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St. Johns Medical Center, P.A.

2511 St. Johns Bluff Road South

Suite 102

Jacksonville, Florida 32246

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Introduction to chiropractic care
Spinal manipulation (like that used by chiropractors in chiropractic medicine) is not a new or recent concept. Records show that manipulation of the spine can be traced back to the time of Hippocrates.

Since the inception of chiropractic medicine in 1895, chiropractors have held as a primary tenet that biomechanical and structural derangement of the spine can affect the nervous system. Because the nervous system is so intimately related to the spine from an anatomical standpoint, identifying and restoring spinal structural integrity through chiropractic treatments can improve the health of the individual by reducing pressure on sensitive neurological tissue. This tenet continues to be the emphasis that many chiropractors embrace and chiropractic patients seek.

The research status of chiropractic medicine, or manipulative therapy, was reviewed in a 1975 NINCDS (National Institute of Neurological and Communicative Disease and Stroke) conference held in Bethesda, Maryland that included experts from many of the disciplines that utilize manipulation. Dr. Joseph Janse, DC, who was president of the National College of Chiropractic at the time, was the spokesperson for chiropractic medicine.

Chiropractic treatment for lower back pain
In his presentation, Dr. Janse reviewed the literature from the time of the founding of chiropractic in 1895 to the 1975 conference date. From that review, various chiropractic hypotheses were identified and research recommendations were drafted in order to dispel the myths and/or to support the tenets of the chiropractic hypotheses. Much of the chiropractic research conducted to the 1975 date supports the proposed hypotheses while others continue to be investigated.

It is important to note that doctors of chiropractic do not utilize drugs or surgery in their practice. However, there are times when a chiropractor will recommend that the patient consult another practitioner if these or other methods of treatment are indicated.

There appears to be firm literature support for chiropractic treatment of lower back pain. Many of the published guidelines recommend spinal manipulation to be included in the treatment plan early in the care of lower back pain.

While there are many causes of low back pain, most cases of low back pain can typically be linked to either a general cause - such as muscle strain - or a specific and diagnosable condition, such as degenerative disc disease or a lumbar herniated disc.

In the US, low back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience low back pain at some point in their lives.

Ironically, with low back pain the severity of the pain is often unrelated to the extent of physical damage. For example, muscle spasm from a simple back strain can cause excruciating back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can actually be completely painless.

Low back pain is typically classified as either acute or chronic:

  • Acute back pain is short term, generally lasting from a few days to a few weeks. Some acute pain syndromes can become more serious if left untreated.

  • Chronic back pain is generally defined as pain that persists for more than three months. The pain may be progressive, or may occasionally flare up and then return to a lower level of pain. With chronic low back pain, the exact cause of the pain can sometimes be difficult to determine.

Lower back pain anatomy
The causes of low back pain can be very complex, and there are many structures in the low back that can cause pain. Any of the following parts of spinal anatomy are typical sources of low back pain:

  • The large nerve roots in the low back that go to the legs and arms may be irritated

  • The smaller nerves that innervate the spine in the low back may be irritated

  • The large paired lower back muscles (erector spine) may be strained

  • The bones, ligaments or joints may be damaged

  • The intervertebral disc may be damaged

Sometimes there is a neurological component, such as leg or foot weakness or numbness, that accompanies the low back pain.

It is important to note that many types of low back pain actually have no known anatomical cause; but this doesn’t mean that the pain doesn’t exist. The patient’s pain generator may not be identifiable, but this does not necessarily signify that the pain is all psychosomatic. Actually, an estimated 90% of patients with pain will not have an identifiable cause of their pain.

This article provides a review of the most common types of low back pain and related symptoms. The vast majority of lower back pain conditions will get better with time and can be addressed with conservative treatments, such as chiropractic manipulation and physical therapy