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GOTTA BAD BACK?
by Dr. Brian S. Seaman, DC, FRCCSS(C), FICC

Back pain --- It is a significant factor in the work place and affects our daily lives. It is generally accepted by health care professionals that about 80% of you will have at least one significant episode of lower back pain during your life. That’s alot isn’t it!

ACUTE VS CHRONIC

Most people think of the word “acute” referring to severe pain. Although it is often used in this manner, “acute” back pain refers to an episode of at least three months duration.

Chronic” back pain is longer than three to six months (authors vary in what time frame is used) and at times can last many months or even years.

If “acute” low back pain is not treated, it can develop into a chronic condition (it is the old “I thought it would go away” syndrome!). This in turn can affect many aspects of your life:

  • Your daily activity level.
  • Your ability to play with your children or grandchildren.
  • Your ability to work at the office and/or around the house.
  • Your ability to exercise.
  • Your relationship with your family and friends.

BACK PAIN IS LIKE A PEBBLE

If you have chronic back pain of a significant degree, it can truly affect your quality of life. If the pain is already there, and never goes away it is like a pebble in your shoe. If you leave it in your shoe all day the irritation of the skin becomes more significant. You may start limping due to the pain on the bottom of your foot. As a result you begin to put more weight on your opposite leg – then your opposite knee begins to bother you. Then you notice that your lower back is starting to bother you --- it may feel tired, achy or sore.

Now you can see how a little pebble can cause your body to compensate and create more problems. Back pain can do the same. Back pain, especially chronic back pain, can cause other problems such as compensatory upper back pain due to moving in a different way in an effort to protect or guard your lower back.

WHAT CAUSES BACK PAIN?

There are several structures in the back which can cause back pain; discs, ligaments, muscles, tendons, nerves and joints can all cause back pain.

It is not just a case of a “slipped disc” or a “pinched nerve” --- although chiropractors often get asked about both of these on a regular basis.  This is not unexpected because these are the terms that people often associate with, or use when talking about back pain. 

DISCS REALLY DON’T “SLIP”

In your entire spine (neck and back) there are 24 vertebrae and 23 discs (point of trivia – there is no disc between the top two vertebrae in your neck; C1 and C2). The discs have a soft centre (nucleus pulposis) and tough outer layer of the fibres (annular fibres). When a disc “slips”, this means that the centre material has pushed through a tear in the annular fibres and is pushing out towards or against the nerve. This is called a disc herniation (there are different types as well). This can cause pain, numbness and tingling in your buttock, leg and foot as well as weakness in your knee, ankle or foot.

As debilitating as disc herniation can be, the vast majority do not require surgery and respond to conservative treatment approaches and exercise prescription (i.e. McKenzie type exercises).

The other piece of good news, is that the majority of back pain is classified as being “mechanical”. That means that the source of your back pain is likely related to the joints (spinal facets), muscles (muscular strain), and/or ligaments (sprain). Treatment of mechanical back pain may include:

  • Specific chiropractic adjustment techniques (spinal manipulation).
  • Muscle therapy techniques (like myofascial release).
  • Exercises (to correct muscular weaknesses or imbalances; especially the core muscles).
  • An ergonomic evaluation (modification of your work station to reduce postural strain).
  • Modification of daily activities (i.e. sports, at work, at home, etc.).
  • Orthotics (remember how the pebble in your shoe can cause back pain? A fallen arch or “flat feet” can as well).

Degenerative and arthritic changes involving the discs or joints in your back can also be a source of back pain. The degree of these structural changes can (but not always) have a bearing on how much pain you have and what is the best treatment approach.

In the upper back, the rib joints (where the ribs attach to the spine) as well as the spinal joints, can be a source of pain if they are not moving properly. In technical terms, back pain can be referred to as “facet mediated pain due to posterior joint dysfunction”. If the spinal or rib joint is restricted in movements, or not moving properly, it can cause back pain. Disc herniations in the thoracic spine (area of your rib cage) are not very common.

WHAT CAN YOU DO?

Don’t be fooled into thinking “it will go away”. Get it checked out by a health care professional such as a chiropractor. Find out what is causing you back pain.

Chiropractors exam and treat back pain every day. Why suffer? Don’t let a bad back rule your life!

Reprinted with permission of
The Seniors' Advocate. P.O. Box 5005, Waverly, Nova Scotia, B2R 1S2

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