At least 80% of individuals experience a significant episode of low back pain at some point in their lives. At any given point in time, at least 15% of individuals report that they are experiencing low back pain. Some consider the symptom of low back pain to be a part of the human experience.
What causes low back pain?
The exact source of acute low back pain is often difficult to identify. In fact, there are numerous possible pain producers including muscles, soft connective tissue, ligaments, joint capsules and cartilage, and blood vessels. These tissues may be pulled, strained, stretched or sprained. Additionally, annular tears (small tears that occur in the outer layer of the intervertebral disc) can initiate severe pain. Even if the actual tissue damage is minor, and likely to repair quickly, the pain experienced may be quite severe.
No matter which tissue is initially irritated, a cascade of events occurs which contributes to the pain experience. Numerous chemical substances are released in response to tissue irritation. These substances “stimulate” the surrounding pain sensitive nerve fibers, resulting in the sensation of pain. Some of these chemicals trigger the process of inflammation, or swelling, which also contributes to pain. The chemicals associated with this inflammatory process feed back more signals which perpetuate the process of swelling. The inflammation attributable to this cycle of events may persist for days to weeks.
Muscular tension (spasm) in the surrounding tissues may occur resulting in a “ trunk shift” (the body tilts to one side more than the other) due to muscular imbalance. Additionally, a relative inhibition or lack of the usual blood supply to the affected area may occur so that nutrients and oxygen are not optimally delivered and removal of irritating byproducts of inflammation is impaired.
How should acute low back pain be managed?
Some of the best advice for treatment for acute low back pain is to continue to remain active “as tolerated”. Continuing to perform everyday activities may seem counterintuitive, and the natural inclination may be to stay in bed or “freeze”, to guard and avoid activity. Yet, activity keeps blood and nutrients flowing to the affected area, inhibiting inflammation and reducing muscular tension. Many individuals with low back pain find that they can perform their usual, but more controlled cardiovascular activities, such as walking, in spite of the pain and often feel better after the activity. More vigorous or uncontrolled activities such as weight lifting or competitive or contact sports are inadvisable while pain is severe. There is no reason not to completely avoid stretching muscles and tissues in the legs and back during an acute episode, but stretching should not cause more severe pain. Local application of heat or ice can temporarily reduce pain and heat may facilitate stretching, but does not necessarily speed long term recovery.
What type of treatment is available for lower back pain?
The chiropractic doctor is unique in the health care field in that much of the training in chiropractic colleges is specifically aimed at identifying and successfully treating and managing lower back conditions.
chiropractic modalities such as ultrasound, electrical stimulation, traction, mobilization and chiropractic manipulation can provide relief. If the pain is severe, participation in activities is impaired, or if motion is significantly restricted, a chiropractor can provide additional education and advice regarding strategies for restoring motion, resuming activities, preventing deconditioning and achieving a position of comfort during sleep.
For those with persistent or recurrent low back pain, a medical evaluation is indicated and a physical therapist-supervised exercise program is likely advisable. The goal should always be towards developing and transitioning to a fully independent home or health club exercise regimen. Emphasis will likely be placed on optimizing trunk or “core” strength and improving general flexibility and cardiovascular endurance.
Dr. Robert Evans, B.Sc. (Kines), D.C.
Chiropractor, Medical Acupuncture
Dr. Robert Evans provides natural, evidence based health care including chiropractic, active soft tissue techniques, medical acupuncture, orthotics, posture advice, and athlete care. He has over 20 years of personal and academic knowledge of: nutrition; weight loss-gain; strength and endurance weight training; endurance, lactate threshold, and VO2max running workouts; lactic acid testing for heart rate training zones.
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Tranquil Therapeutic Solutions
650 Scottsdale Dr, Unit 2-C
The Scottsdale Centre
Guelph, ON N1G 4T7 Canada
Phone: 519-265-3799
Fax: 519-489-1467
E-Mail: info@ttsguelph.com