Toronto. You may be familiar with Evans' work, even if you've never heard of him. He's the man behind the famous “23 1/2 Hours” whiteboard video that says the single-best move for health is being active for a half-hour or so a day. The video became a viral Internet sensation, racking up millions of page views, and even a shoutout on the hit TV show Orange Is the New Black. Evans is passionate about making complex medical ideas simple. He and his team have made more than a dozen whiteboard videos on health topics including how to deal with stress, acne, quitting smoking and even flatulence.