Back pain affects 80 percent of adults at some point in their life and is the number one cause of disability in the working age population. Symptoms of a back problem may include stiffness, muscle spasms, a dull ache, or a burning sensation. A sharp, shooting pain may occur with bending or certain motions. Pain, tingling or numbness may radiate into the hip area or down the leg as “sciatica.” Symptoms may be mild or excruciating. Pain may be intermittent, come on gradually or occur suddenly after a strenuous activity that involves bending, twisting or lifting. Many people report the onset of pain for no apparent reason.
At present, most spine specialists agree that the overwhelming majority of back pain is due to “mechanical causes.” This means pain from dysfunction and irritation of the spinal joints, discs, nerves, ligaments, and muscles rather than from actual pathology of the spine.
A massive review of all types of treatment for back pain conducted by the U.S. Department of Health and Human Services resulted in the publication of a Clinical Practice Guideline for physicians and health practitioners (Acute Low Back Problems in Adults: Agency for Health-Care Policy and Research, Guideline no. 14).
Some highlights of their recommendations:
- “Relief of discomfort can be accomplished most safely with non-prescription medication and/or spinal manipulation.”
- “Bed rest greater than four days is not helpful and may further debilitate the patient.”
- “Patients recovering from acute low-back problems are encouraged to return to work or their normal daily activities as soon as possible.”
Many traditional medical therapies for back pain were not recommended as they were found to be of “insufficiently proven benefit.” Many of these therapies nevertheless continue to be used today.
More than thirty years of practice experience suggests that many individuals have several factors related to their pain rather than a single cause. Restricted joint motion, muscle spasm and nerve irritation often combine to produce pain. Our treatment intervention may involve spinal manipulation to restore joint motion, manual trigger point therapy to reduce muscle spasm, exercises to strengthen back muscles, and advice on lifestyle modifications.
By starting with a thorough evaluation of the patient, using X-rays and imaging studies as needed and taking a multifaceted approach to treatment, we have been able to achieve superior results for our patients with this common problem.