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Are you sitting comfortably?

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Wow, last week was a bummer, wasn’t it? Not the Cyber attack, though I accept that was annoying, not least because the media repeatedly played footage/soundbites of earnest GPs explaining how we were having to resort to pen and paper, like that’s a bad thing.

No, I’m talking about the fact that my back went. As in, I bent over and it went completely into spasm. As in one of the worst pains I’ve felt, and I’ve felt the pain of an FA Cup semi-final penalty shoot-out defeat. As in, while the NHS network was being hacked, so were my sacroiliacs.

It did teach me a very valuable lesson, though. Because I’m me, and patients are patients, that is to say I have a highly developed level of cynicism and patients have a highly developed level of exaggeration, I’ve not always been the most sympathetic of doctors. That applies to symptoms in general but back pain in particular. Indeed, I’ve always taught trainees that patients who claim their back pain is such agony that they refuse to sit down during the consultation are definitely nuts.

Oh dear. I now realise I have been very much mistaken. In fact, the typical patient presentation of, ‘It’s like someone putting a thousand volts through my spine while someone else hits my buttocks with a cricket bat and a third person pushes a million needles into my legs’ represents a masterclass in understatement. It’s much worse than that. And as for not being able to sit down, yes, I understand, because to do so involves as much cautious adjustment, readjustment, potential pain, counting down and fear of not being able to get back up again as the average Apollo moon landing.

Obvs, I still went to work. And the staff were very sympathetic, if we can all accept that, ‘You’re walking like you’ve got a carrot stuck up your arse’ is an expression of sympathy. The main problem was moving from my chair to examine patients. This involved such grimacing, groaning, deliberate and ponderous movement and manifest reluctance that they’d have been forgiven for thinking that having to check them over was a major nuisance, so in that sense they didn’t notice anything unusual.

And, would you believe it, my very first patient that day was an acute back begging for tramadol. Tosser.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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Readers' comments (7)

  • Had me in stitches. Good one. That is why patients like more, lets say mature doctors? The young are less likely to understand pain.

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  • Sympathise with you - have the same - Kneeling chair good for consulting - back actually feels better at end of surgery. You can also use bottom step to sit on when dealing with kids so you are on same level which can be useful. Not so good on knees at end of day though. Found gabapentin simply brilliant for sciatica though - stopped me being off though made me very stupid so only took for 2 weeks. The vet put our dog on it after this but is basset hound so tricky to say if it made him any more stupid.

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  • Wait until your first episode of ureteric colic, then you will also discover that these patients aren't nutters either, they are not just after an opiate injection as I always thought. I've had both conditions now, but you can't get to work with colic!

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  • Acute back pain and renal colic, 'nuff said,true agony. BUT, our patients don't present with that. They come in again and again with the same thing which doesn't happen in true life. They are avoiders, not copers and fall into chronicity. Have you noticed how many people with chronic back pain wear tinted glasses? Back pain + tints=nutter!

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  • please, the correct term is 'biopsychosocial back pain',I admit it takes longer to type than nutter but labels are important and have power. also sympathies with your pain.glad to say my time off work plus microdiscectomy is a 20+years distant memory now so the sympathy for patients in pain does wear off after a while...

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  • I find standing between shelves of notes muffles screaming quite well.

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  • Hope you worked out your STarT back score, and hope it helped with your recovery 😂

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder