Chiropractic & Back Pain
Chiropractic and Back Pain
Low back pain is a very common pain symptom. One out of three of us suffer from some kind of back pain every year, and many people live with chronic spinal pain.
The good news is that chiropractic has been shown over and over to be an effective treatment of back pain. Here's a collection of articles that discuss how chiropractic can help in the treatment of back pain.
Watch our videos in the playlist below, or read some of our articles to learn more about how chiropractic can help ease back pain.
Back Pain After Auto Accidents
Back Pain and Chiropractic
Back Pain Treatments
Articles:
Aortic Calcification, Disc Degeneration, and Back Pain
Back Pain Assessment and Advice in Primary Care
Back Pain, Fibromyalgia, and the Stress Response System
Back Pain: General Information and Symptoms
Back Pain Recovery Can Be Slow
Childhood obesity linked to back problems
Don't Wait For Low Back Pain to Send You to the ER
Fear of Movement and Low Back Pain
Fear of Pain More Disabling than Actual Pain
Job Satisfaction and the Transition from Acute to Chronic Back Pain
Neck and Back Pain in Schoolchildren: The Role of Backpacks
Physical Risk Factors and Back Pain
Predictors of LBP and Return to Work
Prognostic Factors for Low Back Pain patients returning to work
Socioeconomic Impact of Back Pain
Stressful Life Events and Low Back Pain
Study shines light on who develops chronic low back pain
Waddell's Nonorganic Signs in Occupational Low Back Pain Patients
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The Effectiveness of Chiropractic for Back Pain
Articles:
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Eight out of 10 people will experience some kind of back pain in their lifetime, and it's one of the main reasons that patients seek the help of a chiropractor. Watch our videos in the playlist below or read some of our articles to find out more about how a chiropractor can help treat your back pain.
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Study Shines Light on Who Develops Chronic Low Back Pain
Back pain is the leading reason that people seek out the help of a chiropractor, and it is estimated that 80 to 90% of people in the United States will experience some kind of back pain in their lives. Most patients with low back pain (LBP) will find their symptoms improve after a few weeks or months, and chiropractors can assist this process by identifying pain issues in the early stages and helping patients stay active during their recovery. However, in approximately 10% of cases, acute low back pain develops into a chronic condition, one that lasts six months or more. Chronic low back pain is very difficult to treat, and it can have a substantial impact on a patient's quality of life.
Research is beginning to uncover the factors that can determine who develops chronic low back pain, and these findings can have great relevance in determining a treatment path. In a study published in The Spine Journal, researchers from the Netherlands merged the results of three randomized controlled trials of a total 628 workers on medical leave for LBP. The trials drew from a wide base of professions, comparing results among airline, healthcare, industrial, construction, and office workers.
The researchers considered physical factors, including age and gender of participants, pain intensity, disability level, the amount of heavy lifting required at their job, as well as psychological factors like overall job satisfaction and fear of movement triggered by past pain experiences, also known as kinesiophobia. The study followed up with patients after one year to determine which patients had developed chronic conditions.
After reviewing their results, the researchers developed a short list of the most significant factors in predicting who will develop chronic low back pain. Patients who did not experience a decrease in pain intensity or their level of disability within the first three months of the onset of pain were most likely to develop a chronic condition. Those who started out with a higher pain intensity and those with a higher kinesiophobia where also determined to be at higher risk. Previous studies have suggested that patients who do more heavy lifting at work are at higher risk of developing a chronic condition, but this study could not confirm that this was as great a predictor as the other factors.
These findings have important implications for the treatment of low back pain. The results suggest that health practitioners, including chiropractors, should monitor the pain intensity and disability levels of patients with acute LBP frequently within the first three months of treatment. Patients whose symptoms don't change during this critical initial period may require more targeted treatment. In addition, initially intense pain levels can lead to a fear of movement that significantly impedes recovery, so care providers must also be proactive about reducing kinesiophobia in their low back pain patients.
Hemans MW, vanBuuren S, Knol DL, Anema JR, van Mechelen W, de Vet HCW. The prognosis of chronic low back pain is determined by changes in pain and disability in the initial period. The Spine Journal 2010 (10) 847-856.
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Waddell's Nonorganic Signs in Occupational Low Back Pain Patients
Doctors and researchers are interested in simple, quick, and effective ways to determine which low back pain patients are at higher risk for persistent symptoms and disability. Waddell's nonorganic signs have previously been established to evaluate eight behavioral signs that imply a patient is poorly coping in proportion to the physical condition of their back. Low back pain is of course a concern in occupational medicine—since it occurs so regularly and induces costs to employers. This study appraised if Wadell's nonorganic signs in occupational acute low back pain patients predicted a longer time before return to work.
The authors evaluated 55 acute low back pain patients. They defined the diagnosis of "acute" if the pain was the first episode in one year, and present during the intake for less than 10 weeks. Of the 55 subjects, 41 were found without signs, and 14 had one or more of Wadell's nonorganic signs.
The table below indicates the distribution of signs among the 14 subjects.
The Signs |
Number Exhibiting |
Percentage Exhibiting |
Simulated axial loading |
11 |
78.6% |
Simulated rotation |
10 |
71.4% |
General overreaction to examination |
8 |
57.1% |
Superficial tenderness |
8 |
57.1% |
Regional weakness |
4 |
28.6% |
Widespread, nonanatomic pain |
2 |
14.3% |
Regional sensory deficit |
1 |
7.1% |
Distracted straight leg raising |
0 |
0.0% |
The authors stress that, "Patients exhibiting any of Waddell's sign's without an otherwise nonfocal examination had the absence of organic findings positively reinforced." Furthermore, all recovering patients stayed in the work setting and performed modified work tasks; they returned to their regular job when released without restrictions. The authors suggest the modified work arrangement helped patients stay active and supported in a work environment.
Patients without signs returned to their full duties in approximately 15 days. Those with Waddell's nonorgnic signs returned four times longer, at 58.5 days. Physical demands, smoking status, age, gender, and previous history were not associated with return to work time. As the table indicates, the best predictors were the categories of "pain with simulated axial loading" and "pain with simulated rotation."
Although the authors declare that their findings display clinical significance of Waddell's in determining predictive factors in acute low back pain patients, they also point out the limitations of the study. The study had a "small sample size, single institution, and single practitioner with unblinded assessment, treatment, and outcomes." In an attached editorial, Steven J. Atlas notes:
"By not blinding the evaluating and treating physician in any manner, the differences observed may simply be caused by well intentioned but biased physician behavior...To me [the findings] highlight the need to pursue research into the early identification of patients at higher risk for persistent, disabling symptoms. Larger, well-controlled studies are needed to determine whether Waddell's signs can prospectively identify such high risk patients. If it can, then treatment strategies are needed to determine whether earlier interventions can result in improved outcomes. "
- Gaines W, Hegman K. Effectiveness of Waddell's nonorganic signs in predicting a delayed return to regular work in patients experiencing acute occupational low back pain. Spine 1999; 24(4):396-401.
- Atlas S. Point of view. Spine 1999; 24(4):401.
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Weight Loss Eases Back Pain
Low-back pain and sciatica are common among people who are overweight, and a new study shows that losing weight can significantly reduce pain in those patients. Research shows that having a high BMI can slow your rate of recovery from low-back pain and increase your risk of common causes of sciatica like lumbar disc degeneration.Decreased space between the spinal discs can lead to nerve impingement and sciatic pain.
This new study included 30 patients who had undergone bariatric surgery.As patients lost weight, the space between the discs in the lumbar spine increased, easing pressure on irritated nerves. Patients also experienced a significant reduction in low-back pain and radiating leg pain.
For patients concerned with the potential costs and risk of surgery, non-invasive weight loss could be a viable option. A new literature review concluded that exercise and physical therapy can significantly reduce back pain in overweight patients without the risks of surgery.
A chiropractor can create a natural treatment plan for back pain that includes exercise, nutritional counseling, chiropractic adjustments, and more.
To learn more about natural back pain and sciatica relief, call our office today.
References
Atchison J and Vincent H. Obesity and low back pain: relationships and treatment
Pain Management 2012; 2(1): 79-86/(doi: 10.2217/pmt.11.64)
Baumgarten K, Walter C, and Watson E. The Effect of Obesity on Orthopaedic Conditions. South Dakota State Medical Association. http://www.sdsma.org/documents/Carlson.pdf.
Djurasovic M, Bratcher KR, Glassman S, et a. The Effect of Obesity on Clinical Outcomes After Lumbar Fusion. Spine 2008; 33(16): 1789-1792.
Lidar Z, Behrbalk E, Regev GJ, et al. Intervertebral Disc Height Changes after Weight Reduction in Morbid Obese Patients, its Effect on Life Quality, Radicular and Low Back Pain. Spine 2012. doi: 10.1097/BRS.0b013e31825fab16.
Samartzis D, Karppinen J, Chan D, et al. The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study. Arthritis and Rheumatism 2012; 64(5): 1488-1496.
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Will Your Back Pain Become Chronic?
A new study from the journal Spine finds that patients with acute low-back pain frequently develop chronic symptoms.
Acute low-back pain can result from lifting something incorrectly or straining ligaments and muscles in the back. It is often characterized as a temporary episode of pain that will resolve itself in under 90 days.
In this new study, researchers worked with 605 acute low-back pain patients. After six months, 13% of patients still had back pain. After two years, 19% had developed chronic symptoms. Even patients without persistent symptoms still experienced occasional episodes of pain.
In another recent study, 73% of patients reported recurring acute low-back pain and the majority said their symptoms worsened with each episode.
This research means that you shouldn’t ignore an episode of back pain, because it might be the beginning of a chronic problem.
Fortunately, studies show that chiropractic is an effective way to prevent back pain from worsening or recurring. Your chiropractor can treat your current episode of pain and help prevent it from becoming a chronic condition.
If you suffer from back pain, call our office today to see if chiropractic can help.
References
Donelson R, McIntosh G, Hall H. Is it time to rethink the typical course of low-back pain?. Physical Medicine and Rehabilitation 2012; doi:10.1016/j.pmrj.2011.10.015.(In press, corrected proof version).
Mehling WE, Gopisetty V, Bartmess E et al. The Prognosis of Acute Low Back Pain in Primary Care in the United States: A 2-Year Prospective Cohort Study. Spine 2012; 37(8): 678–684.
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Predictors of LBP and Return to Work
Through a light mobilization program, this team of researchers attempted to determine medical, psychological, and sociodemographic predictors that influence a worker's return after taking sick leave for low back pain. The researchers evaluated 260 workers who were on sick leave for 8 to 12 weeks.
Medically, they found that the mobilization treatment was effective in patients who did not have stiffness or restricted mobility at the beginning of the program. The researchers stressed to the patients the importance of not restricting use of the back or movement in the affected area.
Inactivity was found to delay return to normal activity and affect psychological disposition. Activity has been shown in both previous literature and in this light mobilization treatment program to promote well being and assist patients in overcoming the sick role. The researchers suggested the patients, "be encouraged to view themselves as healthy people who, unfortunately, have a bout of low back pain."
The researchers found those who returned to work felt the condition was under their personal control, as opposed to nonreturners who felt their health status was a matter of chance or others more powerful.
In addition the researchers found those who did not return to work to be influenced by sociodemographic factors as well. The study found that non-returners:
- Were older.
- Had more children.
- Had more children living at home.
- Had been in one job for more years.
- Reported more physical workload.
- And had reduced ability to perform ordinary work.
The researchers found numerous factors influencing a worker's propensity to return to work after a low back pain onset. Their findings led them to conclude:
"The results of the current study support the position that the prognosis for long-term pain is a multifactorial phenomenon. The good prognosis for this particular type of treatment depends on a combination of medical, sociodemographic, and psychological factors."
Haldorsen E, Indahl A, Ursin H. Patients with low back pain not returning to work. Spine 1998;(23)11:1202-1208.
Subcategories
Back Pain After Auto Accidents
Back Pain After Auto Accidents
Browse our articles to learn about conditions caused by automotive accidents.