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.
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
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
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
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