Dr. Anderson's Guide to Treating Back Pain
Back Pain Introduction
Eight out of ten people will experience back pain in their lifetime and over 50% of the population will experience more than 10 episodes of back pain within their lifetime. In terms of the American workforce, back pain will cost over 149 million days of work lost per year and cost somewhere between $100-200 million in lost productivity per year.
The Most Common Causes of Back Pain
The most common causes of back pain treated in this office typically come from these factors:
A sedentary lifestyle. Lack of movement accelerates degeneration in the joints and promotes weight gain and advanced aging.
Lack of exercise. Lack of movement not only accelerates degeneration and advanced aging of the joint, but it also accelerates muscle wasting and loss of strength.
Too much exercise. Constant, achy muscle pain and loss of sleep are common symptoms of overtraining. Overtraining will lead to the body breaking down versus building up in strength and stamina.
Poor posture. Long periods of time spent slouched or hunched over a computer screen with the legs oftentimes crossed under the chair to anchor the body puts undue stress on the lower back muscles.
Poor weight management. Just five to ten pounds of extra weight on the body is enough to create undo pressure and accelerate degeneration in the joints.
Occupational hazards. Repetitive motions, workplace injuries, and environmental hazards in the workplace oftentimes can strain and weaken the muscles and joints of the back.
Trauma from accidents and injuries. Falls, sports injuries, and motor vehicle crashes can create long standing chronic pain, imbalance and dysfunction to the spinal joints and muscles.
Acute strain. The quick spasm or pull in the muscle after bending over to pick up something benign like a pencil or pen that dropped to the floor can create muscle imbalances and fear avoidance behaviors promoting more imbalance and degeneration.
Overuse strain. When pushing the body to its limits, the muscles eventually rebel and contract to brace which promotes immobilization, pain, and degeneration in the joints.
The Most Common Back Pain Conditions
The most common causes conditions affecting the lower back include:
Herniated Disc. When an intervertebral disc’s protective outer layer (annulus fibrosus) partially or completely tears, some of the jelly-like inner layer (nucleus pulposus) may leak and cause inflammation and pain.
Degenerative Disc Disease. All discs gradually lose hydration and the ability to cushion the spine’s vertebrae over time. If a disc degenerates enough, for some people it can lead to pain in various ways, such as a herniated disc, pinched nerve, or changes in the facet joints that can cause osteoarthritis.
Spondylolisthesis. Spondylolisthesis is a condition in which one vertebra slips forward over the one below it. Spondylolisthesis is a fairly common cause of lower back pain and leg pain in younger adults (age 30 to 50), and degenerative spondylolisthesis is a fairly common cause of pain in older adults (age 50 and up).
Spinal Stenosis. Spinal stenosis occurs when the spinal cord in the neck (cervical spine) or the spinal nerve roots in the lower back (lumbar spine) are compressed. Symptoms of lumbar stenosis often include leg pain and tingling (sciatica), weakness, or numbness.
Osteoarthritis. Osteoarthritis, the most common form of arthritis, is a condition where the cartilage around the joint wears out, causing the bones in the joint to rub together, creating inflammation and pain. Most forms of arthritis can occur in any joint, including spinal joints. Osteoarthritis of the spine can lead to lost flexibility, bone spurs (osteophytes), irritated nerves, spinal stenosis, and sciatica.
Sacroiliac Joint Dysfunction. Leg pain from sacroiliac joint dysfunction can be particularly difficult to differentiate from radiating leg pain caused by a lumbar disc herniation (sciatica) as they can feel quite similar. Today it is estimated that the sacroiliac joint is responsible for 15% to 30% of lower back pain cases.
Piriformis Syndrome. The symptoms and signs of piriformis syndrome may range from mild discomfort to severe, debilitating pain in the buttock. The symptoms can also travel down the thigh and leg if the piriformis muscle presses on the sciatic nerve.
Back Pain Signs and Symptoms
Dull, aching pain. Pain that remains within the low back (axial pain) is usually described as dull and aching rather than burning, stinging, or sharp. This kind of pain can be accompanied by mild or severe muscle spasms, limited mobility, and aches in the hips and pelvis.
Pain that radiates to the buttocks, legs, and feet. Sometimes low back pain includes a sharp, stinging, tingling or numb sensation that moves down the thighs and into the low legs and feet, also called sciatica. Sciatica is caused by irritation of the sciatic nerve and is usually only felt on one side of the body.
Pain that is worse after prolonged sitting. Sitting puts pressure on the discs, causing low back pain to worsen after sitting for long periods of time. Walking and stretching can alleviate low back pain quickly, but returning to a sitting position may cause symptoms to return.
Pain that feels better when changing positions. Depending on the underlying cause of pain, some positions will be more comfortable than others. For example, with spinal stenosis walking normally may be difficult and painful, but leaning forward onto something, such as a shopping cart, may reduce pain. How symptoms change with shifting positions can help identify the source of pain.
Pain that is worse after waking up and better after moving around. Many who experience low back pain report symptoms that are worse first thing in the morning. After getting up and moving around, however, symptoms are relieved. Pain in the morning is due to stiffness caused by long periods of rest, decreased blood flow with sleep, and possibly the quality of mattress and pillows used.
Low back pain can vary from person to person. Low back pain varies on an individual level, and many factors influence the pain experience, including mental and emotional health, financial stress, or exercise and activity level.
How Does Back Pain Occur?
When an injury to the body happens, a process known as inflammation begins to rapidly work to heal the body:
1) A rush of white blood cells surges to the injury site causing swelling.
2) The skin at the site of injury may appear red from the increased swelling and may feel hot.
3) The pain increases as the swollen tissues press on the nerve endings.
4) Muscles contract to brace and protect the injured area.
Inflammation is good for the first 24-48 hours of an injury. That is the body’s way of healing the tissues. The problem occurs when inflammation stays beyond the 48–72-hour mark, inflammation becomes passive congestion in the tissues, which is bad. Pain becomes chronic. The swelling continues and the body still works hard to brace and protect the muscles, creating a pain-spasm-pain cycle.
Treating Back Pain
Most people will hope the pain goes away at this point and might not do much about it, hoping it will just go away. If the pain lasts long enough, the injured person will start to avoid certain movements and activities, fearing the pain will aggravate the movement.
Some people will then resort to trying ice or heat, over-the-counter medications, sports cremes, or yoga stretches to stop the pain. If you have tried these methods but still find you are experiencing pain, now is the time to come in and get treated with chiropractic adjustment.
Hobby or Hurt?
How Mark got back to his favorite hobby after pushing himself too far.
Mark couldn't believe what a beautiful week it was to golf. The sun was out, the weather was perfect, and he had plenty of free days to hit the golf course on his vacation. He had traveled with his family and best friend's family, and was excited to do what he loved most.
On the eighteenth hole on his third golf trip that week, Mark swung his club up behind his shoulder to hit the ball. After a week of flawless form and great shots, something different happened.
Mark felt a shooting pain down his lower back, and he couldn't even hit the ball. He tried to swing again, but this time he couldn't reach a full swing without the pain worsening.
"Mark felt a shooting pain down his lower back, and he couldn't even hit the ball."
Mike asked him what was wrong. Mark explained the sharp pain in his back and how he was probably done for the day. He thought of the ice pack at the hotel, disappointed he couldn't finish his game.
Mike, who couldn't let his friend miss out on the other game of golf they had planned, mentioned how his back would tense up when he played too much as well.
"A trip to the chiropractor gets me back in the game in no time."
"'A trip to the chiropractor gets me back in the game in no time.'"
A quick search later and the pair found a walk-in chiropractic clinic nearby. They drove over in hopes that Mark could beat the pain in his lower back.
The chiropractor examined Mark and explained how he'd perform manual and activator adjustments. Mark laid face down on the table, and the chiropractor began the adjustment.
The chiropractor used the activator to quickly target and release the tension in the affected areas. The muscles relaxed, and when Mark got up he could reach his arms up again. Mike got an adjustment for maintence, so he wouldn't end up in the same situation as his friend.
On the last day of their trip, the pair returned to the golf course. Mark was so excited he was able to play without pain and even scored a hole-in-one. It was the perfect way to end their trip.
Jeffrey Anderson is the best. Every time I go to his office, I get immediate, drastic results. I had pulled my lower back, and could literally not get our of bed. Dr. Anderson fixed me up in about 40 minutes, and all it cost me was some pain in the office and $40 (without insurance). Dr. Anderson repeatedly improves my quality of life and is a true healer and excellent man. Go visit him any time you need a good chat or the stretch of a lifetime.