Chiropractic + Wellness

An overview of chiropractic treatment for lower lumbar back pain, how it works, how safe it is, and how often treatment is necessary. Along with the principles of chiropractic for the relief of lower/lumbar back pain, whether acute or chronic. Seeing a doctor of chiropractic/DC, a chiropractor or a chiropractic physician can be highly beneficial towards effectively treating low back pain.

Practice 

Chiropractic medicine utilizes a variety of treatments/therapies that are designed to manipulate/adjust the:

• Spine
• Joints
• Tissues

These treatments focus on the entire body to relieve pain and improve functional ability. This is referred to as spinal manipulative therapy or SMT, but there are many other treatment methods and techniques.

Every chiropractor has a personal treatment approach based on the patient's condition/s, medical history, and personalized treatment plan. A chiropractor will begin traditionally starting off with soft, natural, less-invasive treatments. If these do not generate positive results they will move on to more aggressive techniques.

Consent Form

At every stage of the chiropractic process, there is a strict emphasis maintained on proactively discussing with the patient exactly what is taking place and what is going to happen. A chiropractor makes sure that the patient understands everything that occurs during:

• Diagnosis
• Examination
• Procedure/s

This is all done in order to educate the patient and receive direct permission to start the treatment. The emphasis on informed consent is essential. This is because some chiropractic techniques could carry material risk. This means that a certain technique or particular procedure could possibly cause injury.

A chiropractor also informs the patient of the possible risks of not being treated. It is not meant to scare a patient. It is to eliminate any misunderstandings and make sure that the patient has full control over their body, so they can make an informed decision, as to which way they want to go.

Examination

A chiropractor will thoroughly examine a patient before making any sort of diagnosis or treatment plan. The assessment can include:

Medical history

The characteristics of the pain, any red flag symptoms that require further diagnostic testing will be conducted to remove any potentially serious medical issues that can be associated with neck or lower lumbar back pain-like:

• Neurological disorders
• Fractures
• Infections
• Tumors

There can be many reasons as to why low lumbar back pain happens. A chiropractor will investigate and develop a personally customized treatment plan. Next, a physical exam will be performed. This includes an orthopedic and neurological exam. These will test the:

• Reflexes
• Sensory nerves
• Joints
• Muscles
• Other areas of the body

Advanced Diagnostic Testing

Imaging and laboratory tests are not always used for non-specific lower lumbar back pain, but they could be necessary if there are signs/symptoms of an underlying condition.

Severity/Duration of Condition

Chiropractic medicine looks at the symptoms and conditions of an injury or ailment and classifies them on how severe they are, and how long they last. Symptoms can be divided into degrees of severity: They are:

• Mild
• Moderate
• Severe

For the duration period, pain and other symptoms are referred to as:

• Acute pain - lasts for less than 6 weeks
• Subacute - lasts between 6 and 12 weeks
• Chronic - lasts for at least 12 weeks
• Flare-ups - the same symptoms happen irregularly or from an exacerbation of the original injury

Treatment Trial

If an individual is dealing with acute or subacute lower lumbar back pain, then a chiropractic trial could be an option. This could be two to three weekly sessions over the course of two to four weeks adding up to twelve total sessions. This can be a sufficient treatment to completely alleviate the pain. However, when the pain does not go away then additional treatments could be necessary, especially if an individual has other issues/conditions.

Measured Outcomes

Outcome measurements are a valuable tool because they help determine whether or not the treatment is producing significant results. Some outcome measurements of treatments include:

• Numeric Pain Scale for patients to rate the pain
• Pain diagram so patients can describe the location and character of the pain
• Increases and decreases in normal daily practices, like work, exercise, and sleep
• Testing functions
• Lifting ability
• Strength
• Flexibility
• Endurance

For some low lumbar back pain could last and go over the 12-week mark making it a chronic pain condition. A chiropractor will look for signs/symptoms to see if there is a risk of developing chronic pain.

Chiropractic How Often

When the pain is acute lower lumbar back pain, a standard treatment plan can be six to ten sessions over the course of two to four weeks. These treatments emphasize the passive non-exercise approach of manual therapy for relieving pain and improving function.

If the non-exercise method doesn't deliver positive results then a more active exercise-based treatment can be utilized to increase function and return an individual back to normal life.

Back Pain That Doesn't Go Away

Often acute symptoms are resolved within the first 4-weeks. But it is possible that the pain can become chronic, meaning that it lasts longer than 12 weeks. Some individuals can hit a plateau during the recovery process.

This is referred to as MTB or that the patient has met the therapeutic benefits. A chiropractor will want to see if pausing/stopping chiropractic treatment will have a residual effect, exacerbate the pain, or reduce function and activity.

Example: If mild to severe chronic lower lumbar back pain has worsened, a patient could need one to six more visits with each pain episode. And this would be two to three weekly treatments for two to four weeks. However, patients rarely need continuing or ongoing care of one to four visits per month.

Re-Evaluation

Chiropractors will not continue treatment/s if they are not helping the patient. Therefore, every 2 to 4 weeks there is a re-evaluation of the patient to see if the treatment is still having a positive and beneficial effect. Here are some of the criteria for continuing treatment:

• Individual still responds positively to the treatment
• The individual has met the therapeutic benefits and worsens when they are not treated
• Proof shows that self-care alone will not be sufficient to maintain the therapeutic benefits

Continuing Treatment

Living with chronic lower lumbar back pain can be a challenge, but chiropractors want to emphasize to individuals that self-care is an essential component for pain management. This includes physical rehabilitation combined with range-of-motion exercises. A chiropractic physician may encourage a variety of treatment options, like:

• Acupuncture
• Massage therapy
• Crossfit Rehabilitation
• Yoga
• Pilates
• Health coaching
• Psychosocial counseling
• Other beneficial treatment options

Chiropractic treatment and the benefits are different for everybody. This is why it is important to communicate with your chiropractor every step of the way and to be open-minded about the different treatment options they offer.

Why Chiropractic Works

Back and low back pain can strike without warning.

It can come from bending over or lifting something and then you're stuck, unable to move.

However, muscle spasm in the low back is a common occurrence.

Eight out of 10 adults will experience back spasm along with back pain during their lives.

The cause of back pain and spasm can come from:

• Overuse
• Accident
• Sports injury

But a lot of times the root cause of the muscle spasm can come from a tiny injury to one of the structures in or around the lumbar spine.

If there have been one or more episodes of muscle spasm, more than likely it's going to happen again.

The muscles in the low back all work together with the abdominal muscles.

If they weren't there, then extension and lateral movement of the spine would be impossible.

The back muscles provide stability and keep the spine erect and balanced.

The balance can be compromised when spasms present along with an injured lumbar joint or disc.

Muscle spasms

These muscle spasms are involuntary and are contractions that happen spontaneously.

When the spasms occur out of the blue, the triggers are preceded by a series of small strains to the spine which develops over time.

Once the injury is active the inflammation sets in.

Then the nerves become overly-sensitive which causes the muscle/s to contract and spasm.

Disc Disorders & Spasms

Degenerative disc disease or a herniated disc can cause episodes of low back pain.

A herniated or bulging disc can compress a spinal nerve root, which causes irritation and inflammation.

The body tries to control the affected area by tightening the surrounding muscles and that's when the spasms happen.

Muscles can become too tight because of:

• Lack of exercise
• Too much exercise
• Structural imbalances
• Dehydration
• Electrolyte loss
• Combination of all above

Conversely, there can be muscle groups that have become too weak.

Imbalances present themselves and chronic force is transmitted to the spine in a bad way.

Even a single off movement can trigger an injury to a:

• Spinal joint
• Ligament
• Disc

And this results in spasm and back pain.

Muscle spasm in the low back can be very painful and debilitating over a short period.

Treatment

When it starts:

• For the first 48 to 72 hours apply ice for 20 minutes and then every two hours while on your back.
• Always use an ice pack and never apply directly to the skin.
• After 72 hours then apply moist heat, which can be done with a heating pad.

If this does not work, try soaking in the hot tub, with Epsom salt.

Heat increases blood flow to:

• The affected area
• Relaxes tight muscles
• Relaxes irritated nerves

Also elevating the legs takes the pressure off the spine and can help relieve pain.

Over the counter medications like Aspirin or ibuprofen can help reduce inflammation and pain.

Discuss with physician or healthcare provider regarding dosing regimen most suitable.

There can also be a combination of therapies

• Rest
• Ice/heat
• Medication
• Chiropractic
• Massage
• Physical therapy
• Foot Orthotics

A combination of treatments often generates better results than only one therapy.

Prevention

Once the spasm has passed, and the inflammation has subsided focus on prevention:

• Stretch - Incorporate stretching exercises daily, muscles benefit from gentle stretching.
• Pilates or yoga can work wonders and always stretch before physical exercise.
• Get fit - no regular physical activity can lead to serious conditions and possibly chronic pain.
• Exercise benefits all, even some light walking around the neighborhood is enough. Just get moving!
• Playing a sport could be a way to keep active. Remember, in order for any exercise to work is that it is done regularly.
• Strength training is important, just as its name implies strength training builds muscle and reduces muscle imbalances.

It’s never too late to increase strength and flexibility.

Look at activities that you and your friends/family can enjoy and make doing them a regular thing.

A chiropractor is the ideal medical professional to consult with for any unexplained pain in the musculoskeletal system. They are highly qualified professionals that their specialty is treating conditions like lower back pain and they are very affordable. If you or a loved one have pain in the lower back, give us a call. We’re here to help!

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