Chiropractic and Back pain
Almost everyone gets back pain at some time, but staying active, with the help of chiropractic treatment, may well be the best solution.

Back pain is said to be multi-factorial and multi-etiological. It means that it has many causes and there are many reasons for it. Much has been written about back pain and its causes. It is a complex subject and therefore the explanations are often over-simplified, which can be misleading. We as chiropractors, hope that this information will be easy to u nderstand but not too simplistic. At the ISIS Chiropractic Centres we want you to understand your condition before the treatment commence so you can make an informed decision about your care.

The spine consists of many structures that can signal pain and therefore be part of why you have pain. The most common type of injuries are ligament and joint injuries. Sometimes these injuries are referred to as 'simple back pain' but there is rarely anything simple about it.

Disc injuries are much less common. About 5% of all back pain relates to disc injuries. And fortunately only about 5% of them need surgery. The term 'slipped disc' is often used as a blanket diagnosis but is a misleading phrase as discs does not slip (and can not be 'pushed back in' again by chiropractors, or anybody else for that matter).

The Spine
The human spine is quite a phenomenal piece of engineering. Developed through years of evolution or by intelligent design? Well, that is probably a discussion for another forum. But it is extraordinary how well it does its job. You may have heard people say that “we were not made to walk upright” and “if we walked on all fours we wouldn’t suffer from back pain”.

Well, both statements are wrong. The human spine and pelvis are quite different from for example the chimpansee’s who prefer to walk with the aid of their arms and hands. The chimpansee’s back and pelvis is not made for walking upright. Just watch how they walk when they walk on their hind legs only.

And secondly, animals such as dogs and horses do get problems with their backs. Ask any vet or chiropractor who treats animals. The reason we get problems with our backs is mostly down to ourselves. It is not surprising that back pain is on the rise, in general we sit too much, exercise too little and we often eat the wrong things. When we lift we often lift the wrong way and we do too much in one go. Let’s face it we often abuse our backs. Most people do not even give their back a second thought until it starts to hurt.

The spine, although a strong and robust structure, needs to be maintained and looked after to ensure that it is not going to give you pain and discomfort.

The Anatomy
The spine consists of 24 vertebrae with discs between them. In the spinal canal run the spinal cord and a set of two spinal nerves exits at each vertebra. Between each vertebra there are two joints (facet joints), there are ligaments for passive support and several layers of muscles for active support. This makes it a strong but also flexible structure allowing us mobility and at the same time gives good protection for the spinal cord and nerves.

So why do we feel pain?
The spine's components, bones vertebrae, discs, joints, ligaments, muscles, nerves a nd blood vessels, are all pain sensitive to a greater or lesser degree. So why do we feel pain?

Well the sensation of pain is a protective mechanism and without it we would constantly hurt ourselves without knowing it. And that would lead to irreparable injury and therefore ultimately a serious threat to our survival. The distribution of pain nerves is not equal over the body. The greater the risk of injury to a body part the more pain fibres there are. For example, our fingers and toes are more sensitive to pain and temperature than for example our torso. The structures of the spine that has the most pain nerves are the joint capsules of the facet joints (spinal joints). So, it is reasonable to assume that the ‘designer’ of the spine expected the joints to be the most likely to get injured. The joints, muscles and ligaments are also full of mechanoreceptors (nerve endings that sense movement and position), which give the nervous system feedback of our activities. This also helps to protect the spinal structures.

Why do injuries occur?
Essentially, the spine is a long chain of joints which are protected by ligaments and muscles and if some of the links stiffen up through injuries or anatomical changes it makes other links move more to compensate and eventually the overuse of the flexible joints cause pain through sprain. Most injuries are caused by what is called recurrent micro-trauma, it means many small repetitive injuries, until the proverbial 'last straw'. That is why people often hurt themselves doing very trivial things such as bending to pick up a pen, and they hurt themselves before they even get to lift the pen. This can happen through fairly trivial activities. It does not have to involve heavy lifting, it is more often caused by awkward movements. Maybe things that you have done a hundred times before.

Once the injury has occurred and the nerve signals pain the surrounding muscles go into a protective spasm to help to splint the injured area. After a while the muscle becomes more and more painful. Quite often the pain in the tight muscle become more severe and takes over the symptoms. That is why it often feels muscular in nature but the cause of the problem is the injured joint, this is especially true if you have recurring problems.

Why does the back pain recur?
If you suffer recurrent episodes of spinal pain it is usually a sign of what chiropractors would refer to as a functional 'instability'. When you get a join or ligament sprain the healing create scar tissue as part of the normal healing process. Scar tissue is less elastic and breaks more easily. It has been shown that injuries leave the deeper muscles weakened, permanently, even after the pain has gone. The only way to make the muscle recover is to do specific exercises. The nerve endings that are embedded in the ligaments that send signals to the motor control part of your nervous system are also affected when you get an injury and that impairs their ability to warn the active stability system (the muscles) to respond to protect the joints and ligaments.

What can I do to stop the back pain recurring?
There are many different treatments available. Recent research shows that spinal manipulation of the type chiropractors do and in combination with exercise is the most effective treatment for both acute and chronic back pain.Chiropractors advocate to deal with the underlying neurological, mechanical and muscular problems. Just relying on taking pain killers and rest does not deal with neither of these causes, so even if the pain goes away with rest it is bound to come back due to the remaining underlying weakness.

My pain usually goes in a couple of days
That is good. But each time you injure your back you create more of a weakness. The natural progression of back pain is that after each time you are more likely to get another episode. The ep isodes usually get more frequent and start to last longer and eventually the pain does not go away at all. The biggest risk factor for getting back pain is having had a previous episode and recurrent injuries to the same area is what eventually can cause a disc herniation.

Pain killers simply mask the pain!
Chiropractic treats the cause of the pain, unlike pain killing drugs, which just mask the symptoms. For more information and advice on how chiropractic can help you in the treatment of back pain, including disc herniation, sciatica and referred pain, contact your local chiropractor at ISIS Chiropractic Centres.
To find out about common misconceptions about back pain click here.

Read more about the different types of back injuries here:
Muscle spasm
Joints and muscles work together throughout the body to allow the body to move efficiently. Therefore when a joint has been injured, it affects the muscles of the low back as well. Muscles often go into protective spasm to protect the area but the body tends to overcompensate. These tight muscles can then produce pain themselves aggravating the problem. Pain can be localised to the lower back or referred into the buttocks and legs.

Disc herniation / Slipped disc / Disc protrusion
The ‘discs’ are located between each vertebra in the spine. They are strong and flexible allowing movement of the spine. They also act as a shock absorber and transmit loads up and down the spine. When I disc is injured, a gel-like substance from inside the disc can bulge out causing inflammation or compression of the nerves that exit the spine. This results in the associated leg symptoms.

Piriformis Syndrome
This is a condition that involves a muscle called the piriformis. It is located deep in the buttock and can compress the sciatic nerve, giving similar symptoms as a disc herniation.

Central stenosis / Spinal stenosis
Pain is caused by compression of the spinal cord (myelopathy). This can be caused by bony outgrowths (osteophytes) caused by ‘wear and tear’, congenital variations, and scar tissue post-surgery. Walking and standing aggravate pain, causing ‘claudication’ – leg pain. Usually only affects people over 50.


Chiropractic and Neck Pain
Today’s modern living often entails hours of driving and hunching over workstations, which can play havoc with our necks. So it is no surprising that neck pain is the second most common condition that=2 0chiropractors treat. Whilst neck pain is less common than low back pain, millions of people experience neck pain and related arm pain at some stage in their lives and therefore seek chiropractic care.
It results from abnormalities in the soft tissues – muscles, ligaments, and nerves, as well as in the bone and the joints of the spine. The most common causes that chiropractors identify and treat are soft tissue abnormalities from injury or prolonged wear and tear and in many people it is also the source of pain in the upper back, shoulders and arms. When neck pain is caused by muscle strain, you may have aches and stiffness that spread to the upper arm and forearm. Shooting pain that spread down the arm into the hand and fingers can be a symptom of a “pinched nerve” or nerve entrapment in the neck. When a nerve is “pinched” in the neck, numbness, weakness and possibly pain of the hands or arms may occur. Disc injuries are rare but it is the most common cause of nerve entrapments.

Trauma
Injuries to the neck caused by a sudden movement of the head backwards and forwards or sideways, are referred to as “whiplash”. Whether from a car accident, sporting injury or an accident at work, whiplash or neck injuries warrant a thorough chiropractic examination. Whiplash is most commonly suffered as a result of a road traffic accident. An impact or collision causes the head to suddenly jerk back and forth beyond its normal limits. Read more bout how chiropractors treat whiplash.

Wear and Tear
Wear and Tear, Osteoarthritis or Joint Degeneration occurs due to the accumulation of stresses and trauma over time. Throughout life the spine is required to withstand considerable weight bearing strain, purely as a result of the pressures of daily living. The overall effects of degenerative changes of the spine, leads to a feeling of stiffness and reduced spinal mobility. However, just like any other part of the body, the better care that is taken of the spine, the less degeneration is likely to occur. Chiropractic20treatment is usually very effective for the symptoms caused by wear and tear. It is never too late to take proper care of the spine and reduce the effects of aging.

Overuse or Repetitive Strain Injuries (RSI)
There is a constant process of breakdown and repair of the soft tissues in the human body. RSI develop when the balance is upset either from increased use and/or impaired healing. RSI is caused by mechanical irritation, which upsets the body’s highly tuned natural balance. It is an inflammation of the fibrous layer that covers soft tissues. Repeated physical movements, such as typing, can cause damage to tendons, nerves muscles and ligaments. Often problems in the spinal joints of the neck and upper back can aggravate or even cause RSI to develop in the arms and hands. This is because the nerve supply, which control both the tension in the muscles and blood supply of the arm come from the neck. RSI may present as tightness, discomfort, stiffness or pain in the neck, arms or hands. You may experience tingling, coldness or numbness in the hands. There may also be an associated clumsiness, loss of hand strength and co-ordination. We all have occasional aches and pains that go away within a few days, especially when we have overdone things. But if your symptoms are progressive, persistent or recurrent see your Chiropractor as soon as possible.

Posture
Chiropractors recognise that poor posture can contribute to spinal pain. Very often poor posture is a result of an existing muscle imbalance, pain or bad habits and conversely, having poor posture can also contribute to you developing pain and a muscle imbalance. If you work in an office sitting is part of what you have to do, but too much sitting is not good for you. Sitting on an office chair for long periods can contribute to spinal problems. Sitting doubles the pressure on the discs in your low back. The static posture will also affect th e muscles in the lower back, neck, arms and legs. The muscles prefer to be used in dynamic rather than static activities. The reason being that they depend on movement to help the blood flow in the musculature. This is important, as it helps to flush away build-up of lactic acid and other by-products in the muscles. The postural muscles are the ones that are most likely to suffer. Prolonged sitting can cause muscles that support the spine to weaken and over time this weakness becomes significant. As our muscles fatigue it often results in the upper back being more slumped. A slumped posture causes increased musculo-skeletal stress, which in turn may lead to conditions such as; headaches, neck pain, jaw pain, shoulder pain, numbness or tingling in the arms or hands and pain in the shoulder blades. Over time a poor sitting posture and incorrect work ergonomics can damage spinal structures and become the cause of recurrent episodes of pain. Chiropractors place great emphasis on giving both postural and ergonomic advice as part of the chiropractic treatment. Once symptoms have arisen, the problem is usually fully established and a chiropractic treatment program including postural advice, manual treatment (chiropractic adjustments an d soft tissue therapy) and rehabilitation exercises help to re-establish a flexible, strong and pain-free posture.

Choosing the right pillow
A poor quality pillow can cause disturbed sleep and as sleep is very important to the body’s repair process, compromising the quality of your pillow can also affect your overall health and mental fitness. It is important that you use a good quality and supportive pillow, which will hold your neck in alignment and which supports your head. (Your head weighs an average of 4 to 6 kilograms.) A good pillow will encourage your head and neck to remain in the correct position when you move around during sleep. In turn, this will relieve muscle tension around the neck, relax the shoulders and correctly position the head, arms, and lower back for relaxed sleep. Your pillow should offer most support to your neck. To achieve this we as chiropractors recommend that you buy an orthopedic pillow.

Orthopedic Pillows
There are both biomechanical and pain relieving benefits for you in using orthopedic pillows. They are helpful in the treatment of pain by offering support and should be considered an important adjunct to chiropractic care in the treatment of acute and chronic neck complaints regardless of the cause. They are generally made from foam, some are made from memory foam, and they are shaped. They have a bump or contour that gives you the optimum support for your neck and head. Regardless of why you think you have pain it is important to deal with it sooner rather than later. The longer you have a problem the harder it is to get rid of it. The early signs of having a problem might only present as a slight stiffness and tiredness in the shoulders. Having pain is not normal even though it is common. Book a chiropractic assessment to help get a diagnosis and effective treatment program sooner rather than later.