Low Back Pain

Low back pain is often difficult to solve. In fact the literature shows that there is little association between pathological physical findings and the patients pain and disability. In other  words a lot is unknown about its cause from a conventional medical perspective.

What we do know is that low back pain is second only to the common cold in visits to primary care physicians. In fact 43% of the population experience back pain in a given month. Direct cost of treating LBP is $33 - $55 billion per year, and the indirect costs are $90 billion.

The Journal of Bone and Joint Surgery Volume 86-A -Number- August 2004

Many factors increase the incidence of Low Back Pain:

  • Smokers have more incidents of back pain, more disc herniations, progressive disc degeneration, poor treatment outcomes and poor healing of injured backs and necks.
  • Obesity contributes to back pain.
  • Repetitive bending and twisting can increase the risk of low back pain and disc herniation.

We know what works, and what does not work in the treatment of low back pain:

  • Bed rest for more than two days is a very bad strategy in the treatment of back pain.
  • Opioid drugs do not work for back pain over the long run and they lead to drowsiness, dizziness, fatigue, nausea, respiratory depression and constipation. They are addictive and have a reduced effectiveness after only a few weeks.
  • We know all narcotics should be avoided in the management of back pain.
  • Steroids are associated with substantial gastrointestinal injury, decreased bone mass, and degeneration of the bones of the legs.
  • Muscle relaxants do not work for chronic back pain.
  • Drugs do not achieve a lasting improvement in chronic spinal pain.

The Journal of Bone and Joint Surgery Volume 86-A -Number- August 2004

Chronic Spinal Pain: A randomized clinical trail comparing medication, acupuncture, and spinal manipulation, Spine July 15, 2003;28(14): 1490-1502

What is and effective treatment for low-back pain?

So what is the most effective form of treatment for back pain that can be scientifically validated? the answer is simple.

  • Chiropractic Manipulation - In head to head comparisons with conventional medicine, Chiropractic care has been shown to be the best choice .
  • For example in 2003, the Journal of Spine, the most prestigious medical journal published by the American Medical Association found that Chiropractic manipulation was five times more effective than the drugs Celebrex or Vioxx. This was a randomized clinical trial under the highest level of scrutiny.

Chronic Spinal Pain: A randomized clinical trail comparing medication, acupuncture, and spinal manipulation , Spine July 15, 2003;28(14):1490-1502

Joint restrictions lead to biomechanical restrictions, friction, inflammation and eventually degeneration.

Chiropractic manipulation releases joint restrictions to restore normal range of motion. The Chiropractic adjustment helps to break up the restrictions of fibrosis that forms around spinal joints. These restrictions cause friction and increased stress on the normal joint function. This increased friction may cause inflammation or just wear and tear of the joints.

This wear and tear is no small matter. Wear and tear causes Osteoarthritis, a progressive breakdown of cartilage. The cartilage is a very thin layer inside the joint. Thus it becomes very important to remove stress from the joint in order to prevent complete degeneration of the cartilage. Twelve percent of the population suffers from severe osteoarthritis.

It is very important to restore joint function if you are experiencing an inflammatory reaction as a result of these joint restrictions, particularly if you have been experiencing repeated episodes of inflammation. Repeated episodes often lead to chronic problems which effect the surrounding structures: joint capsules, ligaments, muscles, and nerves.

Spinal manipulation is a very effective way of alleviating these types of restrictions and preventing further problems.

Chiropractic Manipulation also effects soft tissue, not just the bones.

Patients often ask me how an adjustment of an osseous structure (bones) can affect soft tissue (muscles). The answer is really quite simple. In your muscles you have stress receptors called Golgi Tendon Organs. These stress receptors react to situations where muscle tension suddenly increases such as with a Chiropractic Adjustment.

These adjustments are low in force but high in velocity. This causes the stress receptors (Golgi Tendons) to inhibit all muscle activity in the surrounding area. It literally causes the entire muscle surrounding the joint to go into an instantaneous state of relaxation. A very important function when you are dealing with an acute episode of low back pain. (Guyton Textbook of Medical Physiology p691-692). This is why Chiropractic Adjustments when performed correctly are done very fast but with very low force.

Understanding Soft Tissue Dysfunction

To understand soft tissue injury, you must comprehend the basic mechanism of cumulative injury. Cumulative trauma disorder is the major injury problem in the workforce and the general population in this country. Federal statistics show that it now surpasses back pain, and has increased by 670% in the last 5 years.

Symptoms of cumulative trauma disorder are sensations of tingling, burning, aching and weaknesses. When a muscle, tendon, ligament, or nerve is damaged from trauma or overuse, the body will attempt to repair the damage with scar tissue. These scar tissue adhesions left untreated perpetuate the cumulative injury cycle and result in progressive loss of function and increased pain. Soft tissue dysfunction often leads to a loss of flexibility, strength, and range of motion. People often attribute these losses to "just getting old," but this is seldom the case.

Active Release Technique (ART) separates, releases and stretches the connective tissue adhesions, restores vascular and lymph circulations, and increases your range of motion, flexibility, and strength.

The treatments can be a bit uncomfortable, or even a little painful, but this pain is an important indicator that the problem has been located and signals that the treatments are correcting the injury. Patients often report that it "hurts good".

Regardless of your activity level you can benefit from ART. From those who are victims of car accidents --- or even the proud weekend warrior --- ART has proven to be a fast, effective, non-invasive way to heal a wide variety of soft tissue injuries.

Why Active Release Technique (ART) is Different

ART is a highly successful approach to injuries of muscles, tendons, nerves, and the surrounding soft tissue. Active Release is not massage, physiotherapy, or chiropractic care. while those procedures relieve muscle and motion dysfunction, they do not necessarily address the underlying problems caused by scar tissue formation.

ART provides a way to diagnose and treat the underlying causes of a variety of conditions. These syndromes are given familiar names like rotator cuff syndrome, tendonitis, and plantar fascitis. Other conditions that fall directly into this category are post-operative scar tissue, carpal tunnel, chronic low back pain, and hyper extension/flexion injury (whiplash).

The three most common mechanisms of injury are:

Acute Trauma

Constant Pressure

Repetitive Motion

All three are a part of the cumulative injury cycle. Soft tissue structures in the body change or adapt with time: these changes are predictable and can be felt by the doctor. Chronic or "older" injuries actually feel different from acute or recent ones.

Active Release has proven to be especially valuable for athletes, from the professional to the beginner. Ninety percent of the time athletes with acute or long-standing muscular strain/sprain injuries experience complete recovery -- in a short period of time.

Many patients experience complete recovery after only 6-12 visits, although this depends on the severity of their injuries. The bottom line is that patients get well quickly, completely, and with much less expense. In fact because success rates are so high and costs are so low, the Colorado Compensation Insurance Authority is funding a study comparing Active Release to more conventional or typical treatments for cumulative trauma injuries.

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