Back Pain

Primary Industry: Alternative Medicine
Back pain (also known as dorsalgia) is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine. Back pain may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull…
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Pain Sources
Spinal injuries can damage a number of pain sensitive structures located in the spinal region. Some of the more common structures that are damaged and that have innervation which allows them to transmit pain include:
anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
outer layers of intervertebral disc (located between adjacent vertebrae)
posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
nerve root dura
capsule of the facet joints
intervertebral ligaments
extensor musculature
flexor musculature: the colli and scalenes

When these tissues are injured, pain is experienced. Damage to these structures also results in tissue inflammation, edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues. In addition, when spinal injury occurs spinal muscles often reflexively spasm to protect the area from further injury - whether or not the muscles are injured. This spasming can lead to muscle ischemia (lack of oxygen) due to increased energy demands.


Back Pain

Back pain or "arthritic back pain" is the most common ailment experienced in the aging population. This is typically the result of many years of uncorrected spinal stresses and injuries which have accumulated to become increasingly symptomatic. However, the risk of more serious disease does exist in the aging population. Thus, we strongly recommend individuals with back pain over the age of 40 schedule an appointment to at least rule out more serious causes which include spinal cancer, compression fracture and infection.
* The Chiropractic Approach To Back Pain In The Elderly
* The Medical Approach To Back Pain In The Elderly



The Chiropractic Approach To Back Pain In The Elderly
The chiropractic approach to treating back pain follows a "holistic" type course. The chiropractor is concerned with the patient's personal health goals. This plays an important role in designing an effective treatment plan which results in the wanted outcome. While evaluating the patients health disorder, the cause as well as all contributing factors which lead to the development of the condition will be sought. Once determined, this information will be combined with the health goals of the individual in order to design the safest and most successful treatment plan. There will also be a careful evaluation to rule out more serious causes of back pain in the aging; cancer, compression fracture, infection, etc.

The treatments utilized by chiropractors do not include drugs or surgery. Instead, safe and natural noninvasive methods of healing are utilized. These include spinal adjustive techniques, physical therapies, soft tissue therapies, exercise and stretching programs, diet and nutritional counseling, and lifestyle modifications. As stated above, these therapies are directed towards the root cause of the health condition. The result is safe, fast, effective long-term relief as well as the overall optimization of health and wellness. Treatments which focus solely on symptomatic relief are short lived, ineffective, and lead to patient frustration and dissatisfaction.


The Medical Approach To Back Pain In The Elderly
While our wish here is not to "bad mouth" medical doctors, it is a well known fact that the majority of primary care physicians simply do not understand back pain and lack not only the knowledge and experience, but lack confidence in treating back pain.

According to a recent study titled Practitioner Self-confidence and Patient Outcomes in Acute Low Back Pain, chiropractors had significantly stronger self-confidence scores than physicians when it came to treating back pain.
Arch Fam Med. 1998;7:223-228

The majority of medical doctors prescribe (1) prolonged rest, (2) avoidance of exercise, and (3) prescription medications like non-steroidal anti-inflammatories (NSAIDs) such as aspirin and Ibuprofen to mask pain and decrease inflammation. The problem with this approach is that although the pain has been artificially lessened with medications, the cause of the pain has not yet been addressed - kind of like cutting the wire to a flashing "low oil" light on your car dash; rather than adding oil to the engine.

i. numerous studies show that bed rest is detrimental rather than beneficial; patients can lose their capacity at a rate of 3-7% daily in total rest but can only improve at a rate of 1% per day,

ii. early motion and mechanical loading stimulate properly aligned, newly formed collagen fibers, promoting synovial fluid diffusion in joints and enhanced local blood flow,

iii. the use of NSAIDs and analgesics do not focus on increasing function or inhibiting progression of the disease, rather, it simply masks the symptoms of pain; moreover, a recent study has found that many NSAIDs (aspirin, ibuprofen, fenoprofen, sodium salicylate, sodium tometin) actually inhibit the repair processes involved with the articular cartilage of joints... rapid deterioration of joints after long-term NSAID use has been termed "Analgesic Arthropathy" and is essentially deterioration of a joint induced by the use of NSAIDs.
Nelson, DC. Top Clin Chiro 1994;1(4):20-29
Gottlieb MS, DC. JMPT 1997; 20(6):400-414
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