Today I woke up with X-ray pain…
What I mean is, it’s very common to consult a health professional about musculoskeletal pain (pain in the knees or hips, neck or lumbar pain, pain in the heel or shoulder). Information about social and work circumstances and the length of time the condition has been suffered contribute to determining the use / misuse / overuse of the particular area of the body, which obviously over time develops its own protection and adaptation mechanisms to ensure its function is maintained. I suppose it’s clear that I’m talking about the dreaded osteoarthritis. This is a slow and gradual process that accompanies the succession of renewals of the national identity document (many patients like the reference to this document).
Now, how do we explain the existence of patients with mild to moderate pain whose X-rays show frankly catastrophic damage, and patients with severe or intense pain whose X-rays are fairly normal?
On occasion we have shown examples of X-rays with dramatic signs of osteoarthritis as an example of a condition which appears to cause the individuals little to no pain.
Two very clear examples I can think of are the so-called “heel spur” and “vertebral osteophytosis”. In both cases over- calcification occurs as a mechanism by which the body seeks to increase support surface (in the case of osteophytosis) or to strengthen an area of insertion that is suffering excessive traction. But most importantly, this is a process that has been going on for years in the same body. The pain is not of the bone itself but of nearby components in the area which are not working dynamically, and as part of the complex cerebral perception system which has activated (as our much admired Dr. Goicoechea says) “the pain programme in the face of possible harm.”
This may explain the difference between “three days ago, when it did not hurt” and “today I woke up with excruciating pain in the heel”.
What is clearhere isthatexcess bonedoes not hurt, and to fall back on your X-raywhenever youneed tojustifya painis a freeandrather promisingway tocombat it.We couldend up with twospurs: one in the calcaneus andthe otheras abutler, opening the famousgatewayofpain perceptionin the brain.
In conclusion, X-rays do not hurt!