Low Back Pain Solutions
Dr Kirshner is a functional medicine doctor, chiropractor and chiropractic neurologist serving serving the Allentown, Pa and Lehigh Valley. Learn how functional medicine, chiropractic and chiropractic neurology might offer a solution to your low back pain.
Causes of Low Back Pain
The first step in finding a real solution to low back pain is to find what type of back pain you have. You need to also understand you might have multiple causes.
Four main categories of causes for low back pain.
Structural
Discs
The vertebrae are separated by “discs.” The outside of a disc is made from cartilage, and in the center is a jelly like solution. Discs serve many purposes, they allow movement of the spine, create space between the vertebrae, and act as shock absorbers. Discs can become damaged for many reasons, both internal and external. Back pain, often a result of injury to the spine can result in disc herniation, bulging, or in the most severe cases rupturing. When disc space is reduced or compressed nerve signals may be inhibited causing pain in the areas served by those nerves.
Disc bulges respond well to chiropractic care. Disc herniations sometimes respond to conservative care such as chiropractic, physical therapy, acupuncture and as a last resort, surgery.
Muscles
The most common causes of low back pain are strains or sprains to the low back. If not handled properly, these types of chronic low back pain lead to the most costs in terms of time and money.
Whoever you choose to examine and treat your low back pain needs to have a full understanding of how muscles effect the back. They need to take into consideration how the muscles became damaged.
Was the muscle weak or strong? short? or long? Was the muscle getting the proper nerve supply. Were the stabilizing muscles weak or strong.
If you just treat the pain and not even consider all the possible contributing factors, you might end up taking more medications, spending more time with pain, and spending more time with doctor visits-this includes chiropractic visits.
Ligaments
Ligaments are tissues that connect bones. Ligaments become damaged for many reasons. The easiest to understand are accidents and falls. Although this isn't the most common reason.
The main reason ligaments become damaged is from poor posture over a long period of time. If you habitually sit, stand, sleep or walk with poor posture, over time this will cause the ligaments to become weak. Its when they become weak and you perform a movement such as picking up something light from the floor, your back will give out.
Inflammatory
Acute Inflammation
Acute local inflammation is when you injure an area. It can be from an accident, slip or fall. Or it can come from weakened discs, ligaments or muscles finally giving out. For acute injuries, its best to use ice for the first 24-48 hours. If you suspect a serious injury, obviously its best to seek immediate medial care.
Acute Inflammation of a Chronic Condition
Acute inflammation of a chronic condition usually occurs when you do something that should normally cause no problem. Bending over to pick up something light, or reaching for a plate are examples of this.
Even though the pain just occurred, the real problem has been brewing for a long period of time.
You actually have two problems. The first is the pain. The second is the chronically weakened area. Obviously, you want the pain to stop but you also need to address the underlying problem. The danger of ignoring this is as time passes you are allowing more tissue to be damaged.
Second, addressing your low back pain as a mechanical problem, you might be taking unnecessary medication.
Systemic Inflammation
Systemic inflammation is when your whole body is having a systemic/inflammatory response and one of the areas being destroyed is tissue is you low back.
You need to be especially careful with this type of inflammation. Addressing it as if it is a mechanical problem could actually worsen your condition. Taking the wrong type of medications can also worsen you condition.
The first step is simple blood tests that will look for systemic inflammatory markers and possibly immune markers.
The two types of doctors for inflammatory low back pain you want to consider are a rheumatologist and/or a functional medicine practitioner.
Functional
To understand how functional problems create low back pain its important to realize the low back is just one part of the movement system. This system is similar to an orchestra. Just one instrument out of tune can make the whole piece sound terrible.
Functional Problem from Knees and Feet
When you walk, your feet, ankles and knees move in way that takes pressure and strain off the low back. When the ankles, knees and feet are not moving correctly, this will cause extra strain on the low back. In this situation, you might be having problems for months or even years with no symptoms and eventually do something to create pain. For this reason, any examination for chronic low back pain should include at least an obsrvation of your walking pattern.
Functional Problem from Shoulders
Similar to the feet, ankles and knees, your shoulder and arms swing a patterns as you walk. Imagine if one arm swings a lot and the other not at all.
What kind of imbalance might that create in the low back? This should also be observed on you low back evaluation.