Back Pain

Back Pain Facts and Statistics

Although doctors of chiropractic treat more than just back pain, many patients initially visit a chiropractor looking for relief from this pervasive condition. In fact, about 31 million Americans experience low back pain at any given time.1

Interesting Facts about Back Pain

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Research Supports Chiropractic Spinal Manipulation

With today’s growing emphasis on quality care, clinical outcomes and cost effectiveness, spinal manipulation is receiving increased attention. The epidemic of prescription opioid overuse and abuse has also led to wider acknowledgment of the benefits of nondrug approaches to pain.

Spinal manipulation is a safe and effective nondrug spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.10

A growing body of research supports spinal manipulation:

Backpain Prospine
  • After an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.11
  • A well-respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nondrug therapies considered effective for acute and chronic low back pain.12
  • According to an article in the medical journal Spine, there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and there is moderate evidence that it is just as effective as prescription NSAIDS combined with exercise. 13
  • An article in the Journal of the American Medical Association suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.14
  • More recently, the results of a clinical trial published in JAMA Network Open showed that chiropractic care combined with usual medical care for low back pain provides greater pain relief and a greater reduction in disability than medical care alone. The study, which featured 750 active-duty members of the military, is one of the largest comparative effectiveness trials between usual medical care and chiropractic care ever conducted.15

Back Pain and the Opioid Epidemic

The opioid epidemic has led many respected health groups to reconsider the value of a conservative approach to low back pain (the most common condition for which opioids are prescribed). Most notably, the American College of Physicians (ACP), the largest medical-specialty society in the world, updated its low back pain treatment guideline in 2017 to support a conservative approach to care.

Published in the Annals of Internal Medicine and based on a review of randomized controlled trials and observational studies, the ACP guideline cites heat therapy, massage, acupuncture and spinal manipulation as noninvasive, nondrug options for low back pain treatment. The guideline further states that only when such treatments provide little or no relief should patients move on to medicines such as ibuprofen or muscle relaxants, which research indicates have limited pain-relief effects. According to ACP, prescription opioids should be a last resort for those suffering from low back pain, as the risk of addiction and overdose may outweigh the benefits.

Tips to Prevent Back Pain

There are several simple strategies that can help to prevent the onset of back pain. Among them:

  • Maintain a healthy diet and weight.
  • Remain active—under the supervision of your chiropractor.
  • Avoid prolonged inactivity or bed rest.
  • Warm up or stretch before exercising or physical activities, such as gardening.
  • Maintain proper posture.
  • Wear comfortable, low-heeled shoes.
  • Sleep on a mattress of medium firmness to minimize any curve in your spine.
  • When lifting an object, lift with your knees, keep the object close to your body, and do not twist.
  • Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
  • Work with your chiropractor to ensure that your workstation is ergonomically correct.
 proper sleeping position

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, click here.  You can also search our database to find an ACA doctor near you.

Are you or a family member on Medicare? Click here to learn how you can support ACA’s efforts to expand coverage of chirpractic services for America’s seniors.

** Extracted from American Chiropractic Association website


References:
 

  1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.
  2. Hoy D, March L, Brooks P, et al The global burden of low back pain: estimates from the Global Burden of Disease 2010 study Annals of the Rheumatic Diseases Published Online First: 24 March 2014. doi: 10.1136/annrheumdis-2013-204428
  3. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl1985; 11: 1-98.
  4. The Hidden Impact of Musculoskeletal Disorders on Americans, United State Bone and Joint Initiative, 2018.
  5. Rubin Dl. Epidemiology and Risk Factors for Spine Pain. Neurol Clin. 2007; May;25(2):353-71.
  6. Sauver, JL et al. Why patients visit their doctors: Assessing the most prevalent conditions in a defined American population. Mayo Clinic Proceedings, Volume 88, Issue 1, 56–67. 
  7. Hartvigsen J et al. Low Back Pain Series: What Low Back Pain Is and Why We Need to Pay Attention. Lancet, June 2018; Volume 391, Issue 10137; p2356-2367.
  8. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  9. Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences [review]. J Bone Joint Surg Am. 2006;88(suppl 2): 21-24.
  10. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.
  11. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
  12. Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
  13. Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
  14. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.
  15. Goertz C et al. Effect of Usual Medical Care Plus Chiropractic Care vs. Usual Medical Care Alone on Pain and Disability Among U.S. Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial. JAMA Network Open

You need to know…

How chiropractic care can help you with headaches

Headaches and Chiropractic

If you have a headache, you’re not alone. Nine out of 10 Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea. What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

Research shows that spinal manipulation – one of the primary treatments provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck. A 2014 report in the Journal of Manipulative and Physiological Therapeutics (JMPT) found that interventions commonly used in chiropractic care improved outcomes for the treatment of acute and chronic neck pain and increased benefit was shown in several instances where a multimodal approach to neck pain had been used1. Also, a 2011 JMPT study found that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches2.

Headache Triggers

Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems. The remaining 95 percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease; the headache itself is the primary concern.

The greatest majority of primary headaches are associated with muscle tension in the neck. Today, Americans engage in more sedentary activities than in the past, and more hours are spent in one fixed position or posture (such as sitting in front of a computer). This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.

What Can You Do?

The American Chiropractic Association (ACA) offers the following suggestions to prevent headaches:
If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

What Can a Doctor of Chiropractic Do?

  • Your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:
  • Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
  • Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
    Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Doctors of chiropractic undergo extensive training to help their patients in many ways beyond just treatment for low-back pain. They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.

  • Text from American Chiropractic Association Website

REFERENCES:

1. Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37: 42-63.
2. Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89.