Back Pain Treatment

Back pain is the most common problem for patients in my office.  Over the past 15 years, I have gotten very good at treating it.  Although chiropractic care cannot cure all low back pain, I would estimate that 85% of the people who seek care for low back pain at my office leave feeling better.

If you have never been to a chiropractor, you may be unsure of what happens at a visit and whether or not it is safe.  Chiropractic has historically been poorly understood and there is still a lot of misinformation floating around.  I will not address every bad or incorrect thing I have ever heard.  Instead, I will detail an average visit and treatment plan.

When a new patient comes in for their first visit, there is paperwork (no surprise!) that will not only include the current pain, but also a complete health history.  Every person has a unique history and this history is important.  Then, there will be a review of the symptoms and health history.  This will include things like "what makes your pain better or worse" and "what are you unable to do."  Next, an examination will be performed.  That will include things like range of motion, orthopedic testing, and palpation (a hands on type of examination that can detect muscle spasm, swelling, joint restriction and other things).  After that, I will take a few minutes to explain my initial impressions of the problem, whether or not further testing is needed, and what, if any, treatment would be appropriate to start that day.  

Unlike many offices, I usually start treatment on the first visit.  Depending on the level of soreness and whether or not X-Rays have been ordered, I may modify care for the first 1-3 visits to make it more gentle or general.  There are certain things that are safe to do for almost any cause of low back pain.  I will stick with those if there is some uncertainty or I am waiting for further test results.  These will include passive modalities like ultrasound or electrical muscle stimulation.  I will also utilize muscle massage techniques and flexion distraction (a specialized form of manipulation through gentle traction).  I may also use an activator, which is a gentle, mechanical tool for adjusting.  Treatment is always based on patient tolerance.  In other words, I will not cause the patient undue or severe pain.  The "no pain, no gain" philosophy does not work well, as it triggers inflammation and a worsening of pain.

Treatment will generally last anywhere from 1 week to 3 months depending on the severity and cause of the problem.  During that time, the treatment may evolve several times, moving to more active or hands-on treatment.  The frequency of treatment will also decrease as the patient progresses.   My rule of thumb is 1-2 visits of no pain prior to release.  That ensures that the patient is stable and is less likely to have their pain return as soon as they stop care.

Chiropractic care looks similar, although not exactly the same, for most low back pain.  This is because treatment is aimed at restoring proper movement and function and not curing a disease.  I often say to new patients "the goal is to make your back function as close to perfectly as possible.  If it is moving correctly, it doesn't usually hurt."  It's simple, but it makes sense.  That approach is safe and effective for treating everything from a muscle strain to a disc herniation.  It works well for arthritis, too.  Even if you cannot make it perfect, you can almost always make it move and function better, which will reduce pain and increase abilities.  To me, that is what chiropractic is all about.

Be well!