Chiropractic care for back pain
“Oh my aching back!”
Have you ever uttered these words? Has a friend? Back pain and neck pain are a common problem, in most circumstances one best handled by a chiropractor. Chiropractic training concentrates on the spine and musculoskeletal system and this makes a chiropractor uniquely qualified to effectively treat these problems.
What causes back pain? Briefly, the structures of the spine and surrounding muscles are nerve-rich, which means that when you injure you back they transmit pain signals to the brain. Sometimes it seems like it doesn’t cause much to create back or neck pain and there are various reasons for this. First of all there’s not much free space in your back! Even a little swelling can cause pressure on the nerve rich structures.
When you first come to my office you fill out a detailed health history form. This is crucial to get an overall history of your health and history of injuries and any underlying issues. Then we sit together and review your history so I have a clear understanding of your needs and expectations. Then I perform a thorough exam comprised of orthopedic, neurological, and chiropractic tests. I can see if swelling is present, muscle spasm or imbalances, diminished range of motion, and joint misalignment. If swelling is present it can be reduced by gentle interferential therapy and ice, which diminishes swelling and reduces pain. In most cases, I will also adjust you on your first visit. If I think x-rays are required in your case I will send you out to an imaging center. If you already have x-rays, x-ray reports, or MRI reports it’s very helpful if you bring these with you.
If it seems that an injury shouldn’t create as much discomfort as you are feeling it may be because you have underlying problems with your back. There may be an older injury that was left untreated, or it might be due to muscle weakness, tightness, or imbalances that have finally become bad enough to be symptomatic. For example, if some of your back muscles are too tight, and others are too weak, this creates un-equal forces into the spine that can cause problems to develop. This situation can cause an uneven gait, un-equal use of limbs, poor posture, all of which can ultimately lead to back pain. I assess these issues by identifying which muscles need to be strengthened, which made more flexible, and instructing you in “home-work” to make these changes. Being out of alignment can also trigger muscle imbalances by causing less nerve input to the muscle, usually causing it to become weak. Restoring the nerve flow to the muscle through chiropractic adjustment is a large (and in some cases, the only) way to make a correction.
To discuss your treatment options to ease back pain, call our office to setup an appointment.
Muscular sources of back pain:
Sometimes back pain is caused by a muscle spasm. Overuse or mis-use of a muscle can cause it to over-contract and generate pain. Weak muscles will often become painful and this pain can often quickly resolve with corrective strengthening exercises. If a joint is sprained, the muscles around it will spasm in an effort to “splint” the joint. This is referred to as splinting muscle spasm and causes pain and stiffness, but rather than treat it with muscle relaxants which would render the joint more vulnerable, it's best to have a chiropractor treat the joint; and the muscles will then automatically relax as the joint heals. Splinting muscle spasm in the lower back is often caused by sacroiliac sprain, easily addressed in my office.
Anatomy of the back and sources of back pain:
Each vertebra of the spine has six joints and each joint contains pain sensitive nerve cells called nociceptors. Each vertebra articulates (joins) with the one above it and the one below it via four facet joints, and the connecting two discs on top and below. All these joints are nociceptor-rich, so, when there's an injury or simple mechanical misalignment these nociceptors send pain signals to the brain.
Disc injury and swelling is a common source of back pain. The disc acts as a sort of washer, or space holder, between the vertebra. The disc is basically tough fibrous tissue surrounding a viscous little fluid sack. The fluid sack is known as the nucleus pulposus and supports the axial (downward) weight of the body. It also acts as the pivot point for rotation in the spine. The fibrous part of the disc, the annulus fibrosus, surrounds the nucleus pulposus and is made of tough layers of tissue who's main function is to contain the nucleus pulposus. Interestingly, pressure on the nucleus pulposus is greatest when sitting.
The annulus fibrosus is very tough, but is weakest under the forces of pressure and torsion combined (think of shoveling snow). The annulus fibrosus can be torn from injury due to pressure and rotation, but also from degeneration: plain old wear and tear.
Swelling of the nerve rich disc can cause pain by itself, or if the swelling impinges on a nerve exiting the spine it can irritate this nerve, and pain can be felt anywhere along the course of the nerve. Sciatica, for example, is, is pain along the course of the sciatic nerve, which exits the vertebra of the low back and travels down the back of the thigh and calf, into the foot. Pregnancy is a common time for sciatic pain and should be assessed at our office. Weakness and tingling may also be a sign of nerve impingement and needs to be assessed.
If the disc is injured or degenerated enough to rupture, a slow leak of the fluid of the nucleus pulposus causes intense pain by releasing cytokines (biochemicals produced in cells) that irritate surrounding structures. Most ruptures need surgical correction but in some cases may resolve with more conservative treatment.
To discuss your treatment options to ease back pain, call our office to setup an appointment.