Tag Archives: low back pain

Spinal Manipulative Therapy for Seniors with Low Back Pain

5 Sep

While low back pain can affect people of all ages, it’s particularly problematic for older adults and is one of the top three reasons they see a doctor. Despite this, low back pain among seniors often persists for longer than three months, and in the presence of multiple comorbidities (which is often the case with advancing age), low back pain may be under treated or mismanaged. While guidelines for the management of low back pain often emphasize conservative approaches first and foremost, older patients tend to be underrepresented in the studies used to formulate such recommendations. Let’s take a look at the current research on the utilization of spinal manipulative therapy—the primary form of treatment provided by doctors of chiropractic—for the management of low back pain in older adults.

A 2022 study scoured electronic databases for randomized controlled trials conducted during the previous two decades that examined the effects of spinal manipulative therapy in older adults with chronic low back pain. The research identified ten studies consisting of a total of 786 individuals over 55 years of age, of which 261 were between 65 and 91 years old. The types of spinal manipulation included in this study are high-velocity low-amplitude (HVLA) techniques and mobilization or low-velocity low-amplitude (LVLA) techniques.  In particular, the research team looked at how these manual therapies fared with respect to improvements in pain and function against other approaches, including standard medical care and exercise therapy, in the short-, medium-, and long-term. 

In their final analysis, the authors concluded there is moderate-quality evidence that spinal manipulative therapy results in similar outcomes (compared to usual medical care and exercise therapy) for pain and functional improvement, and it should be considered a non-pharmacological treatment option for this patient population. This is important as up to 80% of older adults already take multiple prescription medications, with nearly a third taking five drugs, to manage their current health concerns. The addition of one or more prescriptions to manage low back pain increases the risk for adverse events and harmful drug interactions.

The researchers add that while their analysis was unable to establish a safety profile as the studies used had heterogenous data on adverse events, spinal manipulation appears to be safe for older patients. They further note that their findings are consistent with other systematic reviews on the effectiveness of spinal manipulative therapy for all age groups. 

The findings from this analysis confirm that spinal manipulative therapy has a place in the management of low back pain affecting older patients. If you suffer from chronic low back pain, don’t put it off or assume you need to live with it. Schedule an appointment with your local doctor of chiropractic to see if a course of conservative chiropractic care can help reduce your pain and improve your mobility.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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What About Preventing Back Pain?

13 Apr

If you want to prevent low back pain, then you must first understand its cause. A 2008 study found that the majority of low back pain (97%) is mechanical in nature. Mechanical low back pain is the general term that refers to any type of back pain caused by injury to the spinal structures (bones, ligaments, and disks, for example).

In other words, if you have low back pain, the odds are the cause is NOT a tumor or anything life-threatening. But… and this is a very big BUT… every case of low back pain should be evaluated by an appropriate physician to rule out non-mechanical causes. This is why chiropractors are trained in differential diagnosis to determine when low back pain is mechanical and when it is something more serious.

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Low Back Pain and Sleep.

29 Jan

Low back pain (LBP) can arise from a lot of causes, most commonly from bending, lifting, pulling, pushing, and twisting. However, there are other possible causes, including sleep. This not only includes sleeping in a crooked or faulty position, such as falling asleep on a couch, in a chair or while riding in a car, but also from the lack of sleep. So the question is, how much sleep is needed to feel restored and how much sleep is needed to avoid low back pain?

It’s been shown that the lack of sleep, or chronic sleep loss, can lead to serious diseases including (but not limited to): heart disease, heart attack, heart failure, irregular heartbeat, high blood pressure, stroke and diabetes. Sleepiness can also result in a disaster; as was the case in the 1979 nuclear accident at Three Mile Island, the oil spill from the Exxon Valdez, as well as the 1986 nuclear disaster at Chernobyl. With sleep deprivation, our reaction time is slowed down, and hence, driving safety is a major issue. The National Highway Traffic Safety Administration estimates that fatigue causes more than 100,000 crashes per year with 1500 annual crash-related deaths in the US alone. This problem is greatest in people under 25 years old. Job related injuries are also reportedly more frequently, especially repeat injuries in workers complaining of daytime sleepiness which resulted in more sick days. It’s also well published that sleep plays a crucial role in thinking and learning. Lack of sleep impairs concentration, attention, alertness, reasoning, and general cognitive function. In essence, it makes it more difficult to learn efficiently. Also, getting into a deep sleep cycle plays a critical role in “consolidating memories” in the brain, so if you don’t get to a deep sleep stage (about 4 hours of uninterrupted sleep), it’s more difficult to remember what you’ve learned. An interesting study (U. of Pennsylvania) reported that people who slept less than 5 hours/night for 7 nights felt stressed, angry, sad, and mentally exhausted. As shown in another study of 10,000 people, over time, insomnia (the lack of sleep) increases the chances by 5-fold for developing clinical depression. Other clinical studies have published many other negative effects of sleep deprivation, of which some include aging of the skin, forgetfulness, weight gain, and more.

Regarding low back pain, what comes first? Does LBP cause sleep interference or does sleep deprivation cause the LBP (or both)? It’s been shown that sleep loss can lower your pain threshold and pain tolerance, making any existing pain feel worse, so it works both ways. Specific to LBP, in a 28-year, 902 metal industry worker study, sleep disturbances (insomnia and/or nightmares) predicted a 2.1-fold increase in back pain hospitalizations with one and a 2.4-fold increase with both sleep disturbance causes (insomnia and nightmares). Other studies have shown patients with chronic LBP had less restful sleep and more “alpha EEG” sleep compared to controls. Similar sleep pattern differences using EEG (electroencephalogram – measures brain waves) have been shown when comparing chronic LBP patients with vs. without depression compared to controls (non-LBP, non-depressed subjects).

So the BOTTOM LINE, talk to us about how chiropractic helps reduce LBP, stress and facilitates sleep. There are also nutritional benefits from Melatonin, valarian root, and others that we can discuss. Now, go to bed and get a good night’s sleep!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

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Low Back and Obesity.

4 Jan

Losing weight can dramatically reduce Low back pain (LBP). For the next 2 months, we will look at easy ways to lose weight without the need for fancy, hard to follow diets. As the saying goes, this is a “no-brainer.”

Time you meals. Set a timer for 20 minutes and “pace yourself” so that you eat slower. This is one of the most effective ways to reduce weight without a complicated diet plan. Make each bite “count” and enjoy the food’s flavor! This tricks your brain into thinking you’re more full while wolfing down your food in a hurry blocks those brain signals, resulting in over-eating.

Sleep an extra hour. This can result in a drop of 14 pounds a year according to University of Michigan research.

Serve three vegetables and/or fruit vs. one in your evening meal. You can eat more and STILL reduce weight!

Add a broth-based soup to your day. It fills you up without adding calories. Avoid creamy soups as they can be high in fat and calories.

Eat more whole grains. Add brown rice, barley, oats, buckwheat and/or whole wheat when consuming waffles, pizza crust, English muffins, and pasta. If you are gluten sensitive, look for alternatives like quinoa.

Visualize your favorite “skinny clothes.” Think about, or literally take out, a favorite dress or pair of pants that you no longer fit into and use it as a target or goal to wear them again.

Skip the bacon! If you avoid that 2 strips of bacon at breakfast or on your sandwich at lunch, you’ll save about 100 calories / day, about 10 pounds per year! Instead add tomato slices, banana peppers, roasted red bell peppers, grainy mustard, or a light spread of herbed goat cheese.

Pizza perfect! Choose a veggie topping vs. meat and shave 100 calories from your meal. Consider going light on the cheese, use reduced fat cheese and choose a thin, bread-like crust made with olive oil.

Drink “smart!” Trade that soda in for water or zero-calorie seltzer and you’ll avoid about 10 teaspoons of sugar! Add a lemon, mint or frozen strawberries for a much more satisfying beverage.

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Low Back Pain and Balance.

31 Dec

Statistically, most people (estimated to be about 90%) will seek care for Low Back Pain (LBP) at some point in their lifetime.

Balance is a skill that is learned as we develop. Initially, as infants, we have not developed the “neuromotor pathways” or, sequence of signals between the brain and our toes, feet, ankles, knees, hips, and so on. The constant flow of sensory information received and processed by the brain prompts motor messages to be sent back to our limbs and allows us to move in a progressively more coordinated manner as we develop. This natural progression of developing motor control starts with crude, rather uncontrolled movement of the fingers, hands, arms, legs, and feet, and soon, we learn to hold up our head, scoot, roll over, crawl, stand, and eventually walk (usually during the first 12 months of life). The learning process of recognizing sounds, voice quality and inflections, and words occurs simultaneously. This bombardment of sensory information to the brain leads to the ability to gradually perform highly integrated functions including walking, running, jumping, and dancing. As part of that learning process, falling frequently occurs. We all recall the challenges of learning how to ride a bike, swim, do a somersault, climb a tree, swing, dance, do gymnastics, ski, and on and on. As time passes and we enter middle age, we become more sedentary. As a result, we start losing our “proprioceptive edge” and become less steady, leading to more frequent balance loss and falls. Eventually, we have to hold on to hand railings or the wall in order to keep our balance and falling occurs more frequently. Couple this gradual loss of balance with bone demineralization (osteoporosis) and the risk of a fracture, such as a hip or vertebra, increases as well.

So the question arises, what can we do to slow down this process and maybe even reverse it? The answer is, A LOT!!! Just like muscles shrink and atrophy if they are not used, so does our ability to maintain our balance. We have to keep challenging our balance in order to keep those neuromotor pathways open. That need doesn’t stop after childhood, and in fact, becomes more important as we age. Last month, we talked about the “normal” length of time people can stand on one foot with the eyes open verses closed. If you tried the test, do you remember the steadiness difference? This “test” can be used at various time intervals, such as once a month, as you add balance challenging exercises to your daily routine. Frequently, people will find that within the first 2-4 weeks, they will feel more “sure” or secure on their feet, and even may not feel the need for a cane, or they’ll reach out less often for a hand rail. Start with simple exercises like standing with your feet together and hold that position for progressively longer times (eyes open and closed). We will continue this discussion next month with more balance stimulating exercises.

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Low Back Pain and Common Mistakes (Part 2).

14 Dec

Last time, we started a great discussion on “what NOT to do” for low back pain (LBP). Let’s continue that focus!

5. STAY STILL: You’ve heard, “…don’t do that – you’ll get a bad back!” There is something to be said about being careful, but one can be too cautious as well. In order to determine how much activity vs. rest is appropriate, you have to gradually increase your activities by keeping track of how you feel both during and after an activity. If you do notice pain, it may be “safe” to continue depending on the type and intensity of the pain. In general, a sharp, knife-like pain is a warning sign that you should STOP what you’re doing, while an ache is not. Until you’re comfortable about which type of pain is “safe,” start out with the premise, “…if in doubt, stop.” If the recovery time is short (within minutes to hours), then no “harm” was done. If it takes days to recover, you overdid it. Think of a cut on your skin – if you pick at it too soon, it will re-bleed, but if you are careful, you can do a lot of things safely without “re-bleeding.” Talk to us about the proper way to bend, lift, pull, push, and perform any activity that you frequently have to do that often presents problems. There is usually a way to do that activity more safely!

6.  SURGERY IS A “QUICK FIX”: Though in some cases this may inevitably be the end result for your back condition, most of the time, it is not needed. As a rule, don’t jump to a surgical option too soon. It’s tempting to view surgery as a “quick fix,” but non-surgical care at least for 4-6 weeks and maybe several months is usually the best approach. As the old saying goes, you can’t “un-do” a surgery, so wait. UNLESS there are certain warning signs such as: a) bowel or bladder weakness &/or, b) progressive neurological losses (worsening weakness in the leg). If there are no “surgical indicators” meaning, no instability, no radiating leg pain, and only low back pain that is non-specific and hard to isolate what is generating the pain, DO NOT have surgery as the chances of improvement following surgery drops off dramatically in this group. There are guidelines that we all should follow and they all support non-surgical care initially for 4-6 weeks. Chiropractic is one of the best options cited in these guidelines because it’s less costly, involves less time lost from work, and chiropractic carries the highest patient satisfaction.

7. DON’T STRETCH – IT’S HARMFUL: You may have heard or read that stretching can actually increase or worsen your time if you’re a runner, reduce your ability to lift heavy weight (if you’re a weight lifter), or cycle as fast.  Though this seems obviously silly, there IS a growing body of evidence that has found this TO BE TRUE! HOWEVER, it appears (at least at present), that is applies primarily to static, long hold stretching and NOT to dynamic exercising like jumping jacks, toy-soldier like high kicks, or core stabilization. Moreover, no study YET has found a negative effect for non-athletic competitive activities or for low back pain specifically. A good general rule is, if you feel better after exercising, or in this case stretching, it’s probably better for you than not. Also, as stated last month, there is a “right vs. wrong” time to exercise and WAY to exercise. For example, when LBP occurs in flexion but reduces in extension, there is plenty of evidence published that performing exercises INTO the direction of pain relief is VERY helpful. So until you hear differently, KEEP ON STRETCHING, but follow our advice!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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