About Eugene Low Back Pain

chiropractic FOR LOW BACK PAIN

  chiropractic Cox Technic Flexion Distraction and Decompression spine manipulation gives positive outcomes and is supported by the literature on back care. chiropractic spinal manipulation is a standard of care for low back pain and leg pain. Its benefits are well documented in the literature, and research literature citations are discussed here.

 Low Back Pain

 Before we can talk about low back pain, we must first start with a description of what low back pain means to you, the patient. Do you experience any of the following symptoms:

  1.  Pain localized to the low back only
  2.  Pain localized to the low back and buttock
  3.  Pain localized to the low back, buttock, and thigh
  4.  Pain localized to the low back, buttock, thigh and leg and even traveling to the foot and toes 

 Low back pain is typically paired with the above descriptions, but these are only variations of what is normally referred to as low back pain. An accurate statement on back pain is that the further the pain goes down, the more serious the spine problem is, and the more challenging it is to relieve. The reason being that with complete leg pain -- sciatic nerve pain down the back and side of the thigh, leg, and bottom of the foot or femoral nerve pain down the front of the groin, thigh, leg and foot -- there is irritation of the spinal nerve as it exits the spine in the low back. This is more complex and typically involves disc herniation or spinal stenosis.

 The Patient

Let’s begin with the patient who only has low back pain that spreads down the buttocks and thigh, but halts at the knee. This condition is markedly thought of as more amenable to relief.

 The Effects of Care

 Below are the changes in the spine that alleviate pain when this form of spinal adjusting is available:

  1. The intervertebral disc space is elevated, that is, it is increased in height 
  2. The pressure inside the intervertebral disc is lessened. 
    • This scales down the pressure on the nerve it is compressing. 
    • This lessens pressure inside the disc stops the nerve irritation which alleviates low back pain and leg pain.
  3. The size of the nerve opening within the spinal column, called the foramen, is raised up to 28% in size. 
  4. The joints of the spine are moved into their usual ranges of motion to regain normal mobility and freedom of motion without pain.
  
The Benefits of Conservative, Spinal Manipulation Care for Low Back Pain

Research literature over the spine keeps track of excellent outcomes of conservative care for low back pain and are seeing that surgery may not always be necessary.

  • The United States Public Health Service, U.S. Department of Health and Human Services guidelines state that spinal manipulation is safe and recommended for acute low back pain. (1) 
  • 33% of 27,810 people chose chiropractics as their treating physician for low back pain in the National Health and Nutrition Examination Survey (NHANE). (2) 
  • Spinal manipulation is recommended for low back pain. (3) 
  • Spinal manipulation is recommended by the American Pain Society and the American College of Physicians for primary care of low back pain. (4) 
  • Prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective for primary care of low back pain. (4) 
  • Epidural steroid injections give short term but not long-term relief of low back pain. (4) 
  • Spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. (4) 
  • Surgery for leg pain (radiculopathy) with herniated lumbar disc and symptomatic spinal stenosis is associated with short-term benefits compared to non-surgical therapy for low back pain, though the surgical benefits diminish with long-term follow-up. (4) 
  • For patients without leg pain (non-radicular back pain), with disc degeneration, fusion is no more effective than intensive rehabilitation, but associated with small to moderate benefits compared to standard non-surgical therapy. (4)
 Documented Outcomes of Cox Technic Flexion Distraction and Decompression For Low Back Pain

  •  A study of 1000 patients with low back and lower extremity pain treated with Cox Flexion Distraction and Decompression spinal manipulation by 30 chiropractic physicians is shown in the following chart. Note that different diagnoses of low back and leg pain are given such as sprain/strain, spondylolysis, etc., and every one these diagnosed conditions are described elsewhere in this website as to their diagnosis and treatment. 
    • The amount of visits and days to get relief of these conditions, regardless of the individual diagnosis, was found. 
      • the average number of days was 29 days
      • the number of office visits for spinal manipulation was 12 (5,6,7) 

  •  In a comparison study of Cox Flexion Distraction and Decompression spinal manipulation to active exercises for chronic low back pain with and without lower leg pain (sciatica), a total of 235 subjects were studied; 123 were assigned to Cox Flexion Distraction and 112 to active trunk exercise protocols. 
    • Subjects randomly allocated to the flexion distraction group had significantly greater relief from pain than those allocated to the exercise program.
    • Subjects categorized as chronic, with moderate to severe symptoms, improved most with the Flexion Distraction protocol.
    • Patients with radiculopathy (leg pain) did significantly better with Flexion Distraction. 
    • Overall, Flexion Distraction provided more pain relief than active exercises. (8) 
  • Applying axial distraction to the spine is shown to decrease disc stress on the anulus and nucleus. This is anticipated to reduce the compressive disc stresses in back pain. (10)

Incentives to Try Conservative Care for Low Back Pain Before Surgery

  •  95% of patients with low back pain and leg pain will resolve within 1 to 12 months with non-surgical care. (9)
  • A trial of conservative non-operative care is encouraged before surgery for patients with lumbar disc herniation. 95% of low back pain and leg pain patients are well in a time period of one to 12 months without surgery. (11) 
  • A comparison of surgically treated with non-surgically treated patients with chronic low back pain of 349 chronic low back pain patients aged 18-55 years displayed no evidence that surgery was any more beneficial than intensive rehabilitation. Surgery cost more, had potential risks, and was not cost effective. (12) 
  • Cost and clinical outcome comparisons of chiropractic versus medical care for low back and leg pain showed that chiropractic care is cost effective when care extends beyond primary care. (13) 
  • Spinal manipulation gave better short and long-term functional improvement as well as more pain relief in the follow-up than either back school or individual physiotherapy in a study of 210 patients with chronic, non-specific low back pain.
    • Spinal manipulation was associated with higher functional [[improvement/recovery]108] and long-term pain relief than back school or individual physiotherapy. 
    • Spinal manipulation provided better short and long-term functional improvement, and more pain relief in the follow-up than either back school or individual physiotherapy. (14)
  • Traction with relatively low magnitude was found to have significant beneficial effect in maintaining disc height of degenerated disc. (15) 
  • Lumbar fusion for disc degeneration, herniation with or without radiculopathy is associated with significant increases in disability (11% of fusion vs 2% for non-surgical), opiate use (by 41% after surgery with 76% continued to use opioids after surgery), work loss (1140 days for fusion vs 316 days), reoperation (27% needed another surgery), and poor return to work status (26% of fusion vs 67% non-surgical were back at work 2 years later). (16) 
  • Under conservative care, quality of life for lumbar radiculopathy (leg pain) patients improves. (17) 
  • There are currently no clear indications for surgery in non-specific low back pain. (18) 
  • Chronic low back pain patients without severe neurological deficits can cared for with manipulation, acupuncture, exercise, education, self care. (19) 
  • Chiropractic care of worker’s compensation patients exhibits acute, subacute and chronic back and neck pain patients showed improved subjective and functional status under chiropractic spinal manipulation. (20)
  • Second opinions by spine surgeons for a recommended back surgery show that 60.7% were “not needed,” 33.3% were “wrong,” and only 6% were “right.” (22) 

Conclusion

60-80% of health-care consulting patients will continue to experience pain following a year. There are some who say that 90% of patients suffering from back and leg pain will be better in 90 days if no treatment is offered. This simply is not true as research shows that a third to 72% of them will have pain a year later. Chiropractic treatment isvital and recommended (21). Conservative, chiropractic care has a seat in healthcare for effective, cost-effective, recorded treatment for low back pain alleviation. Schedule an appointment with Rethwill Chiropractic Clinic to make your Eugene chiropractic treatment now.
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