Sometimes, we can learn a lot about one condition by comparing it to others. Back pain is often thought of as a chronic, recurring condition. By that I mean that it's rare that people have one episode of back pain in their life and never again. More often, they have one attack followed by others. Few people have subsequent attacks as often as every month; on the other end of the spectrum, few can go for 5 or more years between attacks.

Like low back pain, diabetes is a chronic condition with fluctuating periods of control and can be influenced by lifestyle and activity.

I often hear physicians say something along the lines of, "80% of people with (Type 2) diabetes could reverse it with lifestyle changes but less than 5% actually do."

A study published in Diabetes Care in 2014 addresses the question, "Can diabetes be cured without surgery?"

They followed 120,000 adults with type 2 diabetes. Over 7 years, only 1.47 percent of the entire group had a partial remission, 0.14 percent had a complete remission, and 0.007 percent had a prolonged remission. That's only 70 in a million. Oooookkkayyy... well at least it's not ONE in a million.

Nearly as bad, the most likely to "cure" their diabetes were the least diabetic. People who were older than 65 years of age, were African American, had been diagnosed for less than 2 years, had an A1C of less than 5.7 percent at the start of the study period, or were taking no diabetes medicines at the start of the study period were more likely to have a remission. Keep in mind that one of the definitions of diabetes is an A1c of 6.5 or greater. So at 5.7, they were not technically diabetic at the time the study began.

The question that comes to mind is, "How in the heck do doctors come up with a cure rate that's 1,000% more optimistic than it really is?"

The answer is that this estimate, like a lot of estimates doctors give, are unfortunately based on nothing. Many things physicians and other healthcare providers tell their patients are based on an estimation of their own experience with no hard data to back it up. I train new physicians and I encourage them to find evidence contrary to something they hear me or any other physician say. And you'd be surprised how often someone has actually done a study confirming or disproving some trivial point but how often we get it wrong.

The slightly good news here is that these were not 120,000 people who were in a program or even had a desire to cure their diabetes. All we can say about them is that they continued to be followed by this healthcare group for 7 years. Now imagine that someone in the group completely turned their life around. They were very unhappy with the diabetes diagnosis so became very active, ate better, did all those healthy natural things and after some time were no longer diabetic. So they stopped the medications and no longer needed to see a doctor. Well, there were probably a few such individuals this study missed but not many.

So what does this mean for back pain sufferers? It may mean that it's actually a lot harder to completely resolve or cure back pain than we've been lead to believe. But the impact this news hopefully has on you is that, whatever you are doing to get your back better, you may need to do more. More may be in terms of more often like how often you stretch, or longer like when holding a plank, or more intense like when using weighted exercise.

This also may help us talk about cure. In studying people with diabetes, they found that 200 TIMES more people had partial remission compared to complete remission. Maybe we should talk more about decreasing than eliminating back pain. I think everyone who has eliminated back pain can still cause it if they do enough of the wrong things.

Most of all, I want you to hear that you don't have to live with it as it is. You don't have to accept that it's never going to get better.