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What is “Referred Pain”?

What is “Referred Pain”?

Billings Chiropractor“Referred pain” can be a perplexing phenomenon for anyone who experiences it. Referred pain is what happens when you feel pain in an area of your body that is not actually the original source of the pain signals. The most common example of referred pain is when pain is felt in the left arm, neck or jaw of a person suffering a heart attack, while they often have no feelings of pain in the chest area itself.

It’s important to note that referred pain is different from radiating pain, in which the pain felt in one area travels down a nerve, causing pain along the length of the nerve. This is often the case with sciatica, where pain originates in the lower back and radiates down the leg.

Researchers are still not exactly sure what causes referred pain. Some experts believe that it is due to a mix-up in nerve messaging. The central nervous system (CNS) is constantly receiving a barrage of different messages from different parts of the body. These messages may get mixed up somewhere along the path between the place where the irritated nerve is signaling and the spinal cord or brain where pain signals are processed. With an extensive network of interconnected sensory nerves that serve the same region of the body, such as the nerves of the lower back, thighs and hips, it may be more common for signals to get mixed up than you might imagine.

Although referred pain is usually felt as painful, it can also cause feelings of numbness, tingling or the sensation of pins and needles. Another example of referred pain is a tension headache, in which headache pain is due to an irritation of the nerves in the neck.

Referred pain tends not to cross sides of the body. In other words, if the pain signals are originating in the liver or gallbladder (which are on the right side of the body), you may feel pain in your right shoulder. If the signals originate in the pancreas (on the left of the body), you may feel pain in your left shoulder, etc.

Chiropractic adjustments can address the source of the referred pain, leading to long-term pain relief. Nerves in the area of the spinal cord that are irritated due to a spinal misalignment (subluxation) can be a cause of referred pain. When your chiropractor adjusts your spine, he or she removes the source of irritation, thus providing relief. Dr. Oblander is a Billings Chiropractor who is very knowledgeable about which tests can be performed to determine the underlying cause of your pain (whether direct or referred), and can treat it accordingly. If you have questions or want to seek chiropractic treatment, be sure to give us a call at Oblander Chiropractic: 406-652-3553.

Spinal Anatomy 101

Spinal Anatomy 101

vertebrae-model-200-300 “Never grow a wishbone, daughter, where you backbone ought to be.”

-Clementine Paddleford, American Writer (1898 – 1967)

It’s no accident that so many philosophers and writers have used the backbone as a metaphor for discipline, force of will or character.  Your spine (or “backbone”) is the primary physical support for your body’s entire frame.  It’s a remarkable piece of natural engineering composed of 33 separate vertebrae that act as a single unit to provide stability as well as flexibility while you’re sitting, standing or in motion.  A healthy spine is both strong and resilient.  With proper nutrition, exercise, postural habits and chiropractic care, it can allow us to lead an active lifestyle well into old age.  However, poor biomechanics, injury and disease can cause problems with the spine that result in misalignment, inflammation, pain and restricted movement.

The spine develops from infancy into adulthood, gradually evolving from a C-shape, which is suitable for crawling, to its distinctive S-shape, which is the appropriate shape for two-legged walking.  The natural curves in the spine serve to cushion impact from movement, absorb shock, preserve balance, and allow range of motion.  The three main curves in the spine are known as the cervical curve (the neck region), the thoracic curve (the upper back) and the lumbar curve (the lower back).

There are 7 cervical vertebrae, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal vertebrae.  The sacral and coccygeal vertebrae are those located lowest in the spine, below the area of the lumbar curve.  Twenty-four of the vertebrae in your spine are moveable. They are cushioned by intervertebral discs which act like coiled springs. These discs are fluid filled and—as we age—become thinner and more brittle, often causing us to get shorter.  Over time (or as a result of excessive wear and tear or specific injury), they can degenerate, bulge or herniate, potentially causing significant pain and loss of mobility.

There are several other common spinal disorders.  Lordosis, also known as “sway back,” occurs when there is abnormal forward curvature of the lumbar spine.  Those who have abnormal curvature of the thoracic curve have kyphosis, or “hunchback.”  Scoliosis occurs when there is a side-to-side curvature in the spine. Slight curves of less than 20 degrees do not usually present health or problems and are seldom treated.  Moderate or severe curves usually require treatment because they can interfere with the functioning of internal organs and may significantly limit physical activity.

While the bones and connective tissues of the spine are very good at what they do, they cannot support the body’s weight and facilitate movement on their own.  They need the help of strong core muscles.  Good muscle tone is important to help maintain proper posture and spinal alignment.  This is why it’s so important for us to put effort into maintaining proper posture when we sit, stand, lie, walk and run.  Over time, poor posture can place unnatural stresses on the musculoskeletal system (especially the spine), limiting our range of motion and producing pain.

In addition to its role in supporting the body’s frame and facilitating movement, the spine has another important role as well.  The spine’s bony vertebrae also encase and protect the spinal cord, which is connected directly to the brainstem.  It’s hard to exaggerate how important this protection is.  Damage to the spinal cord can cause numbness and loss of motor function.  Injury to the cervical area can cause tetraplegia (also known as quadriplegia), while injury to the thoracic or lumbar area may result in paraplegia, or loss of the use of the legs and trunk.

This article serves as a brief introduction to just one aspect of your anatomy.  If you are in the Billings area and need a Billings Chiropractor and you have any questions about your spinal health or your musculoskeletal health more generally, please don’t hesitate to call us at Oblander Chiropractic or visit our office (406-652-3553).  We’re here to help!

Chiropractic for Chronic Back Pain

Chiropractic for Chronic Back Pain

back-pain-office-200-300About a third of the millions of people who make appointments with chiropractors every year seek relief from back pain. Back pain can be acute, meaning it happens suddenly, lasts 6 weeks or less and often clears up on its own; or back pain can be chronic, meaning it comes on gradually and lasts 3 months or more. Chronic back pain can be particularly debilitating and can limit movement and mobility.

Traditional treatments for back pain include medication, physical therapy, surgery or steroid injections. While these treatments may provide symptomatic relief, they do not address the root cause of the pain. They can also be painful and expensive to carry out.

The foundation of chiropractic care for chronic back pain is the understanding that misaligned vertebrae can cause the pain. This misalignment can result in many additional problems, such as headaches, body pains and impaired joint mobility. Chiropractic treatment aims to restore alignment to the vertebrae, returning natural health to the spine and all the body parts the spinal nerves serve.

Chiropractors believe in the body’s natural ability to heal itself. Chiropractic care avoids medications and their possible side effects, and it also avoids surgery. As an example of the differences in treatment, surgeons may remove a herniated disk from the spine in order to relieve pressure on the nerves, while chiropractors use non-invasive spinal manipulation to achieve the same result.

Dr. Oblander can treat your chronic pain based on the vertebral misalignments found in your body. A quick, sudden force is applied to the appropriate vertebrae in order to restore the motion of the joint. Another common treatment for chronic pain is known as the flexion-distraction technique. This treatment involves a special table that stretches the spine. It is particularly effective in treating injuries to the discs that have been the cause of long-term back pain.

Chronic back pain will probably also require additional treatments such as massage, exercise, and perhaps physical therapy. A good chiropractor will work with other health professionals as needed to ensure you get the best possible treatment for your pain. He or she will also look at the entire picture of your life, including your diet, health habits, medical history, family history, and other conditions you may have. This approach is holistic and has a better chance of eliminating the root cause of your chronic back pain than traditional treatments that only work on the symptoms.

Every body is different. If you have questions about this article or whether chiropractic is an appropriate choice for your specific situation, please ask. We are here to help those in the greater Billings area!

 

Chiropractic Care Gets High Marks from Back Pain Patients

Chiropractic Care Gets High Marks from Back Pain Patients

satisfaction-survey-200-300Lower back pain is a very common problem across the US. In fact, experts estimate that as much as 84% of the population will experience it over the course of a lifetime!  For about 23%, this pain will be chronic and for 11%-12% it will be debilitating.

While these are sobering statistics, there is also some good news.  Depending on your condition, chiropractic care can be an effective treatment option—helping to relieve pain and restore mobility.

Patient Satisfaction by the Numbers

In addition to the many clinical studies that demonstrate the effectiveness of chiropractic care, a number of well-known public health and consumer research organizations have also conducted surveys and polls in order to better understand the experience of patients when it comes to treating back pain.  In April and May 2009, the Consumer Reports Health Ratings Center surveyed the magazine’s subscribers.  In particular, the Center was interested in learning about back pain patients’ satisfaction with their healthcare providers and with the different treatment options they provided.

  • Of patients who had visited a chiropractor, 59% were highly satisfied* with the treatment and advice they received.  By comparison, fewer than half were highly satisfied with the treatment and advice provided by their medical specialist (44%) or primary care physician (34%).
  • Of patients who had received chiropractic manipulation, 58% reported that the treatment helped a lot.  Only 45% reported that prescription drugs helped a lot and just 22% said the same thing about over-the-counter medications.

What’s especially interesting about these survey results are the number of people who participated and their backgrounds.

  • The Consumer Reports Health Ratings Center surveyed more than 14,000 participants who had suffered from lower-back pain in the prior year but had never had back surgery.
  • More than half reported that pain severely limited their daily routine for a week or longer.  Many reported that pain interfered with sleep, sex and efforts to maintain a healthy weight.
  • 88% reported that the pain recurred through the year.
  • Most had tried five or six different treatments.

Two years later, the Center published an updated report describing how Americans use alternative approaches to healthcare as well as their experience with various providers and therapies.  Chiropractic care once again was found to be the most popular approach to back pain relief and was ranked most highly in terms of patient satisfaction.

Your chiropractor is specially trained to relieve back pain and restore mobility by using drug-free, hands-on techniques called manipulation, adjustments or mobilization.  He or she may also employ other types of therapy, such as massage and cold laser treatment, depending on the nature and cause of your back pain.  In addition, many chiropractic physicians work closely with their patients to develop new, healthier habits—usually around exercise, nutrition and sleep—that can help prevent some types of injuries and chronic medical conditions.  By focusing on both immediate pain relief and the underlying causes of back pain, your chiropractor can help you return to your active lifestyle as soon as possible!

Remember—every patient’s body is different.  If you’re wondering whether chiropractic care is an appropriate choice for you, please call or visit our office today!  We’ll be happy to help!

 

 

 

*Defined as either Completely Satisfied or Very Satisfied.

Chiropractic and the Benefits of Conservative Care

Chiropractic and the Benefits of Conservative Care

chiropractic-counseling-200-300It’s been in the headlines for years now—non-specific back pain has become an epidemic in the U.S. According to some estimates, Americans now spend approximately $100 billion per year looking for relief. At the same time, many public health officials, medical researchers and clinicians see a growing gap between the types and amounts of care being delivered and the results being achieved for patients. In particular, the rapidly growing use of advanced diagnostic tools (especially early imaging) and high-tech treatment options (surgeries, medical devices and drugs) appear to be driving up costs as well as risks without producing widespread benefits. So what is to be done?

Surgery as a Last Resort

According to many experts, the right answer for many patients is a conservative approach that emphasizes proven treatment options and resorts to more expensive and riskier alternatives only after these have failed to produce results. This may be particularly true when it comes to surgery. The Mayo Clinic, for example, recommends caution before choosing this option. Their website warns, “Spine surgeons hold differing opinions about when to operate, what type of surgery to perform, and whether—for some spine conditions—surgery is warranted at all.” A 2013 study in Washington State, published in the journal Spine, also highlighted an interesting correlation between the number of back surgeries performed and the type of doctor first visited. The study found that of those injured workers who saw a surgeon first, 42.7% chose surgery (a relatively expensive and risky option) as a solution. Of those injured workers who first saw a chiropractor, the rate of surgeries dropped to 1.5%. In other words, those who visited a chiropractor first found that surgery was less likely to be necessary.

There are of course situations where back surgery may be absolutely necessary. However, study after study has shown that other methods of treating back pain are far less expensive, less risky and frequently more effective. If you have been advised to have back surgery, it’s always good to get a second or even third opinion from different medical professionals to be sure you do not undergo a surgical procedure that may be best treated more conservatively.

The Chiropractic Alternative

Interestingly, most cases of back pain are mechanical, as opposed to being caused by more serious medical conditions such as infection, arthritis, fractures, or cancer. Some are caused by sports injuries or accidents, but others can be triggered by nothing more severe than bending down to pick up a dropped pencil. Still others are caused by misalignments of the spine, neck and joints that have built up over many years, as opposed to being caused by a single trauma.

Most of these conditions can be successfully treated by Doctors of Chiropractic, who are specially trained to use manipulation and mobilization techniques to relieve pain and address the underlying causes. Over time, chiropractors can help to return your spine and whole body to a more normal state of health, in which reoccurrences of back pain are less likely to appear.

Chiropractic care has received high marks in clinical studies as well as in patient satisfaction surveys conducted by governments and leading consumer research organizations. It is also recognized as one of the safest therapies you can use to treat back, neck and joint pain when performed by properly trained and licensed healthcare professionals. Potential side effects are usually limited to a mild aching or short-term soreness in the spinal joints or muscles. Spinal adjustments pose few serious risks, although rare complications include the possibility of a herniated disk or compression of the nerves in the lower spinal column.

During your visit, you should be very specific about your symptoms and about any concerns you have. This will help us offer the safest and most effective treatment for you. Depending on your condition and the specific problems being treated, you and your chiropractor may choose to forego manipulation in favor of joint mobilization, therapeutic exercise, soft-tissue techniques, or other types of therapies.

Chiropractic care is a safe, effective and—above all—conservative approach to the treatment of back pain. It is non-invasive and uses no drugs that may have potential negative side effects. The Agency for Health Care Policy and Research conducted a study of all available care for lower back problems and recommended spinal manipulation as the safest and most effective initial treatment of lower back pain in adults.

If you are one of the four out of five people who will experience back pain during their lifetime, you can do something about it. This is an important thing to know. Unfortunately, many people aren’t aware of their options. A survey conducted by the American Physical Therapy Association found that although two-thirds of Americans experience low back pain, more than a third of them don’t seek professional help for it. So if you’re experiencing back pain, call or visit our office today. All you have to lose is your pain!

Think Twice about Back Surgery

Think Twice about Back Surgery

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woman-against-concrete-wall

Back pain is incredibly common—in fact, just about every adult in the United States has experienced back pain in some form or another, and it is one of the top complaints heard in doctors’ offices and hospitals around the country. Yet the cause of any one type of back pain is one of the most difficult things to diagnose. There are many treatments for back pain, such as chiropractic, physical therapy, acupuncture, surgery, saline injections, and steroid injections, all with varying degrees of risk. According to experts, you should treat back pain conservatively—that is, you should opt for the least risky, minimally invasive treatment option first before considering treatments such as spinal surgery.

Of course, there is risk with any surgery, but failed back surgeries can be calamitous—so much so that there is a condition called “failed back surgery syndrome,” also commonly referred to as failed back syndrome. According to the University Hospital of Columbia and Cornell, New York-Presbyterian Hospital, “Failed back syndrome is a general term that refers to chronic severe pain experienced after unsuccessful surgery for back pain. Surgery for back pain is conducted when there is an identifiable source of pain—usually to decompress a pinched nerve root or to stabilize a painful joint. However, back pain can have a number of causes and accurate identification of a source of pain is complicated; often symptoms do not correlate well with x-rays or magnetic resonance imaging scans. As a result, diagnosis and patient selection for surgery are essential.”

Failed back syndrome has a large array of causes. For example, the original source of the pain can return or complications may arise during surgery. The nerve root triggering the pain may be ineffectively decompressed, joints or nerves may become irritated during the surgical procedure, or scar tissue may compress or bind nerve roots. Additionally, nerve damage sustained during the surgery can add to already existing pain. In some cases, nerves may rejuvenate to a degree, but even this can result in pain if the regeneration is abnormal.

Numerous factors can add to the onset or advancement of failed back syndrome. Contributing causes include residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness, and spinal muscular deconditioning. Insufficient or unfinished rehabilitation and physical therapy, particularly in patients whose back muscles are out of shape, can cause chronic pain as well. A patient can also be susceptible to the advancement of failed back syndrome due to systemic conditions such as diabetes, autoimmune disease, and peripheral blood vessels (vascular) disease.

There are other risks of surgery as well—contamination can occur when a surgeon’s gloves have bacteria present on them, passing them to the patient and causing infections that range from mild to very severe.

As an alternative to surgery, there are steroid injections for back pain—but they aren’t always successful. Lumbar epidural steroid injections, as they are called, can help relieve pain, but they carry with them their own hazards. As Spine-Health.com puts it, “In addition to risks from the injection, there are also potential side effects from the steroid medication itself. These tend to be rare and much less prevalent than the side effects from oral steroids. Nonetheless, reported side effects from epidural steroid injections include: Localized increase in pain, non-positional headaches resolving within 24 hours, facial flushing, anxiety, sleeplessness, fever the night of injection, high blood sugar, a transient decrease in immunity because of the suppressive effect of the steroid, stomach ulcers, severe arthritis of the hips, and cataracts.”

To reduce the risk of these side effects of invasive back pain treatments, it is wise to pursue conservative therapies first. When looking at back pain treatment options, always be sure to get a second—and maybe even a third—opinion on how your back pain should be handled. If you’re looking for a drug-free, non-invasive alternative, consider chiropractic care. In addition to treating your back pain directly, your chiropractor can also act as your back-pain quarterback to coordinate care across multiple treatment methods.

 

Top 5 Exercises for Increasing Range of Motion in Your Neck

Top 5 Exercises for Increasing Range of Motion in Your Neck

girafe réticulée 06Pain and stiffness can significantly reduce your neck’s range of motion. Although a decreased range of motion in your neck may not seem like a major problem, it can actually contribute to a number of unpleasant conditions, including headache, fatigue, irritability and sleep loss. Like any other part of the body, our neck can become stronger and more flexible through exercise. Following are some useful exercises that can help to increase the range of motion in your neck.

All these exercises should be done while sitting comfortably in a chair with your feet flat on the floor and your neck in a neutral position. Your neck should be positioned right above your spine (in other words, be sure your head is not jutting forward or back), and you should be looking straight ahead. If you feel pain (rather than just discomfort) while doing any of these exercises, stop immediately and do not resume them until you have consulted with your chiropractor.

1) Neck rotations – Keeping your head level, gradually turn your head to the right as far as you comfortably can, looking over your right shoulder, and hold for 10 seconds. Then slowly turn your head to the left, looking over your left shoulder, and hold for another 10 seconds. Repeat 5 times.

2) Neck tilts – Tilt your head to the right, bringing your right ear as close to your shoulder as possible, and hold for 10 seconds. Do the same on the other side, tilting your head to the left, again holding for 10 seconds. Repeat 5 times.

3) Neck flexion and extension – This is simply bending your head forward and back. Beginning in a neutral position, gradually bend your head forward, letting it hang with your chin close to your chest, and hold for 10 seconds. Then slowly bring your head up and back so that you are looking at the ceiling. Repeat 5 times.

4) Half circles – Start by tilting your head toward your right shoulder as far as possible, then slowly swing it to the left in a fluid half-circle, moving your head forward and down until your chin is close to your chest, continuing until your head is tilted to the left with your left ear above your left shoulder. Then repeat the movement in the other direction.

5) Levator scapulae stretch – Tilting your head to the right over your shoulder, turn and drop your head slightly so that your nose is pointed toward your elbow, and hold for 10 seconds. You should feel the stretch in the muscle connecting the back of the left lower neck to your shoulder blade. Repeat on the other side.

Can Poor Posture Really Cause Back and Neck Pain?

Can Poor Posture Really Cause Back and Neck Pain?

back-pain-neck-pain-collage-200-300In a word, yes!

Unless your back or neck pain has been caused by some type of over-exertion or acute trauma, it’s actually very likely that poor posture is at least a contributing factor. The alignment of the spine—from the neck through the lower back and hips—is critical to the body’s ability to support its own weight and move efficiently, so posture problems (which are often chronic) can gradually lead to pain and reduced mobility.

When it comes to pain in your back or neck, the relationship between poor posture and injury can also be a complicated one. On the one hand, having poor posture makes it more likely that you will suffer an injury. On the other hand, suffering an injury can also affect your posture. Mary Ann Wilmarth, DPT, spokeswoman for the American Physical Therapy Association explains, “Little things add up. You can increase the pressure on your back by 50% simply by leaning over the sink incorrectly to brush your teeth. Keeping the right amount of curvature in the back takes pressure off the nerves and will reduce back pain.”

How posture problems contribute to neck pain

One of the most common posture problems is a “forward head and shoulder posture”. This occurs when someone “hunches over” and places their head in front of their neck. The weight of the head towards the front stresses the lower neck vertebrae, and leads to overworking of the upper back muscles to compensate for the pull of gravity on the head. Many people with this posture problem also have a rounded upper back and rounded shoulders, which can lead to further stress and shoulder pain. Often, poor desk and chair ergonomics contribute to these problems, but even slouching on the couch or at a table with your mobile phone can lead to hunching over.

How posture problems contribute to back pain

The “forward head” posture described above causes stress on the lower cervical vertebrae, which may end up sliding forward relative to each other as a result of gravity. This is a particular problem for people who have jobs requiring them to look forward or downwards all day. Eventually, the prolonged pressure on the cervical vertebrae will irritate the ligaments and soft tissues, radiating downwards to the upper back. This process can lead to disc degeneration, cervical osteoarthritis and herniated discs.

Tips for improving poor posture and relieving back and neck pain

Poor posture is typically the result of habits that have been developed over long periods of time performing the same activities over and over again. Here are just a few of the most common culprits:

  • Staring at computer monitors or mobile devices that are badly positioned.
  • Sitting in poorly designed office chairs.
  • Sleeping on mattresses that don’t provide the necessary support.
  • Carrying heavy backpacks or purses.

But how do you know which activities are contributing to your poor posture and causing you pain? The clues are usually fairly easy to spot once you know what you’re looking for. For instance, the pain in your neck or back may be worse at some times during the day than at others, or it may come and go with changes in your body position. If you experience fatigue or pain when you first wake up in the morning or after you’ve been sitting at your desk for a couple of hours, it might be time for a new mattress or new office furniture.

The good news is that once you become aware of the activities that are contributing to your posture problems and pain, most can be fixed relatively easily, with no need for either medication or surgery. Learn to recognize when you’re hunching over your computer, slouching in your chair or craning your neck to look at your mobile phone. Then sit up straight, aligning your hips, shoulders and ears in one vertical line.

Sometimes, however, the solution is not so simple—especially when poor posture has caused structural changes in the spine and neck. In these cases, a chiropractor can help by designing posture correction and spinal rehabilitation programs to restore the spine’s normal curvature. These programs will usually involve a combination of mechanical techniques that actively remodel the spine (including the use of braces and molding blocks), exercises and stretches that strengthen postural muscles and restore range of motion, and lifestyle changes to address the root causes.

As experts in diagnosing and treating musculoskeletal conditions, chiropractic physicians are specially trained to recognize and correct postural problems. If you’re suffering from neck or back pain and suspect that your posture may be at least partially to blame, call or visit our office today. We can help!

Which Chiropractic Technique is Most Effective? Why the Answer is “It Depends.”

Which Chiropractic Technique is Most Effective? Why the Answer is “It Depends.”

woman-with-question-listening-200-300When patients come to us for chiropractic care, it’s not unusual for them to ask us which chiropractic technique is most effective. This is especially true if they have prior experience with chiropractic care or if they have friends or family who do. The patients who ask this question are often surprised when we respond with “It depends.”

The simple truth is that the human body is a complex machine, and no single approach will produce the same results for every individual or in every set of circumstances. Rather, your chiropractor must take several factors into consideration to find the best treatment options for you.

What Factors do Chiropractors Consider When Choosing a Treatment?

When you first visit a chiropractor, you will go through a “new patient” or “patient intake” process that is not dissimilar to what you may experience in other medical settings. This process allows your chiropractor to gather information about your general health and the extent of your discomfort or injury, two factors that help inform his or her treatment recommendations. During this process, you should expect to fill out a questionnaire about your health history as well as undergo a routine physical exam. Depending on the situation, your chiropractor may also use a variety of diagnostic tools, including advanced imaging technologies that can help identify structural problems in your back.

When deciding which treatment would be most effective for you, your chiropractor will also take your goals and lifestyle into consideration. You may come to see your chiropractor with a very clear goal in mind: perhaps you are experiencing back pain due to an accident and you are hoping for relief. In this case, your chiropractor might recommend some form of soft tissue mobilization and low level laser therapy (LLLT) to relieve pain, reduce inflammation and speed healing. Alternatively, you may not have a single health problem you wish to address. Perhaps you’re more interested in improving your lifestyle and general well-being. Your chiropractor can work with you to build a strategy to help you meet your goals, perhaps focusing on nutrition, exercise and stress management techniques.

Finally, the most effective chiropractic treatment depends—at least in part—on your own experience and personal preferences. A technique that works well for one patient may not be tolerated well by another. Therefore, it is important to communicate openly with your chiropractor about how each technique feels to you. If you find a certain style of adjustment to be too intense, there may be gentler, low-force techniques that can achieve the same effect while keeping you more comfortable.

Taking Advantage of Many Techniques

Another reason we can’t provide a simple answer to the question “Which chiropractic technique is most effective?” is because it is very often necessary to make use of more than one technique to reach a patient’s goals. Your chiropractor will work with you to find both manual and non-manual therapies to help relieve your immediate pain and discomfort while also improving your function. You might find that dietary changes, exercise, or orthotic supports are all helpful in helping you reach your own goals, making them irreplaceable components of a well-rounded chiropractic treatment plan.

There simply is no one chiropractic technique that is most effective. Instead, the most efficient and reliable path to an effective treatment plan is good communication with your chiropractor. By being clear about your own goals and preferences, honest about your lifestyle choices, and open to your chiropractor’s recommendations, you can help us build a treatment plan that is most likely to deliver the results you want to achieve.

Head-to-Head: Chiropractic Adjustments or NSAIDs for Acute Lower Back Pain?

Head-to-Head: Chiropractic Adjustments or NSAIDs for Acute Lower Back Pain?

???????????????????????Lower back pain (LBP) is so widespread that it was listed in the 2010 Global Burden of Disease report as being the single leading cause of disability worldwide. Over half of all working Americans have lower back pain symptoms each year, resulting in lost work time and enormous expense – Americans spend over $50 billion each year to treat their back pain.

So it’s not surprising that a great deal of research is being conducted to determine the most effective methods for treating acute LBP. Much of this research has sought to compare the effectiveness of spinal manipulation (the sort of adjustments performed by Doctors of Chiropractic) with nonsteroidal anti-inflammatory drugs (NSAIDs). While these studies have generally not produced definitive findings one way or the other, they have served to highlight potential safety concerns related to NSAIDs. For example, investigators in one study found that diclofenac (an NSAID commonly used to treat LBP) increased the risk of gastrointestinal complications by 54% and posed other risks to the kidneys.

Given the added concern about NSAID side effects, researchers and clinicians have had a renewed interest in learning whether drug-free manual therapies—chiropractic care, in particular—can really be just as effective, but safer. According to a recent study published in the April 2013 edition of the journal Spine, the answer is YES! In fact, the research team that conducted the study found that chiropractic adjustments were both safer and FAR MORE EFFECTIVE.

In this study, investigators divided a total of 101 patients suffering from acute lower back pain into three groups. One group received chiropractic spinal manipulation plus a placebo (sham) version of the NSAID diclofenac (meaning that the only treatment actually being offered was chiropractic care). A second group received sham spinal manipulation and real diclofenac (meaning that the NSAID was the only treatment being employed). And a third group received the same sham spinal manipulation plus placebo diclofenac (meaning that no treatment was actually being offered – this was the “control group”). All treatments were “blinded,” meaning that the patients did not know whether they were receiving real or sham spinal manipulation or real or placebo diclofenac. Outcomes were measured based on a combination of patient self-reporting, physical examination, missed work time, and the amount of rescue medication (paracetamol tablets) participants required over a 12-week period.

Perhaps unsurprisingly, about half of the participants in the “control” group receiving no treatment dropped out of the study because of intolerable pain. Comparing the remaining no-intervention subjects and the two remaining intervention groups, researchers found that the group receiving chiropractic high-velocity low-amplitude (HVLA) manipulation fared significantly better than the group being treated with diclofenac and the control group.

Researchers reported a clear difference between the two intervention groups: “The groups receiving spinal manipulation showed a faster and more distinct reduction in the RMS [root mean square, a standardized test of flexibility and mobility]. Subjects also noted a faster and quantitatively more distinct reduction in their subjective estimation of pain after manipulation.” They also found that the group treated only with the NSAID diclofenac required more rescue medication (paracetamol) than the spinal manipulation group, taking 3 times as many tablets and for twice the number of days. No negative effects were reported from the spinal manipulation group, but several negative effects were reported from the diclofenac group.

So, overall, this study indicates a clear “win” for chiropractic in the treatment of acute lower back pain. Not only does HVLA spinal manipulation avoid the potential safety concerns of NSAID medications such as diclofenac, it has been found to be far more effective. Remember this the next time you experience lower back pain, and consider seeing your chiropractor first. This one simple decision may help you recover more quickly and more completely while also helping you avoid the negative side effects of NSAIDs.