This article was published by Dr. Erik in the Telegraph-Journal online and KV Style in early 2017.
You are probably receiving the wrong treatment for your low back pain
Chances are, the treatment you receive for your low back pain is probably not the right one. This is because even with this common problem, scientists have yet to be able to agree on what works even after decades of trying to figure it out. The reality is, there are commonly two huge problems, especially with therapists: too many hold old-school beliefs and choose not to further educate themselves. On the other hand, others treat every patient pretty much the same way, seeing low back management with a catch-all solution. This is very concerning because getting people better is all that matters. Full stop. Unfortunately, I see this go on every single day. The factors affecting low back pain are diverse and require full body biomechanical analysis, assessment of skeletal and muscular imbalance, work/home habits, diet, stress, and other emotional issues. The American College of Physicians just released a brand spanking new guidelines and they recommend therapy before drugs. Below we discuss what you should and shouldn’t do.
Low back pain is most often temporary muscle or joint stress that is coming from some form of overcompensation. Essentially an on-going issue that tends to rear its ugly head every once in a while. If you had a car where the strut was rusted out, would you continue to patch the strut and have repeated breakdowns, or would you fix the car so it worked optimally? Some of the most popular treatments are merely patches. Getting ultrasound treatment, TENS, IFC, ice packs is effectively patching the strut. These passive modalities don’t fix any problems. Active modalities such as hands-on deep muscle work, the advice to stay active, spinal manipulation, and mindfulness/stress reduction DO fix problems. Mechanical spinal syndromes require hands-on, active solutions to return your body to optimal function. Further, these strategies are proven to show more positive responses in the brain (vs. electronic tools like ultrasound). How the brain responds to the sensations you are experiencing is just as important as the problem itself, because the brain modulates how you feel pain.
Sometimes, when I am being asked for a second opinion, people want to know what to look for in a great therapist. There are a few simple guidelines: your therapist should apply active, hands on care and encourage you to keep moving. Your therapist should understand the WHY of the problem and be able to explain it in simple, yet specific terms, what is going on, and how they are fixing your problem in a step by step fashion. For mechanical spine syndromes, if you’re under care at a clinic, you should see some symptomatic change by the third visit, and you should feel great by visit ten. Even with sciatic problems, fifteen visits is all that should be required for acute flare-ups in most cases. If not, a referral is likely warranted. Finally, find out that your therapist is doing a TON of continuing education, continuing to build their skill sets and tool belts so they can help you be your greatest as quickly as possible. When you begin care, demand the best and if you aren’t improving fast, seek a second opinion.
There really is a dog’s breakfast out there for options for low back pain, and much of it is frankly wrong because it’s easy or quick to implement and a lot of people can be covered in a short period of time. Efficiency is frequently rewarded over results. With new guidelines though, we know better. Great clinicians dive deep in (both mentally AND physically) to unravel WHY this is happening and this takes attention and time, but the results speak for themselves and people see the difference.
Dr. Erik Klein is a health policy expert, published author, and practicing chiropractor in Saint John, and Hampton. Dr. Erik is the CEO of ‘Town Health Solutions’ an award-winning network of clinics in Atlantic Canada. He can be reached at drerikceo@townhealthsolutions. For further information, please go to www.townhealthsolutions.com, or search on Facebook.