Education

Low back pain is a common health care and social problem associated with impaired function and absence from work. This short document will help to explain some key issues about your back pain and what can be done to help you.

Natural History

Most cases of acute lower back pain will resolve within 6 to 8 weeks with or without treatment. One of the great challenges of lower back pain is that it has a very high recurrence rate.  More than 70% of those with an initial episode of lower back pain which resolves within 6 weeks will have a recurrence of back pain within 1 year. (P. Croft, BMJ).

One 2005 medical study of spinal pain stated that the “lifetime prevalence of spinal pain has been reported as 54 to 80%, with as many as 60% of patients continuing to have chronic pain five years or longer after the initial episode.”¹

Treatment Options

The availability and nature of other treatment options, listed from least invasive to most invasive are:

Self administered such as over- the-counter pain medications and relative rest (staying away from activities that generate aggravate pain)

Physical medicine care such as chiropractic care, physical therapy care, exercise rehabilition programs, back school programs

Medical care with prescription drugs (e.g. anti-inflammatory medications, muscle relaxants, narcotic pain-relievers), injections into joints, discs, nerves to block pain

Hospitalization, surgery, multidisciplinary rehabilitation centers

The best treatment option may involve several of the above choices to achieve the best result.

RISKS/BENEFITS

Chiropractic care has been shown to compare favorably in many cases to medical care with respect to long-term pain and disability outcomes.²

In order to achieve and maintain optimal health, chiropractors may prescribe therapeutic exercises, stretches, nutritional counseling, ergonomic advice and lifestyle modifications.  Chiropractors may perform, order and interpret laboratory and diagnostic imaging studies.

            A key treatment administered by chiropractors is spinal manipulation, also known as an “adjustment.”  We offer techniques that range from traditional manual manipulation to gentle mobilization procedures.

            Your doctor will palpate (feel) and examine your spine for several indicators of the need for manipulation/adjustment. These include:

·         Regions of local muscle tightness and tenderness

·         Asymmetry in the contours of the spine

·         Restrictions in overall movement of the spine

·         Abnormal postural deviations

The goal of chiropractic treatment is to:

·         Increase the joint mobility/range of motion

·         Relieve pain

·         Reduce muscle spasm

·         Restore optimal joint function

What should I do after being adjusted? 

•              Stay Active
• ·         Try to use your full range of motion
• ·         Although you feel better, you may not be fully recovered.  Do not                            jump into strenuous activities too early.
• ·         Do your home exercises and stretches as recommended.
•           Stay active without creating too much discomfort.
  
•           Avoid bed  rest unless specifically advised by your doctor

          Approximately 20% of patients will experience some temporary stiffness and soreness following the first couple treatments.  The risk of serious injury has been estimated between one in one million to one in ten million.  If you have specific concerns about potential complications from receiving chiropractic manipulations, please discuss them with the doctor before receiving treatment.  Chiropractors receive the highest level of education on spinal manipulative therapy and administer greater than 90% of skilled manipulation services provided by the .

The material risks inherent in such options and the probability of such risks occurring include:

         Overuse of over-the-counter medications produces undesirable side-effects.  If complete rest is impractical, premature return to work and household chores may aggravate the condition and extend the recovery time.  The probability of such complications arising is dependant upon the patient’s general health, severity of the patient’s discomfort, pain tolerance and self-discipline in not abusing the medicine.

         Prescription muscle relaxants and pain-killers can produce undesirable side effects and patient dependence.  The risk of such complications arising is dependent upon the patient’s general health, severity of the patient’s discomfort, their pain tolerance, self discipline in not abusing the medicine and proper professional supervision.  Such medications generally entail very significant risks; some with rather high probabilities.

         Hospitalization in conjunction with other care bears the additional risk of exposure to communicable disease, iatrogenic (doctor induced) mishap and expense.  The probability of iatrogenic mishap is remote, expense is certain; exposure to communicable disease is likely with adverse result from such exposure dependent upon unknown variables.

        Please be sure to discuss each of these options with your provider before service to evaluate your particular risk and benefits.

The Risks and Dangers attendant to remaining untreated:

         Remaining untreated may promote the formation of adhesions and reduction of mobility.  A pain reaction may result that further reduces mobility.  Over time, this process may complicate treatment, making it more difficult and less effective the longer it is postponed.  The probability that non-treatment will later complicate rehabilitation is relatively high.

References

1.      Boswell MV, Shah RV, Everett CR, et al. Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Physician, 2005;8(1):1-47.

2.      Nyiendo J, Haas M, Goldberg B, Sexton G. Pain, disability, and satisfaction outcomes and predictors of outcomes: a practice-based study of chronic low back pain patients attending primary care and chiropractic physicians. J Manip Physiol Ther, 2001;24(7):433-9.

3.      Croft, P.  Outcome of low back pain in general practice: a prospective study  BMJ   1998; 316: 1356-1359