Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).
Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.
Can healthcare professionals provide the best non-surgical therapeutic options for individuals with chronic low back pain?
Introduction
Chronic low back pain can happen to numerous individuals, affecting their daily routine and making them miss out on important life events. With the ever-changing world, many individuals, especially working individuals, will experience chronic low back pain at some point due to unbearable stress that seems to affect the surrounding muscles that protect the lumbar spine. This causes many individuals to overstretch or shorten the muscles that are contributing to lower back pain, which can be the causing factor in the development of lower back pain. At the same time, when individuals suffer from low back pain, it can be imposed as a grave economic cost to society. (Pai & Sundaram, 2004) This, in turn, causes many individuals to miss out on work and be financially burdened as the cost of chronic low back pain treatment is high. However, numerous therapeutic options are cost-effective, safe, and effective in reducing chronic low back pain. Today’s post looks at the effects of chronic low back pain and how many individuals can look at various non-surgical options that many individuals can utilize to reduce chronic low back pain. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce chronic low back pain. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with the factors that cause chronic lower back pain. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer
The Effects Of Chronic Low Back Pain
Have you been dealing with chronic pain that flares up in your lower back after a hard workday? Do you feel muscle aches or pains that don’t relieve itself after a day of rest? Or do you and your loved ones take any medication to temporarily relieve your back pain, only to have it come back after a few hours? Many people with chronic low back pain will feel symptoms of stiffness, muscle aches, and radiating pain traveling to their lower extremities. When chronic low back pain is associated with musculoskeletal conditions, it can impact their daily routine. To that point, musculoskeletal disorders correlating with chronic low back pain can encompass a spectrum of conditions and increase naturally over time. (Woolf & Pfleger, 2003) When many individuals are dealing with chronic low back pain, it can become a socio-economic burden that leads to disability. (Andersson, 1999) However, there are numerous options for individuals with chronic lower back pain who can find the relief they need to reduce its effects and will be able to get back to their daily routine.
Understanding Long-Lasting Injuries- Video
Chronic low back pain is when back pain that lasts longer than a few weeks and is one of the most common problems many people experience. When finding relief for chronic low back pain, many individuals will try home remedies to alleviate the pain. However, it can temporarily relieve the issue and mask the symptoms. When individuals see their primary doctor for chronic low back pain, many will seek a personalized plan to reduce chronic low back pain and its associated symptoms. When relieving chronic low back pain, comprehensive pain management treatments often rely on physical therapy, multidisciplinary approaches, and non-surgical options to reduce chronic low back pain. (Grabois, 2005) When understanding how the individual has chronic low back pain, it is important to identify the causes and how it can cause lifelong injuries that can develop into disability. When primary doctors start to utilize non-surgical treatments in their practices, many individuals can find the benefits of non-surgical treatments as they are cost-effective, safe, and gentle on the spine and lumbar region and can be personalized with associated medical providers to reduce pain-like symptoms correlating with chronic low back pain. Check out the video above to learn more about how non-surgical treatments can help reduce chronic low back pain and help revitalize a person’s body through a personalized treatment plan.
Non-Surgical Options For Chronic Low Back Pain
When treating chronic low back pain, non-surgical treatments effectively relieve pain and restore mobility to the back. Non-surgical treatments can be customized to the individual’s pain severity while being cost-effective. When individuals are evaluated for chronic low back pain, they are provided with many healthcare providers to reduce the pain-like symptoms caused by chronic low back pain. (Atlas & Deyo, 2001) Many individuals will incorporate various treatment options like:
Exercises
Spinal Decompression
Chiropractic care
Massage Therapy
Acupuncture
Many of these treatments are non-surgical and incorporate various mechanical and manual manipulation techniques to stretch and strengthen the weak back muscles, elongate the spine through realignment, and help restore movement while reducing symptoms in the lower extremities. When individuals incorporate non-surgical treatments consecutively, they will have a positive experience and feel better in the long run. (Koes et al., 1996)
Atlas, S. J., & Deyo, R. A. (2001). Evaluating and managing acute low back pain in the primary care setting. J Gen Intern Med, 16(2), 120-131. doi.org/10.1111/j.1525-1497.2001.91141.x
Koes, B. W., Assendelft, W. J., van der Heijden, G. J., & Bouter, L. M. (1996). Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine (Phila Pa 1976), 21(24), 2860-2871; discussion 2872-2863. doi.org/10.1097/00007632-199612150-00013
Pai, S., & Sundaram, L. J. (2004). Low back pain: an economic assessment in the United States. Orthop Clin North Am, 35(1), 1-5. doi.org/10.1016/S0030-5898(03)00101-9
Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bull World Health Organ, 81(9), 646-656. www.ncbi.nlm.nih.gov/pubmed/14710506
For individuals about to engage in physical activity or exercise, how does warming up the body help prepare for the work ahead?
Central Nervous System Activation
A proper warm-up before physical activity or working out prepares the mind and body to reduce risks of injury, mentally and physically transition to physical activity work, and enhance performance. A well-designed warm-up also primes the central nervous system/CNS for activity. The central nervous system transmits messages to the muscles to prepare them for action. Central nervous system activation increases motor neuron recruitment and engages the sympathetic nervous system so the body can better handle the physical stressors. The process may seem complex, but priming the nervous system is as simple as warming up with light aerobic activity before getting into more explosive movements.
CNS
The CNS consists of the brain and spinal cord. This central communication system uses another part of the nervous system known as the peripheral nervous system or PNS to transmit and receive messages throughout the body. The PNS is connected to the entire body and the brain and spinal cord (CNS).
Nerves run throughout the body, receiving signals from the CNS to the muscles, fibers, and organs, transmitting various information back to the brain. (Berkeley University. N.D.)
There are two types of systems within the peripheral nervous system – somatic and autonomic.
Somatic nervous system actions are those controlled by the person through voluntary actions like choosing to pick something up.
Properly preparing the body for an intense strength training session or other physical activity needs the correct messages to be sent through the autonomic nervous system.
Parasympathetic and Sympathetic States
The autonomic nervous system consists of two subcategories, which are parasympathetic and sympathetic.
The sympathetic nervous system helps the body get ready to face stress which includes physical stress. (R. Bankenahally, H. Krovvidi. 2016)
The fight, flight, or freeze response describes the sympathetic nervous system’s aspect.
The parasympathetic nervous system is responsible for relaxation and de-stressing.
Individuals are recommended to perform a few calming movements and actions after a workout to return the body to a parasympathetic state. This can be:
Activating the CNS can increase performance and prevent injuries. The process wakes up and alerts the body for the activity. Individuals are recommended before beginning a training session, to communicate to the body about the physical stress it is about to endure and to prepare for the work ahead. This is a concept known as post-activation potentiation/PAP. (Anthony J Blazevich, Nicolas Babault. 2019) PAP helps increase force and power production, which enhances physical performance.
Whenever an individual trains, the brain adapts and learns what the body is doing and the purpose of the training.
Muscle memory describes this interaction.
Individuals who have started up a new strength training routine or after an extended break report feeling awkward for the first few sessions, or even weeks, depending on their experience. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)
However, after a few sessions, the body is more adept at performing the movements and ready to increase resistance, repetitions, or both.
This has to do with the neural drive and muscle memory than it has to do with true potential physical abilities. (Simon Walker. 2021)
The first step is a general warm-up that should use large muscle groups and be of low intensity so as not to exhaust the body before beginning the actual training. General warm-up benefits central nervous system activation and the entire body include: (Pedro P. Neves, et al., 2021) (D C. Andrade, et al., 2015)
Increases blood circulation.
Assists the release of oxygen from hemoglobin and myoglobin.
Warms the muscles, so they contract more effectively.
Increases nerve impulse speed.
Increases nutrient delivery.
Lowers joints’ resistance through increased synovial fluid/joint lubrication.
Increases joint range of motion.
Improves joint resiliency.
Removes metabolic waste quicker.
Reduces risk of injury.
A general warm-up can be simple as any aerobic activity will work. This can include:
Performing bodyweight movements – light jumping jacks or jogging in place.
Treadmill
Rowing machine
Stair climber
Elliptical trainer
It is recommended to use the rating perceived exertion scale/RPE to determine the general warm-up effort. An exertion rating of between 5 to 6 is equivalent to moderate walking or a slow jog. Individuals should be able to speak clearly without taking a pause.
Try this strategy before the next workout to see increased performance and reduced injury risks.
Blazevich, A. J., & Babault, N. (2019). Post-activation Potentiation Versus Post-activation Performance Enhancement in Humans: Historical Perspective, Underlying Mechanisms, and Current Issues. Frontiers in physiology, 10, 1359. doi.org/10.3389/fphys.2019.01359
Hughes, D. C., Ellefsen, S., & Baar, K. (2018). Adaptations to Endurance and Strength Training. Cold Spring Harbor perspectives in medicine, 8(6), a029769. doi.org/10.1101/cshperspect.a029769
Walker S. (2021). Evidence of resistance training-induced neural adaptation in older adults. Experimental gerontology, 151, 111408. doi.org/10.1016/j.exger.2021.111408
Andrade, D. C., Henriquez-Olguín, C., Beltrán, A. R., Ramírez, M. A., Labarca, C., Cornejo, M., Álvarez, C., & Ramírez-Campillo, R. (2015). Effects of general, specific, and combined warm-up on explosive muscular performance. Biology of sport, 32(2), 123–128. doi.org/10.5604/20831862.1140426
As the body ages, individuals want to stay active and maintain a healthy pain free lifestyle. Can regenerative cells for arthritis and cartilage damage be the future of neuromusculoskeletal medicine and joint healing?
Regenerative Cells For Arthritis and Cartilage Damage
Individuals want to continue to do the physical activities they love, which require healthy joints. Scientists are learning how to harness the abilities of regenerative cells to repair and regrow damaged and deteriorated cartilage. Current stem cell treatment of cartilage problems has not been shown to reverse the effects of arthritis and while studies show clinical improvement, further research is necessary. (Bryan M. Saltzman, et al., 2016)
Cartilage and How It Gets Damaged
Cartilage is a type of connective tissue. In the joints, there are a few types of cartilage. The most commonly referred to is the smooth lining known as articular or hyaline cartilage. This type forms a smooth layer of cushion on the end of a bone at the joint. (Rocky S. Tuan, et al., 2013)
The tissue is very strong and has the ability to compress and absorb energy.
It is very smooth allowing a joint to glide effortlessly through a limb’s range of motion.
When joint cartilage is damaged, the cushioning can wear down.
In traumatic injuries, a sudden force can cause the cartilage to break off and/or suffer damage, that exposes the underlying bone.
In osteoarthritis – degenerative or wear-and-tear arthritis, the smooth layer can wear down thin and unevenly.
Eventually, the cushion wears away, the joints become inflamed and swollen and movements become stiff and painful.
There are treatments for arthritis and cartilage damage, but these treatments are usually focused on relieving symptoms by smoothing down the damaged cartilage or replacing the joint surface with an artificial implant, like knee replacement or hip replacement surgeries. (Robert F. LaPrade, et al., 2016)
Regenerative Cells
Regenerative stem cells are special cells that have the ability to multiply and develop into different types of tissue. In an orthopedic surgery setting for joint problems, stem cells are obtained from adult stem cell primary sources which are bone marrow and fatty tissue. These cells have the ability to develop into cartilage cells, called chondrocytes. (Rocky S. Tuan, et al., 2013)
They also help by stimulating the body to reduce inflammation, stimulate cell repair, and improve blood circulation.
This process is caused by cellular signals and growth factors to stimulate the body to activate the healing processes.
Once stem cells have been obtained, they need to be delivered to the area of cartilage damage.
Cartilage is a complex tissue that is described as a scaffold structure that is composed of collagen, proteoglycans, water, and cells. (Rocky S. Tuan, et al., 2013)
To regenerate cartilage, the complex tissues must also be reconstructed.
There are studies on types of tissue scaffolds engineered to recreate a similar type of cartilage structure.
The stem cells can then be injected into the scaffold, in hopes of restoring a normal type of cartilage.
Non-Surgical Arthritis Treatments
Standard treatments such as cortisone shots or physical therapies work as well and provide benefits that could be utilized in combination with regenerative cells for arthritis and cartilage damage in the near future. Data takes time and therefore how this impacts the long-term health of a joint needs continued research in terms of tissue engineering and cell delivery to determine the best approach to help individuals.
Arthritis
References
LaPrade, R. F., Dragoo, J. L., Koh, J. L., Murray, I. R., Geeslin, A. G., & Chu, C. R. (2016). AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries. The Journal of the American Academy of Orthopaedic Surgeons, 24(7), e62–e78. doi.org/10.5435/JAAOS-D-16-00086
Saltzman, B. M., Kuhns, B. D., Weber, A. E., Yanke, A., & Nho, S. J. (2016). Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist. American journal of orthopedics (Belle Mead, N.J.), 45(5), 280–326.
Tuan, R. S., Chen, A. F., & Klatt, B. A. (2013). Cartilage regeneration. The Journal of the American Academy of Orthopaedic Surgeons, 21(5), 303–311. doi.org/10.5435/JAAOS-21-05-303
Back problems and discomfort symptoms are a common ailment that many types of healthcare providers diagnose and treat it. Can knowing a little about what each back pain specialist does and what they have to offer help in choosing a provider?
Back Pain Specialists
Nowadays individuals have options for treating back pain. Primary healthcare providers, general practitioners, pediatricians, and emergency room workers are usually the first to examine the injury or problem. If they are unable to properly diagnose or treat the injury, they will refer the individual to a specialist. Specialists include:
Osteopaths
Chiropractors
Orthopedists
Rheumatologists
Neurologists
Neurosurgeons.
They specialize in chronic conditions and diseases like arthritis or problems like herniated discs. Complementary and alternative providers treat individuals solely or with help from a care team. They look at the whole body and focus on improving overall function.
Family and General Practitioners
When neck or back pain begins a regular doctor that’s usually a family or general practitioner/GP or primary care provider PCP is a recommended place to start. They will:
Order diagnostic tests.
Recommend exercises and stretches.
Prescribe medication.
Refer the patient to a physical therapist or other back pain specialist.
However, studies suggest general providers can be uninformed and slow to adopt new back treatments. (Paul B. Bishop, Peter C. Wing. 2006) It is recommended to research possible treatment options, ask a lot of questions during an appointment, and ask or request a referral to a specialist.
Pediatricians
Pediatricians diagnose and treat children. They cover a wide range of issues including back problems and injuries. As with a general practitioner or primary care provider, a child’s pediatrician is the place to start. Depending on the child’s needs, they’ll refer them to the proper specialist.
Emergency Healthcare Providers
When there is serious neck or back trauma, individuals need to go to the emergency room. Trauma can include automobile collisions, sports accidents, work accidents, and/or personal home accidents. Someone with a possible spinal injury should not be moved. (W Yisheng, et al., 2007) Go to the ER if there is back pain with loss of bowel or bladder control, or the legs become progressively weaker. These are symptoms of an emergency condition known as cauda equina syndrome. (American Association of Neurological Surgeons. 2023)
Orthopedists
Orthopedists and orthopedic surgeons treat the musculoskeletal system, which includes:
Muscles
Bones
Joints
Connective tissues
Cartilage
Common orthopedic issues include:
Repetitive stress injuries
Sports injuries
Bursitis
Tendonitis
Ruptured discs
Nerve impingement
Scoliosis
Osteoporosis
Osteoarthritis
Orthopedics can overlap with other specialties. As orthopedists and rheumatologists both treat arthritis and orthopedic surgeons and neurosurgeons do some of the same procedures that include spinal fusions and discectomies.
Rheumatologists
A rheumatologist treats autoimmune, inflammatory, and musculoskeletal conditions that can include different types of arthritis, lupus, and Sjogren’s syndrome. A primary care provider may refer a patient to a rheumatologist if they have symptoms that include:
Sacroiliitis – inflammation of the sacroiliac joint at the base of the spine.
Axial spondylosis – a form of spinal arthritis.
Axial spondylosis – spinal arthritis that causes the bones to fuse together.
Rheumatologists can also treat spinal stenosis or advanced osteoarthritis as they overlap with orthopedists.
Neurologists
A neurologist specializes in the function of the nervous system. They treat disorders of the brain, spinal cord, and nerves that include:
Parkinson’s disease
Multiple sclerosis
Alzheimer’s disease
Chronic back or neck pain
They are experts in the origins of pain. (David Borsook. 2012) However, a neurologist does not perform spine surgery.
Neurosurgeons
A neurosurgeon specializes in nervous system surgical procedures that include the brain, spine, and spinal cord. However, neurosurgeons do not provide overall treatment for back pain because they are usually the last to be seen after exhausting all other treatment options.
Osteopaths
An osteopath is a licensed physician who practices medicine using conventional treatments and osteopathic manipulative medicine. They have the same education as an MD plus 500 hours of musculoskeletal system studies. (National Library of Medicine. 2022) They take the same exams and are licensed as an MD. Many osteopaths are primary care providers. For back pain, they will focus on:
Posture rehabilitation and training.
Stretching
Therapeutic massage
Spinal manipulation
The goal is to relieve pain and muscle tension, increase mobility, and improve musculoskeletal function.
Physiatrists
Physiatrists are holistic providers that focus on physical function. They can be thought of as a primary care provider plus a physical therapist. These back pain specialists provide rehabilitation for various types of conditions and injuries including:
Back pain
Sports injuries
Stroke
Often they will coordinate a team of specialists to develop a targeted treatment plan.
Chiropractor
Chiropractic is a hands-on alternative medicine. The goal is to restore neuromusculoskeletal function by realigning the spine to its proper form. They do this with spinal manipulations, non-surgical mechanical decompression, traction, and massage techniques. (Michael Schneider, et al., 2016)
The purpose of most chiropractic adjustments is to relax and retrain tight muscles and increase flexibility.
Chiropractic helps to relieve stiff muscles and restore range of motion.
Individuals may not be referred to a chiropractor if they:
Have loose-joints
Have connective tissue problems or conditions.
Have osteoporosis/thinning bones
All types of back pain specialists provide various forms of therapy that may be able to help.
Spinal Decompression in Depth
References
Bishop, P. B., & Wing, P. C. (2006). Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. The spine journal : official journal of the North American Spine Society, 6(3), 282–288. doi.org/10.1016/j.spinee.2005.10.008
Yisheng, W., Fuying, Z., Limin, W., Junwei, L., Guofu, P., & Weidong, W. (2007). First aid and treatment for cervical spinal cord injury with fracture and dislocation. Indian journal of orthopaedics, 41(4), 300–304. doi.org/10.4103/0019-5413.36991
Schneider, M., Murphy, D., & Hartvigsen, J. (2016). Spine Care as a Framework for the Chiropractic Identity. Journal of chiropractic humanities, 23(1), 14–21. doi.org/10.1016/j.echu.2016.09.004
Individuals with fixed sagittal imbalance, a condition where the normal curve of the lower spine is greatly reduced or absent altogether that can cause pain and difficulty balancing. Can chiropractic treatment, physical therapy, and exercise help improve the condition?
Fixed Sagittal Imbalance
The condition is commonly known as flat back syndrome and can be present at birth or can happen as a result of surgery or a medical condition.
Individuals with flat back syndrome position their head and neck too far forward.
A major symptom is difficulty standing for long periods of time.
Symptoms
The spine has two curves. The lumbar spine in the lower back and cervical spine in the neck curve inward. The thoracic spine in the upper back curves outward. The curves are part of the spine’s natural alignment. They help the body balance and maintain the center of gravity.
If these curves begin to disappear the body can have trouble and difficulty standing up straight.
The loss of curvature causes the head and neck to pitch forward, making it hard to walk and do regular normal activities.
A chiropractor and/or physical therapist can recommend exercises and other forms of treatment. (Won-Moon Kim, et al., 2021)
Life-Changing Chiropractic Relief
References
Columbia University Irving Medical Center. Flatback syndrome.
National Health Service. Common posture mistakes and fixes.
Lee, B. H., Hyun, S. J., Kim, K. J., Jahng, T. A., Kim, Y. J., & Kim, H. J. (2018). Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities. Journal of Korean Neurosurgical Society, 61(2), 251–257. doi.org/10.3340/jkns.2017.0181
Kim, W. M., Seo, Y. G., Park, Y. J., Cho, H. S., & Lee, C. H. (2021). Effect of Different Exercise Types on the Cross-Sectional Area and Lumbar Lordosis Angle in Patients with Flat Back Syndrome. International journal of environmental research and public health, 18(20), 10923. doi.org/10.3390/ijerph182010923
Can combining chiropractic treatment with the common therapies of medication, exercise, and/or physical therapy help relieve sciatic endometriosis pain symptoms?
Sciatic Endometriosis
Sciatic endometriosis is a condition in which endometrial cells (tissue that resembles the lining of the uterus) grow outside of the uterine lining and compress the sciatic nerve. This places stress and pressure on the nerve causing back, pelvic, hip, and leg pain, especially before and during the menstrual cycle. It can also cause pain, irregular periods, and infertility. (The American College of Obstetricians and Gynecologists. 2021)
These areas of endometrial tissue growth are also known as lesions or implants.
Women with sciatic endometriosis often experience leg pain and weakness around the time of their menstrual cycle. (Lena Marie Seegers, et al., 2023)
Sciatic endometriosis can also cause pain when urinating, during a bowel movement, during sex, and fatigue, and irregular vaginal bleeding.
The abnormal growth may be caused by higher-than-normal levels of estrogen.
Researchers believe that endometriosis is related to retrograde menstruation, which causes menstrual blood to flow back into the pelvis instead of out through the vagina. (World Health Organization. 2023)
Sometimes, the cells grow in the area of the pelvis right above the sciatic nerve. (Adaiah Yahaya, et al., 2021)
The sciatic nerve is the longest nerve in the body and travels down the back of each leg. (Johns Hopkins Medicine. 2023)
When endometrial lesions place pressure on the sciatic nerve, they can cause irritation and inflammation leading to severe pelvic pain, which makes it harder to conceive. (Liang Yanchun, et al., 2019)
Symptoms
Some women with endometriosis experience no symptoms or misinterpret the symptoms as typical premenstrual syndrome/PMS signs. The most common signs and symptoms of sciatic endometriosis include:
Difficulty walking or standing.
Loss of sensation, muscle weakness, and reflex alteration.
Limping.
Balance problems.
Bloating and nausea.
Constipation or diarrhea before or after a period.
Painful, heavy, and/or irregular periods.
Bleeding between periods.
Pain during sex, urination, and bowel movements.
Pain in the stomach, pelvis, lower back, hips, and buttocks. (MedlinePlus. 2022)
Weakness, numbness, tingling, burning, or dull aching sensations in the back of one or both legs.
Endometriosis, including sciatic endometriosis, typically cannot be diagnosed with a pelvic examination or ultrasound by themselves. A healthcare provider may need to perform a biopsy using laparoscopy and discuss menstrual cycles, symptoms, and medical history.
The laparoscopy procedure involves making tiny incisions and taking a tissue sample with tools attached to a thin tube with a camera. (MedlinePlus. 2022)
Imaging tests, like magnetic resonance imaging/MRI, and computed tomography/CT scans, can help provide essential information about the location and size of any endometrial lesions. (The American College of Obstetricians and Gynecologists. 2021)
Treatment
Symptoms can sometimes be temporarily relieved with over-the-counter/OTC pain relievers. Depending on the condition and severity a healthcare provider may prescribe hormonal treatment to prevent new endometrial implants from growing. These can include:
Hormonal birth control.
Progestin – a synthetic form of progesterone.
Gonadotropin-releasing hormone – GnRH agonists.
If pain persists or worsens, individuals may need to undergo surgery to remove the tissue.
The American College of Obstetricians and Gynecologists. Endometriosis.
Seegers, L. M., DeFaria Yeh, D., Yonetsu, T., Sugiyama, T., Minami, Y., Soeda, T., Araki, M., Nakajima, A., Yuki, H., Kinoshita, D., Suzuki, K., Niida, T., Lee, H., McNulty, I., Nakamura, S., Kakuta, T., Fuster, V., & Jang, I. K. (2023). Sex Differences in Coronary Atherosclerotic Phenotype and Healing Pattern on Optical Coherence Tomography Imaging. Circulation. Cardiovascular imaging, 16(8), e015227. doi.org/10.1161/CIRCIMAGING.123.015227
World Health Organization. Endometriosis.
Yahaya, A., Chauhan, G., Idowu, A., Sumathi, V., Botchu, R., & Evans, S. (2021). Carcinoma arising within sciatic nerve endometriosis: a case report. Journal of surgical case reports, 2021(12), rjab512. doi.org/10.1093/jscr/rjab512
Johns Hopkins Medicine. Sciatica.
Yanchun, L., Yunhe, Z., Meng, X., Shuqin, C., Qingtang, Z., & Shuzhong, Y. (2019). Removal of an endometrioma passing through the left greater sciatic foramen using a concomitant laparoscopic and transgluteal approach: case report. BMC women’s health, 19(1), 95. doi.org/10.1186/s12905-019-0796-0
MedlinePlus. Endometriosis.
Center for Endometriosis Care. Sciatic endometriosis.
Chen, S., Xie, W., Strong, J. A., Jiang, J., & Zhang, J. M. (2016). Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats. European journal of pain (London, England), 20(7), 1044–1057. doi.org/10.1002/ejp.827
Siquara de Sousa, A. C., Capek, S., Howe, B. M., Jentoft, M. E., Amrami, K. K., & Spinner, R. J. (2015). Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases. Neurosurgical focus, 39(3), E15. doi.org/10.3171/2015.6.FOCUS15208
Can non-surgical options be beneficial for many working individuals with low back pain than surgical therapeutic options?
Introduction
Many working individuals will experience pain in their lower backs due to their demanding workloads that are causing unwanted pressure load on the lumbar region of the spine. With the spine’s main job to support the body’s upper and lower quadrants, many individuals with demanding jobs are either constantly sitting down at their desks or carrying heavy objects to different locations. With low back pain being a normal problem for everyone at some point, many individuals find temporary solutions to relieve the pain, only to repeat the factors. To that point, this leads to chronic musculoskeletal disorders that can cause referred pain to the lower and upper extremities and can be pricey when going into treatment. However, there are numerous options for working individuals that are cost-effective and safe on their lower backs. Today’s article examines how low back pain affects the working individual and how non-surgical treatment options vary with surgical possibilities when dealing with low back pain. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to ease low back pain associated with musculoskeletal disorders. We also inform them that there are non-surgical options to reduce the effects of low back pain and restore their quality of life. We encourage our patients to ask amazing educational questions to our associated medical providers about their musculoskeletal symptoms correlating with low back pain. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer
How Does Low Back Pain Affect The Working Individual?
Have you been dealing with constant radiating pain in your lower back, legs, or feet after a long workday? Do you feel pain when moving around, only to find relief when resting? Or do you and your loved ones feel muscle aches and strains when stretching in the morning? Many individuals, especially working individuals, deal with low back pain daily when dealing with these musculoskeletal issues. Low back pain is extremely common for working individuals as it can affect their job performance and be an economic burden when treated. Low back pain is a multifactorial problem that has an increased rate of affecting individuals and contributes to the growth of numerous health problems. Low back pain can cause many individuals to miss work due to the lack of clarity on the causes, treatments, and factors contributing to this musculoskeletal disorder. (Pai & Sundaram, 2004)
So, how would low back pain affect the working individual? Since many people have demanding jobs, it can cause the surrounding muscles, ligaments, and tissues in the lumbar region to be overworked, and the spinal discs degenerate over time. When there are unrelenting changes within the spine, it can be associated with affecting the lumbar structures of the spine to degenerate over time. This, in turn, causes the lumbar spine to go through biochemical changes that can generate pain-like symptoms in the lumbar region and cause structural changes to the spine, leading to lower back pain. (Benoist, 2003)
Additionally, there are many causes and factors that many working individuals will do that lead to low back pain. Normal factors like improper lifting, stepping wrong, or sitting down excessively can contribute to lower back pain. At the same time, traumatic factors like accidents, injuries, or playing sports can also lead to lower back pain. When musculoskeletal conditions like low back pain become an issue, it can become a major burden to health and social care systems for many individuals, with indirect costs that can be pricey when treated. (Woolf & Pfleger, 2003)
Chiropractic Care After Accidents & Injuries-Video
Now, with low back pain being a nuisance to many, individuals will seek out treatment to reduce the pain they are experiencing in their lower back and mitigate the residual symptoms they have been dealing with in the other body extremities. Sadly, low back pain, especially in its chronic state, can become a diagnosis of convenience for many people, affecting their socioeconomic, work, and psychosocial lifestyles. (Andersson, 1999) Many individuals will seek out numerous treatment opportunities to reduce low back pain. Surgical treatments for low back pain are great for individuals when regular home therapies don’t work but can be pricey. Many will opt for non-surgical therapies when it comes to finding cost-effective treatments for treating low back pain. Non-surgical treatments, including chiropractic care and spinal decompression, are excellent for treating low back pain. Pain specialists like chiropractors and massage therapists utilize various techniques (mechanical and manual) to realign the body and stretch out the affected muscles that are affected by low back pain. The video explains how these treatments can reduce low back pain associated with accidents and injuries.
Non-Surgical Options For Low Back Pain
As stated earlier, non-surgical treatments can help reduce low back pain and can be combined with other therapies to manage the pain. Non-surgical treatments can be personalized to the person’s pain and can provide pain relief to the body. When individuals undergo a non-surgical treatment, pain specialists incorporate mechanical and manual manipulation to restore joint and spinal motion to the lower back. (Park et al., 2023) Additionally, individuals with low back pain include an exercise regime to effectively increase the person’s range of motion while increasing the person’s chances to return to normal daily activities and work. (van Tulder et al., 2000)
Non-Surgical Options Vs. Surgical Options
There is a vast difference between non-surgical and surgical options for treating low back pain. Anyone can personalized non-surgical options to provide more effective improvement in reducing pain, restoring lumbar range of motion, and improving back muscle endurance within a few sessions. (Amjad et al., 2022) Now, when home remedies and non-surgical options do not reduce pain, surgical options are only effective for low back pain. This is due to the psychological component that causes individuals to have persistent back pain that is not causing the relief that the person needs. (Corp et al., 2021) But both options are excellent when reducing low back pain as many doctors tell their patients to be more mindful about how they are using the muscles in their bodies and make small changes to reduce the chances of the pain from returning. When many working individuals start to think more about their pain and how to minimize its chances of returning, they can continue to live life to the fullest pain-free.
References
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x
Corp, N., Mansell, G., Stynes, S., Wynne-Jones, G., Morso, L., Hill, J. C., & van der Windt, D. A. (2021). Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. Eur J Pain, 25(2), 275-295. doi.org/10.1002/ejp.1679
Pai, S., & Sundaram, L. J. (2004). Low back pain: an economic assessment in the United States. Orthop Clin North Am, 35(1), 1-5. doi.org/10.1016/S0030-5898(03)00101-9
Park, S. C., Kang, M. S., Yang, J. H., & Kim, T. H. (2023). Assessment and nonsurgical management of low back pain: a narrative review. Korean J Intern Med, 38(1), 16-26. doi.org/10.3904/kjim.2022.250
van Tulder, M., Malmivaara, A., Esmail, R., & Koes, B. (2000). Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine (Phila Pa 1976), 25(21), 2784-2796. doi.org/10.1097/00007632-200011010-00011
Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bull World Health Organ, 81(9), 646-656. www.ncbi.nlm.nih.gov/pubmed/14710506
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