Chiropractic has been around as a profession for over 125 years and there is evidence that manipulation in various forms has been around for thousands of years. But what is it that chiropractors do that is so effective for the relief of pain? Why do millions of people reach out to Doctors of Chiropractic every year seeking relief from pain?
The answers are quite simple. Chiropractic care is an effective form of treatment. As a second-generation doctor of chiropractic, I have witnessed chiropractic miracles since I was very young. My father would often tell me that his patients would come to him as a last resort. Those patients had tried other types of treatment, all of which were ineffective (as they were in my dad’s office), or they would get some relief, but since the actual cause of the problem was not addressed, the pain would return. Now when you are now the doctor of “last resort”, you do not have room for failure. If chiropractic was not effective, the profession would not have survived for as long as it has, nearly unchanged from the day the first chiropractic adjustment was delivered on 20 September 1895.
When we see patients in our modern chiropractic office, we have many tools at our disposal to help our patients get and stay well. Doctors of chiropractic are generally trained to treat the whole person. We see a low back issue is connected to other regions of the spine, meaning that at times it may be necessary to treat “other” areas in order to improve low back function.
I want to outline the treatment protocols that we have established in our practice for the treatment of low back pain. As there are different reasons for pain in the low back, not everyone should or would receive the same treatment. It depends on the cause of the problem, which I will outline in this brief article.
As a brief review of the anatomy of the low back, there are 5 moveable vertebrae that comprise the low back or lumbar spine along with dozens of muscles, tendons, discs, ligaments, and supporting structures to the spine. These vertebrae have the role of protecting the delicate spine which is housed inside but they also serve to allow us to have freedom of movement as well as the ability to stand erect. I often tell my patients when I show them a plastic model of the spine that they need to dress up the model. They need to image the model with the supporting muscles, ligaments, tendons, blood vessels, and nerves that make up the lumbar spine. Which is really hard to do, but is vital to understand physiologically what is happening when they have pain.
It is important that the vertebrae have movement from segment to segment. When the vertebrae lose this normal movement between the bones, they can irritate the nerves and tissues around the vertebrae. When one of our chiropractors detects a loss of this normal function a very effective treatment for this is an adjustment to the spine to help restore this lost movement. In conjunction with adjustments to the spine, it may also be necessary to help to stabilize the muscles of the spine by teaching our patients exercises.
Between the bones of the spine are the vertebral discs. Discs are cartilage tissue that provides a cushion to the spine and shock absorption. Without discs between the vertebrae, you would have bone on bone and the spine would wear out very quickly. Another condition that we will see in our office is patients who come in with advanced deterioration of these discs. This can be from trauma to the spine, genetics, or from overuse and abuse of the spine. When the disc is highly overloaded, the fibers that keep the disc intact can tear creating a herniation. If this herniated disc starts to put pressure on the nerve this can lead to pain, nerve damage, or loss of muscle strength. One of the most effective forms of non-surgical treatment of a disc injury is decompression of the spine.
Decompression is a form of traction to the spine which uses advanced computer algorithms to apply the right amount of decompressive forces to the vertebral disc which helps to reduce the pressure in the joint itself and which also helps to open up the space between the two vertebrae separated by the disc. Another important point to make regarding the disc is that it does not have a blood supply, therefore in order for nutrients to get into the joint to help the joint heal, the body relies on movement and gravity. However, when there is a loss of integrity of the disc, as noted above, the disc greatly loses this ability to move fluids into the joint. Decompression therapy helps to “pump” nutrition into the joint helping the joint to heal quicker than relying on nature alone.
Lastly, I wanted to talk about what we see on x-rays and how they help our doctors make the correct recommendations for our patients. When we see patients in our office, we will often recommend that we get a picture of the spine. We equate this to when an architect makes a drawing of a home for a contractor to follow. X Rays give us the ability to see several things about the spine that may be important to us when making our recommendations.
First off, we want to see if there are any bone or joint changes on the x-ray. An x-ray can show fractures, and congenital anomalies but the x-ray may also show us if there is any degeneration occurring in the spine. Degeneration is sometimes talked about as arthritis of the spine. The term “itis” means inflammation in medicine and “arthro “ means joint. Therefore, when there is an inflammation of the joint, the joint may go through some very physical changes that are easily seen on an x-ray film. This degeneration tells us a lot about the patient. It can give an estimate as to how long the body has been breaking down and in which area the spine has the most stress.
The second thing we will look for is the shape of the vertebrae themselves as well as the space between the vertebrae. Prior to this article, I mentioned the importance of the disc. When the vertebrae are closer than we would normally like to see, this could indicate that the integrity of the disc is compromised. Doctors of chiropractic are trained to help use an x-ray, which is a two-dimensional picture of the spine to help create a treatment plan along with the physical exam that is done in our office. This treatment plan will outline:
What is the cause of the pain or loss of function?
Approximately how long did the problem take to get this bad?
What is going to be needed to get the patient well?
An important point is that just because a patient comes to the office today with pain does not mean that the problem started that day. Cardiologists see patients with advanced heart disease or heart attacks. They understand and educate their patients that a heart problem didn’t start the day of the first symptoms, but rather years or decades ago. They understand, as we do in chiropractic, that problems take a long time to develop and that pain is the last indicator that something is wrong. Undformatnualy in our quick-fix society we tend to forget this and expect the pain to go away as fast as it came on. Therefore, the last point I want to make in this article is the importance of giving your body the time necessary to heal.
I doubt many of us would expect a broken arm to be healed in a day, or that a cut finger would heal as quickly. No, we understand that healing takes time. When we see patients in our office, this is an important concept for our patients to understand because there can be the inclination to believe that you are better after an adjacent or after one decompression session. This just is not the case and can lead to a patient’s condition worsening over time to the point that arthritis and degeneration get so bad, all that will really help them at that point are pain medications. Our goal is to avoid this and to educate all of our patients on how they can take care of their spines. It is not hard to do, but I doubt anyone (except maybe a chiropractor) has helped to teach you this.
This does not mean that if a problem took 10 years to develop that it will take 10 years to heal, as a matter of fact, the body has the ability to heal very quickly, however, very quickly is in a few weeks to a couple of months. Not 1 or 2 visits. Fortunately, our doctors are great at explaining this to our patients and most get it and understand. What is really important about this concept is the ability to maintain feeling good for a long period of time. If you work with our doctors to get your problem stabilized and then strengthened, and finally if you follow a program of preventative maintenance once we have discharged you from your treatment plan, you can expect, like the vast majority of our patients, to have success well into the future with your body.
To summarize this article I want to emphasize that there are many reasons for low back pain. They range from disc issues to pinched nerves. The type of treatment that you should get depends on the type of problem that you have. In our office, we have many years of experience dealing with the low back because we have treated many patients with these complaints. Further our office is particularly suited to help you because we have treatment tools, such as decompression tables, class IV lasers, and treatment protocols to get you well and keep you staying well.
I hope this article was useful in your understanding of what causes pain in the low back and how modern chiropractic provided in our office care can help our patients without the use of addictive medications or surgical procedures.
