According to the American Chiropractic Association, back
pain affects half of Americans, is the most common reason for missed work, and
is the second most common reason a person visits the doctor. This condition is most likely caused by
something that is non-organic (organic being cancer, rheumatoid arthritis) and
is mechanical in nature.
Many patients are concerned with the cause of the back pain
but also with answers as to why anti-inflammatory medications and muscle
relaxers do not alleviate completely their condition. Back pain can be multifaceted with many sources
being the cause of the pain and often it is not one pain generator but multiple
that need to be addressed. To
understand why a pain medication may not be enough, we must briefly discuss the
anatomy of this condition. Your
spine is composed of ligaments (structures that connect bones), tendons
(structures that connect muscles to bones), joints (areas were bones move with
one another), and lastly muscles (structures that generate movement in
bones). These four anatomical
components have the potential to generate pain and discomfort in different
ways.
Let’s take a back sprain (injury of a ligament) or strain
(injury to a muscle) for example.
If a person lifts something heavy without the appropriate strength and
core stability, they may sprain/strain the back ligaments or muscles. When the muscle strength is not
adequate, the back relies on the ligaments to help stabilize joint
segments. Rarely does one occur
without the other. If the ligament
is sprained, it typically coincides with an injury of the muscles which spasm
or contract in protection. To add
to what appears to be a complex situation, the joint can also become injured in
this situation resulting in joint inflammation. If a muscle relaxer is prescribed, it may relieve the muscle
pain but what about the injured ligament and/or joint pain? Lastly, muscles often do not fire
properly after a serious injury, so is the pain reduction a complete assessment
of a person’s function or should we also care whether a person’s movement is
appropriate after such an injury?
While the last paragraph was quite technical in it’s
delivery, the message is important.
There is not a single therapy in most situations that alleviate all the
levels of back pain (especially when chronic), but rather a combination of
therapies that will deliver complete relief. Treatment plans for every
condition, including back pain, must be specific and targeting the areas of deficient
in the person’s body. It is
necessary to have a comprehensive evaluation to derive such a treatment
plan. Patients often want to know
how long it should take to experience relief. Any precise treatment plan should deliver relief in a
reasonable time frame with 8 weeks being the absolute longest and 3 weeks
potentially being all you need. If
the treatment targets the right anatomical issues, back pain and all other
mechanical issues should experience a percentage of relief with every
visit.
We would not be a holistic practitioner without recognizing
that back pain is not just mechanical but could be as a result of other
issues. We recognize pain related
to the meridian system (think acupuncture) and it’s imbalance and internal
medicine complaints (for example, constipation) that refer pain to the
spine. These conditions require a
different therapeutic approach which we can discuss in another post.
Are you wondering what you can do to make your back pain
better? Here is a list of changes
you can make to reduce the pain you experience and potentially remedy it all
together.
· If
you are overweight or obese, reduce your weight which will reduce the stress on
the spine and aid in strengthening the core.
· Wear
shoes that support the arch and have no more than a 1-inch heel
· Stretch
your legs after sitting for extended periods – if you work at a desk, stand all
day, or stand/sit in any position for too long, your body develops tight
muscles that need to be stretched.
· Strengthen
your abdominal muscles
· Sleep
on a supportive surface with a pillow beneath your knees if you sleep on your
back or between your knees if you sleep on your side.
· Hydrate
and nourish your body with water and nutrient rich foods.
If these changes are not effective, you should consider
being evaluated for holistic care.
