Resolving your lower back pain requires more than applying a treatment or ordering tests; here’s why.
A patient recently visited our office complaining of lower back pain that began months ago but gradually became acute over the New Year’s holiday.
Since our office was closed, he visited another chiropractic office that told him his problems were due to swollen muscles and discs in his lower back. The treatment consisted of muscle stim and heat initially and then an adjustment. The patient also mentioned that when the lower back pain began, his neck was stiff and painful but the chiropractor relieved this with a spinal adjustment.
He touched back with us after several chiropractic visits in the other office after several visits relieved some of the pain but he was expecting faster results.
While this experience may be similar to that of many of you out there, the patient was concerned about the one size fits all approach this doctor used since each visit was the same.
The factory approach to healthcare is deeply embedded in our healthcare system, incentivized by insurance carriers resulting in a less personalized approach to care. Schools teach doctors how to diagnose and treat, however, patients and the reason why their back hurts is individual to them. In other words, we all adapt as I discussed in the book Cheating Mother Nature, what you need to know to beat chronic pain.
Back pain can result from foot problems, hip problems, core issues, and even the upper body. Is it an old injury, poor adaptation over the years, or perhaps another problem?
Perhaps this is why a holistic approach to musculoskeletal care is the only way to fully understand why someone hurts. An ankle injury years ago can alter the way you walk resulting in lower back pain. That frozen shoulder which took 6 months to improve may have improved much faster had the healthcare provider looked at what was acting on the shoulder from the lower body to create the condition. Chronic stiffness is often a warning sign of things to come although we may consider it to be normal until the pain doesn’t go away.
This patient has a similar story to many of those we treat; he went to a healthcare diagnosis, he gave me a diagnosis, worked on me, and looked at my area of complaint, rather than looking at me. After several visits, my neck felt somewhat better but it was still difficult getting out of a chair.
If you‘re not thorough, what is that diagnosis worth?
Tendonosis, swollen disc, sciatica, neuropathy, pinched nerve, and bursitis are some of the diagnoses that often say very little about why you hurt, yet so many doctors use this and then apply therapies to the area of complaint. While this may offer relief, you should ask yourself why am I hurting and what don’t I understand. Pain is what happens when things go wrong. Stiffness is what happens when things malfunction in most people leading to pain.
How to choose the right doctor for your back pain.
Chiropractors have the best reputation for lower back pain, likely because they are trained to think holistically. Most patients expect a good exam and treatment in the area of complaint. Often, this expectation also drives their doctor’s approach. Unfortunately, the area of complaint is often not the area causing the problem.
Patients in our office often joke that their right shoulder pain may have the doctor working on the left ankle while I trace the malfunction to the area of complaint. This is quite different than just getting on the table and doing something to it hoping the pain goes away.
The rationale is simple, understand the mechanism and be able to test for it before you treat. Does your healthcare provider do this or is it a routine visit that does not consider that appropriate care will result in changes of function from visit to visit.
What therapy is best
This is where most practitioners and doctors get it wrong; it’s not the therapy, it’s understanding the problem, choosing the right therapy as if you are picking something out of a toolbox and improving function, then retesting the area to see how effective it was at improving function.
Results don’t come from the therapy, but the therapy can be a way to achieve long-lasting relief, otherwise, the problem will return.
One size fits all things such as Yoga may help and has one problem; it’s one-size-fits-all. Does that solve your problem or help you feel better when you do it? There is a difference.
Feeling good results from good body alignment and function. Getting the result for most people is a result of improving this. While there are problems such as cancer that may cause lower back pain, they are rare and a good history and exam will often help us diagnose this quickly.
For a pain-free lower back, see a chiropractor first. A great chiropractor will evaluate you on every visit, use treat test treat active evaluation methods to improve the efficiency of care, and will use techniques such as myofascial release and give you appropriate exercises as needed to strengthen and retrain an area.
Do you need that test or that procedure?
Keep it simple. MRIs are probably the most over-ordered test I am aware of as most people improve. Unless the test will change how you function and improve the outcome or result in a needed referral, in most cases, the right treatment will improve your problem and the test is unnecessary medically. When doctors don’t know, they test, If they do a great exam, they should know more and test less. Unfortunately, in the medical world, they have little training in musculoskeletal diagnosis. This is another reason to see a chiropractor first for back pain. Keep it simple; chiropractic keeps it simple.
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