June 26, 2014

Low Back Pain

Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.

Chronic low back pain and chronic pain from any source severely affects your body in many ways. Biomechanical changes have been known to occur, but the extent of why it occurs and what other non-mechanical changes occur are just beginning to show up in the literature. Chronic low back pain has effects on brain size, nerve sensitivity, and which parts of the brain perceive and react to pain stimuli. Let’s take a look at what happens to chronic back pain patients and how chiropractic is the best answer to help those people return to a more normal life.

Inactivity and sitting lead to chronic back pain(LBP) in many, many people. It is no wonder, then, that chronic back pain has been proven to decrease brain size in the prefrontal and thalamic gray matter. Chronic back pain patients are characterized by alterations in brain structure and function. The brain changes can be categorized as neurological, structural, or functional. Certain areas of the brain that show less brain cells are correlated with more pain intensity and unpleasantness. These brain changes super sensitize the nerve endings and result in an over-the-top response to any pain stimulation. So even a small movement or tweak that doesn’t actually cause any damage results in a surge of pain that the brain perceives as severe.  This is why you still need to exercise to some degree even when you are in pain.

Differences in resting brain activity between patients without pain and LBP patients have also been measured. This means that even when no pain stimuli is being sent to the brain, chronic back pain patients’ brains acted as if there was a pain stimulus and reacted accordingly, by tightening muscles of the lower back and sensing pain.

This means significant impairments in memory, language skills, and mental flexibility; deficits in thinking and processing ideas; and changes in decision making and appraisal have also been seen in chronic back pain patients. This is very bad information. It essentially says that those people with chronic back pain literally have brain malfunctions that can lead to incorrect thinking and altered decision making. Chronic pain patients exhibit increased anxiety, depression, and deficits in learning and memory as well.

All of these terrible outcomes arise from physical, structural changes to your brain. You have no say in the matter once you are entrenched in chronic long term pain syndromes.  You can, however, do something to reverse the process.

Isn’t that all the more reason to take control of your spinal health now? Do you really want to live the remaining years of your life with your back pain and the consequences of it?

Chiropractic has been proven to change the course of back pain, even chronic back pain, more than exercise alone and better than the most widely prescribed NSAID, diclofenac. Adjusting the spine helps virtually all cases of acute and chronic back pain, given time and patient participation in their own care.

A study by Goertz, CM, DC, PhD in Spine, 2013, compared standard medical care for back pain to spinal manipulation by a chiropractor. All patients in the study received standard medical care which included medication, education on management of back pain, medication including painkillers and anti-inflammatories, physical therapy and modalities, and referral to a pain clinic. Not everyone received all of these, but all received some treatment as indicated. Then, half of the group also received chiropractic care, up to two times per week, for four weeks. They also may have had brief massage, ice or heat, stretching exercises, and posture/ergonomic advice by the chiropractor.

The amazing part of the study is the outcome. 73% of the patients with chiropractic treatment reported improvement. Only 17% of the standard medical care only patients showed improvement. This shows that chiropractic care offers a significant advantage for decreasing pain and improving physical function as compared to only standard medical treatment. 

Yet another 2014 study by Weigel PS, MS, shows there is a significant protective effect with chiropractic against declines in activities of daily living (dressing, bathing, eating, and getting in/out of bed), instrumental ADL’s (such as using a telephone, taking medication, shopping, and preparing meals) and self-rated health compared to medical care for treatment of an episode of low back pain in older adults. Chiropractic can be started at any age, and will still show significant benefits over standard medical care for quality of life assessments.

You can stay away from chronic low back pain with chiropractic and exercise. By keeping your spine functioning, you can keep your brain from shrinking and thoughts more clear. If that isn’t a good enough reason to start chiropractic today, you obviously aren’t yet interested in taking control of your own health. Start caring about your health before it’s too late.