Low back pain- why it happens and how- Roseland Online article 3

Ever wondered why you get low back pain and how it occurs? Understanding this can be a step in managing your pain if you are a sufferer, of which about 80% of us suffer from at some point in time. This is at immense cost to the NHS and particularly those cases that are poorly managed due to either wrong referral, poor services or lack of understanding and compliance of the person suffering.

Research is positive for all the therapies that support back pain care and I am very respectful to the gamut of professionals out there that are part of the package of care available, however sometimes we could work better together with the patient as the primary focus, and that is my intention here.

What I hope to do in this article is to make clear from a chiropractors viewpoint where patients benefit from our services so that those that do not receive it can make the choice of whether they need our services or not and where they should be for the best outcome of their back pains, as these pains can change our lives and often I find they don’t need to with the right intervention.

The back is a chain of joints sitting on top of a ring pelvis. If you can imagine the spine twisting like a wet towel being rung out then this is what happens when we get back pain and that twist is triggered usually by one joint, or muscle associated to a joint, which is the primary trigger in this twist. The pelvis is like a chassis of a car, which has its own twist along the line of the hips. As chiropractors we specialize in the diagnosis of which bone, or muscle and bone (as it is never one or the other as I am often asked) is involved in the lower back pain. This ‘misalignment’ causes pressure in the joint, tissue, disc or nerve and the degree of pressure in these small segments relates to how much pain you suffer or degenerative arthritis occurs in these spinal joints.

Many people think back pain occurs, then it goes. I’d like to bust that myth once and for all as this leads to the start of mismanagement. A free check at our clinic to anyone who’s acute pain has diminished would show segments of their spine where the body has lost normal motion still present even if they are improving. This applies more often to the chronic sufferer (if you’ve had it more than once) and less so to the ‘one off’ that only lasts a day or two. Dysfunction of the bony structure in our spine or any joint is a process that occurs over time due to changes in our shape, weakness that occurs over time, bad habits of posture, emotions (the fight or flight response) or trauma. If this dysfunction had a cumulative scale of 1-10 you would say that the chronic back pain person who had an acute attack would be at 10 (some sufferers say 11!) when in pain and would drop back to lets say 7 or 8 out of 10 as their normal, ie close to maximum joint dysfunction or tolerance and pain. A pain free person would be at 0 or 1 in their adaption to life but often like a ratchet, many of us are tightening until we cannot take any more change. Then comes the sneeze, the shoe or whatever triggers that pain and ‘voila’ it’s the shoe or book to blame! Not so.

Once these parts have been specifically re-organized so that the pressure in between the vertebrae has been eased people are often restored to a new sense of themselves that has not been felt for many years. If this specific investigation of the movement of your bony parts has not been done then rest assured you are in some degree of adaption that is cumulative. No one else does this type of fine tuning and I often compare us to the dentist where families join, receive the acute frequent care package to put things right, then use the service when pain arrives again, or more cautiously joins an ‘MOT’ programme of say one checkup regardless of pain every 3 months. No dysfunction means no MOT.

I feel privileged to be in a profession that is having progressive positive outcomes in evidence for our part in the management of back pain and am proud to say that in 2009 NICE (National Institute for Clinical Excellence which advices health centers on what therapies/ medicines have enough evidence to be used in the NHS) advised GP’s that we should be referred to if lower back pain persists longer than 6 weeks. Osteopaths are included in this advice. Add to this the patient satisfaction that we receive indicated by our in house survey that 80% of our new patients come from other patients who enjoyed recovery with chiropractic and it’s a good recipe in the right hands.

Hopefully I haven’t medicallised back pain so much that you have fallen into a stupor but our next chat will be about the mystical!!

Kind regards in health,

Mike Noone, Chiropractor, BSc, DC


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