BACK PAIN
Overview
The most common reason people start Chiropractic care is because they are in pain, more specifically, they have some sort of back pain. In reality, if you are experiencing back pain, you are not alone – 80 to 90% off all people are likely to experience it at some stage in their life.
Globally, low back pain is the LEADING cause of disability.
The Australian Institute of Health and Welfare (AIHW) has reported that back problems are a “significant cause of disability, lost productivity and the third leading cause of disease burden in Australia.”
The most frequent types of back pain and complaints we see in our practice are:
- Low back pain
- Mid or upper back pain
- Sciatica
Causes of Back Pain
The majority of back pain is caused by Macrotrauma and Microtrauma.
Macrotrauma
These are injuries to the spine caused by falls and accident such as motor vehicle accidents (MVA), work injuries, sporting injuries etc. Often you will know what event caused the injury because the pain will start at the time of accident or shortly after.
Microtrauma
These are overuse type injuries that result from repetitive and frequent overuse of muscles, ligaments, tendons and joints of the spine. Some examples are slouching, poor posture, poor ergonomics and lifting technique, sedentary habits etc. With these injuries, people often will say things like, “I just bent over to brush my teeth and my back went” or the pain might come on without any obvious trigger event as such.
In reality, most back pain is due to a combination of Microtrauma and Macrotrauma. It is important to identify the contributing factors, especially the Microtrauma as majority of back pain is caused by environmental factors, not our genes.
If we zoom in and take a closer look at the spinal level, these are the most common causes of back pain:
Sprains, Strains and Spasms
Just like the skull protects the brain, the spinal column acts as a suit of armour that protects the delicate spinal cord. The soft tissues surrounding the spinal column are the ligaments, tendons and muscles. Sprains, strains and spasms of these soft tissues often happens when we have overloaded the spine and the soft tissues and they can no longer cope with the added tension. Overloading the soft tissues can cause small tears which can inflame and cause pain. These types of injuries tend to resolve relatively quickly with Chiropractic care.
Disc Bulge or Herniation
Although it is commonly thought that a disc bulge or herniation will always cause pain – this is not the case. In fact, a 2015 study found that half of all adults, without any back pain, had at least one disc bulge. On the other hand, a disc bulge or herniation can cause excruciating and often debilitating pain that can result in permanent disc and neurological injuries. The pain can be local to the back or often if the bulge or herniation is significant enough it can cause referred pain, numbness, pins and needles and muscle weakens.
Degenerative Joint Disease (DJD)
The facet joints in the spine allow for smooth spinal movement and like other synovial joints in our body are susceptible to wear and tear under stress. Inflammation and wear and tear to the spinal facet joints can cause pain, stiffness, decrease in the normal range of motion and even irritation to the nerves as they exit the spine. Over time, if proactive measures aren’t taken, the formation of osteophytes can significantly encroach the intervertebral foramen and cause severe disc degeneration.
Stress
Whenever you become stressed, your body responds by increasing your blood pressure and heart rate, releasing stress hormones and tensing up the muscles in your spine and body. Essentially, your body is sensing danger, the sympathetic nervous system kicks in and the muscles tense up to protect the body. Long term stress causes serious health problems and when it comes to the muscles, they eventually fatigue, become sore and get loaded with painful trigger points. With prolonged stress, muscles can in fact change to a more tendon like structure, loosing flexibility and strength.
Chiropractic Care for Back Pain
It is a common thought amongst clinicians that back pain, specifically low back pain will spontaneously resolve on its’s own after three months. A 2012 study from the European Journal of Pain found that although 35% of patients back pain spontaneously resolved (this doesn’t mean then actual cause was corrected, merely that the pain went away), 65% of patients still had pain one year after their initial reported complaint. There is no valid evidence to support the spontaneous resolution of low back pain. Imagine if Dentists took this approach, since decaying teeth do eventually stop hurting!
In addressing back pain, it is imperative to first get to the root cause. By taking a thorough history, physical exam and diagnostic imaging if required, a Chiropractor can make the best recommendation that will not only alleviate the pain but address the root cause.
Numerous case studies show that Chiropractic care is effective, cost effective and safe in treating back pain. When compared to placebo, non-steroidal anti inflammatories (NSAIDS) and physiotherapy, Chiropractic care was found to be far more effective. A 2011 study published in the Journal of Occupational and Environmental Medicine concluded that, “In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.”
References:
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32154-2/fulltext
- https://www.aihw.gov.au/getmedia/d4df9251-c4b6-452f-a877-8370b6124219/19663.pdf.aspx?inline=true
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907819/
- https://www.ncbi.nlm.nih.gov/pubmed/22641374
- https://www.ncbi.nlm.nih.gov/pubmed/21407100
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