Back pain is a fact of life for many people. Research shows that up to 80% of the population will experience back pain at some point during their lives. It is also the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
Sometimes back pain is sharp and intense, caused by a wrong move or an injury, and heals in a few days or weeks. Others experience back pain as a chronic condition, seriously altering their ability to work and enjoy time with family, friends and other leisure activities—leading to depression in some cases. A recent global survey of health conditions identified back pain as the single most disabling condition worldwide. Moreover, as lifestyles have become more sedentary and the rate of obesity has risen, back pain has become increasingly prevalent, even among young children. Spinal health is an important factor in preventing back pain, as well as maintaining overall health and well-being. The American Chiropractic Association (ACA) encourages people to take steps to improve their spinal health and avoid injury. Things such as better nutrition, exercise, ergonomic workspaces and proper lifting and movement techniques can go a long way in helping people to strengthen their spines and potentially avoid serious injury and chronic pain. When back pain hits, research shows that a conservative approach to treatment is the best option. CONSERVATIVE TREATMENT OPTIONS SUPPORTED BY RESEARCH
Treatment for back pain has come a long way. It was once believed that taking pain medication and getting some rest and relaxation were the best course of treatment for a bout of lowback pain, but nowadays research supports first trying drugfree, conservative options for pain management while remaining as active as possible during recuperation. The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity and psychological stress can cause or complicate back pain. While most cases of back pain are mechanical or non-organic (not caused by serious conditions such as inflammatory arthritis, infection, fracture or cancer) it can also directly result from diseases of the internal organs such as kidney stones, kidney infections, blood clots or bone loss.
A CLOSER LOOK AT BACK PAIN AMERICAN CHIROPRACTIC ASSOCIATION HEALTHY LIVING
The epidemic of prescription opioid overuse and abuse has also led many health groups to reconsider the value of a conservative approach to common conditions such as back pain. For example, the American College of Physicians (ACP), the largest medical-specialty society in the world, updated its back pain treatment guidelines to support a conservative approach to care. In March 2016, the Centers for Disease Control and Prevention released updated guidelines for prescribing opioids that also promote the use of non-pharmacologic alternatives for the treatment of chronic pain. In 2015, the Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. (including every major hospital), recognized the value of non-drug approaches to pain management by adding chiropractic and acupuncture to its pain management standard. Beyond the risks of overuse and addiction, prescription drugs that numb pain may also convince a patient that a musculoskeletal condition such as back pain is less severe than it is, or that it has healed. That misunderstanding can lead to over-exertion and a delay in the healing process or even to permanent injury. With the steep costs associated with prescription drugs, chiropractic’s conservative approach makes economic sense as well. A 2012 study found that spinal manipulation for neck and back pain was cost-effective used either alone or combined with other therapies first. Another study based on Washington state workers found that 42.7 percent of people who visited a surgeon first for work-related back pain eventually had surgery, compared to only 1.5 percent of those who visited a chiropractor 6 first.
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic services are used most often to treat conditions such as back pain, neck pain, pain in the joints of the arms or legs, and headaches. Chiropractors practice a hands-on, drug-free approach to health care that includes patient examination, diagnosis and treatment. Widely known for their expertise in spinal manipulation, chiropractors are also trained to recommend therapeutic and rehabilitative exercises, and to provide nutritional, dietary and lifestyle counseling. Published in 2017 in the Annals of Internal Medicine and based on a review of randomized controlled trials and observational studies, the ACP guidelines cite heat therapy, massage, acupuncture and spinal manipulation (a centerpiece of chiropractic care) as possible options for non-invasive, non-drug therapies for low -back pain. Only when such treatments provide little or no relief, the guidelines state, should patients move on to medicines such as ibuprofen or muscle relaxants, which research indicates have limited pain-relief effects.5 According to the guidelines, prescription opioids should be a last resort for those suffering from low- back pain, as the risk of addiction and overdose may outweigh the benefits.
1. Rubin Dl. Epidemiology and Risk Factors for Spine Pain. Neurol Clin, 2007; May;25(2):353-71.
2. Hart LG, et al. Physician Office Visits for Low Back Pain: Frequency, Clinical Evaluation, and Treatment Patterns from a U.S. National Survey. Spine, 1995; 20:11–9.
3. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016 Oct 7; 388:1545–1602.Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med, 2017;166(7):514-530.
4. Machado GC, et al. Non-steroidal Anti-inflammatory Drugs for Spinal Pain: A Systematic Review and Meta-analysis. Annals of the Rheumatic Diseases. Published online first, Feb. 2, 2017; doi: 10.1136/annrheumdis-2016-210597
5. Michaleff ZA, et al. Spinal Manipulation Epidemiology: Systemic Review of Cost Effectiveness Studies. J Electromyogr Kinesiology, Oct 2012; 22(5):655-652.
6. Keeney et al. Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State. Spine, 2013; 38(11):953964.