Low Back Pain
Low back pain is not normal
It is common but it is NOT normal. If you have low back pain it means that something is going on. Your body’s nervous system serves as an alarm system to alert you to problems. If the nerves that come out of the lower part of your spine are pressured you will feel pain either at the place where the nerve is pressured or where that nerve runs to. That pressure can be relieved and that is what we will cover today in this article.
First, to get an understanding just how prevalent low back pain is lets look at some statistics
- Back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
- It is the second most common reason for visits to the doctor’s office.
- Experts estimate that as much as 80% of the population will experience back pain at some point in their lives.
- American spend at least $50 Billion each year on back pain. That’s BILLION with a B!
Now, what is the process
The process that has been followed most commonly in the past when people have gone to their medical doctor with low back pain complaints? Examination, pain killers, muscle relaxants, expensive testing, referrals to expensive specialists, physical therapy and if you’re really unlucky…surgery. The problem with this approach is that the vast majority of low back pain is a structural problem but most people look first for a medical solution. This is a major reason why we have such a crisis with opioids in this country. Many people develop an addiction from a subscription they received for low back pain. When they can’t get another prescription, the need for the feeling doesn’t just disapper. The street cost of their medication is 5-10X more than a drug like heroin, one of the most addictive substances on the planet. Lives have been ruined for the simple mistake of trying to resolve a structural problem with a medical solution.
Another major problem
A major problem we see is the recent explosion of spinal surgeries. In 1993 there were 150,000 spinal fusions, which is a surgery that fuses two or more vertebrae together, taking away all of the natural motion of the segment. In 2007 there were 350,754 spinal fusions! At an average cost of about $75,000, not to mention the months of rehab needed and weeks of lost work, it is a steep price to pay. Surgery is always available as a last resort, but as I always tell my patients, if it was my back I would want to try EVERYTHING conservative first.
Lets talk a little about the three most common structures
The structures that we see causing the problem in our office. That is the spinal vertebrae, the supporting spinal musculature and the spinal discs. As you can see in this picture the nerve that comes out between the vertebrae is surrounded by all of these structures. If any of these impinge on the nerve itself it will create that low back pain. Now in our office we make sure to address all three because they are so interconnected. The muscles can be tight on one side of the spine causing rotation of the vertebrae which then presses on the nerve. Or the vertebrae may not be moving correctly which causes the disc to not function properly, causing it to bulge and hit the nerve. As you can see there are many ways low back pain can be caused.
How to Solve the Problem
Now that you understand how the vast majority of low back pain is caused you can understand how taking a pain killer or muscle relaxant to take away the pain isn’t going to solve the problem. If you have a vertebrae that is pressing on a nerve, until that pressure is removed, you will continue to have pain. If you have a disc bulging against a nerve, until you get that disc back in its correct space, you will continue to have pain. If you have a tight muscle on one side, causing inflammation and pressure around the nerve, you will continue to have pain. Our goal is to remove that pressure and in turn remove that pain. But before we get into how we help our low back pain patients lets go over some things you can do on your own.
The key to avoiding low back pain
Is to do preventative things everyday. Even if you already are suffering from low back pain these strategies will help you recover quicker, especially if it is a newer, simpler problem. I want to show you three stretches, three exercises and a couple of tips to avoid pain when you are in the car.
3 Tips To Travel Without Low Back Pain
- Remove Your Wallet
- Move Closer To The Steering Wheel
- Add Lumbar Support
Okay, you tried everything on your own. Now what? This is the point that I would suggest to see a chiropractor as your first contact, and obviously if you live near Hillsborough, NJ I would suggest to see a chiropractor at our office. But Dr. Loniewski, aren’t all chiropractors and chiropractic offices the same? Absolutely not. Chiropractors and offices span a large spectrum. There are a few reasons I think our office is the best in Hillsborough:
- We have the largest and most diverse set of state of the art equipment of any chiropractic office in the state of New Jersey
- We have multiple types of providers that focus on different areas including chiropractors, massage therapists, functional fitness experts and nutritional health coaches
- We have a 2,000 sq ft functional fitness facility as well as massage therapists and a spinal decompression table in the office which allows us to service all of your natural spinal health needs.
- Our staff is the friendliest in town!
Lets get into the three ways we help the most
First and foremost is the chiropractic adjustment. Your nervous system is the basis of all of the function and feeling in your body. Without it functioning properly your life will not be optimal. You spinal column is what protects your spinal cord. The spinal cord is the highway that the information from the brain to the body travels. The spinal nerves are the branches that come off the spinal cord that actually gets the information out to the body. The spinal cord is made up of 24 moveable vertebrae. If those vertebrae stop functioning properly or get stuck out of alignment it can create inflammation and pressure on the nerve. What we do as chiropractors is assess the spine for proper motion and alignment. If we find any issues in either realm we are able to deliver a spinal adjustment to help alleviate the problem. If the adjustment holds and the inflammation and/or nerve pressure are removed the pain will be gone and we can then work to strengthen and stabilize the area. The adjustment is the base which we work from because it addresses the most common issue that causes low back pain. Watch this video of how a chiropractic adjustment is performed and how it helps.
The next most important thing
We look at in our office is the intervertebral disc. This acts as a cushion and shock absorber for the spine. The disc is dependent on the spinal segments moving the way they are supposed to. It doesn’t have its own blood supply so it stays healthy and hydrated through a process called imbibition. This means that when the vertebrae move the way they are supposed to it draws water into the disc and keeps it full. If the vertebrae stop moving as well as they are supposed to the disc can start to dehydrate. When this happens the fibers that hold the nucleus can begin to tear. The nucleus is a gelatinous material so it will move into an empty space created by a tear. If enough of these fibers tear the nucleus will move closer and closer to the outside of the disc.
Eventually the disc will bulge into the space where the spinal nerve resides, or worse, into the spinal cord. If this happens, as we talked about before, the nerve will be pressed and you will feel pain. If enough of the fibers tear the nucleus can actually rupture and come outside of the disc. At this point it is much more difficult to treat and this is why we strongly encourage people to tackle these problems when they are small instead of waiting until they are an emergency. For disc issues we love our flexion distraction table.
If we are able to get the vertebrae moving well again and strengthen the muscles around the disc then the disc has the opportunity to begin to heal and get back to normal. This is such a key part of our care and most offices do not have the equipment necessary to address this issue.
The surrounding musculature
This is our final thing that we want to address. We want to look at two things. Hypertonicity and hypotonicity. Meaning tightness and weakness. Tight muscles will put pressure on the vertebrae and not allow them to move correctly or go back into the proper alignment. Weak muscles will create instability in the spine meaning it will move too much and cause irritation. So when we do our exam we do functional movement tests to determine where the tightness and weaknesses lie. For tight areas we use different soft tissue like IFC, massage and stretching. For weak areas we create a custom plan to be done at home, in the office or both. This plan will give you functional movements that will target with precision the exact areas you need to strengthen to stabilize your spine. Without addressing the surrounding muscles you run the risk of ending up in a never ending loop of the same problem. Our goal is always to help you get better and stay better long term.
I hope this blog was able to shed some light on what a complex problem low back pain can be, but I also hope that it simplified it to the point that you understand now that a mechanical problem always has a mechanical fix. Rarely, does it have a medical one. If you are interested in working with us and would like to join the thousands of other Hillsborough residents that have been helped in our office give us a call at 908-431-7700 or visit us online at www.LivingWell4Life.net.