Back Pain

Back Pain

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.

From the October 10, 2003 BBC News comes a report that urges people to be aware of their posture while driving. Whether in Britain or in the United States, people spend much of their lives driving. The article notes that poor posture while driving contributes to spinal problems.  According to the British Chiropractic Association, (BCA),  32,000 people each month visit one of the BCA members with a back problem related to poor driving posture.

Dr. Tim Hutchful, from the BCA, says that people who sit incorrectly in car seats are asking for trouble. He said: "There is almost twice as much pressure on your back when you are sitting incorrectly than there is if you stand up." He goes on to state, "Those most at risk are the people who not only spend long periods of time in the car, but also those who make infrequent short journeys in the car, because it can be compared to an unaccustomed form of exercise."

The BBC article concludes with a list of tips for proper driving posture from the British Chiropractic Association. These are: Relaxing at the wheel - A relaxed driving position reduces stress on the spine, Always adjusting the seat when you enter the car, Taking regular breaks from driving - once every two hours or so, Clench your buttocks if stuck in traffic - add some side bends and shoulder shrugs if possible, Unload items off the back seat from the back doors of the car, rather than the front, Don't wear tight clothes while driving.

A release by the Foundation for Chiropractic Progress (F4CP) cites new studies showing that chiropractic care is not only more effective for helping people suffering from lower back problems, but is also more affordable. The F4CP release dated, April 08, 2013, cites the results of two recent studies documenting the chiropractic advantage for patients with lower back problems.

Gerard Clum, D.C., spokesperson for the F4CP commented on one of the studies by saying, "Chiropractic care is a cost-effective, evidence-based approach that is well-documented for its outstanding patient outcomes and satisfaction scores." The study he referenced was published on April 1, 2013 in the medical journal Spine, which found that spinal manipulation (as the study authors termed it) was significantly better than non-steroidal anti-inflammatory drug diclofenac and clinically superior to placebo for patients with acute non-specific low back pain. Dr. Clum added, "When used as a primary treatment option for back pain, chiropractic can boost avoidance of risky and costly measures, and promote equal or greater clinical outcomes.

The second study referenced by the F4CP release was published in the Journal of Manipulative and Physiological  Therapeutics in January 2013. The study titled, "Aging baby boomers and the rising cost of chronic back pain: secular trend analysis of longitudinal Medical Expenditures Panel Survey data for years 2000 to 2007," showed that with the common (medical) care of chronic lower back problems the costs will continue to escalate. The author concluded, "The prevalence of back pain, especially chronic back pain, is increasing. To the extent that the growth in chronic back pain is caused, in part, by an aging population, the growth will likely continue or accelerate. With relatively high cost per adult with chronic back pain, total expenditures associated with back pain will correspondingly accelerate under existing treatment patterns."

The F4CP makes the point that utilization of chiropractic care presents opportunities for improved patient outcomes and decreased costs. Dr. Clum emphasizes the point that chiropractic would lower the cost of chronic lower back care as well as overall healthcare by saying, "To improve the system, it will be essential that patient care approaches with clinical and economic advantages -- such as chiropractic care -- be the focal point of progressive healthcare and health policy discussions."

A new study from Italy published in the March issue of The Spine Journal, showed that chiropractic care was effective in helping patients with acute back pain and sciatica with disc protrusion. This randomized double-blind clinical trial involved 102 ambulatory patients with at least moderate pain or radiating pain, who had an MRI study showing disc protrusion.

The patients were divided into two groups. One group received chiropractic adjustments 5 days per week by experienced chiropractors, with a maximum of 20 visits. The second group received what the study termed, "simulated manipulations" in order to have a group for comparison to those receiving real chiropractic care.

The results showed that those who got the real chiropractic care improved significantly over the group that received the simulated manipulations. In the group that received the chiropractic care, 55% were free of radiating pain in the follow ups compared to 20% of patients who got the simulated manipulations. Additionally, when measuring local pain, 28% of those who received real chiropractic were free of local pain, versus only 6% of those who got the simulated manipulation.

The results also showed improvements in days of pain with the group that received the real care reporting 6 less days of pain than those in the simulated care group. In addition to these benefits the group with the real care reported using less medications to help with the pain as a result of the chiropractic care.

In this study none of the patients in either group had any adverse effects, and one from each group did report no results at all and were listed as "treatment failures". The researchers conclusions were, "Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion."

The above is a direct quote from a headline that appeared in of all places, the November 17, 2005, Medical News Today. The article, also picked up by UPI news and several other sources, was reporting on a new study published in the October 2005 issue of the scientific journal, The Journal of Manipulative and Physiological Therapeutics (JMPT).

In this study 2780 patients with mechanical low-back pain referred themselves to 60 doctors of chiropractic and 111 medical doctors. These cases were reviewed for effectiveness of care and for costs. One of the articles noted that back pain care in the United States alone is estimated to reach $48 billion this year, and, at any given time, 80 percent of the U.S. population suffers from back pain.

The results of the study showed several interesting facts. With regards to the outcomes, the study showed that both the acute and chronic patients showed better outcomes in pain and disability reduction and higher satisfaction with their care after undergoing chiropractic care, as compared to medical care.

The costs of the care for the medical and chiropractic showed different results depending on the usage. Without adding the costs of any over-the-counter drugs, hospitalization, or surgical costs, when you simply compared the costs of in-office chiropractic to in-office medical care, the chiropractic care was slightly more expensive. If you then add in the additional costs for any referrals made by the chiropractor or the medical doctor, the chiropractic care costs for chronic patients were then 16 percent lower than medical care costs.

The authors of the study, noting that the satisfaction for the chiropractic care was higher, and the overall total costs were lower, made a concluding statement urging more chiropractic utilization in the health care system. They stated, "With their mission to increase value and respond to patient preferences, health care organizations and policy makers need to reevaluate the appropriateness of chiropractic as a treatment option for low-back pain."

A research journal, the "Journal of Manipulative and Physiological Therapeutics" published a study that showed high levels of patient satisfaction for those who went to chiropractors with what was classified as severe to moderate pain in either the back or neck. A total of 369 patients were sampled who had gone to chiropractors with these problems. These individuals were asked to complete surveys tracking all kinds of information from the type and severity of their problem to their level of satisfaction with care.

The results showed a very positive response from the study group in both the results they felt and their overall level of satisfaction with their care. The results of the published study summed it up best; "Based on the results of this survey, it seems that patients suffering from back and or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments. Moreover, the patients surveyed demonstrated a high degree of satisfaction with the care they received. Numerous other studies have demonstrated that chiropractic is as effective, if not more effective than conventional medical management of such complaints."

The medical research journal Spine, published a report on April 15, 2013 titled, "Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients With Acute Low Back Pain: Results of a Pragmatic Randomized Comparative Effectiveness Study."  The study was conducted on military personnel.

This study did not compare chiropractic care to medical care for patients with back problems. This study looked at the difference between patients who received only medical care versus those who received both chiropractic and medical care for acute lower back pain.  

This study looked at patient responses relative to pain and  physical functioning for the both the group receiving  only medical care and the group that also received chiropractic.  The 91 subjects in this study were active-duty US military personnel between the ages of 18 and 35 years. The study was conducted from February 2008 to June 2009 at William Beaumont Army Medical Center (WBAMC), Fort Bliss, El Paso, Texas.  

Lead author,  Christine Goertz, D.C., Ph.D., vice chancellor for research and health policy for Palmer College of Chiropractic, explained the reasoning behind the study by saying,  "While a number of studies have shown spinal manipulation to be effective in treating low back pain in research settings, the appropriate role of chiropractic care in treating low back pain within the health care delivery system, including the military, has not been clearly established."

The results showed that those who received the chiropractic care in addition to the medical care did significantly better both with pain reduction and functional ability, than those who received only medical care. Col. Richard Petri, Chief of the Interdisciplinary Pain Management Center (IPMC) at WBAMC commented, "This is a significant step for recognizing the value of chiropractic care in the military," he said. "Continued research in this area will ultimately result in better healthcare delivery systems as well as the improved health of our beneficiaries."

Wayne B. Jonas, M.D., President and CEO of Samueli Institute who funded the study noted, "It is critical that we explore drug-less approaches to reduce pain." He added, "Chiropractic manipulation is an important option to consider for musculoskeletal disorders, which is the most prevalent pain complaint in the military."

The study authors concluded, "The results of this trial suggest that CMT (Chiropractic Manipulative Therapy) in conjunction with SMC (Standard Medical care) offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard (medical) care, for men and women between 18 and 35 years of age with acute LBP.




In a May 12, 2003 release from the "Canada NewsWire" was some information and advice about gardening. The news release reported on a new poll just released that reveals that gardening and yard work are the number one causes of back and/or neck pain in the spring and summer months. The poll was conducted by national research firm Pollara, where 500 Ontario Canada chiropractors were asked what were the largest causes of back and neck pain among their patients.  The results of the poll showed that eighty-eight per cent of Ontario chiropractors report that working in the yard and garden are the most common sources of back and neck pain they see during the warm weather season. Golf ranked in second place at 31 per cent, tied with outdoor sports in general at 30 per cent.

Dr. Dennis Mizel, President of the Ontario Chiropractic Association noted, "In Canada, gardening is an estimated $3.5 billion business and all that digging, lifting, raking, pruning, planting, weeding and watering can cause significant strain to the muscles and back." Dr. Mizel continued, "The good news is that it's preventable. Gardening can be a serious workout. That's why we're encouraging people to treat it like any other kind of exercise. Warming-up before digging in, and using the proper techniques and tools can go a long way to letting people enjoy the results of their labor pain-free."

The Ontario Chiropractic Association is partnering with the Ontario Horticultural Society, the Garden Clubs of Ontario and Sheridan Nurseries to help get the word out about back safe yard work and gardening. "Thousands of people visit our gardening centers once the warm weather hits," says Mary-Beth Brown, Marketing Coordinator, Sheridan Nurseries. "So we're pleased to be able to reach our customers with this public education program. It's a good idea to limber up before you get to the gardening centre and start loading supplies into your car or truck, and we always have someone to help out if a customer needs assistance."

In the article the Ontario Chiropractic Association offered several tips for back smart gardening:

- Stretch Before You Start: Warming-up your muscles with stretches before going out helps to reduce the stress and strain on your joints and muscles, reducing the chance of injury.

- Bend Your Knees to Lift with Ease: When lifting, keep your back straight and bend your knees. Always carry the load close to your body and avoid twisting.

- The right tools, the right moves: Use the right tools and moves for the job. Kneel to plant and change positions frequently when raking, digging, hoeing or pruning.

- Use ergonomically designed, long handled, lightweight tools.

- Take a Break Before It Aches: Give yourself and your back a break. As a rule-of-thumb take a brief rest or stretch break at least three times each hour, and drink fluids frequently.

Published in the January 2003 issue of the peer-reviewed periodical, Journal of Manipulative and Physiological Therapeutics (JMPT), is the results of a study on lower back pain in children. The journal article starts off by noting that about 50% of children suffer from lower back pain at one time or another. It also notes that about 15% of children experience frequent or continual pain.

The study was conducted on 54 children between the ages of 4 and 18 in the cities of Calgary, Alberta, and Toronto, Ontario, Canada. In the study the children with lower back pain received chiropractic care from a variety of volunteer chiropractors in Canada. The children were tracked regularly during the study to monitor their progress. Results were obtained in several ways including responses from the patients themselves on how they felt their progress was coming.

Results of the study showed improvement over the follow-up period was observed in 46% to 92% of the children for various criteria. In a period of 30 days 82% of the children reported that they were "much improved."
The researchers conclusions were, "Patients responded favorably to chiropractic management, and there were no reported complications."