Chiropractic and low back pain
How can Chiropractic help with low back pain?
Low back pain can be divided in acute (new onset) and chronic (around for longer than 6 months). Each low back pain case can then also be divided in to sciatica (leg pain or radicular) or non-sciatic (non- radicular). Often this can be determined at your first Chiropractic appointment which category you fit. Once you have a category it is easy for the Chiropractor to inform you of your prognosis (how long it will take and if it will get better). From the research, sciatic or radicular associated low back pain will often take longer to recover as there is often some nerve involvement.
I once met a Chiroprator who said ‘THERE ARE ONLY 2 MAIN CAUSES OF LOW BACK PAIN – DISC or FACET’. I tend to agree with him. If you remove the 2 % of cases that are related to actual muscle tears (in the case of injury) or malignant causes, you really are only left with these two most common causes of low back pain.
Disc related low back can take a while to recover, and if the disc has herniated it is likely some sort of surgical intervention may be required. These cases will present with leg pain, weakness and sometimes bladder disturbances. Patients with disc bulges really don’t like to stand and especialy can’t sit for long periods. Bending forward is extremely painful and my ‘disc alarm bells’ ring when a patient describes this.
Low back pain related to lumbar facet irritation is probably the most common low back pain presentation I see in the clinic. It’s that annoying niggle that just sits in the lumbar region, it comes and goes and can be related to absolutely nothing you do! It hits you at night or it might be half way through a walk or maybe just as you bend forward your back ‘jars’. This is facet syndrome and one that chiropractors are very good at picking up.
To be honest, disc related low back pain and facet related low back pain are treated both the same in my clinic. Usually just getting the sacro-iliac and lumbar joints moving and releasing the hips is enough to get the inflammation to settle in the low back.
If we look at the history of the medical management of low back pain, doctors really haven’t been very good at this traditionally. In fact, over prescribing oral medications has now become the interest of the American College of Physicians and in the USA, it has been established that GP’s MUST refer to a chiropractor AND Physiotherapist before they deliver any high dependency form of oral pain relief. This year, a review published in the AMA for USA found that spinal adjustments, when delivered by a chiropractor, can help improve the pain and function for people with low back pain*
Sadly there is still some fear around Chiropractors but if you can find yourself a good chiropractor that you trust and who helps you on your journey, it really can make a difference in your low back pain experience. If you’re unsure where to start, see my previous blog on finding a chiropractor that suits you.
*NeilM.Paige, MD MSHS; Isomi M Miake-Lye, BA’ Marika Suttorp Booht, MS et al. ‘ Association of Spinal Manipulative Therapy with Clinical Benefit and Harm for Acute Low Back Pain. Systemativ Review and Meta Analysis. JAMA. 2017;317(14):1451-1460