Low back pain is the leading cause for patients to miss work; therefore, in my Fort Lauderdale Chiropractic office, we have seen quite a few patients that suffer from acute and chronic low back pain. I think it would be safe to say that low back pain is most likely the most common symptom that patients complain about. Almost every American, at some point or another in their adult life, has suffered to some degree with low back pain.
The low back is defined as the area that begins along the spine right below the rib cage and runs down to the pelvis, or hip area. Typically low back pain is caused by a strained muscle and can be either a dull ache or a sharp shooting pain. The pain can be so significant at the time of injury that it can take you to your knees. Patient often complains of having a hard time going from sitting to standing. When they walk into the office they often can not even stand up straight and have a bit of a lean to their posture. Since the muscles of at area are extremely dense and powerful, when we overdo it or pick something up incorrectly, those muscles can become overworked and strained. Therefore, many people experience that with some rest, ice, and heat the pain will subside and go away in a few days. The problem is that when “your back goes out” (as so many people like to categorize it) once or twice a year this is a huge red flag that there is another reason for the pain and not just a pulled muscle. This is where the Chiropractor comes in…
Chiropractor… the perfect low back doctor?
So many people think of Chiropractic when they think of low back pain. While, yes, we do see and help many people that suffer from low back pain, we also have the potential to additionally increase the quality of life for these same patients. You see… low back pain (while it can be an acute onset of pain from an injury or a fall) is usually a chronic condition that people suffer and deal with for decades of their lives. It does not have to be that way for everyone. Early detection, diagnosis, and treatment in a Chiropractic office will yield the absolute best opportunity for restoring activities of daily living as close back to normal as we can expect. Nowhere in my world is it just “normal” or “ok” to not be able to get on the floor and play with your children, not be able to walk around Disney with your grandchildren, or not be able to take your dog for a long walk. Quality of life is so much more important and quantity.
At Dynamic Chiropractic we begin with a detailed consultation to have a starting point for further examinations and testing in (and outside of) the office. If, during the consultation, we determine that our office might be able to help we continue with a thorough examination. Since the bones of your low back (lumbar spine) are designed to completely encapsulate and protect the nerves that exit the spine, it is vital at this point to find out if your discomfort is caused by a bone, muscle, or something even more serious. This information is very important in deciding if Dynamic Chiropractic is the right place for you and if we can help or not. During the examination, we will palpate or feel the movement of your spine. This removes the muscle involvement and allows us to specifically see how the bones move in relation to the ones above and below. Then we perform a range of motion test. This will actively use the muscles of the low back to see if there are any limitations. A posture evaluation will allow us to visually see if there are any potential global misalignments within the spine that are distorting your general posture (one hip higher than the other… torso leaning to one side… one leg longer than the other… etc.). Finally, an X-Ray series is completed to objectively see and measure the abnormal alignment of the spine. We all know that you can look relatively fine on the outside and be very sick on the inside. That is precisely why a picture is worth a thousand words at this point. If we find that we can help you with your low back pain, in addition to spinal adjustments to realign the spine, we will give you functional exercises and specific stretches relative to your individual needs to help work with the musculoskeletal component as we are moving the bones. Additionally, we will give you specific home instruction to reduce the inflamed area and facilitate healing faster. If within a few days of specific treatment we are not experiencing a reduction of the swelling in the area or the pain, we will refer you to the appropriate physician to get the medications necessary to reduce the inflammation so that Chiropractic can work better to fix the underlying problem. We find that this “adjust it from all angles” approach seems to yield the best results the quickest.
5 Common causes of low back pain
Muscle Strain or Ligament Sprain
This type of injury can occur of sudden onset with trauma or can be a result of repetitive movement. An example of trauma or repetitive movements might be: lifting something heavy and/or possibly twisting while lifting, a sudden movement that places too much stress on the muscles of the area, a fall, poor posture or ergonomics at work, and finally years of sports-related activity or injury. Even though a “pulled muscle” does not sound serious and would be expected to resolve by itself within a few days, this can be extremely painful and with multiple episodes over years can lead to more serious conditions.
Pinched Nerve due to a Disc Bulge or Herniation
What is the difference between a disc bulge and herniation? A bulging disc is when the fibers that hold a disc together become weak and sag thereby putting pressure on the nerve root (pinched nerve). A herniation is when the bulge is there for a prolonged period of time and/or there is some type of trauma that tears the fibers that hold the disc together. This causes parts of the disc to leak out into the spinal canal. Both situations cause to seek the help of a healthcare practitioner. Either of these instances could be associated with numbness, sharp, shooting pain along the nerve pathway. It may even have a tingling, pins and needles sensation. Depending on what we find during the consultation and upon analysis of the x-rays, we may feel so inclined to get an MRI done to definitively diagnose if it is a bulge or a herniation. As long as the pinching on the nerve is from a bulge, we may be able to help reverse the condition or limit the progression of the damage in the future. However, if the condition has progressed to the point of a herniation, we would need to refer to a spinal surgeon. Seeking a specific diagnosis at this time is vital to the proper healing of this condition.
Again… you have heard me say this before. Arthritis is the most loosely used and most misunderstood condition surrounding low back pain. There is no scientific evidence that arthritis is genetic. However, it can 100% be habitual. There are many different types of arthritis that are potential for the spine. I am sure you have heard of some of them: osteoarthritis and spinal stenosis (to just name a few). Different names for arthritis explain two things: where the arthritis is located and the characteristics of what the excess bone growth is doing to the surrounding tissue. Osteoarthritis is associated with degeneration of the discs and excess bone growth on the larger boney structure of the spine called the vertebral bodies. Spinal stenosis is a narrowing of the canal (or hole) that either the spinal cord or the nerve root travels through.
I would like to break down the process of how arthritis comes about to empower you to stop it if you in fact have it… or… take control of your spinal health to prevent it from happening in the first place. When bones of the spine are misaligned and not functioning properly the body perceives that as an unstable situation. The only way that the body knows how to create stability within a joint is to calcify connecting tissues and create more bone in the area. That excess bone growth is defined as arthritis. How do you stop it? Go to a chiropractor who can help realign the bone structure to a more “normal” position so that the bone growth slows down or stops. How do you prevent excess bone growth in the first place? Go to a chiropractor who can help realign the bone structure to a more “normal” position so that the bone growth is limited or never happens. Of course, many people opt for waiting and procrastinating to the point when the only option is risky surgery. That does not have to be your only option if you catch it early enough. Just don’t ignore the early signs.
Degenerative Disc Disease
This is what I have found to be the silent cause for chronic low back pain. Over the years there is trauma, muscle pulls, bad posture, unsupportive beds, and of course the sports we played “back in the day”. All of that over time results in wear and tear that goes unnoticed because if there is any pain it is short-lived or easily treated with a Tylenol. Prevention and routine chiropractic checkups are so vital when it comes to degenerative conditions. The sooner you see and address a degenerative condition the easier it is to stop further damage. Don’t be a victim… get a checkup.
Scoliosis is defined as any lateral (or side to side) movement of the spinal column depicted on an x-ray. The biggest concern with scoliosis over time is significant and possibly severe nerve compression. This potentially could decrease the function of organs and muscles where those nerves innervate. There are two types of scoliosis: structural and functional scoliosis. Structural scoliosis is caused by some type of deformity of one or more bone structures within the spine causing lateral movement. Functional scoliosis mimics (or looks like) structural scoliosis; however, is originated from a misalignment of the bones of the spine and not a deformity. A trained Chiropractor would be able to take an x-ray and determine the diagnosis, cause, and help with a course of treatment. It is extremely common for people that deal with and live with scoliosis to experience bouts of low back pain due mostly to the compression of the nerve roots to the muscles of the low back region. Again… the earlier there is a diagnosis and treatment the better the outcome.
5 Most Frequently Asked Questions about Low Back Pain
1. What causes low back pain in women?
Women suffer from disc issues and degeneration just the same as men. Women do have a tendency to seek the help of a healthcare provider before men; therefore, early detection of spinal misalignments and postural abnormalities are found sooner. Hormonal changes can also cause a redistribution of body composition causing more pressure on the low back. Pain directly related to menstruation is also common. Kidney and gallbladder issues are sometimes misdiagnosed as low back pain especially in women just outside of childbearing years.
2. When do I know if my low back pain is something more serious?
Low back pain can come on quickly or gradually, it can be a dull ache or severe pain. Bottom line is that low back pain shows up in many forms; however, if you are experiencing any of these additional symptoms along with your low back pain you should seek emergency medical attention right away: increased weakness in your legs, loss of bladder and/or bowel control, severe pain upon sneezing or going to the bathroom, or severe stomach pain. When in doubt… go to the doctor… better to be safe than sorry.
3. When should I worry about my low back pain?
Seeking medical help sooner than later is always a good key for prevention. It is always better to be safe than sorry. However, if you try to manage your discomfort on your own with over-the-counter pain medication and nothing is working for a period of 7-10 days it is a good idea to get help right away. Additionally, you should seek help sooner if your condition is not getting better or even getting worse if you begin to experience numbness or tingling down one or both legs, if you lose bowel control, if you are under the age of 20 or over the age of 55, if you experience a fever, or if you notice rapid unexplained weight loss.
4. How do I tell if my low back pain is from a muscle or a disc?
Generally, (not always) a disc herniation hurts both with bending forward AND with returning from bending back up to a standing position. A muscle strain or sprain tends to hurt less with bending forward but much more with returning from a forward bend to a standing position.
5. How should I sleep with low back pain?
The best way to sleep when experiencing low back pain is on your side with your knees bent. By bending your knees you take pressure off of your low back. Some people even find it helpful to place a small pillow between their knees to make that position more comfortable.
In conclusion, years of wear and tear is usually the culprit with low back pain. However, just because the pain goes away with some rest, a Tylenol, or just time, does not mean that you should ignore it or just pretend that it did not happen. Take this as an opportunity to prevent a furthermore severe or serious condition from happening in the future. Obviously, the sooner a condition is evaluated and treated the better opportunity the outcome in the long term. Famous last words in a Chiropractic office… I thought it would just go away on its own, but it keeps coming back worse every time. Call Dynamic Chiropractic… a simple x-ray could save you weeks, months or even years of suffering.