1981 HS grad here. My junior high and high school would always have at least one student who had a Milwaukee brace, which they don’t use any more. With one exception, all of them were girls.
My 23-year-old niece wore a Boston brace, which is basically a clamshell she wore for 18 hours a day, and when that didn’t work, she had a spinal fusion and “grew” several inches. We’re puzzled about how it happened, because there’s no history of this on either side of the family.
The insurance grudge motive has been dismissed. There was nothing but sensationalist speculation behind that. He imagined himself serving the public, not himself personally. And he’s clearly a couple of tacos short of a combination platter. Much of the public considers him a hero now, demonstrating their own grip on reality is tenuous.
Long story I won’t get into in detail, but my cat needed an x-ray once, and he being a cat, it was pretty much a full-body x-ray of my cat lying on his right-hand (right-paw?) side. The veterinarian pointed out to me what he was looking at and for. Included was an exam of the cat’s lower intestine. “See this and this and this?” he asked, pointing at the x-ray. “Those are turds. And the spaces between them? Those are farts.”
It made me laugh, but it also made me realize that a lot more can show up on an x-ray than just bones.
Yeah, lifted a lot in my teens and twenties, and played football.
Never injured my shoulders or arms at all, but now that I’m in my 50s, they’re the part of me that probably hurts me the most. I attribute it to a lot of chest/shoulder related lifts that I used to do. That and the semi-competitive swimming I did as a teenager were the only shoulder-intensive activities I’ve ever done.
I feel like there’s more to this in a philosophical sense. Are we supposed to be pain-free, or is there some baseline level of discomfort at each age that’s usual and customary? And if that’s true, how far off the mark does that put people who believe we should be pain free?
I believe we should have enough pain to remind us not to do stuff that’s bad for us. And there’s more of that stuff as we age.
But i think a lot of chronic pain is just the body not working properly, and sending unhelpful signals. Like my friend with the continuous glucose monitor whose phone app kept going off to tell her it had lost connection with the monitor. For a couple of seconds. Annoying as hell and unhelpful. Yes, she needs to know if the monitor and the phone aren’t talking. And no, she doesn’t need to know RIGHT THIS INSTANT, and there ought to be some way to pause that alert when she’s in a place with bad coverage. But there isn’t. And there’s not a good way to “pause” unhelpful pain, either.
Adding to this thought, it appears Mangione was born misshapen. Or at least developed in a misshapen manner as he grew to adulthood. Most mechanical systems, bio- or otherwise, work badly when built misshapen versus their design.
I’ll suggest that an anatomically typical young adult human has a reasonable expectation of existence free of chronic pain. He drew a bad hand though. A “reasonable expectation of” is less than an “inalienable right to”. Which is what many folks mean when they say “are supposed to.”
His cry amounts to “Why me?” Why indeed.
@Puzzlegal: As always you’ve hit a good point.
The “purpose” of pain is a bottom-up system to tell the consciousness up top '“don’t do that” for whatever you’ve just done to injure or annoy some low-level component in your body. But that’s real unhelpful when the “that” you’ve done is simply exist in a way that continuously irritates something you can’t fix.
Not a radiologist - but it should be noted that abnormalities on imaging generally correlate poorly with presence of/degree of back pain.
So, concluding that someone’s x-ray or MRI abnormalities explain their pain (or lack of it) frequently is erroneous.
While this is true in general (the correlation between disk abnormalities and pain is almost zero, for instance) I would guess there are some abnormalities that routinely generate pain. I have no idea whether Mangione’s abnormalities fall into that category. Other than the metal spikes in his back, I can’t even tell what’s abnormal.
Not to get all evo-psyche, but I’m not at all convinced that the human body is at all made to live pain-free. The great apes that left the forest walked upright as a survival trade-off, resulting in all kinds of complications. I doubt we’d be having this same cultural moment if a CEO had been shot over some poor soul’s hemorrhoids
The important point is that diagnosing and treating back pain is a multifactorial process. Practitioners shouldn’t depend overmuch on what imaging shows.*
*the most notorious abuse of imaging involves chiropractors, who often overinterpret/mistakenly characterize back x-ray abnormalities, including nonexistent “subluxations”.
Way off field from the OP by now and I can’t find the study from years back on a quick search but pretty sure my memory is accurate:
Pain to some degree is fairly endemic with aging including among those who have regular moderate exercise habits. The difference is that the regular exercisers do not as frequently get disabled by their pain, and tolerate it better. It is background buzz.
This came to mind recently out to dinner with another couple. The husband was bemoaning how he has so many aches and pains now, sore getting out of bed. My thought was that I also am often a hey but I blame it on the run or lifting session I did the day before and feel good about it. Maybe I would be the same sore no matter what? Exercising just lets me delusionally place it in a positive frame?
As the philosophical … pain is not bad per se, any more than any stress is. But like other stressors (again, like exercise) the benefit is when it is moderate and intermittent with recovery between. Chronic pain, like what @Exapno_Mapcase describes enduring? That is pure harm. And very hard to manage well. Not just normal aging.
I sometimes have pain or stiffness getting up, but so long as it’s transient i ignore it and get on with whatever i planned to do.
Yeah, there is a qualitative difference between transient or intermittent pain arising from normal aging or overwork, and the chronic pain of back and joint maladies, most of which are (setting aside congenital conditions and traumatic injuries, and of course the horror that is rheumatoid arthritis) a result of not developing and maintaining joint strength and flexibility through some kind of varied bodyweight or rotational weight activity such as yoga, Pilates, club/mace/kettlebell exercises, “flow” bodywork, or something else that in some way mimics the pre-agricultural motions that plains dwelling hunter-gathers would do as a part of their normal daily survival activities.
Of course, once you are getting past five or six decades evolution is starting to be done with you at a basic metabolic level, even as a senior matron helping young mothers or a tribal elder passing on accumulated wisdom, and it is much harder to recover from injury and illness or perform physically stressing endurance tasks.
Stranger
I’ll never forget the teenager who had outpatient surgery and ended up in the ICU with a morphine overdose, because he didn’t understand the difference between “pain control” and “pain free.”
He did go home in a day or two, but it was pretty scary for a while.
Since veterinary care has entered the conversation, the reason they aren’t real big on pain control for animals, the way we are with people, is because some pain is helpful for an animal, so it’s less active while it heals.
No surprise there.