Lower Back Pain
Lower back pain affects about 80% of people at some point in their lives. Back pain may be classified based on duration as being:
- ACUTE (pain lasting less than 6 weeks)
- CHRONIC (more than 12 weeks)
Most acute episodes are not serious and the symptoms will reduce over time.
If you experience leg pain that moves into the calf and it is associated with numbness and/or weakness then you should call a Physiotherapist or Chiropractor immediately.
How do I know if my back pain Is Disc Related?
A disc herniation (“disc bulge”) will be diagnosed based upon specific tests carried out by your physiotherapist or chiropractor.
How does a Chiropractor diagnose a bulging disc?
When testing for a bulging disc, it is important to understand what impact a disc bulge has on the sciatic nerve that runs down the back of your legs.
When the sciatic nerve is compressed by the disc bulge it impairs the nerve supply to the muscles & skin of the legs.
Testing for a disc bulge, therefore, involves a series of tests that test both muscle function and skin sensation in the legs & feet. When the tests are positive, it is generally a strong indicator of a disc herniation.
However, negative test results does not rule out the presence of a disc herniation. Suspicion will be based on clinical findings and reported symptoms & aggravating movements.
This is where the utilisation of a skilled and experienced practitioner is key.
Tests for a herniated disc include:
- Reporting of pins & needles, numbness or sensory changes in the legs or feet
- Weakness on muscle strength testing of the leg (special emphasis is placed on strength testing of the foot)
- Foot drop (where the foot drops down towards the floor when it is lifted off the ground)
- Diminished reflexes at the foot or knee
- Decreased sensation in certain segments of skin of the effected leg (a dermatomal pattern)
None of these symptoms are grounds for panic & most can be managed conservatively by your physiotherapist or chiropractor without needing to resort to invasive surgery.
Ross discussing Low Back Pain on KFM radio:
Back Pain Specialist:
- Treating back pain since 2002 in some of the countries top back pain clinics.
- My passion & lifetime commitment to helping others is based on my own personal experience of chronic pain.
- This experience led to a personal commitment to obtain training across a range of professions so that I could utilise the best elements of each profession in order to help others.
- During my 10 years of study I have focussed on research relating to chronic back pain management & rehabilitation.
Lower Back Pain Treatment:
The best advice is remain as active as possible and avoid long periods of rest. Movement is critical!
Symptoms frequently recur with back pain and by consulting with a physiotherapist or chiropractor you can implement a preventative plan to reduce your pain and prevent the likelihood of future reoccurrence.
This will involve a combination of manual treatments and a home exercise programme designed to address your specific weaknesses.
Physiotherapy Treatment for a Disc Bulge
- Research suggests that appropriate physiotherapy & chiropractor treatment that incorporates graduated loading (weight-bearing rehabilitation exercises) can help bring about changes in the disc itself that will facilitate healing & prevent re-occurrence.
- Running has been shown to stimulate disc cell metabolism & prevent disc narrowing in rats (Wei et al., 2009).
Is Chiropractic treatment helpful for a herniated disc (disc bulge)?
- Research performed by Beattie et al., (2009) demonstrated that a single session of spinal joint mobilisation like those utilised by chiropractors increased water diffusion within a degenerated disc.
- Degenerative IVD changes are characterised by a dramatic loss of water content and disc height.The increased water diffusion correlated with a significant improvement in pain and mobility.
I have been diagnosed with degenerative disc disease. Should I be worried?
While a diagnosis of degenerative disc lease sounds serious, degeneration is a natural part of ageing. While the use of the term “disease” has negative connotations, the truth that it is less of a disease and more characteristic of the natural ageing process.
Adams et al. (2010) describes how biochemical ageing primarily effects the inner components of the disc (the nucleus) and gives rise to a “dark disc” on MRI. This is what is often highlighted to people by medical practitioners as being serious and requiring surgical intervention when, in reality, it is relatively normal.
Age-related changes occur from the inside out (Haefeli et al., 2006), progress over many years (Hassett et al., 2003) and are difficult to modify because central regions of the disc have an extremely low cell density.
Pain on the other hand is associated with discrete structural changes in the outer elements of the disc (the peripheral anulus), (Moneta et al., 1994; Videman and Nurminen, 2004; Freemont et al., 1997; Peng et al., 2009a) and vertebral endplate (Freemont et al., 2002; Peng et al., 2009b), and the consequent reduction in disc height (Cheung et al., 2009; de Schepper et al., 2010).
The outer parts of the disc are innervated (Fagan et al., 2003), have a relatively high cell density (Hastreiter et al., 2001) and nutrient supply (Ferguson et al., 2004), and can heal effectively from the outside-in (Osti et al., 1990), at least in young animals.’
In Summary: the inner part of the disc is the part that often shows up as degenerative on an MRI scan; however, the outer parts of the disc that give rise to pain are more responsive to loading & can be rehabilitated & strengthened to prevent reoccurrence.
To find out more about getting treatment visit our physiotherapy clinic in Naas.
Impact on Lifespan
New research consolidates previous findings that suggests there is a link between back pain and earlier mortality (1). The research involved more than 8000 American women aged 65 years or older, who were followed for an average of 14 years. The authors concluded that frequent, persistent back pain is associated with shorter lifespan.
A similar study (2) previously conducted that involved 1,484 Australian women aged 70–85 years who were followed up for 5-years, also identified a similar link. They found 103% higher risk of mortality associated with daily back pain.
Although the mechanisms between elevated mortality and back related issues unknown, it is clear that frequent back pain is a serious health problem. The management of spinal pain and related health conditions of older people are likely to be important factors affecting mortality rates and demands on health care resources.
How do I Prevent Recurrence of Back Pain?
Exercise is effective in preventing recurrence of back pain in those with pain that has lasted more than six weeks.
There is little evidence that utilisation of back belts are any more helpful in preventing back pain than education about proper lifting techniques.
Maintaining an active lifestyle that involves regular exercise & back strengthening is an important component of back pain prevention.
Impact on Quality of Life
Evidence for Chiropractic Treatment
A recent analysis of the scientific literature suggests that chiropractic care may be as effective as pain-killing medications without the resultant side effects associated with medications.
The Cochrane review found that manipulation provided similar relief to anti-inflammatory drugs; however, chiropractic care exposed patients to none of the risks associated with medication.
More recent research suggests that over the counter painkillers are linked to heart attacks. Recent media attention has also highlighted the grave consequences of use of opioid drugs.
Chiropractic Treatments Show Improvement in Pain & Function
Of 26 randomised clinical trials (RCT’s), 15 RCTs (1,711 patients) showed that spinal manipulation has a statistically significant association with improvements in pain.
Twelve randomized controlled trials (1,381 patients) showed that spinal manipulation has a statistically significant association with improvements in function.
No RCT reported any serious adverse event.
To read more on chiropractic treatment of low back pain go to: https://www.physioclinic.ie/chiropractor-naas/
Journal References:
Call Naas Physio Clinic Naas today on: (045) 874 682 or email us at info@physioclinic.ie
Return to Naas Chiropractor page at: https://www.physioclinic.ie/chiropractor-naas/
