In recent years many government studies and other reports have been conducted to try to determine the cause and best treatment for low back pain. These medical reports have made these points:
Most episodes of acute low back pain are in the non-specific category, in other words not originating from a specific pathology. Many episodes are self-limiting and will improve within a few weeks or months.
Acetaminophen (Tylenol, etc.) and ibuprofen (Advil, Motrin, etc.) are often helpful. Narcotics should be avoided. Bed rest is not usually helpful and often causes increased incapacity.
Spinal manipulations (chiropractic adjustments) are safe and effective in treating back pain.
Some insurers and even some doctors have read these reports and concluded that since the reports say the pain would typically be limited to a few weeks or months there is little reason to treat it at all.
There are two primary faults with this reasoning. First, if it is your back pain, do you really want to suffer for a month or more because some report says that you may eventually feel better?
Second, this does not take into account people who don't fit the average or have recurring episodes of low back pain. Practicing healthcare based on averages rather than caring for individuals is always a bad idea.
In today’s column I will reveal the two secrets I promised about effective treatment of low back pain.
The first secret is that although most medical evaluations are focused on identifying anatomical or pathological abnormalities that are blamed for back pain, the most important factor related to most back pain is function.
Your spine is made up of a column of bones called vertebrae. These vertebrae are connected by several joints that allow free movement, so that you can bend and turn.
The ability of the muscles to contract and move these spinal joints, the ability of the joints to move freely, and the ability of the joint ligaments to stretch properly and provide integrity to maintain stability are all critical to overall joint function.
If there is a limitation in any component of this system of joints, muscles and ligaments, the result will be restriction and ultimately pain. To eliminate the pain, it is critical to correct the function.
This is the primary reason that spinal manipulation as performed by a chiropractor is effective. Chiropractors perform physical maneuvers called adjustments that induce proper motion into the affected spinal joints.
The simplest way to describe a chiropractic adjustment is to explain that the chiropractor is trained to effectively identify joints that are not moving adequately, determine the reason for the dysfunction, and apply corrective physical forces in a way to restore proper movement to the affected spinal joint. This is accomplished by a series of successive applications of the appropriate procedures.
In practice, spinal manipulation is usually very effective, safe and typically quite comfortable for the patient. There are dozens of ways to perform spinal manipulation. Some approaches are vigorous and some are very gentle. Spinal manipulation can be very successful in restoring function and reducing pain even in chronic conditions.
Other recommendations also can improve function. Exercising, massage, stretching or walking may increase the ability of the joints to function properly. Guided movement practices such as yoga, tai chi and Pilates may help. This is also the reason it is important to maintain non-strenuous activity if possible. Movement reinforces proper function.
The other secret is that often a combination of treatments is necessary to obtain the best results. In our clinic, we have found that combining spinal manipulation with rehabilitative exercise, massage, application of therapeutic modalities and even acupuncture produces optimum results for patients. Most successful clinics use various combinations of treatments.
For the really difficult cases such as bulging discs or spinal disc degeneration, I may recommend non-surgical spinal disc decompression. In our clinic we have seen very good results using this advanced protocol. This form of therapy is intended to gradually restore function to damaged or deteriorated discs.
Next week I'll share a few tips about tension headaches. Until then, keep those spinal joints functioning properly!