Lower back pain, sciatica, snake oil salesmen and your health; 6 reasons why you need a body mechanic At a party the other day, a woman was describing her husband’s back problems and how she just wished he would visit a chiropractor. Over the July 4th holiday weekend, he played golf and ended up in one of the walk in clinics, who evaluated him, gave him medication and offered little more for relief of a back problem that has plagued him for years. Over the years, as a primary spine physician, body mechanic and chiropractor, we see many people who just don’t understand that back pain is a mechanical problem, requiring a mechanical solution. While chiropractic should naturally comes to mind, people are often sent on journeys including different lower back specialists who practice using pain theories based on belief systems, referrals, referral bias, dogma and questionable internet advice. As a healthcare consumer, who should we trust first? The provider you choose first can make all the difference in the world regarding how fast your lower back problems resolve or improve and what your experience is like. For any condition we suffer from, there is always someone with a great way to treat or throw therapies at it. Years ago, we had snake oil salesman who would sell an elixir that would cure our ills. Of course, these potions did not work, but since most of them were mostly alcohol, perhaps the purchaser forgot about their problem for a while. Many therapies offered today have the same rate of effectiveness unfortunately. In today’s healthcare environment, we have the same issue of snake oil salesmen who have cultural authority through their medical or other degrees who we have learned to trust based on their professional degree, yet they know or understand little about why your lower back or even your disc in your lower back has gone bad. Worse, they may not refer you to the most cost effective healthcare provider based on their own dogma (belief system). How can you suggest a cure for something you do not fully understand (which is a reasonable question)? This is the problem with the current state of lower back treatment. Everyone from chiropractors to surgeons to pain management to physical therapists have a treatment, a cure or a management for the condition. The bad news, as discussed in the book Cheating Mother Nature, what you need to know to beat chronic pain is that most of these methods do not work reliably or consistently enough and some of these management methods are so unbelievably expensive such as epidural injections, yet, they offer little in the way of long term consistent relief. Other methods work so poorly, that people choose risky solutions such as surgeries or injections out of desperation, and then either see little benefit or in some cases, are worse off than before the intervention. Perhaps, the problem is that most doctors and therapists are quite knowledgeable about how to apply a treatment; yet, the back is really just a symptom. Worse, most healthcare providers suffer from professional bias, and see back problems through the lens of their profession, rather than as a mechanical problem, which leads to more tests and poor treatment recommendations. If you have lower back pain after numerous episodes that results in an MRI and perhaps a disc based diagnosis, is the problem the disc, the back, or maybe the mechanism that created the problem is really the problem. If we use therapies, medications and other regimens to work on the area of pain, rather than the mechanical cause of it, aren’t we are just treating a symptom, rather than the problem. Perhaps, this is why people who have one lower back, or even a knee surgery or injury, continue over the years to have more problems with it since the actual cause was never properly diagnosed and addressed. There are numerous therapies we can choose from to treat our pain which include medications, injections, manipulations, exercises and more. Everybody seems to have a solution however, now that deductibles for care are going higher, choosing the wrong treatment can be expensive for you, not just the insurance carrier so it pays to choose wisely. Also, since back problems can be quite debilitating, repeat episodes is a sure sign that the problem has never been properly addressed. 6 reasons why you need a body mechanic if you have lower back and leg pain To properly diagnose and treat a lower back problem, a healthcare practitioner must look at everything including the way you walk, move and stand. This is important since lower back and leg problems are mechanical problems most often beginning at the feet. This is why you need a body mechanic to looks at you, not just the symptoms you are experiencing. If you are from a family of people experience back problems, you not only look like them but probably walk like them too. A healthcare practitioner must dig deep into your history for facts; An example of this asking questions regarding problems outside of the complaint such as is the neck stiff all the time, do you have shoulder problems in your history or do your knees crack all the time when you crouch down. These are signs of a chronic lower back problem that involves the way you walk, even though the symptoms may be in the lower back now. Most of us once leave toddler gait (usually around the age of 5 or 6), are walking the way we will when we are adults. If we are built asymmetrically and are stiff all the time, we have no way of knowing this since we assume this is normal based on our life’s experiences. The truth is that there is no normal to us, there is the fact that we are in pain now and before things were as they always were, whatever that state of function was.If your healthcare practitioner just asks when the problem began, and how the injury occurred, while this may be fine if you are just lifted your child wrong, they should still dig for facts in your previous history which can help them better help you. The healthcare practitioner recommends a conservative, non invasive treatment based on the evaluation. If the evaluation is more holistic (looking at the entire mechanism, rather than just the back), it will lead to better treatment recommendations. Most people can avoid taking medications after the first couple of days of pain as their pain improves. The health care practitioner explains things simply, in plain English. Using big words and scary terms or what if scenario’s are often used when they practitioner themselves are unsure of why you hurt. Those who are unsure are most likely to order expensive tests such as an MRI and give medications first, rather than recommend a functional mechanical solution to your problem. This type of behavior often leads to invasive procedures such as injections and surgeries which should be considered last. The most effective healthcare practitioners will treat – test -treat, a scientifically proven protocol that is both cost effective and helps you get the best outcome. This is also known as active evaluation and treatment, which is becoming more common in the most effective healthcare providers. Years ago it was the standard of practice to diagnose and use a similar treatment or protocol for 10 visits and then reevaluate. This is very wasteful and expensive as well as ineffective. The most effective healthcare providers will monitor your success as they use methods such as manipulation of the spine and extremities, myofascial release treatment or other soft tissue methods to affect the myofascial (always involved in lower back or sacroiliac problems) and exercises once you are fully capable of doing them (exercises given too early will make your problem worse, not better). Active care regimens are the wave of the future, which get the patient involved in their recovery. Passive care which includes things such as stim, heat and other things aimed at the painful region may be helpful for the first couple of days of care, but the practitioner should then work toward improving how your body handles the forces of gravity and the activities of their daily life for the best outcome. Whom should you choose as your body mechanic? Our chiropractic sports practice is designed to help you get better cheaper, better and faster. We offer active care, are experts at the art of myofascial release treatment, Instrument assisted soft tissue treatment and since the doctor has an engineering background, does a mechanical evaluation before thinking like a chiropractor. Minimizing professional bias is important with problems such as lower back pain, since a professional cannot help you improve your lower back without fully understanding the mechanisms creating the pain. Choosing the right practitioner first can make all the difference.What do you think? Read Cheating Mother Nature, what you need to know to beat chronic pain available through Amazon.com.