For patients with chronic low back pain (cLBP), treatment guidelines recommend a non-surgical approach as the FIRST-LINE treatment. Ideally, the goal would be to avoid an initial surgery unless it’s absolutely indicated. That means, unless there is loss of bowel or bladder control or retention (which represents a medical emergency) or if there is progressive neurological motor and sensory loss, one can safely avoid surgery and conservatively manage the condition.
Interestingly enough, a systematic review of the results from three randomized controlled studies carried out in Norway and the United Kingdom found the outcomes or results between the surgical fusion vs. non-surgical treatment of patients with cLBP showed NO DIFFERENCE at an 11-year follow-up!
Studies have shown chiropractic to be highly beneficial for acute and chronic low back pain cases. In one study, researchers reviewed data on 72,326 cLBP patients in the Medicare system who received one of four possible treatment combinations between 2006 and 2012: 1) chiropractic only; 2) chiropractic followed by conventional medical care (CMC); 3) CMC followed by chiropractic; 4) CMC alone.
The research team found that chiropractic care alone (group 1) resulted in the lowest costs, and these patients had lower rates of back surgery and shorter episodes of care.
The group receiving CMC alone (group 4) had the highest costs, with the second and third groups being similar—both costing less and being more effective than CMC alone.
The conclusion of the study reads, “These findings support initial CMT [chiropractic manipulative therapy] use in the treatment of, and possibly broader chiropractic management of, older multiply-comorbid cLBP patients.”
Chronic pain is frustrating. Back pain and neck pain can pop up as the result of an injury or from an existing condition, but a lot of times our daily activities are to blame. Here are six common everyday activities that you may not realize could be causing your pain.
1. Driving – Driving for long periods of time is sure to generate some stress on your lower back, especially if you’re not using correct posture. If you have a long commute to and from work or you are required to drive for extended periods, consider purchasing a lumbar pillow to place behind your back for added support. And always sit up straight with your back completely against the seat.
2. Sleeping – Another culprit of back and neck pain is your sleep position. If you’re waking up with a sore back or neck, consider altering your sleep posture. Stomach sleepers tend to have the most complaints because that position places stress on your spine - especially your neck, since you must turn your head to breathe. We encourage you to sleep on your back with a pillow under your knees, or on your side with a pillow between your knees.
3. Sitting at a desk all day – Studies have proven that sitting for prolonged periods of time is detrimental to our health. Combat your sedentary day by moving more. Take small walking breaks every 30 minutes and use proper posture at your workstation. You may also want to consider using a standing desk.
4. Using your phone or tablet – Repeatedly looking down at devices throughout the day puts excessive stress on your neck, causing a condition we refer to as “Text Neck”. Limit time on your devices and when you must use your phone or tablet, hold the screen at eye level to prevent hunching over.
5. Carrying heavy bags – Whether you tote around a backpack throughout the day or have a heavy purse, your neck and spine can be at risk from the excessive weight. For backpacks, we recommend using both straps and keeping the pack as close to your body as possible. You could also opt for a rolling bag to help save your back. For purses, only bring with you what you’ll need for that day, and be sure to switch arms often.
6. Doing chores – Putting clothes in the washer and dryer, loading and unloading the dishwasher, vacuuming, and all life’s other necessities are possible precursors to back pain from repeated bending and twisting. The key to preventing pain is always to be aware of your posture and work on correcting it whether you’re standing, squatting, bending over, or carrying heavy loads. One trick is to imagine that you have a fluorescent light tube strapped over your spine, from your head to hips. Try not to break the bulb when you move.
If you’re one of the 90% of people that end up experiencing back pain at some point in your life, contact us to help you pinpoint the exact cause and develop a treatment plan that helps you recover quickly.
Summer is winding down, and families across America are gearing up for the beginning of a new school year. Help your kids (or yourself) start the year off right by considering some of our healthy back-to-school tips.
Although backpacks are practical, carrying around heavy books and supplies every day can cause discomfort and injury over time.
Be sure to do a quick backpack check:
Encourage your child to practice good posture when sitting in the classroom. Hunching over the desk for hours every day is sure to cause discomfort.
To sit at a desk correctly, they should:
Safely Return to Sports
Back-to-school also means back-to-sports for many kids. Remember that if your child was inactive in their sport for a couple of months, they might need to ease back into it. Always encourage them to warm-up beforehand, stretch afterward, and keep their workouts reasonable for their conditioning level and age.
By being proactive in your child’s health, you can help prevent problems. If your child does experience back, neck, head, or joint pain this school year, please give us a call at 772-286-5277.
Spinal manipulation is reaching a tipping point in the United States as a well-accepted treatment for Low back pain and disability. There are abundant studies demonstrating the benefit of SMT as a stand-alone treatment for LBP; however, manipulation, when combined with exercise has even better results. (1,2) To date, most studies have focused almost solely on adult populations. There are very few studies analyzing the treatment of children or adolescents with LBP. (3) And for studies of adolescents, there have been no randomized trials utilizing manipulation as a potential strategy. Many chiropractors treat adolescents with LBP pain on a daily basis. So, is manipulation and exercise beneficial for adolescents?
Chiropractic treatment of adolescents with LBP is growing. In fact, twelve percent of children age 4-17 utilized complementary healthcare approaches. SMT is strongly recommended in the treatment of LBP for adult populations. However, management of children suffering from LBP does not have a widely accepted treatment algorithm. There is an urgent need for non-pharmacologic LBP treatment options, especially in this young population. Evans et al. set out to answer the problem in a multi-center randomized trial comparing 12 weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) to exercise therapy alone.
“For adolescents with chronic LBP, spinal manipulation combined with exercise was more effective than exercise alone over a 1-year period, with the largest differences occurring at 6 months.” (4)
Participants included 185 adolescents aged 12-18 with chronic LBP. The primary outcome was LBP severity at 12, 26, and 52 weeks. Secondary outcomes included disability, quality of life, medication use, patient-rated and caregiver-rated improvement, and satisfaction. Adding SMT to ET resulted in a larger reduction in LBP severity over the course of one year. The group difference in LBP severity (0-10 scale) was small at the end of (12 weeks) treatment but was larger at weeks 26 and 52 weeks. At 26 weeks, SMT with ET performed better than ET alone for disability and improvement. The SMT with ET group reported significantly greater satisfaction with care at all time points. There were no serious treatment-related adverse events.
Adolescents should not have chronic pain. Unfortunately, the increase in sports specialization and year-round training has led to an epidemic of children with LBP. On the opposite end of the spectrum, there is a growing number of school-aged kids with a sedentary lifestyle. Both extremes result in LBP and should be addressed. Many patients with LBP benefit from SMT to restore motion to the lumbar spine and surrounding areas. SMT is safe in adolescents and shows a more significant benefit than exercise alone.
Cliff Atwell, B.S., D.C.