You have back pain and you come in to the clinic to be faced with a questionnaire containing so many questions that include ‘List all operations with dates’. I can imagine that a lot of you wonder ‘Why is it important that a chiropractor knows about my ingrown toenail operation, so many years ago?’, so I thought I would give a short run down on why we do ask this question and why it might be relevant to your care.
A – Appendectomy, arthroscopy (operation on any joint)
Appendix operations can lead to pain in the lower abdomen following lifting – could be a presentation of low back or pelvis problem or many months after this operation, acute inflammation of the residual tissue of the appendix can give this pain referral.
Any abdominal surgery can cause chronic post surgical pain that can refer to the back.
Any operations you have had on any joint is obviously of interest to chiropractors – one joint problem can lead to many others – did you see Andy Murray’s back x-ray that he posted on Instagram – he has pubic bone issues and low back facet problems!
B - Bunion removal, breast surgery, breast lump removal, back pain surgery
Bunions – Operations on your feet can either alter the way you walk or you may have been walking badly prior to the operation.
Breast surgery – we need to know why – if you had breast reduction surgery you may have developed mid back problems from poor posture prior to the operation.
Breast lump removal – could be for cancer or a benign lump, we need to know the history.
If you have had any surgery however minor on your spine then we need to know before we perform manipulation on your spine.
C – Cholecystectomy (gall bladder removal), Caesarian section, colostomy, cataracts, carpal tunnel, cystoscopy (bladder surgery)
Gall bladder problems can lead to back and chest pain – if yours has been removed then it cannot be a potential cause of your pain and can be eliminated.
Caesarian sections – research has shown that there is an increased risk of low back pain among those women who have had a caesarean section delivery of a baby.
Colostomy – we need to know why you have had a colostomy bag fitted. The permanent opening you have in your abdominal wall may interfere with the function of the abdominal muscles and make it more likely that you develop low back pain.
Cataracts – how long was your vision impaired prior to the operation – if you could not see properly for ages before, you may well have been peering at the computer screen with your neck at an odd angle, which may have contributed to your neck and upper back pain.
Carpal Tunnel – Surgery can be very effective, but there is often a neck problem associated with carpal tunnel syndrome that may have been overlooked by the surgeon.
Bladder surgery – why you had this is important – if due to a prolapse then that can compromise the strength of muscles in your abdomen and thus cause low back problems.
E – Ear surgery
You may hold your head at an awkward angle in order to hear better, which could contribute to neck pain or headaches.
G – Gastric band
Have you been very overweight in the past that could have impacted on your joints.
H – Haemorroidectomy, hysterectomy, hernia repair, hip replacement, heart surgery
Piles or haemorrhoids can be due to chronic constipation, which can give rise to pain around the base of your spine in the coccyx area. Digestive issues that may have contributed to the need for the operation can lead to bloating in the abdomen and pain that radiates to the back – we need to consider all the potential reasons for your low back pain.
Hysterectomy – you may experience back pain as a result of the position you were put in during the operation, prolonged bed rest after the operation, moving awkwardly afterwards.
Hernia – If you were in pain for some time before the operation then your abdominal muscles – or your ‘core’ may well have suffered as a result and be deconditioned.
Hip operations – may give rise to low back pain or groin or thigh pain – I have worked with many hip surgeons to try to eliminate post surgery pain in these areas.
Heart surgery – can displace ribs and cause mid back pain. Forty percent of patients who had bypass or valve replacement had pain after 3 months, and 10 percent had pain after two years according to a Canadian study. Some people have post sternal pain (behind the breastbone).
L – Laminectomy, lumpectomy, lymphadenectomy, lobotomy, lumpectomy, lipoma, laparoscopy
M – Mastoidectomy,
Any surgery on your breast we need to know about as some manipulations may involve leaning on your back while you are lying on your front.
P – Prostatectomy, plastic surgery
Why was the prostate surgery performed. Back pain can be due to many things other than local problems so we need to know of any potential causes we need to consider, particularly if you do not respond to treatment as we expect.
R – Rhinoplasty (nose operation)
Was this due to an accident or injury that may have occurred years ago and you have forgotten about but it could have caused neck problems if the impact on your nose was big enough.
T – Tonsillectomy, thyroidectomy.
Tonsillectomy – why did you have it? If due to sleep apnoea then you may have been at risk of stroke. We need to take this and other risk factors into account, such as whether you have high blood pressure if you come to see us with headaches, before we manipulate your neck.
Thyroid removal may increase the risk of bone thinning (osteoporosis) especially for younger patients and women. The incidence of thyroid cancer has been progressively increasing resulting in an increase in the number of thyroidectomy operations.
V – Varicose veins.
Can give rise to leg or pelvic pain – and if you have had varicose vein surgery it is good to know what was the cause.