Pain Relief Chiropractic

Low back pain (LBP) typically results from relatively “benign” causes, meaning it’s usually safe to wait and try conservative / non-emergency care first. However, there are a handful of times when prompt medical emergency management is appropriate, and it’s important that everyone is aware of these uncommon but dangerous and sometimes deadly causes of LBP, hence the purpose of this article.

“Red flags” trace back to the 1980s and 1990s, so this is not a “new” topic. In fact, guidelines for the care of LBP that have been published around the world ALL commonly state the anyone exhibiting these “red flags” needs to be promptly diagnosed and referred for emergent care. The common conditions cited in these guidelines include (but are not limited to): 1) Cancer, 2) Cauda equine syndrome, 3) Infection,  4) Fracture. The patient’s history can sometimes uncover suspicion of these four conditions BETTER than a routine physical examination, though a definitive diagnosis is usually made only after special diagnostic tests have been completed including (but not limited to) imaging (x-ray, MRI, CT, PET scans), blood tests, bone scans, and more.

1) Cancer: a) Past history of cancer. b) Unexplained weight loss (>10 kg within 6 months). c) Age over 50 or under age 18. d) Failure to respond to usual care (therapy). e) Pain that persists for four to six weeks. f) Night pain or pain at rest.

2) Infection: a) Persistent fever (>100.4º F). b) Current/recent URI (upper respiratory tract infection like pneumonia) or UTI (urinary tract or kidney infection). b) History of intravenous drug abuse. c) Severe back pain. d) Lumbar spine surgery within the past year. e) Recent bacterial infection (cellulitis or persistent wound – e.g., a decubitus ulcer or “pressure sore” in the low back region). f) Immunocompromised states such as those caused by systemic corticosteroids, organ transplant medications, diabetes mellitus, human immunodeficiency virus (HIV).

3) Cauda Equina Syndrome: a) Urinary incontinence or retention. b) Saddle anesthesia. c) Anal sphincter tone decrease or fecal incontinence. d) Bilateral lower extremity weakness or numbness. e) Progressive neurologic deficit or loss – major muscle weakness or sensory deficit.

4) Fracture: a) Prolonged corticosteroid use. b) Age >70. c) History of Osteoporosis (poor bone density). d) Mild trauma over age 50. e) Major trauma at any age (such as a fall).

Another red flag is an Abdominal Aortic Aneurism. Signs include: a) Abdominal pulsations. b) Hardening of the arteries (atherosclerotic vascular disease). c) Pain at rest or night time pain. d) Age >60.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

Unfortunately, low back pain (LBP) is something MOST of us cannot avoid. There is solid evidence that chiropractic care is one of the most effective methods of treating LBP, but there are times when a referral for surgery is needed. What about manipulative therapy (MT) AFTER surgery? Is this a good idea? Does it help?

In March 2015, an article published in the Journal of Back and Musculoskeletal Rehabilitation discussed the pros and cons of MT after lumbar open laser microdiscectomy, a common surgical technique used to treat patients with a pinched nerve due to a herniated lumbar disk. Unfortunately, patients who undergo this procedure can experience early post-surgical physical disability that reduces their ability to perform required daily activities. For this reason, the objective of this study was to look at whether early individualized spinal manipulation would reduce the occurrence of post-surgical disability. To do this, 21 patients (aged 25-69) who had a microdiscectomy were randomly placed into either a spinal manipulation or an active control group. Manipulation was performed two to three weeks after surgery, at two times a week for four weeks.  The researchers found patients in the MT group experienced a 55% reduction in disability while those in the control group reported a 5% increase in disability! Also, leg pain was reduced by 55% in the MT group compared with only 9% in the control group. This pilot study concluded that while a larger-scale study is recommended, the findings indicate that manipulation “…may be an important option for post-operative management after spinal surgery.”

This is yet another testimony that spinal manipulation can not only help many people avoid surgery, but it can also significantly reduce or eliminate back pain and disability AFTER surgery! Spinal manipulation is the most common treatment approach performed routinely by chiropractors. And although other healthcare professionals are showing an increasingly greater interest in learning this skill, manipulation must be performed on a regular, concentrated basis in order to obtain the best outcomes or therapeutic results for patients. So, regardless if you have or have not had surgery for LBP, the benefits of chiropractic and spinal manipulation are recognized as a recommended course of treatment!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

Statistics suggest that low back pain (LBP) will plague most of us at some point in our lives, if it hasn’t already. Most healthcare professions that manage patients with low back pain focus on pain management. In fact, studies have reported that 67% of patient satisfaction is driven by pain elimination. One of the most common strategies for reducing pain is managing inflammation. The “easiest” way to do this (according to the many TV commercials and magazine advertisements) is to take one of the many non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen (Advil, Nuprin), Piroxicam Flurbiprofen, and Indomethacin. Let’s take a closer look to see if this is a good or bad idea!

In a recent March 2015 article, researchers investigated the use of NSAIDs between 1993 and 2012 in patients who had fractures that failed to heal, technically called “non-union fractures.” They found that non-union fractures increased during years when NSAID use was increasingly recommended for patients with fractures and dropped in years when NSAID use declined. This isn’t the first study to report poor fracture healing results from NSAIDs when they’re used as the primary form of pain relief and in fact, studies on this subject date back to the early 1990s. So how does this equate to LBP? Most directly, fractures are one of the many causes of LBP, so for that population, the answer is clear. However, LBP is much more commonly caused by sprains (ligament injuries) and strains (muscle/tendon injuries), as well as cartilage injury. Here too, studies show that the healing rate of sprains, strains, and cartilage is also delayed when NSAIDs are used as the primary pain relief approach. This healing delay is reportedly due to NSAIDs’ inhibition of “proteoglycan synthesis,” a component of ligament and cartilage tissue regeneration and repair. NSAIDs also inhibit release of prostaglandins (especially prostaglandin E2), which is needed for tissue repair. These effects are ESPECIALLY observed with long-term use, but recent studies show injured athletes are best off NOT taking NSAIDs AT ALL as these drugs delay the healing process and thus the athlete’s ability to return to their sport.

In a January 2015 study, researchers criticized the common use of NSAIDs in elderly patients for the treatment of non-cancerous pain. They found 75% of the elderly population studied was prescribed NSAIDs which, in retrospect, the researchers determined to be inappropriate!  Because NSAIDs interfere with healing, the net effect is an ACCELERATION of osteoarthritis and joint deterioration! In 1995, a North Carolina School of Medicine study compared four groups of patients with soft tissue injuries (tendon strains): Group 1 received NO treatment (control group); Group 2 received exercise only; Group 3 received exercise AND Indomethacin; and Group 4 received Indomethacin only. At 72 hours post-injury, ONLY the exercise group had an INCREASE in prostaglandins (E2 particularly – necessary for healing). This effect was even more profound at 108 hours after injury. The research team also found DNA synthesis in the fibroblasts (an important part of the repair mechanism) was greatest in the exercise group and was completely lacking in the NSAID-only group.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

First, the majority of low back pain is mechanical and can be treated with chiropractic care. Second, many cases of low back pain can be prevented in the first place by avoiding awkward positions, distractions, and fatigue while performing physical activities.

Learning proper posture while sitting can help prevent the abnormal stress and strain that lead to low back pain over time. If you develop low back pain, seek the proper treatment, one that has a proven track record. Getting the best care to get out of pain as fast as possible is extremely important. Also, make sure your treatment plan includes information on how you can prevent your low back pain from coming back (such as learning proper lifting technique) because relapses are often worse than the original injury.

Chiropractic has been shown to be both safe and effective for the treatment of mechanical low back pain.  For example, a study published back in 1990 in the British Medical Journal (BMJ) compared Chiropractic care to hospital outpatient treatment and found:  “Chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain.  A benefit of about 7% points on the Oswestry scale was seen at two years.  The benefit of chiropractic treatment became more evident throughout the follow-up period.  Secondary outcome measures also showed that chiropractic was more beneficial.”

The study concluded, “For patients with low back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain.”

It is great that Chiropractic care can help low back pain, but the main goal of any treatment should be to get you out of pain AND prevent your pain from coming back.

New research published in Arthritis Care & Research, the journal of the American College of Rheumatology, shows that being engaged in manual tasks involving awkward positions can increase an individual’s risk for a low back injury by up to 800%. Researchers also found that those who are distracted or fatigued while performing physical tasks are also at significantly higher risk for a low back injury.