Back Clinic Chronic Back Pain Team. Chronic back pain has a far-reaching effect on many physiological processes. Dr. Jimenez reveals topics and issues affecting his patients. Understanding the pain is critical to its treatment. So here we begin the process for our patients in the journey of recovery.
Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting.
Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.
Chronic back pain can have real effects on your day-to-day life and your mental health. But you and your doctor can work together to treat it.
Do call upon us to help you. We do understand the problem that should never be taken lightly.
Understanding chronic pain and its alleviation requires an understanding of the anatomy of the nervous system. The nerves of the body are the carriers for the nervous system, as it sends messages to and from the brain. It is quite a complex system. The central nervous system consists of the spinal cord and the brain. The peripheral nervous system branches off the spinal cord.� Both the central and peripheral nervous systems can be affected by neuropathic pain, a type of chronic pain caused by nerve malfunction.
The peripheral nervous system contains 31 pairs of nerve roots that extend from the spinal cord to the rest of the body. There are the feeling nerves/sensory nerves and moving nerves/motor nerves. The chart shows how many pairs of spinal nerves are at each level of the spine.
The somatic nervous system is comprised of nerves that connect to the musculoskeletal system’s:
It’s what helps generate feeling and what generates the feeling of pain.
The autonomic nervous system controls the involuntary functions of the body.
It makes sure the heart keeps pumping and the digestive system breaks down food correctly without thinking. Damage to any nerves can lead to the development of chronic pain. The nerves are responsible for sending pain messages, and if they get damaged, they can continually send a steady stream of pain messages.
Nociceptors are another important part of the nerve body. Nociceptors are receptors at the nerve endings, which are activated when something happens and triggers a pain message.
Example: Nociceptors�in the finger turn on and send a pain message through the peripheral nerve to the spinal cord, on to the brain when a finger gets smashed in the car door. Before the finger was smashed, the nociceptors were not on because there was nothing to make them respond.
One possible cause of chronic pain could be malfunctioning nociceptors. Even if there is not a direct or root cause, they could be continually sending pain messages. Using the same example of the finger smashed in the car door. The finger heals after the smashing but pain signals are still being sent. The�finger’s�nociceptor’s nerves could be malfunctioning, which is why they are still sending pain messages. The result is chronic pain.
Chronic pain is pain that does not stop for more than 6 months. Pain is a subjective experience, it is different for everyone and takes on many forms. The pain could be:
Chronic pain can lead to other problems, specifically social, psychological and emotional. It can:
These added conditions feed off each other. Example: Sleeping is impossible when the pain is active, the next day nothing gets done because of the tiredness. As a result of the inactiveness, a loss of self-esteem begins to set in causing withdrawal from family and social life.
To get the best treatment possible, take note of activities, diet, accidents, injuries, etc before the pain began. Depending on the diagnosis, chiropractic care could help. Research studies have shown that two weeks of regular adjustments/manipulation can bring significant improvement.
Physical therapy combined with stretching and strengthening exercises is part of the treatment for chronic pain. Physical therapy could consist of ice, heat, transcutaneous electrical nerve stimulation, ultrasound, and myofascial release. A chiropractor and other pain professionals can help bring alleviation, so you can fully live your life.
Individuals can develop a herniated, slipped or bulging disc in the neck or back.�Too much stress on the disc/s whether from poor posture, being overweight, injury, aging, and an unhealthy lifestyle can increase the risk for disc problems. Herniation can be caused by a combination of factors or physical injury. Several common questions about disc problems are answered.
A slipped disc can mean a ruptured or herniated disc. We use the term slipped disc, however, the discs do not slip. Each disc is sandwiched between two vertebrae that are supported by a system of ligaments that hold the spine together. A bulging or herniated disc is the proper term.
Disc disorders are categorized as contained or non-contained. Bulging disc is an example of a contained disc disorder.
A bulging disc has not broken open meaning the nucleus is still contained inside the annulus fibrosus. The disc could protrude into the spinal canal without breaking open. The gel, the jelly interior does not leak out. The disc stays intact except a small bubble pops out.
A non-contained disc has either partially or completely broken open, and that is a herniated/ruptured disc. Imagine a closed tube�being squeezed placed under pressure, which causes the contents to move wherever they can. If a portion of the tube is weak or there is too much pressure, the contents could leak or burst out. When a disc herniates the gel-like contents could spread out to the spinal cord and nerves.
The disc’s gel-like nucleus has a chemical that irritates the nerves and causes them to become inflamed and swell. The chemical stays and continues to press on the irritated nerves. Sometimes fragments from the disc wall or the tube break off from the disc and drift into the spinal canal causing other nerves to inflame and swell. Based on the type of injury and condition of the discs, more than one disc could herniate, rupture, or bulge. Sometimes injury causes a combination of disc disorders.
Symptoms of a herniated disc can include:
Sometimes, however, a herniated disc does not cause any symptoms at all. When this happens it is called an asymptomatic herniated disc. Disc/s could be bulging or herniated, but if it or they are not applying pressure on the spinal nerve/s or the cord, symptoms like pain may not present. This makes a point about herniated disc symptoms that they are dependent on where you have a herniated disc.
With a herniated or bulging disc in the neck, then you could experience:
With a herniated disc in the low back the following symptoms could happen:
Referred pain means that you have pain in another part of the body from the disc problem. An individual could have a bulging or herniated slipped disc in the low back and have pain in the leg. This is lumbar radiculopathy or sciatica. Usually, just one leg is affected. If you have a herniated disc in the neck, there could be referred pain going down the arm and into the hand.
A chiropractor can help relieve back pain and other herniated disc symptoms. A chiropractor will go through your medical history, do a physical exam, and perform orthopedic and neurological tests. They are looking at several things. Orthopedic and neurological exams can help the chiropractor figure out what’s going on.
They will carefully look at posture, and will probably order an X-ray or MRI to help with the diagnosis.
Chiropractors evaluate the entire spine. Even if you only have lower back pain, your chiropractor will examine your neck, too. They want to see how well your spine is functioning overall. Remember what happens to one area of your spine can influence another part of the spine and/or body.
Pain from a herniated disc can make it difficult to enjoy daily life. Walking, sitting, and sleeping normally/comfortably can become a nightmare. You should make an appointment with a doctor or chiropractor if your herniated slipped disc symptoms last for more than two weeks.
In the United States alone, acute cases of lower back pain are the fifth most frequent reason for doctor visits and cause 40% of missed days off work. What�s more, it is the leading cause of disability worldwide.
More and more individuals are looking to add or try out complementary, alternative or integrative treatments for their back and neck pain. To help understand the differences as well as the similarities between the terms, try to remember:
Choosing the right practitioner for your spine problem whether osteoarthritis, chronic back pain, or whiplash is just as important as choosing a medical physician or chiropractor.
You want to find an alternative or complementary/ integrative professional who is
A good place to start is to ask your primary care physician, chiropractor for a referral. Others include:
Credentialing, licensing and certifying are terms you will find when learning about a particular complementary alternative medicine clinic or practitioner. Credentials can include the practitioner�s education, where and what they are allowed to practice. Certification in a particular field of practice like acupuncture, for example, is typically needed before the state issues a license and allows the professional to begin treating patients.
You can check your state�s mandatory licensure process for the type of complementary, alternative or integrative practitioner or clinic you are looking into. Most states require the practitioner to register their education, graduation, training, and continuing education credits. Your state agency can provide this information explaining what services the practitioner is allowed to provide such as the ability to provide dietary supplements.
Questions to think about when doing your research.
Treatment or therapy that the complementary, alternative or integrative practitioner/clinic provides is considered non-medical.
These practitioners need your medical history, that includes over-the-counter and prescription medications, allergies, prior treatment like surgery/spinal injections along with vitamins/supplements you take. Additional information that could be needed is the contact information of your primary care physician or the doctor who referred you. Keep your primary physician/chiropractor informed about all treatments or therapies you will be receiving.
The spine is the primary support for the body. When it breaks down, the body suffers.�Regular chiropractic treatment ensures that the spinal column remains in proper alignment which, in turn, keeps the body in proper alignment. It helps with joint health as well as the health of the related muscles and ligaments.
Q: Can back pain be hereditary and run in the family? I’m 24 and have chronic low back pain. But I found out that my mother, grandmother, and brother also have back pain. None of us were diagnosed with any type of spine condition. So I’m wondering if there is a hereditary/gene link or if it’s just a coincidence? El Paso, TX.
A: Back pain is a very common problem, and it is not uncommon that you and family members have back pain. Every year, 13 million people visit a chiropractor for chronic back pain. I can’t say without further study and research of your family whether the chronic low back pain is directly associated with your genes. But there are studies that support the connection between back pain and genetics.
Research in the past was difficult to rule out environmental factors like stress, smoking, and diet as the only cause of back pain. But today, there is evidence that shows genetics do have a role in back pain.
Doctors are finding that chronic back pain does show a significant genetic hereditary link. Specifically the development of low spine degenerative disc disease, which is a disc-related condition associated with normal wear and tear.
In fact, several twin sibling studies and genetic marker studies have researched this connection. Below are a couple of studies that stand out in the correlation between back pain and genetics.
A spinal study, which began in 1991, was a multidisciplinary, multinational research project on the cause of disc degeneration. The most significant findings were that there was a substantial influence of genetic/hereditary influence in lumbar disc degeneration.
It identified the specific genes that are associated with disc degeneration. However, environmental factors, work, sports, injuries, etc are also part of the condition, what the study found is that there is a connection of disc degeneration through genetic influences.
A study on genetics and lumbar disc disease found evidence that back pain could run in families. Specifically, lumbar disc disease could be inherited. The severity of the disease could not be determined or a patients’ response to various treatments. But it does suggest that genetics do play a role. Other findings include:
And as you said that you or your family have not been diagnosed with a spine condition,� this could be something to talk to your doctor or chiropractor about, along with creating a back pain treatment plan. For now, you can do physical therapy, chiropractic massage, CrossFit rehabilitation, etc to reduce and prevent back pain. Hopefully, it is a coincidence, but if it is genetics, not to worry as there is a treatment plan for that as well. But do not wait to make an appointment and let the pain get any worse.
Our team has taken great pride in bringing our families and injured patients only clinically proved treatment protocols. �By teaching complete holistic wellness as a lifestyle, we also change not only our patient�s lives but their families as well.� We do this so that we may reach as many El Pasoans who need us, no matter the affordability issues.
Lumbar spine disc herniation is a well-known type of injury that often causes impairing low back pain, however, it can also compress the nerve roots in the area and generate radicular pain and other symptoms along the lower extremities, such as altered sensations and muscle weakness.
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