Back Clinic Back Pain Chiropractic Treatment Team. At the El Paso Back Clinic, we take back pain very seriously.
After diagnosing the root cause of your discomfort/pain, we’ll do everything within our power to cure the area and relieve your symptoms.
Common causes of back pain:
There is an infinite number of forms of back pain, and a variety of injuries and diseases may cause discomfort in this area of the body. One of the most Frequent ones we see one of our patients in East Side El Paso and surrounding areas comprise:
Disc Herniation
Inside the backbone are flexible discs that cushion your bones and absorb shock. Whenever these discs are broken, they may compress a nerve leading to lower extremity numbness. StressWhen a muscle at the trunk is overexerted or hurt, causing stiffness and pain, this type of injury is generally classified as a back strain. This can be the consequence of attempting to lift an item that can result in excruciating pain and impairment and is too heavy. Diagnosing the underlying cause of your pain.
Osteoarthritis
Osteoarthritis is characterized by the slow wearing down of protective cartilage. When the back is affected by this condition, it causes damage to the bones that results in chronic pain, stiffness, and limited mobility. SprainIf ligaments in your spine and back are stretched or torn, it’s called a spine sprain. Typically, this injury causes pain in the region. Spasms cause back muscles to overwork they may start to contract, and can even stay contracted– also called a muscle spasm. Muscle spasms can present with pain and stiffness until the strain resolves.
We want to accomplish the diagnosis straight away, integrating a background and exam along with state-of-the-art imaging, so we can provide you with the most efficient therapy choices. To begin, we will speak with you regarding your symptoms, which will provide us with critical information regarding your underlying condition. We’ll then perform a physical exam, during which we’ll check for posture issues, evaluate your spine and assess your backbone. If we guess injuries, like a disk or neurological injury, we’ll probably order imaging tests to obtain an analysis.
Regenerative remedies to your back pain. At the El Paso Back Clinic, you may be certain that you’re in the best possible hands with our Doctor of Chiropractic and Massage Therapist. Our purpose during your pain treatment isn’t only to relieve your symptoms — but also to avoid a recurrence and to treat your pain.
Back pain sometimes strikes without warning. One minute you’re bending or lifting something heavy; the next minute you’re unable to move. Sudden onset of muscle spasm from the back is common. Roughly 8 out of 10 adults will experience back pain at some point in their lives. Generally, the origin of back pain and muscle spasm can be credited to overuse, an accident or a sports injury. But more often than not, the origin of muscle spasm is the effect of damage to a structure within the lumbar spine.
One matter is clear: if you have had one or more episodes of muscular strain in the back, chances are it’ll happen again. The muscles in the back function together. Without all the muscles of the back working together, no lateral and extension motion of the spine would be impossible. Stability is also added by the muscles of the back in order to keep the spine erect and maintain equilibrium. When the muscles are in spasm due to a spinal health issue, that balance can be compromised.
What are Muscle Spasms?
Muscle spams are involuntary contractions of a muscle. Although “back attacks” seem to happen out of nowhere, the motion that triggers the episode is generally preceded by a collection of health issues to the structures of the spine that develops gradually, over time. Inflammation sets in once injured. This, in turn, sensitizes the nerves, causing the muscle/s to contract and spasm.
Disc Disorders and Muscle Spasms
Conditions, such as degenerative disc disease or a herniated disc, may cause an acute episode of low back pain. A disc bulge or disc herniation may also compress a spinal nerve root causing irritation and inflammation. The body tries to immobilize the affected area by tightening the musculature to stop pain and as a result, debilitating muscle spasms occur.
Muscles can get too tight due to insufficient exercise, a lot of exercise, structural imbalances, dehydration and electrolyte loss, or any mix thereof. By comparison, some muscle bands are weak. When muscle imbalances become persistent, aberrant forces are transmitted into the spine. Consequently, an accident can be triggered by one movement out of the norm to a joint, ligament, or disk resulting in spasm and back pain. As these structures are already “primed,” the event that activates the spasm is nothing more than an effect of an underlying health issue. Muscle spams in the back are frequently painful. Here are several remedies which can help you get moving.
Remedies for Back Spasms
Initial 48 to 72 hours: Apply ice for 20 minutes every 2 hours while lying on your back. Constantly use an ice pack, never apply ice directly to skin.
After 72 hours: Apply moist warmth. A heating pad is ideal. You might find relief by soaking in a bathtub of warm water.
Whereas ice reduces redness, warmth relaxes muscles and increases blood flow to the area and nerves that are irritated.
By elevating your legs, pressure is taken off the spine and may help relieve pain.
Aspirin or ibuprofen can help reduce inflammation and alleviate pain. Consult with your doctor or healthcare provider regarding the dosing and drug regimen most acceptable for your problem. With reduced back muscle spasms, combination remedies (ie, remainder, ice/heat and drugs) generally yield much better outcomes than one therapy alone.
Back Spasm Prevention
When the back spasm episode has passed, and you’ve allowed enough time for the inflammation to subside, begin focusing on what you can do to keep it from happening again.
Start stretching: Incorporate stretching exercises in your daily routine. Muscle fibers gain from stretching and so will you. Consider taking yoga courses or Pilates; always stretch before exercise.
Get in shape:�Now’s the time to get started in case you do not take part in routine physical activity. Exercise confers advantages too important to ignore and too numerous to mention. Join a fitness center. Start playing a sport. The key to any exercise routine is that it be done consistently.
Strength training: A�significant part of any exercise regimen, strength training not only builds muscle, it can reduce imbalances. Remember: muscles operate with one another, so be sure to balance your strengthening regularly.
Make preventing another incident of muscular spasms your priority. It’s never too late to start increasing your strength, flexibility and mobility. Choose activities that you enjoy and commit to performing them. In addition, several healthcare professionals can help decrease muscles spasms. Chiropractic care is a well-known alternative treatment option which utilizes a variety of treatment methods to help ease muscle spasms caused by spinal health issues.
How a Chiropractor Can Help
Muscle spasms both disrupt your life and can be painful. There are several ways in which a chiropractor can help you find relief for your muscle spasms. Here’s how chiropractic care can help to decrease the severity and frequency of your muscle spasms.
Chiropractic care, can go a long way toward assisting you to avoid tightness in your muscles that result in constantly painful symptoms, when you get regular spinal adjustments and manual manipulations. Chiropractic treatment includes spinal adjustments and manual manipulations which help align your body to take pressure off of soft tissues within the body and nerves, reducing the nerve signals your brain might be receiving that cause an involuntary contraction. Manual manipulations and spinal adjustments also allows your spine and joints to restore normal motion, which in turn contributes to a decrease in muscle spasms and pain.
Your chiropractor may also utilize massage treatment to help relax the muscles in your body which are prone to spasm. These kinds of treatments help to decrease fluid, reduce scar tissue and supply relief. Massage may also help to reduce any inflammation that communicates with the cramps and spasms your own muscles. Your chiropractor can also provide nutritional advice to help put an end to chronic spasms. If you are dehydrated you could have an electrolyte imbalance which may be causing your cramping and muscle spasms. Making certain modifications to your diet and drinking more water can help restore balance and decrease the number or spasms you’re experiencing as well.
Moreover, the chiropractor may use associated therapies for the treatment of muscle spasms. This can include hot and cold treatments, ultrasound and electric stimulation of the muscle. These therapies help greatly to increase flow and also prevent swelling or scarring of the muscle. Associated treatments are a means for prevention of further damage and injury recurrences as well as to reduce pain. What’s more, a doctor of chiropractic may suggest a series of appropriate stretches and exercises to speed up the recovery process. Certainly, the ultimate objective is to alleviate the muscle spasms.
Dr. Alex Jimenez’s Insight
Muscle spasms are common symptoms caused by a variety of injuries and/or aggravated conditions which can result in back pain. Regardless of the cause of your back pain, muscle spasms can often become a constant and debilitating health issue that can affect your overall quality of life. Chiropractic care is a common treatment option utilized to help ease soft tissue injuries caused by accident and/or sports injuries. Through the use of spinal adjustments and manual manipulations, a chiropractor can restore the original alignment of the spine, helping to reduce stress and tension build up in the soft tissues surrounding the spine, ultimately improving muscle spams.
Remember, it’s not normal to experience muscle spasms. If you do, then it is likely you have an underlying problem that has to be diagnosed and treated. You don’t have to suffer from the pain and discomfort of muscle spasms, your chiropractor can be your partner.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
About 50 to 80 percent of pregnant women experience some type of pain back during their pregnancy. Access to the right treatment can be challenging because the connection between pregnancy and back pain is not fully comprehended. Luckily, back pain is typically short-term where most cases will go away shortly after the birth of your baby, however, waiting for the symptoms to go away on their own isn’t much of an appealing option. Back pain associated with pregnancy is often localized to a specific region of the spine rather than widespread. Back pain tends to arise between the fifth and seventh months of pregnancy, even though it can begin sooner.
Pregnancy-Related Back Pain
Women generally experience pregnancy-related back pain in the lower back, pelvic and sacrum regions of the spine. Pain along the pelvic area, for which a straightforward diagnosis isn’t yet determined, is referred to as peripartum pelvic pain. Peripartum refers to the period of time surrounding childbirth, which is usually several weeks prior to birth and a few weeks after birth.
Back pain associated with pregnancy presents itself most commonly in the following regions:
Sacroiliac joints in the posterior superior iliac spine
The groin areas
Coccyx
Pubic symphysis anteriorly
Furthermore, other areas of the pelvis and thighs may change and cause painful symptoms, however, radiating pain rarely occurs below the knees. Back pain during pregnancy tends to be associated with posture and can by influenced by a waddling gait.
What Increases Back Pain Symptoms During Pregnancy?
While several factors, including age and smoking status, have not been necessarily demonstrated to affect symptoms of back pain, a history of pain during pregnancy and a history of back pain in general, along with increased body mass, have already been linked to an increase in peripartum pain. Additionally, younger women often have more extreme pain compared to older women. Studies have reported that approximately 10 percent of women said back pain during pregnancy prevented them from engaging in their work and more than 80 percent stated that their ability to perform daily tasks was tremendously impacted.
What Causes Back Pain During Pregnancy?
The cause of pregnancy-related back pain is likely associated with a combination of metabolic, circulatory, and psychosocial factors. However, most of the causes can be grouped into these areas:
Weight gain: Women typically gain between 20 and 40 pounds throughout pregnancy, which puts pressure on the spine. This added pressure might result in lower back pain and other painful symptoms.
Shift of gravity in center: As you gain weight along while your belly grows, your ability to keep proper posture becomes contested. Posture changes in pregnancy have been connected to spine issues such as herniated discs and lordosis, which might contribute to back pain.
Hormonal changes: Some women report back pain at the first trimester even though the majority of women begin experiencing pain back during the fifth and seventh months. Since the baby isn’t large enough to cause any stress to the spine, it may be hormonal changes causing the symptoms. Relaxin, a hormone that relaxes pelvic and spinal joints as well as the ligaments to ease childbirth is produced by pregnant women. Relaxin might cause some spinal distress and may result in lower back pain. In reality, sacroiliac dysfunction can be caused by certain hormones produced during pregnancy.
Stress: Pregnancy can be an exciting and special time for many women, but it can also be stressful. Stress can worsen back pain or even cause it. Finding ways to manage stress while pregnant may help ease your back pain.
Treatment
Treatments for pregnancy-related back pain involve lifestyle modifications, for example:
Avoiding excessive weight gain: A nutritious diet is one of the very best ways to maintain a healthy weight during pregnancy, and some foods have been associated with easing spinal distress (a frequent cause of low back pain). Eating 5 or more daily servings of veggies and fruits will provide nutrients. Other good options include fatty fish and nuts, such as mackerel, which pack a healthy dose of omega-3 fatty acids and inflammation fighting agents.
Exercising to reinforce the core and back muscles: In general, pregnant women should avoid the extremes when it comes to action: little and too much action can possibly cause an increase in back pain. Walking, swimming, and yoga are great ways to condition yourself but always remember how to safely exercise while pregnant.
Reducing stress: Finding methods to manage your stress during your pregnancy has psychological in addition to physical benefits. A massage, getting lots of rest, and relaxing with a heating pad against your back are excellent ways to manage stress while helping your spine.
Posture: Talk to your doctor about ways you can keep good posture as your pregnancy progresses.
Investing in a pregnancy pillow to give support during sleep:�Pregnancy and sound sleep don’t always mix, but a supporting pillow may deliver more comfy mornings.
Wearing sensible shoes: Spine maintenance and footwear are all connected. Avoid high heels and flip flops, if your shoe size changes during pregnancy purchase new footwear.
If your back pain does not respond to these treatments, your doctor may suggest a prescription pelvic belt, medicine therapy, injection therapy, or bed rest. In addition, chiropractic care is a safe and effective alternative treatment option for back pain during pregnancy.�Fortunately, back pain may disappear within 6 months following birth, letting you focus on the addition to your own life, your baby. Speak with your doctor about which treatment will be best for you if your pain does not subside after your baby arrives.
Chiropractic Care During Pregnancy: Benefits And Safety
Chiropractic care is the health care of the spine, discs, related nerves and bone geometry without the use of surgery or drugs and medications. It involves science and the art of adjusting and manipulating the joints of the spine, which reduces spinal nerve stress and promotes health and wellness throughout the entire body.
Is Chiropractic Care During pregnancy safe?
There are no known contraindications to chiropractic care throughout pregnancy. All chiropractors are trained to use spinal adjustment and manual manipulations on women who are pregnant. Investing in the maternity and fertility wellness of women who are pregnant or trying to conceive is a top priority for chiropractors. Some chiropractors take a particular interest in prenatal and postnatal care and seek out additional training. Below represents designations of chiropractors that have taken these additional steps.
DACCP � Diplomate with ICPA reflecting highest level of advanced training
CACCP � Certified with the ICPA reflecting advanced training
Member of ICPA reflecting special interest
Webster Certified � trained to work specifically with pelvic balance in pregnancy
Chiropractors that have been trained to work with pregnant women can use tables that adjust to a pregnant female’s body, and they will use treatment methods and techniques that prevent unnecessary pressure on the abdomen. A doctor of chiropractic, or chiropractor, who is trained in the requirements of pregnant women may also supply you with exercises and stretches that are safe to participate in when pregnant.
Why Should I Have Chiropractic Care During Pregnancy?
During pregnancy, there are several physiological and endocrinological changes that occur in preparation for establishing the right environment for your growing baby. However, these changes can result in a misaligned spine or joints, including:
Protruding abdomen and increased spine
Pelvic changes
Postural adaptations
Establishing pelvic balance and orientation is just another reason to consider chiropractic care during pregnancy. When the pelvis is misaligned, or subluxated, it may reduce the amount of space available for the growing baby. This limitation is called intrauterine constraint. A misaligned pelvis may also make it hard for the baby to get in the best possible position for delivery. This may affect the mother’s ability to have a natural, non-invasive birth. Breech and posterior positions lead to interventions such as c-sections and can interfere with the ease of labor. The nervous system is the master communication system to all the body systems including the reproductive system. Keeping the spine healthy assists the whole body to function more effectively.
What are the Benefits of Chiropractic Care During Pregnancy?
Chiropractic care during pregnancy can offer benefits for women that are pregnant. Possible advantages of chiropractic care throughout pregnancy include:
Maintaining a healthier pregnancy
Controlling symptoms of nausea
Reducing the time of labor and delivery
Relieving back, neck or joint pain
Preventing a potential cesarean delivery
Chiropractic Care and Breech Deliveries
The late Larry Webster, D.C., Creator of the International Chiropractic Pediatric Association (ICPA), developed a specific chiropractic evaluation and modification which empowers chiropractors to establish balance in the pregnant female’s pelvis to reduce undue stress for the uterus and supporting ligaments of pregnant women. This balanced state in the pelvis has been clinically demonstrated to allow for optimal fetal positioning. The technique is known as the Webster Technique.
It is considered ordinary by a few for a baby to present breech until the next trimester. Most birth professionals aren’t concerned with breech presentations until a patient is 37 months into their pregnancy. Roughly 4 percent of all pregnancies lead to a breech presentation. The Journal of Manipulative and Physiological Therapeutics reported in the July/August 2002 issue an 82 percent success rate of babies turning vertex when doctors of chiropractic used the Webster Technique. Furthermore, the results from the study suggest it may be beneficial to use the Webster Technique, in the 8th month of pregnancy, even when a female has a breech presentation.
Currently the International Chiropractic Pediatric Association (ICPA) recommends women receive chiropractic care during pregnancy to set up pelvic balance and optimize the area in which a baby needs for growth during pregnancy. With a balanced pelvis, babies have a greater prospect of moving to the correct place for arrival, and the crisis and worry related to breech and posterior presentations may be avoided altogether. Optimal infant positioning in the right time of birth also removes the potential for dystocia (hard labou) and, therefore, results in simpler and safer deliveries for both the mother and baby.
Dr. Alex Jimenez’s Insight
During pregnancy, the overall health and wellness of the mother is essential towards the proper development of the baby. Because the body of a woman goes through many changes throughout their pregnancy, however, some changes to the human body may cause health issues if not properly checked by a healthcare professional. Back pain is a common health issue reported by many pregnant women. Fortunately, safe and effective alternative treatment options for both mothers and their babies are available to help ease their painful symptoms. Chiropractic care is a well-known treatment which can be used efficiently to help ease back pain in pregnant women.
Talk to a Healthcare Professional
As more women are seeking the benefits of chiropractic care throughout pregnancy, more health care providers are seeking trained doctors of chiropractic in their own communities to refer their pregnant patients to. Discuss these options with your healthcare provider. Ask them to find out more about its benefits, if they are not yet knowledgeable about chiropractic care in pregnancy. Above all, seek options that support your body’s natural abilities to function and find a team of healthcare professionals that are respectful of your options. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
Chiropractic care is generally the first choice of treatment for back pain as well as for a variety of other injuries and/or aggravated conditions associated with the musculoskeletal and nervous system.�Chiropractic care has numerous health benefits that can focus on helping patients of all ages. But, what many people don’t realize is that chiropractic care was not designed for only a certain person or body type, instead, a chiropractor can adjusts their treatment techniques to match each person’s specific needs. Doctors of chiropractic, or chiropractors, feel strongly about improving the overall health and wellness of their patients. In the tradition of chiropractic care, a chiropractor will treat the body of a patient as a whole, rather than focusing on a single injury and/or condition.
A doctor of chiropractic can treat many of the health issues that may be causing a patient’s back pain, however, what if the patient’s back pain is caused by obesity? The topic between whether chiropractic care can be used to treat obesity is frequently discussed among healthcare professionals and the patient. Many people are not aware of the benefits chiropractic care can have on obesity. Read below to find out how chiropractic care can help improve back pain as well as help manage obesity.
Chiropractic Care and Obesity
Obesity can affect more than just the way a person feels cosmetically. It is a health issue that may ultimately affect the individual’s skin, organs, joints, muscles, and even the spine. Excess weight can place unnecessary amounts of stress on the spine, joints and muscles, which can commonly lead to back pain, among other health issues. Its an individual’s constant struggle between managing their weight as well as coping with the symptoms manifesting as a result of the weight gain that can make weight loss difficult for many people without the proper treatment. Fortunately, chiropractic care is a safe and effective, alternative treatment option which can help diagnose, treat and prevent a variety of health issues while helping to improve overall health and wellness.
Because chiropractic care focuses on both the body and mind, the purpose of the spinal adjustment and manual manipulation in the treatment of obesity is to help improve symptoms of back pain by carefully correcting the alignment of the spine in order to reduce pressure on the spine as well as to decrease stress which may be affecting the individual’s mood. Once the patient has been geared towards a healthier body and mind, a chiropractor can also recommend a series of lifestyle modifications, such as nutritional and fitness advice, which can help a patient manage their excess weight.�The largest connection in your body is the one between your brain and the rest of the body through the communication of the nervous system. When the connection between the brain and the body is interrupted as a result of a spinal misalignment, or subluxation, it can lead to a variety of mental and physical health issues that may result in painful symptoms as well as stress, anxiety and depression, all of which have been associated with weight gain and obesity.
Furthermore, chiropractic care can also help throughout the process of weight loss. Because your body will be continuously changing as you lose weight, your spine and joints will need to be accordingly maintained to keep up with the ongoing changes. By receiving regular chiropractic care, a patient participating in a weight loss program or simply following the chiropractor’s nutritional and fitness advice will be able to fully engage in their exercise and physical activity routines due to the reduced back pain and other symptoms. In order to understand how chiropractic care can work towards excess weight and obesity, its essential to first comprehend the relationship between back pain and obesity as well as what type of treatment methods can benefit weight management.
Back Pain and Obesity
Obesity is defined by doctors as a disease. Being overweight or obese is a serious disorder that can affect children and adults. Many healthcare professionals know that obesity contributes to the development of high blood pressure, diabetes, coronary heart disease, and even colon cancer. But were you aware that obesity is a common contributing factor for back pain? Being overweight or obese may significantly contribute to symptoms associated with osteoarthritis, osteoporosis, rheumatoid arthritis, degenerative disc disease, spinal stenosis, and spondylolisthesis.
Has your primary care physician suggested you lose weight to reduce the severity of your back pain? Perhaps you have back pain, but have not considered extra body weight to be a possible cause. Even an extra 10 pounds to your average weight can eventually lead to back pain. The outcomes of a big cross-sectional population-based research study confirmed the link between obesity and back pain. The analysis involved 6,796 adults where researchers found that the risk for back pain increases as body mass index, or BMI, does. The probability of low back pain among adults who are obese is four times larger than among adults with an average weight.
BMI and What It Means
BMI is a number based on your weight and height. In general, the higher the number, the more body fat a person has. There are four categories of BMI:
Normal weight�BMI less than 25
Overweight�BMI of 25 to 30
Obese�BMI of 31 to 35
Extremely obese�BMI of 36 or higher
For instance, someone who is 5�10� tall and weighs 174 pounds has a BMI of 25, while a person who is 5�10� and weighs 251 pounds has a BMI of 36.
Obesity and Risk for Low Back Pain by the Numbers
2.9% for people of normal weight
5.2% for overweight adults
7.7% for obese adults
11.6% for extremely obese adults
The study did not address why obesity increases the risk of low back pain. But, additional body weight can contribute to how the spine works and its mechanical well-being.
Small Changes
Modest changes in the degree of physical activity can substantially lower the risk for back pain. Individuals with extreme obesity (BMI 36+) who increase their time in moderate actions by at least 17 minutes every day can reduce their risk for low back pain by approximately 32 percent. Moderate activities may include briskly walking, performing water aerobics, riding a bike, ballroom dancing, and gardening.
How Obesity Can Impact the Spine
The spine is designed to carry your body’s weight and distribute the loads encountered during rest and action. When excess weight is carried, the spine is made to assimilate the burden, which may lead to structural undermining and harm, as in the case of injury, or sciatica. One area of the spine that is most vulnerable to the consequences of obesity is the lower back, or the lumbar spine.
Why Exercise is Essential
Lack of exercise may lead to poor mobility and flexibility as well as weak muscles, especially in the back, core, pelvis and thighs. This may raise the curve of the lower spine, causing the pelvis to tilt too far ahead. Further, this is detrimental to proper posture as well as posture, causing health issues along other regions of the spine, such as the neck, and resulting in debilitating symptoms. You might attempt to dismiss the reason behind some of these spinal health issues to the practice of normal aging. It’s true that to anatomy, structural and functional changes can be caused by the degeneration of the body with age. However, if you are obese or overweight, you likely have, or may have, back pain. You may also have or develop a few of the following conditions:
Posture: Unhealthy posture accounts for neck and back pain. A level of physical fitness is necessary to properly support the spine.
Low Back Pain: Obesity may aggravate an existing low back problem and contribute to recurrence of the condition.
Osteoporosis: A sedentary lifestyle coupled with an unbalanced diet can affect the density, or strength of the bones (spinal vertebrae). When the structural architecture of a vertebral body is compromised, it is at risk for fracture. Vertebral fractures can be painful and disabling. If you have been diagnosed with osteoporosis, you have probably lost between 25% to 30% of desirable bone density.
Osteoarthritis (OA) and Rheumatoid Arthritis (RA): The joints in the spine are called facet joints. Excessive body weight places unnatural pressure and stress on the joints during movement and at rest.
Development of Obesity
Industrialization and modernization has had a huge effect on the food we eat today. Food can be bought just about everywhere. No more is it necessary to expend effort to forage and hunt for food. There are vast numbers of processed food items available and devices which require little use of labor like microwave ovens to cook meals. The market for kitchen devices and several convenience foods came about when women entered the workforce. For the time period 2011-2012, the following statistics were published:
34.9% of adults (age 20 and older) were obese
16.9% of children and adolescents (ages 2-19) were obese
Dr. Alex Jimenez’s Insight
A healthy weight is important towards many aspects of overall well-being, including for the wellness of the spine. Because the spine is the main source of support for the human body’s weight, obesity or excess weight can place great amounts of stress on the complex structures surrounding the spine, resulting in a variety of health issues. As a matter of fact, many cases of back pain have been previously attributed to obesity. Chiropractic care can benefit patients with back pain and obesity. Through the use of chiropractic treatment methods, a chiropractor can help reduce symptoms of back pain as well as recommend nutritional and fitness advice to help with weight management.
There are many tools available that could help people lose and maintain a healthy body weight. Speak with a chiropractor to find out how to begin a weight loss program alongside back pain treatment. This is important since in the event that you have spinal health issues, your exercise program will be different compared to a person without back pain. Bear in mind, no two individuals are the same, and believing that obesity is a disease, obtaining professional help might be the initial step for you. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
Back pain can affect 8 out of 10 people throughout their lifetime. Because it’s become such a common complaint over many generations, it’s not uncommon for the average person to turn to self-care remedies in order to find immediate relief for their symptoms without the need to seek medical attention. As a result, many myths about back pain and its treatments have developed over the years. Neel Anand, MD discusses several of the most common myths regarding the symptoms, causes and treatments of back pain. Dr. Anand is the Director of Orthopedic Spine Surgery at the Cedars-Sinai Institute for Spinal Disorders in Los Angeles. Below are seven of the most prevalent myths which have been debunked by healthcare professional Neel Anand, MD. We will then discuss debunked chiropractic care myths regarding back pain.
Sitting Up Straight
Every time your mother told you to sit up straight, she wasn’t wrong about how hunching over could be bad for your back, however, sitting up straight can certainly have its own health issues. Sitting up straight for an extended period of time, with no break and in a position which doesn’t feel quite natural for your body, can alternatively cause strain on your spine. An improper posture can eventually lead to spinal misalignment, or subluxation, which may then cause back pain. If you work in an office for 8 hours each day, maintaining a proper posture can be difficult. To provide your body with the proper support it needs in an office work setting, make sure to keep your feet resting flat on the ground while maintaining your chair at a height where your knees are at a 9-degree angle. Also, make sure that you stand up and stretch several times a day or simply take some time to go for a walk several times a day in order to keep your muscles from becoming stiff and/or shortened. Proper posture is important for managing back pain, especially if you have a sedentary lifestyle.
Utilizing the Firmest Mattress
People who suffer from back pain may experience worsening pain and discomfort if they switch their current mattress for one of the firmer choices. A mattress that is too firm can place unnecessary amounts of stress on an individual’s shoulders and hips. Conversely, a mattress that is too soft can lack the support necessary to allow proper movement.�In both circumstances, the individual can suffer a misalignment in their spine from improper sleeping posture. Improper sleeping posture caused by an improper mattress can cause back pain. Research studies have also demonstrated that a good mattress can be just as helpful to prevent further health issues.
Exercise and the Spine
A poll from the North American Spine Society revealed that one of the biggest misconceptions regarding back pain involves exercise. Of course, if you have a sedentary lifestyle and decide to participate in strenuous physical activity, you’re bound to experience some type of injury which could result in back pain, however, an individual who properly engages in the appropriate amount of exercise their body can sustain will experience countless benefits towards their spinal health. You can prevent symptoms of bak pain by preparing your body for the shock of everyday movements with stretching and warm-up exercises in order to help wake up your muscles. Take a cue from professional athletes that engage in stretching and warm up routines during their daily routine to avoid injury on the field. Strengthening your core and back muscles can also help you avoid injuries which could cause back pain. Exercises focused on cardio as well as strengthening your stomach and back muscles can help improve overall health and wellness.
Degeneration Associated with Age
Back pain is not an unavoidable side-effect that comes with age and certainly, getting older does not mean life has to become debilitating. While the degeneration of the structures of the body is a natural and even a normal process that comes with age, remaining physically active by participating in regular exercise and physical activity can help keep our bodies strong, flexible and mobile.��There are many fitness alternatives, including yoga, Pilates and T�ai Chi as well as other treatment options ranging from acupuncture to physical therapy, which can help improve symptoms of back pain which may be caused by the wear-and-tear of the body. Just because you’re getting older doesn’t mean that you simply have to live with aches and pains.
Back Pain without a Cause
You’ll often hear back pain sufferers claim that their symptoms started without a cause or that they simply began on their own. In almost all cases, however, individuals who suffer back pain may have caused their own symptoms without them even realizing it. From improperly lifting a heavy object and twisting your back incorrectly to overdoing a workout, poor posture and even weight gain, back pain can be the result of many different factors. All of these circumstances can place too much pressure on the spine, leading to these seemingly “out of nowhere” symptoms of back pain. While most cases of back pain may improve on their own, a persistent case of back pain that is left untreated for an extended period of time may lead to some very serious health issues. Therefore, if you experience back pain without an apparent cause, make sure to seek immediate medical attention to properly diagnose the source of your symptoms and begin the proper treatment for it.
Heat and its Effects
There aren’t many things as relaxing as sinking yourself into a wonderful hot bath, however, after injuring your back, doing so may make your situation worse. While heat therapy might be beneficial for some types of injuries and/or conditions to help relax and loosen the tissues as well as to stimulate blood flow to the affected area, applying heat to some of these can increase inflammation, worsening your symptoms of back pain. Instead, many healthcare professionals recommend the use of ice therapy for back pain because it can help decrease pain, swelling, inflammation and muscle spasms or cramping. Doctors recommend applying ice to the affected area for 20 minutes at a time to reduce painful symptoms. Play it safe and check with a healthcare professionals for the best recommended treatment for your specific source of back pain.
Back Pain Treatment Methods
Many individuals who suffer from back pain will avoid seeing a doctor entirely out of fear of surgery. But, as a matter of fact, although most people experience back pain at some point throughout their lifetimes, the majority of them are able to find relief from their symptoms without the need for invasive treatment procedures. Commonly utilized treatment methods for back pain include over-the-counter drugs and/or medications or lifestyle modifications like exercise and physical activity. Other alternative treatment options, such as chiropractic care and physical therapy, are common treatment options for many individuals with back pain. Only when a healthcare professional has determined that no other treatment method has been effective towards the improvement of your symptoms is it when surgery may be recommended for you and even then, many patients will often seek a second opinion from another healthcare professional. Furthermore, patients who may require surgery to relieve their back pain generally suffer from more severe injuries and/or conditions. Whether you understand the source of your back pain or not, fear of surgery should never keep you from seeking medical attention. But if you prefer a much more natural approach, chiropractic care may be the best treatment option for you.
Chiropractic Care Myths Debunked
Just as there’s many myths regarding what works and what doesn’t when it comes to back pain, there’s also several myths regarding the use of alternative treatment options for your symptoms. As with any other medical procedure, there are many misconceptions out there about what chiropractic care can do for your health issues, when in fact, chiropractic care can be tremendously beneficial for your back pain. However, it is best to have these misunderstandings cleared up once and for all. If you’re considering chiropractic care for your back pain, below we will discuss several of the most common chiropractic care misconceptions and myths which have been debunked through various research studies.
If you suffer from back pain and have considered visiting a chiropractor, you might have heard the myth that chiropractors are not real healthcare providers and that they do not have any medical training. As the Council on Chiropractic Education (CCE) and the American Chiropractic Association (ACA) have made it clear before, a doctor of chiropractic, or chiropractor, receives graduate degrees from Doctor of Chiropractic programs plus they also complete residency programs afterwards to complete their studies. In total, chiropractors spend a minimum of eight years in higher education, including four years as part of their chiropractic college education.
Given that chiropractic care commonly utilizes spinal adjustments and manual manipulations for the treatment of various spinal health issues, a common myth is that this type of treatment isn’t safe. The truth is that chiropractic care is a safe and effective, alternative treatment option for neck and back pain. A qualified and experienced chiropractor utilizes careful precision when using chiropractic treatment methods on a patient. Moreover, a doctor of chiropractic will first make sure to properly diagnose the source of a patient’s back pain symptoms in order to determine which type of treatment method will be best for them. In addition, you may have heard that chiropractic care is only effective for back pain. Research studies have demonstrated that chiropractic care can be helpful for a variety of health issues, including neck pain, headaches and even migraines. Also, individuals who suffer from fibromyalgia and osteoarthritis can also find pain relief with chiropractic care.� Approximately 35 percent of people who receive chiropractic care are seeking back pain relief, whereas the remaining 65 percent visit a chiropractor to seek relief from neck pain, arm pain, leg pain and head pain.
Dr. Alex Jimenez’s Insight
When it comes to back pain, chiropractic care is one of the most popular alternative treatment options people will turn to for relief of their symptoms. Several myths and misconceptions about chiropractic care often turn people away from receiving the proper treatment they deserve, when in fact, chiropractic care can help treat a variety of injuries and/or conditions, including back pain. As a chiropractor in practice, I have helped restore the original health and wellness of many of my patients, giving them back their quality of life. Research studies have debunked these myth, demonstrating that chiropractic care is a safe and effective alternative treatment option because it allows the human body to naturally heal itself through the proper alignment of the spine.
In conclusion,�if you are suffering from back pain, or any other spinal health issue for that matter, chiropractic care can safely and effectively help improve your symptoms. Chiropractic care is a well-known alternative treatment option which focuses on the diagnosis, treatment and prevention of a variety of injuries and/or conditions associated with the musculoskeletal and nervous system. Through the use of spinal adjustments and manual manipulations, among other treatment methods, a chiropractor, or doctor of chiropractic, can help tremendously reduce your symptoms, however, it is essential for you to choose a qualified and experienced chiropractor. Dr. Alex Jimenez is a chiropractor dedicated to enhancing the overall health and wellness of his patients by restoring the original integrity of their spine as well as providing them with the pain relief they deserve. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
Are you experiencing back pain right now? The impact may seem identical, although it can be characterized as a dull throb or a sharp pain. Your life may have already been negatively affected as a result of your back pain. Some estimates show that 80 percent of people may experience the distress of back pain at any point in their life. And from an employer’s perspective, more than 25 percent of those working adults missed a period at work in the previous few months following back pain. Back pain can be aggravating. The pain and discomfort might only last a few days or a couple weeks, however, it may often become a chronic health issue if left untreated for an extended period of time, impacting the lives of the average person as well as that of athletes alike.
Typically, back pain originates from a mechanical problem caused by the regular wear-and-tear of the spine and associated to the aging process of the human body. Daily usage, or the average movement during the course of the day, can take a toll on the structure and function of the spine, discs, and the joints. Sprains and strains, skeletal irregularities, or being involved in an auto accident can also cause the degeneration of the spine but the end results are exactly the same. While anyone can experience back pain, there are some factors that can raise the risk, including age, fitness level, pregnancy and weight gain, occupational risk factors with physically demanding tasks, preexisting mental health difficulties and even overloaded backpacks carried by school children.
Fortunately, relief can be achieved by chiropractic care. Experts estimate it that roughly 22 million Americans visit their chiropractor each year and 35 percent of these patients are seeing their chiropractor to get a remedy for their back pain, recurring neck pain, headaches and numbness or tingling in their arms and legs.
Chiropractic Care Helps Back Pain
Chiropractic care involves the manipulation of the spine with varying levels of pressure exerted through a treatment method intended to restore the health of the human body. The hope is the proper alignment of the spine, adjusted during a process known as a spinal adjustment, to allow the body to heal itself, without forcing the individual to switch to surgical interventions or the use of drugs and/or medication. Patients can expect a thorough evaluation with a comprehensive questionnaire, followed by a physical examination. Lab tests and diagnostic instruments might be used to diagnose the source of back pain.
Spinal manipulation or adjustments take place on densely padded treatment tables which places the patients lying down, which allow the chiropractor to apply the necessary pressure. It is during these spinal adjustments that patients can experience the benign “popping” or “crackling” sound often associated with chiropractic care. A chiropractor might also utilize ultrasound therapy electrical stimulation and massage therapy to treat patients. Chiropractors might additionally suggest nutritional advice, such as the usage of vitamins, as well as recommend a few exercises to enhance the patient’s strength, flexibility and movement in order to help speed up the recovery process.
Chiropractic care is a well-known alternative treatment option for pain back. Some patients feel immediate relief following treatment, although a couple of people may experience mild aching or soreness. Before seeking a diagnosis for your back pain pain, however, it may be important for you to first understand several of the common causes of back pain. Having an understanding of the types of injuries and/or conditions which could be the source of your symptoms could help you and the chiropractor arrange the best type of treatment for your specific cause of back pain. Below are six of the most common causes of mechanical back pain.
Causes of Mechanical Back Pain
The most common causes of back and neck pain are mechanical, meaning they may manifest due to the movements of the spine. The mechanical parts of the spine include the tendons, ligaments, muscles, intervertebral discs and the facet joints. The most frequent region for mechanical back pain is the lumbar spine, or the lower back. This area of the spine�disperse and absorb the majority of the human body’s weight during active and static movement. Static means the body is stationary (eg, standing) although not actively moving (eg, walking). Meanwhile, the neck, or the cervical spine, is the most mobile region of the spinal column. Here, the spine supports the weight of the head. The diversity of motion includes nodding, bending forward, backward, and side to side movements.
However, even if the body isn’t moving, parts of the body continue to support the spine. There are also mechanical forces, such as gravity, pressure, compression and stress, which can still affect the spine. Below are six of the most common causes of mechanical back pain.
Back or Neck Sprain and Strain
A back or neck sprain occurs when a ligament of the spine, or a complex group of strong tissues that hold the bones of the spine together, is overstretched or torn as a result of trauma from an injury. In contrast, neck or back strain involves the over-stretching or tearing of a muscle or tendon attachment due to an injury. Because a sprain or strain can affect any of the complex structures in the spine, finding the exact source of the patient’s symptoms may be challenging without the proper equipment. If you sprain or strain your back (or neck), the delicate tissues are hurt and respond by swelling, thus causing pain and discomfort. Muscles that are affected may go into spasm which can also be painful. Stiffness is another symptom that may make movement difficult.
Disc Herniation
Intervertebral discs divide the drum-shaped vertebral bodies of the spine. Each disc is carefully anchored into place by endplates; a fibrous connective tissue that makes up each intervertebral disc. Intervertebral discs are made of fibrocartilage and allow a small amount of movement at each vertebral segment (2 vertebrae and one disk). The disc’s outer ring, known as the annulus fibrosis, protects the internal workings centre of the disc, known as the nucleus pulposus. Disc herniation occurs when the gel-like substance breaks through the outer ring, often causing nerve compression, inflammation, irritation, and pain. Pain may radiate or travel down to an arm or leg, depending on the region of the spine where the herniation occurred. Weakness, numbness, and tingling sensations can accompany pain and discomfort associated with the herniation of the discs. In addition, an intervertebral disc may rupture in various directions: front (anterior), back (posterior), and/or side (lateral), causing stress against the complex structures of the spine.
Vertebral Compression Fracture (VCF)
A vertebral compression fracture occurs when force from an impact causes the vertebrae of the spine to collapse. Trauma (eg, fall) is a common cause of vertebral compression fracture, though VCF is often related to osteoporosis, a weight loss reduction of bone mineral density and strength. A VCF can also occur during bending forwards or lifting. These fractures usually result in sudden and severe back pain.
Lumbar Spinal Stenosis (LSS)
Spinal stenosis in the lower back, or lumbar spine, develops when the nerve root passageways and/or the spinal canal become narrow. As a matter of fact, the term stenosis means “narrow”. When complex structures of the spine, such as the nerve roots, are compressed as a result of the narrowing of the spinal canal, the dominating symptoms includes pain and discomfort which radiates into one or both legs, a commonly known collection of symptoms referred to as sciatica. Lumbar spinal stenosis, or LSS, prevalently affects adults and may be related to hormonal changes which cause tissue or bone to develop into neural pathways, compressing the spinal cord canal.
Spinal Osteoarthritis (Spondylosis)
Spondylosis is a medical term used to define degenerative spinal osteoarthritis; frequent in older adults. Similar to other kinds of arthritis, spondylosis can affect the facet joints, causing symptoms of swelling, stiffness, pain in the back. It might develop in the neck, known as cervical spondylosis, mid back, known as thoracic spondylosis, and in the lower back, known as lumbar spondylosis. Spondylosis can consist of other degenerative changes that can often lead to disc herniation and spinal stenosis.
Spondylolisthesis
If one vertebral body slips forward over the vertebra underneath, it is characterized as spondylolisthesis. Spondylolisthesis may occur in the neck, however, the lower back or lumbar spine is most commonly affected by this type of condition. The diagnosis and identification of the severity of a patient’s spondylolisthesis includes determining the degree of the vertebrae’s movement. Grade 1 means the vertebra has shifted forward by about 25 percent where Grade 5 refers to a complete slip of the vertebra, known as spondyloptosis. Grade 5 might be caused by a fracture of the bone that helps stabilize the placement of the vertebrae. Aside from pain and discomfort, severe muscle spasms and sciatic-type symptoms may develop.
Dr. Alex Jimenez’s Insight
Although back pain is one of the most common complaints frequently treated in the medical field today, properly treating it may often be difficult because the source of the symptoms may be due to a variety of spinal health issues, including sprains and strains as well as spinal disc herniation and spinal stenosis. Chiropractic care is a popular, alternative treatment option commonly utilized to diagnose, treat and prevent a variety of injuries and/or conditions associated with the musculoskeletal and nervous system. After a thorough medical evaluation is performed by a chiropractor, the back pain specialist may use spinal adjustments and manual manipulations to carefully restore the original alignment of the spine. By correcting spinal misalignments, or subluxations, a chiropractor can release the tension and pressure being placed agains the spine, allowing the human body to naturally heal itself without the need for surgical interventions and drugs and/or medications. Visit a chiropractic care office to discuss the treatment options for your specific type of back pain.
In conclusion,�back pain can occur as a result of a variety of injuries and/or conditions. However, mechanical back pain, caused by the movement of the spine, has been referred to as the most common cause of back pain and spine health issues. Understanding the type of injuries and/or conditions discussed above can help you and the healthcare professional determine the best type of treatment for your specific health problems. Chiropractic care is a well-known alternative treatment option commonly utilized to help treat back pain symptoms, among other types of health issues.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
Approximately 8 out of 10 people living in the United States will experience back pain at least once throughout their lifetime. Fortunately, many healthcare professionals, including chiropractors and physical therapists, are qualified and experienced in the treatment of back pain. Because symptoms of back pain may occur due to a variety of health issues, however, properly diagnosing the source of an individual’s back pain in order to treat them accordingly may often be difficult.
Chiropractic care is a well-known, alternative treatment option commonly utilized to diagnose, treat and prevent a variety of injuries and/or conditions associated with the musculoskeletal and nervous system. A chiropractor, or doctor of chiropractic, will carefully use spinal adjustments and manual manipulations, among other treatment methods, to safely and effectively correct any spinal misalignment, or subluxation, found along the length of the spine which may be causing symptoms of back pain. By restoring the original alignment of the spine, a chiropractor can improve the function of the spine, allowing the human body to naturally heal itself without the need for invasive procedures and/or the use of drugs and/or medications.
Chiropractic care can improve a patient’s ability to better manage their back pain symptoms because it can help reduce pain and discomfort, decreases inflammation, and improves strength, mobility, and flexibility. Furthermore, a chiropractor may recommend lifestyle modifications, including nutritional changes and fitness advice, to speed up the patient’s recovery process. However, before seeking any type of treatment for your specific symptoms of back pain, it’s essential to understand the different types of back pain, its symptoms and its causes as well as what you can expect from a doctor visit for back pain.
Upper, Mid Back, Low and Lower Back
Back pain is one of the most common complaints frequently reported in doctor office visits on a regular basis. As a matter of fact, back pain has been identified to affect approximately three in four adults at least once through their lifetime. When referring to “back pain” healthcare professionals utilize the term loosely to medically define it as pain which originates anywhere between the upper back, or the cervical spine, and the lower back, or the lumbar spine, regardless of the cause of the symptoms.
Other Symptoms Associated with Back Pain
Back pain can also be characterized by different types of pain. Acute back pain is identified as short-term but severe in nature. Chronic back pain is long-term and may vary in intensity. It can often be severe, but it may also be identified as mild, deep, achy, burning, or electric-like in nature. Back pain which radiates into another part of the body, including the upper and/or lower extremities, is identified as radicular pain, particularly when it radiates below the knee, into the feet. This type of back pain is commonly known as lumbar radiculopathy. Fortunately, not all types of back pain include radiating pain symptoms.
It is not uncommon for back pain to cause other symptoms, such as numbness and tingling sensations, stiffness, achiness, and weakness. Furthermore, specific activities are known to aggravate existing back pain symptoms. Everyday activities like sitting, walking, standing, bending over, and twisting at the waist are several movements which can make back pain worse. However, not every patient will experience every symptoms associated with their specific type of back pain. Symptoms of back pain generally depend on the diagnosis, level of the injury and/or condition affecting the spine, or cause of back pain.
Dr. Alex Jimenez’s Insight
Back pain is a common symptom which affects about 80 percent of the population at least once throughout their lifetime. Because a variety of injuries and/or conditions may be the cause of back pain symptoms, many healthcare professionals consider the diagnosis of back pain to be difficult, however, back pain specialists, including chiropractors and physical therapists, can safely and effectively diagnose the source of an individual’s back pain symptoms. As a chiropractor, the use of spinal adjustments and manual manipulations can help naturally restore the original structure and function of the spine, without the need for drugs and/or medications or surgical interventions.
Understanding Back Pain Doctor Terms
When you visit a doctor regarding your symptoms, they may often use terms such as thoracic, lumbar, lumbosacral, or sacrum to describe your type of back pain. Back pain can originate anywhere along the spine, therefore, a healthcare professional will use the following terms to describe the source of the patient’s symptoms. The different regions of the spine are explained below.
The cervical spine refers to your neck.
The thoracic spine is found along the upper and middle regions of the back and where your ribs attach to the spinal column.
The lumbar spine refers to your low back.
The lumbosacral is found along the low back, sacrum, and the tailbone, also referred to as the coccyx.
The sacrum�refers to the part of the spine that is at the back of your pelvis.
Back pain can be challenging to properly diagnose because the spine consists of 17 vertebral bones, from the upper back to the tailbone, many joints, the sacrum and tailbone. In addition, the spine is made up of other fibrous and muscular supporting structures, intervertebral discs, the spinal cord and nerve roots, as well as blood vessels. Trauma from an injury, such as a back sprain/strain from lifting and twisting simultaneously, can cause immediate and severe back pain which may often become debilitating if left untreated.
Not all cases of back pain are due to trauma from an injury. Many other spinal health issues are congenital, meaning they developed since birth, degenerative or associated with age, due to disease, and they may even be connected to poor posture, obesity or the result of an unhealthy lifestyle habit, such as smoking. In other cases, the back pain may be worse than the severity of the injury and/or conditions causing it, which raises the question, �When should I seek medical attention for back pain?� If you are experiencing symptoms of back pain, among others commonly associated with spine health issues, you should seek immediate medical attentions if:
You cannot stand upright;
Fever accompanies pain;
Loss of bladder or bowel function or control occurs;
Leg pain and/or weakness progressively worsens; or if
Pain is relentless or worsens.
It’s normal for patients with back pain to feel afraid and anxious about seeking medical attention for their symptoms. Most individuals who experience severe and debilitating back pain will intuitively known when it’s time to receive the proper health care they need for their spinal health issues. Many healthcare professionals, such as chiropractors and physical therapists, are qualified and experienced back pain specialists who will help safely and effectively treat your specific back pain.
What to Expect from a Back Pain Specialist
Whether your doctor office visit is due to the urgent symptoms above or if you’re simply seeking immediate medical attention to prevent worsening back pain, below is a list of what you can expect in a back pain specialist visit. In order to properly diagnose the source of the patient’s back pain symptoms, a healthcare professional will first:
Review your medical history, including that of immediate family members who also have spinal health issues. Some instances of back pain, like scoliosis and osteoporosis, have a genetic potential.
Discuss when back pain started, what you were doing when the symptoms started, current severity and characteristics of your back pain as well as how these may have changed since they began, among other questions. Your doctor wants to learn as much about your pain and discomfort before they evaluate you accordingly�while the exam may be uncomfortable at first, your doctor doesn�t want to make the process intolerable.
Physical examination�to evaluate your vital signs, including heart rate. Blood pressure levels may become elevated as a result of pain. The doctor will examine your spine, feeling for abnormalities and areas of tenderness.
Neurological examination involves assessing sensation and function. The doctor may employ the pin prick test to determine if feeling is the same on both sides of particular parts of the body. Function, strength, mobility and flexibility are assessed while you walk, bend forward and backward (if able to), and during other movements. The doctor may also test your reflexes.
After a thorough examination, a healthcare professional should then be able to come up with a proper diagnosis for the patient’s back pain. To obtain more information and to help confirm the diagnosis, the doctor may order an X-ray, CT scan, or MRI. Sometimes lab tests may be ordered as well. It’s essential to keep in mind that an accurate diagnosis is essential towards a well-developed treatment plan. Once a proper diagnosis has been established, a healthcare professional will begin treatment accordingly, utilizing the recommended treatment methods for the patient’s specific cause of their back pain. Furthermore, a doctor may also be able to advice the patient regarding the best treatment methods to prevent further back pain.
In conclusion, back pain is a�common�symptoms which affects a majority of the population in the United States on a regular basis. Understanding the different types of back pain, its symptoms and its causes is essential towards receiving the right treatment from a qualified and experienced healthcare professional. Several procedures can be expected in a doctor office visit for back pain. Chiropractic care is a popular, alternative treatment option commonly utilized to help treat back pain and other injuries and/or conditions associated with the musculoskeletal and nervous system. A chiropractor, or doctor of chiropractic, will utilize spinal adjustments and manual manipulations to carefully restore the natural integrity of the spine, reducing symptoms of back pain. The overview above can help patient’s understand the process they must undergo in order to find relief from their back pain.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
Low back pain represents one of the most common complaints in healthcare settings. While various injuries and conditions associated with the musculoskeletal and nervous system can cause low back pain, many healthcare professionals believe that work injury may have a prevalent connection to low back pain. For instance, improper posture and repetitive movements may often cause work-related injuries. In other cases, environmental accidents at work may cause work injuries. In any case, diagnosing the source of a patient’s low back pain to correctly determine which would be the best treatment method to restore the individual’s original health and wellness is generally challenging.
First and foremost, getting the right doctors for your specific source of low back pain is essential for finding relief from your symptoms. Many healthcare professionals are qualified and experienced in treating work-related low back pain, including doctors of chiropractic or chiropractors. As a result, several work injury treatment guidelines have been established to manage low back pain in healthcare settings. Chiropractic care focuses on diagnosing, treating, and preventing various injuries and conditions, such as LBP, associated with the musculoskeletal and nervous system. By carefully correcting the misalignment of the spine, chiropractic care can help improve symptoms of low back pain, among other symptoms. The purpose of the following article is to discuss occupational health guidelines for the management of low back pain.
Occupational Health Guidelines for the Management of Low Back Pain: an International Comparison
Abstract
Background: The enormous socioeconomic burden of low back pain emphasizes the need to manage this problem, especially in an occupational context effectively. To address this, occupational guidelines have been issued in various countries.
Aims: To compare available international guidelines for managing low back pain in an occupational health care setting.
Methods: The guidelines were compared regarding generally accepted quality criteria using the AGREE instrument and also summarised regarding the guideline committee, the presentation, the target group, and assessment and management recommendations (that is, advice, return to work strategy, and treatment).
Results and Conclusions: The results show that the guidelines variously met the quality criteria. Common flaws concerned the absence of proper external reviewing in the development process, lack of attention to organizational barriers and cost implications, and lack of information on the extent to which editors and developers were independent. There was general agreement on numerous issues fundamental to occupational health management of back pain. The assessment recommendations included diagnostic triage, screening for red flags and neurological problems, and identifying potential psychosocial and workplace barriers to recovery. The guidelines also agreed on advice that low back pain is a self-limiting condition and that remaining at work or an early (gradual) return to work, if necessary with modified duties, should be encouraged and supported.
Dr. Alex Jimenez’s Insight
Low back pain is one of the most prevalent health issues treated in chiropractic offices. Although the following article describes low back pain as a self limiting condition, the cause of an individual’s LBP can also trigger debilitating and severe pain and discomfort of left untreated. It’s important for an individual with symptoms of low back pain to seek proper treatment with a chiropractor to properly diagnose and treat their health issues as well as prevent them from returning in the future. Patients who experience low back pain for more than 3 months are less than 3 percent likely to return to work. Chiropractic care is a safe and effective alternative treatment option which can help restore the original function of the spine. Furthermore, a doctor of chiropractic, or chiropractor, can provide lifestyle modifications, such as nutritional and fitness advice, to speed up the patient’s recovery process. Healing through movement is essential for LBP recovery.
Low back pain (LBP) is one of the industrial countries’ most common health problems. Despite its benign nature and sound course, LBP is commonly associated with incapacity, productivity loss due to sick leave, and high societal costs.[1]
Because of that impact, there is an obvious need for effective management strategies based on scientific evidence derived from studies of sound methodological quality. Usually, these are randomized controlled trials (RCTs) on the effectiveness of therapeutic interventions, diagnostic studies, or prospective observational studies on risk factors or side effects. The scientific evidence, summarised in systematic reviews and meta-analyses, provides a solid basis for guidelines on managing LBP. In a previous paper, Koes et al. compared various existing clinical guidelines for managing LBP targeted at primary healthcare professionals, showing a considerable commonality.[2]
The problems in occupational health care are different. Management focuses mainly on counseling the worker with LBP and addressing the issues of assisting them to continue working or return to work (RTW) after sick listing. However, LBP is also an important issue in occupational health care because of the associated incapacity for work, productivity loss, and sick leave. Several guidelines, or sections of guidelines, have now been published dealing with the specific issues of management in an occupational health care setting. Since the evidence is international, it would be expected that the recommendations of different occupational guidelines for LBP would be more or less similar. However, it is not clear whether the guidelines meet currently accepted quality criteria.
This paper critically appraises available occupational guidelines on managing LBP and compares their assessment and management recommendations.
Main Messages
In various countries, occupational health guidelines are issued to improve the management of low back pain in an occupational context.
Common flaws of these guidelines concern the absence of proper external reviewing in the development process, lack of attention to organizational barriers and cost implications, and lack of information on the independence of editors and developers.
In general, the assessment recommendations in the guidelines consisted of diagnostic triage, screening for red flags and neurological problems, and identifying potential psychosocial and workplace barriers to recovery.
There is general agreement on advice that low back pain is a self-limiting condition and that remaining at work or an early (gradual) return to work, if necessary with modified duties, should be encouraged and supported.
Methods
Guidelines on the occupational health management of LBP were retrieved from the authors’ personal files. Retrieval was checked by a Medline search using the keywords low back pain, guidelines, and occupational up to October 2001, and personal communication with experts in the field. Policies had to meet the following inclusion criteria:
Guidelines aimed at managing workers with LBP (in occupational health care settings or addressing occupational issues) or separate sections of policies that dealt with these topics.
Guidelines are available in English or Dutch (or translated into these languages).
The exclusion criteria were:
Guidelines on primary prevention (that is, prevention before the onset of the symptoms) of work-related LBP (for example, lifting instructions for workers).
Clinical guidelines for the management of LBP in primary care.[2]
The quality of the included guidelines was appraised using the AGREE instrument, a generic tool designed primarily to help guideline developers and users assess the methodological quality of clinical practice guidelines.[3]
The AGREE instrument provides a framework for assessing the quality on 24 items (table 1), each rated on a four-point scale. The full operationalization is available on www.agreecollaboration.org.
Two reviewers (BS and HH) independently rated the quality of the guidelines and then met to discuss disagreements and to reach a consensus on the ratings. When they could not agree, a third reviewer (MvT) reconciled the remaining differences and decided on the ratings. To facilitate analysis in this review, ratings were transformed into dichotomous variables of whether each quality item was or was not met.
The assessment recommendations were summarised and compared to recommendations on advice, treatment, and return to work strategies. The selected guidelines were further characterized and reached regarding the guideline committee, the presentation of the procedure, the target group, and the extent to which the recommendations were based on available scientific evidence. All of this information was extracted directly from the published guidelines.
Policy Implications
The management of low back pain in occupational health care should follow evidence-based guidelines.
Future occupational guidelines for managing low back pain and updates of those guidelines should consider the criteria for proper development, implementation, and evaluation of approaches as suggested by the AGREE collaboration.
Results
Selection of Studies
Our search found ten guidelines, but four were excluded because they dealt with the management of LBP in primary care,[15] were aimed at the guidance of sick-listed employees in general (not specifically LBP),[16] were intended for the primary prevention of LBP at work,[17] or were not available in English or Dutch.[18] The final selection, therefore, consisted of the following six guidelines, listed by date of issue:
(1) Canada (Quebec). A scientific approach to the assessment and management of activity-related spinal disorders. A monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Quebec Canada (1987).[4]
(2) Australia (Victoria). Guidelines for the management of employees with compensable low back pain. Victorian WorkCover Authority, Australia (1996).[5] (This is a revised version of guidelines developed by the South Australian WorkCover Corporation in October 1993.)
(3) the USA. Occupational Medicine Practice Guidelines. American College of Occupational and Environmental Medicine. USA (1997).[6]
(4) New Zealand
(a)Active and working! Managing acute low back pain in the workplace. Accident Compensation Corporation and National Health Committee. New Zealand (2000).[7]
(b)Patient guide to acute low back pain management. Accident Compensation Corporation and National Health Committee. New Zealand (1998).[8]
(c) Assess psychosocial yellow flags in acute low back pain. Accident Compensation Corporation and National Health Committee. New Zealand (1997).[9]
(5) the Netherlands. Dutch guideline for managing occupational physicians of employees with low back pain. Dutch Association of Occupational Medicine (NVAB). Netherlands (1999).[10]
(6) the UK
(a)Occupational health guidelines for managing low back pain at work principal recommendations. Faculty of Occupational Medicine. UK (2000).[11]
(b)Occupational health guidelines for managing low back pain at work leaflet for practitioners. Faculty of Occupational Medicine. UK (2000).[12]
(c)Occupational health guidelines for managing low back pain at work evidence review. Faculty of Occupational Medicine. UK (2000).[13]
(d)The Back Book, The Stationery Office. UK (1996).[14]
Two guidelines (4 and 6) could not be evaluated independently from additional documents to which they refer (4bc, 6bd), so these documents were also included in the review.
Appraisal of the Quality of the Guidelines
Initially, there was an agreement between the two reviewers regarding 106 (77%) of the 138 item ratings. After two meetings, the consensus was reached for all but four items, which required adjudication by the third reviewer. Table 1 presents the final ratings.
All included guidelines presented the different options for managing LBP in occupational health. In five of the six policies, the overall objectives of the procedure were explicitly described,[46, 1014] the target users of the system were clearly defined,[514] easily identifiable key recommendations were included,[4, 614] or critical review criteria were presented for monitoring and audit purposes.[49, 1114]
The results of the AGREE appraisal showed that none of the guidelines paid sufficient attention to potential organizational barriers and cost implications in implementing the recommendations. It was also unclear for all included guidelines whether or not they were editorially independent of the funding body and whether or not there were conflicts of interest for the members of the guideline development committees. Furthermore, it was unclear for all guidelines whether experts had externally reviewed the policies before publication. Only the UK guideline clearly described the method used to formulate the recommendations and provided for updating the approach.[11]
Development of the Guidelines
Table 2 presents background information on the development process of the guidelines.
The target users for the guidelines were physicians and other healthcare providers in the field of occupational healthcare. Several policies were also directed at informing employers, workers [68, 11, 14], or members of organizations interested in occupational health.[4] The Dutch guideline was only targeted at the occupational health physician.[10]
The guideline committees responsible for developing the guidelines were generally multidisciplinary, including disciplines like epidemiology, ergonomics, physiotherapy, general practice, occupational medicine, occupational therapy, orthopedics, and representatives of employers’ associations and trade unions. Chiropractic and osteopathic representatives were in the guideline committee of the New Zealand guidelines.[79] The Quebec task force (Canada) also included representatives of rehabilitation medicine, rheumatology, health economics, law, neurosurgery, biomechanical engineering, and library sciences. In contrast, the guideline committee of the Dutch guideline consisted only of occupational physicians.[10]
The guidelines were issued as a separate document,[4, 5, 10] as a chapter in a textbook,[6] or as several interrelated documents.[79, 1114]
The UK,[13] the USA,[6] and Canadian[4] guidelines provided information on the search strategy applied to the identification of relevant literature and the weighing of the evidence. On the other hand, the Dutch[10] and the Australian[5] guidelines supported their recommendations only by references. The New Zealand guidelines showed no direct links between suggestions and concerns [79]. The reader was referred to other literature for background information.
Patient Population and Diagnostic Recommendations
Although all guidelines focused on workers with LBP, it was often unclear whether they dealt with acute or chronic LBP or both. Acute and chronic LBP were often not defined, and cut-off points were given (for example, <3 months). It was usually unclear whether these referred to the onset of symptoms or absence from work. However, the Canadian guideline introduced a classification system (acute/subacute/ chronic) based on the distribution of claims of spinal disorders by time since absence from work.[4]
All guidelines distinguished specific and non-specific LBP. Specific LBP concerns the potentially serious red flag conditions like fractures, tumors, or infections, and the Dutch and UK guidelines also distinguish the radicular syndrome or nerve root pain.[1013] All procedures were consistent in their recommendations to take a clinical history and to carry out a physical examination, including neurological screening. In cases of suspected specific pathology (red flags), x-ray examinations were recommended by most guidelines. In addition, New Zealand and the US guideline also recommended an x-ray examination when symptoms did not improve after four weeks.[6, 9] The UK guideline stated that x-ray examinations are not indicated and do not assist occupational health management of the patient with LBP (distinct from any clinical indications).[1113]
Most guidelines considered psychosocial factors as yellow flags as obstacles to recovery that healthcare providers should address. The New Zealand[9] and UK guidelines [11, 12] explicitly listed factors and suggested questions to identify those psychosocial yellow flags.
All guidelines addressed the importance of the clinical history identifying physical and psychosocial workplace factors relevant to LBP, including physical demands of work (manual handling, lifting, bending, twisting, and exposure to whole-body vibration), accidents or injuries, and perceived difficulties in returning to work or relationships at work. The Dutch and the Canadian guidelines contained recommendations to carry out a workplace investigation[10] or an assessment of occupational skills when necessary.[4]
Summary of Recommendations for the Assessment of LBP
Diagnostic triage (non-specific LBP, radicular syndrome, specific LBP).
Exclude red flags and neurological screening.
Identify psychosocial factors and potential obstacles to recovery.
Identify workplace factors (physical and psychosocial) that may be related to the LBP problem and return to work.
X-Ray examinations are restricted to suspected cases of specific pathology.
Recommendations Regarding Information and Advice, Treatment, and Return to Work Strategies
Most guidelines recommended reassuring the employee and providing information about LBP’s self-limiting nature and good prognosis. Encouragement of return to ordinary activity as generally as possible was frequently advised.
In line with the recommendation to return to regular activity, all guidelines also stressed the importance of returning to work as rapidly as possible, even if there is still some LBP and, if necessary, starting with modified duties in more severe cases. Work duties could then be increased gradually (hours and tasks) until total return to work was reached. The US and Dutch guidelines provided detailed time schedules for return to work. The Dutch approach proposed a return to work within two weeks with an adaptation of duties when necessary.[10] The Dutch system also stressed the importance of time-contingent management about a return to work.[10] The US guideline proposed every attempt to maintain the patient at maximal levels of activity, including work activities; targets for disability duration in terms of return to work were given as 02 days with modified duties and 714 days if modified duties are not used/available.[6] In contrast to the others, the Canadian guideline advised return to work only when symptoms and functional restrictions had improved.[4]
The most frequently recommended treatment options in all the included guidelines were: medication for pain relief,[5, 7, 8] gradually progressive exercise programs,[6, 10] and multidisciplinary rehabilitation.[1013] The US guideline recommended referral within two weeks to an exercise program consisting of aerobic exercises, conditioning exercises for trunk muscles, and exercise quota.[6] The Dutch guideline recommended that if there is no progress within two weeks of work absence, workers should be referred to a graded activity program (gradually increasing exercises) and, if there is no improvement by four weeks, to a multidisciplinary rehabilitation program.[10] The UK guideline recommended that workers who have difficulty returning to regular occupational duties by 412 weeks should be referred to an active rehabilitation program. This rehabilitation program should include education, reassurance and advice, a progressive vigorous exercise and fitness program, and pain management according to behavioral principles; it should be embedded in an occupational setting and directed firmly toward a return to work.[11-13] Extensive lists of possible treatment options were presented in the guidelines of Canada and Australia [4, 5], although most of these were not based on scientific evidence.
Summary of Recommendations Regarding Information, Advice, Return to Work Measures, and Treatment in Workers with LBP
Reassure the worker and provide adequate information about LBP’s self-limiting nature and good prognosis.
Advise the worker to continue ordinary activities or to return to regular exercise and work as soon as possible, even if there is still some pain.
Most workers with LBP return to more or less regular duties quite rapidly. Consider temporary adaptations of work duties (hours/tasks) only when necessary.
When a worker fails to return to work within 212 weeks (there is considerable variation in the time scale in different guidelines), refer them to a gradually increasing exercise program, or multidisciplinary rehabilitation (exercises, education, reassurance, and pain management following behavioral principles). These rehabilitation programs should be embedded in an occupational setting.
Discussion
The management of LBP in an occupational health setting must address the relation between low back complaints and work and develop strategies aimed at a safe return to work. This review compared available occupational health guidelines from various countries. Policies are rarely indexed in Medline, so when searching for guidelines, we had to rely primarily on personal files and personal communication.
Quality Aspects and Development Process of the Guidelines
The assessment by the AGREE instrument[3] showed some differences in the quality of the guidelines reviewed, which may partly reflect the variation in the dates of development and publication of the guidelines. The Canadian guideline, for example, was published in 1987 and the Australian guideline in 1996.[4, 5] The other guidelines were more recent and incorporated a more extensive evidence base and more up to date guideline methodology.
Several common flaws related to the development process of the guidelines were shown by the assessment by the AGREE instrument. Firstly, it is important to make clear whether a guideline is editorially independent from the funding body, and whether there are conflicts of interest for the members of the guideline committee. None of the included guidelines clearly reported these issues. Further, reported external review of the guideline by clinical and methodological experts prior to publication was also lacking in all guidelines included in this review.
Several guidelines provided comprehensive information on the way relevant literature was searched and translated into recommendations.[4, 6, 11, 13] Other guidelines supported their recommendations by references,[5, 7, 9, 10] but this does not permit assessment of the robustness of the guidelines or their recommendations.
Guidelines depend on the scientific evidence, which changes over time, and it is striking that only one guideline provided for future update.[11, 12] Possibly there are updates planned for the other guidelines but they are not explicitly stated (and conversely stating there will be future update does not mean it will actually occur). This lack of reporting may also hold true for other AGREE criteria that we rated negatively. The use of the AGREE framework as a guide for both the development and the reporting of guidelines should help to improve the quality of future guidelines.
Assessment and Management of LBP
The diagnostic procedures recommended in the occupational health guidelines were largely similar to the recommendations of clinical guidelines,[2] and, logically, the main difference was the emphasis on addressing occupational issues. The reported methods for addressing workplace factors in the assessment of LBP of the individual worker concerned the identification of difficult tasks, risk factors, and obstacles for return to work by occupational histories. Obviously, these obstacles for return to work not only concern physical load factors, but also work related psychosocial problems regarding responsibilities, cooperation with co-workers, and the social atmosphere at the workplace.[10] Screening for work related psychosocial yellow flags may help to identify those workers who are at risk for chronic pain and disability.[1113]
A potentially important feature of the guidelines is that they were consistent regarding their recommendations to reassure the employee with LBP, and to encourage and support return to work even with some persisting symptoms. There is general consensus that most workers do not have to wait until they are completely free of pain before returning to work. The lists of treatment options provided by the Canadian and Australian guidelines may reflect the lack of evidence at that time,[4, 5] leaving users of the guidelines to choose for themselves. It is, however, questionable whether such lists really contribute to improved care, and in our view guideline recommendations should be based on sound scientific evidence.
The US, Dutch, and UK occupational guidelines[6, 1013] recommend that active multidisciplinary treatment is the most promising intervention for return to work, and this is supported by strong evidence from RCTs.[19, 20] However, more research is still needed to identify the optimum content and intensity of those treatment packages.[13, 21]
Despite some evidence for a contribution of workplace factors in the aetiology of LBP,[22] systematic approaches for workplace adaptations are lacking, and are not offered as recommendations in the guidelines. Perhaps this represents a lack of confidence in the evidence on the overall impact of workplace factors, a difficulty of translation into practical guidance, or because these issues are confounded with local legislation (which was hinted at in the UK guideline[11]). It may be that the participatory ergonomics intervention, which proposes consultations with the worker, the employer, and an ergonomist, will turn out to be a useful return to work intervention.[23, 24] The potential value of getting all the players onside[25] was stressed in the Dutch and the UK guidelines,[1113] but further evaluation of this approach and its implementation is required.
Development of Future Guidelines in Occupational Health Care
The purpose of this review was to give both an overview and a critical appraisal of occupational guidelines for the management of LBP. The critical appraisal of the guidelines is meant to help direct future development and planned updates of guide- lines. In the still emerging field of guideline methodology we consider all past initiatives as laudable; we recognise the need for clinical guidance, and appreciate that guidelines developers cannot wait for research to provide all the methodology and evidence required. However, there is room for improvement and future guidelines and updates should consider the criteria for proper development, implementation, and evaluation of guidelines as suggested by the AGREE collaboration.
The implementation of the guidelines is beyond the scope of this review, but it was noted that none of the guideline documents specifically described implementation strategies, so it is uncertain to what extent the target groups may have been reached, and what effects that may have had. This may be a fruitful area for further research.
The very existence of these occupational health guidelines shows that existing primary care clinical guidelines for LBP2 are considered inappropriate or insufficient for occupational health care. There is a clear perception internationally that the needs of the worker experiencing back pain are intrinsically linked to a variety of occupational issues not covered by usual primary care guidance and, consequently, practice. What emerges is that, despite the methodological flaws, considerable agreement is evident on a range of fundamental occupational health strategies for managing the worker with back pain, some of which are innovative and challenge previously held views. There is agreement on the fundamental message that prolonged work loss is detrimental, and that early work return should be encouraged and facilitated; there is no need to wait for complete symptom resolution. Although the recommended strategies vary somewhat, there is considerable agreement on the value of positive reassurance and advice, availability of (temporary) modified work, addressing workplace factors (getting all the players onside), and rehabilitation for workers having difficulty returning to work.
Acknowledgements
This study was supported by the Dutch Health Care Insurance Council (CVZ), grant DPZ no. 169/0, Amstelveen, Netherlands. J B Staal is currently working at the Department of Epidemiology, Maastricht University, PO Box 616 6200 MD Maastricht, Netherlands. W van Mechelen is also part of the Research Centre on Physical Activity, Work and Health, Body@work TNO-VUmc.
In conclusion, symptoms of low back pain are one of the most common health issues associated with work injuries. Because of it, several occupational health guidelines have been established for the management of low back pain. Chiropractic care, among other treatment methods, may be utilized in order to help the patient find relief from their LBP. Furthermore, the article above demonstrated the safety and effectiveness of a variety of traditional as well as alternative treatment options in the diagnosis, treatment and prevention of a variety of low back pain cases. However, further research studies are required in order to properly determine the efficiency of each individual treatment method. Information referenced from the National Center for Biotechnology Information (NCBI). The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
1. Van Tulder MW, Koes BW, Bouter LM. A cost-of-illness study of back pain in the Netherlands. Pain 1995;62:233�40.
2. Koes BW, van Tulder MW, Ostelo R, et al. Clinical guidelines for the management of low back pain in primary care: an international
comparison. Spine 2001;26:2504�14.
3. The AGREE Collaboration. Appraisal of Guidelines Research &
Evaluation Instrument, www.agreecollaboration.org.
4. Spitzer WO, Leblanc FE, Dupuis M. Scientific approach to the
assessment and management of activity-related spinal disorders. A monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Spine 1987;12(suppl 7S):1�59.
5. Victorian WorkCover Authority. Guidelines for the management of employees with compensable low back pain. Melbourne: Victorian WorkCover Authority, 1996.
6. Harris JS. Occupational medicine practice guidelines. Beverly, MA: OEM Press, 1997.
7. Accident Compensation Corporation and National Health Committee. Active and working! Managing acute low back pain in the workplace. Wellington, New Zealand, 2000.
8. Accident Compensation Corporation and National Health Committee, Ministry of Health. Patient guide to acute low back pain management. Wellington, New Zealand, 1998.
9. Kendall, Linton SJ, Main CJ. Guide to assessing psychosocial yellow flags in acute low back pain. Risk factors for long-term disability and work loss. Wellington, New Zealand, Accident Rehabilitation & Compensation Insurance Corporation of New Zealand and the National Health Committee, 1997.
10. Nederlandse Vereniging voor Arbeids- en Bedrijfsgeneeskunde (Dutch Association of Occupational Medicine, NVAB). Handelen van de bedrijfsarts bij werknemers met lage-rugklachten. Richtlijnen voor Bedrijfsartsen. [Dutch guideline for the management of occupational physicians of employees with low back pain]. April 1999.
11. Carter JT, Birell LN. Occupational health guidelines for the management of low back pain at work�principal recommendations. London: Faculty of Occupational Medicine, 2000 (www.facoccmed.ac.uk).
12. Occupational health guidelines for the management of low back pain at work�leaflet for practitioners. London: Faculty of Occupational Medicine, 2000 (www.facoccmed.ac.uk).
13. Waddell G, Burton AK. Occupational health guidelines for the management of low back pain at work�evidence review. Occup Med 2001;51:124�35.
14. Roland M, et al. The back book. Norwich: The Stationery Office, 1996.
15. ICSI. Health care guideline. Adult low back pain. Institute for Clinical Systems Integration, 1998 (www.icsi.org/guide/).
16. Kazimirski JC. CMA policy summary: The physician�s role in helping patients return to work after an illness or injury. CMAJ 1997;156:680A�680C.
17. Yamamoto S. Guidelines on worksite prevention of low back pain. Labour standards bureau notification, No. 57. Industrial Health 1997;35:143�72.
18. INSERM. Les Lombalgies en milieu professionel: quel facteurs de risque et quelle prevention? [Low back pain at the workplace: risk factors and prevention]. Paris: les editions INSERM, Synthese bibliographique realise a la demande de la CANAM, 2000.
19. Lindstro?m I, Ohlund C, Eek C, et al. The effect of graded activity on patients with subacute low back pain: a randomised prospective clinical study with an operant-conditioning behavioural approach. Physical Therapy 1992;72:279�93.
20. Karjalainen K, Malmivaara A, van Tulder M, et al. Multidisciplinary biopsychosocial rehabilitation for subacute low back pain in working-age adults: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2001;26:262�9.
21. Staal JB, Hlobil H, van Tulder MW, et al. Return-to-work interventions for low back pain: a descriptive review of contents and concepts of working mechanisms. Sports Med 2002;32:251�67.
22. Hoogendoorn WE, van Poppel MN, Bongers PM, et al. Physical load during work and leisure time as risk factors for back pain. Scand J Work Environ Health 1999;25:387�403.
23. Loisel P, Gosselin L, Durand P, et al. A population-based, randomised clinical trial on back pain management. Spine 1997;22:2911�18.
24. Loisel P, Gosselin L, Durand P, et al. Implementation of a participatory ergonomics program in the rehabilitation of workers suffering from subacute back pain. Appl Ergon 2001;32:53�60.
25. Frank J, Sinclair S, Hogg-Johnson S, et al. Preventing disability from work-related low-back pain. New evidence gives new hope�if we can just get all the players onside. CMAJ 1998;158:1625�31.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
