Herniated (slipped discs) in the back and neck; What consumers need to know to choose the best care to get relief
All you did is bend over, hear a pop and you are now in pain. Whether this has happened before means nothing since you are having problems now that interfere with your ability to work, put on your own socks in the morning and sitting for long periods of time is excruciating. After trying some home remedies, you decide to call someone however, whom can you trust to help you recover; an orthopedic, a chiropractor, a physical therapist, the family doctor?
If this sounds familiar, you likely had sprained or strained your lower back. If it took weeks to recover, you likely injured one of the discs in your back. The question of who would be best to help you through this is simple enough.
Orthopedist – Likely to place you on medications that help kill the pain but are more likely to make you lethargic and upset your stomach. They are likely to order a test such as an MRI which can be difficult to tolerate since you need to sit still for 40 minutes in the machine while in pain, and when the test comes back, it may not lead to better care although they are likely to then send you to physical therapy.
Physical Therapist – Will evaluate you, and then carry out the doctor’s office to work on your back, and then have you do some exercises which can help alleviate the pain over time. Since this is practitioner dependent, hopefully you will find a good practitioner who helps you.
Chiropractor – Chiropractors are joint specialists that look at the entire system, not just where the pain is. While you are in pain, you will want them to focus on the area of pain however, there is more to back pain and disc problems than just the back. In the book Cheating Mother Nature, what you need to know to beat chronic pain, it talks about kinetic chains, the series of joints from your foot to your knee to your back and how they even affect the upper extremities. If you are built asymmetrically, you are also most likely to herniate a disc or sprain your lower back. The chiropractor is trained to look at your body mechanics and find a treatment appropriate for the condition that will not only stabilize the area but also take care of the cause which may be a foot problem or other walking abnormality which is usually inherited and something you are probably unaware of.
Why address the cause and not just the back issue?
People who have chronic lower back problems generally have abnormalities with their gait and body style they are not aware of, likely because no one ever explained it to them. It is important to understand why you hurt, both for the practitioner and the patient because accurate diagnosis is what will lead to effective treatment. Diagnosing a herniated disc on an MRI shows you a resulting lesion, but it does nothing to help you understand why it occurred and how to resolve that problem so the likelihood of another episode is greatly reduced. Knowledge is power and not knowing can make you a victim of poor recommendations and surgeries you may not need.
A few years ago, the NY Times ran headlines about how we were losing the war on back pain, even though since 2000, the cost and the amount of surgeries that have been done have risen 37 percent while the outcomes have become poorer.
If we address the problem with conservative active care regimens and properly educate the patient, 80% or more of our patients improve with chiropractic care safely, often at a much lower cost. The traditional model of MRI, medication, lost work time, physical treatments directed at the painful area and then when this fails, pain management to manage the pain that is poorly understood is much more expensive, and is what the NY Times reported about. While an MRI can diagnose a disc problem, it will not show you how it got there which in the long run is going to help you reduce the likelihood of future injuries. Ask yourself is the appropriate diagnosis is a disc problem found on the MRI or perhaps the gait issue that create it and its affect on the pelvis and the way you walk that was really the true reason you are in pain and this is what needs to be addressed, leading to a faster improvement and fewer future injuries.
Choosing care from a consumers point of view
If you visited a store, or shopped on the Internet for a television, chances are that you did some research, had data and then could price shop the television you wanted and then have it in your living room the next day.
Health care is more complicated because most health care providers do not disclose their prices and in this time of consumer based plans where you have a high deductible, and are paying the bill until you reach the deductible, who would choose a more expensive and less effective option? If you knew the MRI that costs just under $1000 probably costs more than the chiropractor does to treat the condition and you have less time laid up, would you visit the orthopedic for $300 for a 15 minute consult, then the medications which likely cost a couple of hundred dollars, and then the lost time from work or productivity, when an option that is safer and effective may have you out of pain faster? Of course, as the pain persists, they may suggest pain management and injections for thousands more with a questionable level of safety and effectiveness.
Likely, you would weigh all these factors except when you are in pain, you are likely to be more panicked and choose poorly because of fear. Most people who have read the book Cheating Mother Nature would always choose based on knowledge because the book is designed not as a self help book but as a self knowledge book about body mechanics and it is written for the average person, however doctors can appreciate its lessons as well. When you have the data or the knowledge, you would even in pain be able to make a more rational decision especially since more of the costs now are borne by you, the consumer.
What you should expect on a chiropractic visit and whom should you choose.
1. 30 Years ago, the standard of care was to use methods like heat, ice, muscle stim and other passive therapies. With the advent of managed care and the current methods progressive and sports chiropractors are using, most are now hands on, using methods such as Myofascial Release, Active Release, Graston and manipulation which improved joint mobility, one of the most important concepts in the chiropractic paradigm of care.
2. The most up to date chiropractors use active evaluation methods to help them and you understand what is wrong and more efficiently resolve the problem. They use active rehabilitation to improve body function once the your body mechanics are fixed.
3. Often, a referral can be quite helpful to find someone who is good however, many patients now find us on the Internet via Facebook, twitter or our YouTube page. Our office has many resources for our patients such as videos, on the web site exercises (just in case you require re instruction) and most important, a discharge date. Care should never take forever and treatment plans should be reasonable.
4. Most minor lower back problems will resolve and be rehabbed in a relatively short period of time (4-6 weeks or less). Herniated discs can take much longer since the pain can be deep and lingering. It is not unusual for a herniated disc problem to resolve in 3-4 months if the problem is quite bad. If the doctor suspects that something more is involved with your problem, he may order an MRI to rule it out which is the standard of care vs. ordering it up front. Since few people actually require the MRI, and since many people are walking around with asymptomatic disc problems in their back, an MRI is only as valuable as the rest of the data surrounding it, plus it may open up doors to more aggressive treatments that are dangerous, expensive and may create more problems for you in the future. Conservative care is always a wise consumers first option. As with all types of health care providers, skill levels may vary and results can be practitioner dependent.
5. While a chiropractor cannot solve all disc problems, and occasionally, a referral to a surgical specialist is necessary and appropriate, using the chiropractor as primary care or contact for disc and back issues is as many current studies and now Consumer Reports show is your best option for a back and disc problem. Savvy consumers choose chiropractic first.
Read Cheating Mother Nature, what you need to know to beat chronic pain available through Amazon.com and other booksellers.