Me: "So you're here for back pain?"
Patient: "I don't really have any back pain. I'd like a back brace."
Me: "Uh, why?" Because back braces are cool?
Patient: "For my swayback."
Me: "What's swayback?"
Patient: [incredulous] "You don't know what swayback is??"
Me: "No..."
Patient: "It's a well known condition!"
Me: "Uh."
Patient: "Here, look!" [shows me totally normal-appearing back]
Me: "Uh. How long have you had it?"
Patient: "I was born with it, of course! I can't believe you don't know what swayback is."
Me: "Do you mean scoliosis?"
Patient: "No, but I also have scoliosis."
Later:
Me: "The patient said she has... swayback."
Attending: "What's swayback?"
Me: "Oh my god, that's what I said!"
Attending: [googles "swayback"]
Apparently, swayback is excessive lumbar lordosis. It's also a rock band with the feel-good hit of the summer.
The patient must own a horse. It's a commonly used term for horses with huge "dips" in their spines. They can only be companion pets because the spine problem makes riding the horse dangerous / painful for the animal.
ReplyDeleteYes, it must be a horse thing. My attending, who saw back pain day in and day out for years, had never heard the term.
DeleteI admit I was a little surprised that you'd never heard the term "swayback" before. But like anon above said, maybe I just know about it because of the horse thing.
ReplyDeleteMaybe it's regional, because I just assumed it was lordosis, having heard that before. But I don't know why she'd want a brace if she's not having pain.
ReplyDeleteMy mom used to call my lower back curve "swayback" when I was little. I do/did have a little bit of an excessive curvebut it was never a medical problem. Apparently my mother had the same characteristic as a child and much was made of it by adults in her life. They made her do exercises & stuff to straighten it out. She was from a rural area, where comparisons to horses wouldn't be out of hand, so maybe that is where the term originated.
ReplyDeleteWow, you have never heard of swayback? That's a little embarrassing for a physiatrist.
ReplyDeleteHaha jk
It's a common term in sewing circles because you have to make certain adjustments for your clothing to fit the curve of the lower back properly, but no one ever talks about it as a medical condition, just a natural variation.
ReplyDeleteMy grandmother was a fantastic home ec teacher and seamstress. I like the idea of a sewing derivation for the term rather than horses, especially since it was applied to me as a kid! :-)
DeleteFirst thing I thought: How on earth would you get a back brace on a horse...
ReplyDeleteNot a medical term, but also not an uncommon lay term.
ReplyDeleteIt is kind of a common term that refers to excessive lordosis.
ReplyDeleteit sounds like a term that would be thrown on a board exam to freak out medical students like me during the test...like the other day a practice question had the term "water brash" and I was like WTF is that??? There are too many terms for the same thing...kind of makes you hate the thesaurus!
ReplyDeleteI think water brash is an older, previously very well known term as I learned it from an older Pulmonologist who asked incredulously, "Really, you've never heard the term 'water brash?'". After he explained I started seeing it in my general reading and in board-related material.
DeleteWas familiar with swayback as a lay term for an exaggerated lumbar lordosis.
I wonder if it's a regional term? I'm new around here, so I don't know if you've mentioned your geography, but here in the Midwest swayback and hunchback (kyphosis) are both common terms.
ReplyDeleteI did my residency on the east coast, which is where I'm originally from.
DeleteMy family is from Missouri. Maybe it is regional.
DeleteApparently I have a lot to say on the subject of swaybacks today. :)
As a med student, I learned "hunchback" and "swayback" as lay terms for lordosis and kyphosis as well. No lay term for scoliosis I can think of, though? Squiggly back...
DeleteAs someone from NY with no horses, I never heard of it.
ReplyDelete