Tag Archives: back pain

The Neck and Low Back Connection

15 Jan

When a patient seeks chiropractic care for a condition like neck pain or low back pain, it’s natural to assume the underlying cause is located in the region where the patient feels symptoms. But this isn’t always the case. Sometimes, the primary or contributing factor to the patient’s chief complaint can be elsewhere in the body. A July 2024 study involving patients with cervical myelopathy helps illustrate this point.

Cervical myelopathy is a condition in which the spinal canal narrows due to a variety of potential causes—age-related degeneration, cervical spinal stenosis, herniated disks, trauma, rheumatoid arthritis, ossification of the posterior longitudinal ligament, or even tumors, infections, or congenital narrowing—and compresses the spinal cord. While neck pain is common, irritation of the spinal cord can produce downstream effects in the areas those nerve fibers reach. In this study, which involved 786 individuals with cervical myelopathy, two-thirds also reported low back pain.

Following treatment for cervical myelopathy, about half of those with concurrent low back pain experienced meaningful improvement in both lower back pain and function, and some even reported complete resolution. This suggests that for roughly half of these patients, the issue in their neck was a major contributing factor to their low back symptoms.

Beyond cervical myelopathy itself, several soft-tissue systems span the entire spine—including fascia, long spinal muscles, and ligamentous structures—making it possible for restrictions or dysfunction in the upper spine to influence symptoms in the lower spine. The reverse is also true: issues affecting the feet, ankles, knees, hips, or low back can lead to compensatory postural changes that place additional strain on the neck as the body works to keep the eyes level.

This helps underscore the importance of evaluating the whole patient rather than narrowing attention to the immediate area of complaint—something doctors of chiropractic are trained to do. The good news is that the hands-on care chiropractors provide can often help resolve these contributing issues, and when necessary, your doctor of chiropractic will coordinate with allied healthcare providers to support the best possible outcome.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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The Evidence Map of Low Back Pain Treatment Options

5 Jan

Low back pain is extremely common and remains one of the leading causes of disability worldwide, resulting in substantial healthcare utilization and cost. Because of this broad impact, identifying and implementing effective, safe, and cost-efficient strategies to diagnose, manage, and prevent low back pain is essential to improve patient outcomes and reduce overall healthcare burden. In 2022, researchers conducted a comprehensive analysis of the available evidence for ten commonly recommended treatments for low back pain—five medication-based and five non-medication-based—drawn from multiple clinical practice guidelines:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) work by blocking the COX-1 and COX-2 enzymes responsible for producing prostaglandins, which influence pain sensitivity, inflammation, fever, and tissue blood flow. Evidence supports short-term improvements in pain and disability, but use is limited by potential side effects such as stomach irritation, increased bleeding risk, kidney strain, and caution in patients with certain heart conditions.
  • Acetaminophen (paracetamol) also blocks prostaglandin production, but its effects are largely restricted to the central nervous system. Importantly, available evidence shows little to no meaningful benefit for pain, function, or quality of life in patients with low back pain.
  • Opioids blunt incoming pain signals and alter how the brain interprets pain. Due to risks of misuse, dependence, and overdose, guidelines recommend restricting their use to severe acute pain or postoperative situations and strongly discourage long-term use.
  • Muscle relaxants can reduce muscle spasm through several central mechanisms. Evidence supports short-term symptom relief, but high-quality evidence is limited, and side effects—including drowsiness, dizziness, cognitive slowing, dry mouth, low blood pressure, nausea, drug interactions, and dependence—must be carefully considered.
  • Antibiotics are intended to treat infection. Evidence supporting their role in low back pain management is weak, inconsistent, and not broadly applicable.
  • Psychological or behavioral therapies can be especially valuable for patients with persistent or recurrent low back pain, as psychological factors strongly influence whether patients engage in behaviors that support or hinder recovery.
  • Staying active and avoiding bed rest are strongly recommended. Activity helps maintain function, reduce disability, and speed recovery.
  • Reassurance—emphasizing that low back pain is common, manageable, and rarely dangerous—reduces fear and catastrophizing and lowers the risk of progression to chronic pain.
  • Exercise, including both general physical activity and targeted movement strategies, provides modest but meaningful improvements in pain and disability. Exercise also reduces recurrence risk.
  • Manual therapy, which includes manipulation and mobilization, helps restore normal movement to the spine and associated tissues, reducing pain and disability. Practitioners often combine different manual techniques based on examination findings, patient preference, and clinical training and experience.

The great news is that doctors of chiropractic frequently employ a multimodal treatment approach that includes manual therapy, exercise, reassurance, and activity recommendations—among the most strongly supported options in this evidence map!

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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Risk Factors for Postpartum Low Back Pain

1 Dec

It’s estimated that as many as 50–70% of new mothers experience low back pain and
related disability, which can hinder their ability to carry out daily activities such as household
chores, self-care, and meeting the physical demands of infant care—including feeding, lifting,
and carrying. When severe enough, these physical limitations can contribute to stress, anxiety,
and postpartum depression, further interfering with the mother’s ability to bond with her
newborn and diminishing her overall quality of life. What are the underlying causes of
postpartum low back pain?
Interestingly, some risk factors may be present even before conception. Research
suggests that being overweight or obese, physically inactive, or exposed to occupational risk
factors such as whole-body vibration, poor ergonomics, and frequent lifting can set the stage for
low back pain both during pregnancy and after delivery. Women with a prior history of low back
pain are also at elevated risk for symptoms during and following pregnancy.
As the baby grows, the center of mass shifts forward in the body. To compensate, the
pelvis tilts anteriorly and the lumbar spine increases in lordosis, placing added stress on the
lumbar intervertebral disks and facet joints. The stretching of the abdominal muscles can reduce
spinal stability, while hormonal changes that prepare the pelvis for childbirth can increase joint
laxity, further affecting stability in the lower spine and pelvic region. To compound these effects,
expectant mothers may experience fluid retention, deconditioning from reduced activity, sleep
positions that strain the lower back, and psychosocial factors such as stress and anxiety that
heighten pain perception.
Childbirth itself can also contribute to postpartum low back pain. The physical effort of
pushing during delivery can strain the lower back, and the hormonal changes that allow for
ligamentous laxity during pregnancy may persist afterward, leaving the spine more susceptible to
mechanical stress. In cases of cesarean delivery, factors such as spinal anesthesia, post-surgical
immobilization, and prolonged bedrest can further delay recovery and exacerbate pain.
Unfortunately, it’s a common misconception that postpartum low back pain will simply
resolve on its own. In reality, studies suggest that up to 1 in 5 new mothers with low back pain
will develop chronic symptoms lasting a year or longer. While some risk factors for postpartum
low back pain are beyond a woman’s control, others—such as maintaining an active lifestyle,
avoiding prolonged inactivity, and seeking chiropractic care to help restore proper joint motion
and function in the lumbar spine during and after pregnancy—can play a key role in prevention
and recovery.
Brent Binder, D.C.

4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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Treatment for Vertebral Compression Fracture

3 Nov

While there are many potential causes of low back pain in older adults, one of the most common—especially among women—is vertebral compression fracture (VCF). By age 80, up to 30% of women and 20% of men will have sustained at least one VCF. Interestingly, only about one-third of cases produce acute, noticeable pain. The remainder are either asymptomatic or go undiagnosed due to lack of imaging or because other pain-generating conditions such as osteoarthritis or spinal stenosis may mask the fracture. The type of treatment to address the injury depends largely on whether the fracture is stable or unstable.

A vertebral compression fracture occurs when the bony structure of the vertebra collapses, often due to osteoporosis and weakened bone health. If the fracture extends beyond the anterior portion of the vertebra, radically alters spinal alignment, or places pressure on neural structures, it is considered unstable. These cases usually require surgical intervention, such as vertebroplasty or kyphoplasty (injecting a cement-like material into the vertebra) or spinal fusion to stabilize the spine. Fortunately, only 10–15% of vertebral compression fractures are unstable.

Most VCFs are stable and can be managed conservatively, which may include chiropractic care. Treatment guidelines recommend activity modification during the early healing phase—avoiding heavy lifting, twisting, or prolonged sitting or standing. However, patients are encouraged to remain active within pain tolerance, as inactivity can lead to deconditioning and slower recovery. Bracing may be considered on a case-by-case basis, though evidence for its effectiveness is mixed. Spinal manipulation is generally contraindicated, but chiropractors can employ low-force manual therapies, modalities for pain and muscle spasm (such as ultrasound, TENS, or cold laser), and prescribe posture and core stabilization exercises. Co-management with a medical physician may include short-term medications to control acute pain.

Ultimately, the most effective treatment is prevention. Osteoporosis—the most common underlying cause of VCFs—is often silent until a fracture occurs. Guidelines recommend that all women over age 65 undergo a bone density (DEXA) scan, with earlier screening for those with family history or risk factors. While there is no consensus for men, approximately 1 in 6 will develop osteoporosis in old age. Just as important is adopting a healthy lifestyle that includes a nutrient-dense diet, weight-bearing exercise, maintaining adequate vitamin D levels, not smoking, and avoiding excessive alcohol consumption.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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The Most Common Cause of Hip Pain in Active Adults

9 Oct

Femoroacetabular impingement (FAI) is a painful hip condition that occurs when there is abnormal contact between the femoral head/neck junction and the rim of the acetabulum (hip socket) during certain movements, especially hip flexion, internal rotation, and adduction (inward motion). While hip problems are often associated with older adults, the vast majority of FAI cases occur in active young and middle-aged individuals.

Essentially, the condition results from bone shapes that disrupt the normal smooth motion of the hip joint. The most common type is called cam morphology, in which the femoral head/neck junction is not perfectly round, creating a bony prominence that interferes with joint motion. Cam morphology accounts for roughly two-thirds to three-quarters of symptomatic FAI cases and is most common in active young men. Another type, pincer morphology, occurs when there is excess coverage of the socket’s rim and is seen more often in active middle-aged women. These morphologies usually develop during puberty, and while they are often symptom-free, they can lead to impingement when the hip is subjected to repetitive, high-force movements such as running, jumping, or kicking—which is why active individuals are more prone to the condition.

Surgical intervention may be considered as an early option, particularly in young athletes with severe, function-limiting symptoms and clear imaging evidence of impingement. However, randomized controlled trials show that while surgery can offer faster symptom relief in the short- to mid-term, the long-term differences compared to structured non-surgical care are small, and surgery carries greater cost and risk. For this reason, clinical guidelines recommend conservative care as the first-line approach, with surgery reserved for cases that do not improve.

Conservative chiropractic management of FAI may include activity modification, anti-inflammatory measures (such as ice, dietary adjustments, or supplements), and rehabilitative strategies like stretching tight hip flexors, strengthening the core and hip extensors, and improving postural control. Chiropractors may also employ modalities such as ultrasound, electrical stimulation, laser therapy, or pulsed magnetic field therapy, along with manual techniques to restore motion in the hip. A comprehensive evaluation also considers the kinetic chain—since altered mechanics in the feet, ankles, knees, or lower back can increase stress on the hip and worsen FAI.

As with most musculoskeletal conditions, early intervention improves outcomes. Addressing FAI promptly not only reduces the risk of joint degeneration but also prevents compensatory movement patterns that can strain other areas of the body and contribute to additional painful conditions.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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Monthly Pain Relief Update: Neck Pain / Headaches

28 Jul

Text Neck Syndrome and Chiropractic Care

Neck pain is a leading cause of disability worldwide, and after low back pain, it’s the second most common reason people seek chiropractic care. In the past two decades, a new contributor to neck pain has emerged: text neck syndrome, a condition linked to prolonged use of smartphones and other digital devices.

Text neck syndrome results from spending excessive time looking down at a screen. In more clinical terms, it’s caused by sustained neck and head flexion, which places strain on the muscles and soft tissues at the back of the neck. For every inch the head moves forward from its neutral position, the neck muscles must support approximately ten pounds of additional force—similar to how it’s harder to hold a bowling ball with your arm extended than when it’s held close to the body. Over time, the body adapts to this strain by altering posture, such as rounding the shoulders or altering the curves of the cervical and thoracic spine. These postural changes can impair range of motion and negatively affect joint health, increasing the risk of chronic neck pain and related conditions.

What’s especially concerning is that text neck syndrome is common among younger individuals. A history of neck pain in young adulthood is a known risk factor for more severe neck problems later in life. Research involving university students around the world has found that between half and two-thirds report signs of text neck. The risk is further increased among individuals who are overweight, physically inactive, and those who spend more than three hours each day engaged in sedentary leisure activities.

To reduce the risk of developing text neck syndrome and the neck pain that may come with it, experts recommend limiting time spent on electronic devices; taking regular breaks to stand, stretch, and walk around; holding devices at eye level; increasing physical activity; reducing sedentary behavior; maintaining a healthy weight; managing stress; and following an anti-inflammatory eating pattern, such as the Mediterranean diet.

For those already experiencing neck pain associated with device use, chiropractic care may offer relief. In addition to in-office manual therapies that help restore joint movement and reduce muscular tension, chiropractors can provide guidance on exercises to retrain the muscles of the neck, chest, and upper back, which may help correct postural faults and reduce the likelihood of recurring pain.

Pain Relief Chiropractic

painreliefcare.net

Mechanicsburg, PA

 (717) 697-1888

We are watching your back!

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