Back Surgery

Modern Treatment for Back Pain: Beyond Bed Rest, Pain Pills and Surgery

June 9, 2016 oblanderchiropractic

chiro_counseling-whiteboard-200-300 According to the National Institutes of Health and Dr. Michael S. Wilkes of the Western Journal of Medicine, “Despite a plethora of research intended to guide physicians in their management of back pain, physicians still hold strong non-evidence based beliefs dating back to the 19th century.” What beliefs is Dr. Wilkes referring to? He’s talking about the long-held conventional wisdom that says bed rest is one of the best ways to treat back pain.

And it turns out that physicians aren’t the only ones who hold “strong non-evidence based beliefs” about how back pain should be treated. One study, according to the Daily Mail, found that 35% of people thought bed rest is the best way to handle such aches and pains. The study included 1,000 people from 25–65 years of age.

So why are many doctors so quick to prescribe bed rest? And why are so many patients inclined to comply? Simple—pain avoidance. Certainly our minds are part of the feedback loop in any therapy, especially where intense pain is involved. Dr. Michael Vagg, Clinical Senior Lecturer at Deakin University School of Medicine has pointed out that the mind’s expectation of pain “can itself cause protective movements to persist for longer than necessary.” Thus, the tendency to use bed rest as a solution.

The Evidence Against Bed Rest

For most types of back pain, there is powerful evidence that extended bed rest does not help. One study showed that when comparing routine care, bed rest and exercise, bed rest seemed to result in greater intensity of pain, greater disability and more work days lost. Exercise had the most favorable outcome. According to Wilkes, “14 of 18 controlled studies do report that active exercise can improve outcomes.”

Short-term bed rest can be helpful to reduce painful muscle spasms when such spasms are an attempt for the body to limit movement in an injured part of the body. However, bed rest restricts the spine’s motion and, unlike other body parts, spines require motion in order to get nutrients to stay healthy. Restricted movement can result in lost strength and can make it harder for the spine to recover. When the patient is experiencing their most acute back pain, they may need to temporarily change their routine, but the majority of such patients should minimize bed rest and return to their normal routine as soon as possible. Exercise can help produce better results and quicken the healing process.

Part of a Broader Pattern

Unfortunately, the outdated (and ill-advised) bed rest recommendation is part of a broader pattern that some healthcare observers believe they see in the treatment of back pain. Dr. Bruce Landon, a professor of health care policy at Harvard Medical School, and a team of researchers have found that many medical doctors ignore expert clinical guidelines when it comes to treating back pain. And the results aren’t limited to inappropriate guidance about bed rest. They include unnecessary medical imaging, needless exposure to addictive painkillers and surgeries that are often risky, expensive and ultimately ineffective.

Interestingly, a study published in the September 2014 edition of the Journal of the Canadian Chiropractic Association found that chiropractors, physical therapists and medical doctors have very different rates of adherence to current evidence-based practice guidelines as they relate to treating nonspecific back pain. Their analysis found that medical doctors follow such guidelines only 52% of the time, compared with 62% for physical therapists and 73% for chiropractic physicians.

Whether you’re suffering from acute or chronic back pain, it’s important to seek out the best evidence-based treatment you can find. Chiropractors are experts in diagnosing and treating health conditions that affect the musculoskeletal and nervous systems, especially those that involve the back and the neck. Chiropractic treatment has been shown in studies to be both safe and effective. Plus, chiropractic patients have consistently reported high levels of satisfaction with the results as well as the experience.

If you or someone you care about is suffering from back pain, there’s help available. Remember—you have options! We encourage you to call or visit our office today!

Chiropractic and the Benefits of Conservative Care

April 12, 2016 oblanderchiropractic

It’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

March 3, 2016 oblanderchiropractic

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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.

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