First things first, the injury:
Low back pain affects most of us at some point, differing markedly in how much it affects one person compared with another. Most low back pain has at its source faulty joint function. You injure a part of the joint, this inflames, triggers a reactive spasm which restricts and tightens the joint further. There is generally an over reliance on muscle function, and an under reliance on mechanics or joint function. Muscles are important, but are usually secondary to the joint injury. Its not very common to have to have muscle replacement surgery, while joint replacement surgery is very common. It is this neglected joint problem that turns arthritic over time.
Two main factors happen in the initial injury:
- Injured tissue and inflammation (the tissues are injured).
- Restricted or abnormal joint movement, nerve irritation and spasm (the function is injured).
The body looks after the 1st factor itself, but struggles with fixing the 2nd factor. The abnormal spinal joint movement/position/function is the important part to correct in the acute and sub-acute phase to ensure that we go from there back to normal, and not to chronic.
This is the main aim with acute back injuries, stopping the longer term chronic/arthritic stuff from happening. The Chiropractic adjusting is essential for fixing this abnormal joint function, and then can be combined with other therapies that help out with the healing. I find Acupuncture is one of the best tools for reducing the muscle spasm, and massage at the appropriate stage has shown good validity.
Next, Chronic Low Back Pain:
It is chronic back pain that is responsible for 80% to the cost of LBP. This is also the area that we start with chronic old LBP. Find the old joint injuries and start correcting the movement (unless its gone too far), and then when we are getting better joint movement we can start giving exercises. You can do a lot with exercise, but it will always work better when you have basic joint movement. Often the best exercise is being more active (sitting less and walking). A recent study showed that walking was the best exercise for LBP, and proved more beneficial than clinical back exercises. An important note is that different adjusting techniques are appropriate for different spinal types and the different injury phases.
The spine is unique:
Part of the problem with spinal joint injuries, that differentiates them from knees, elbows and other joints of the body, is that the spinal joint injury can affect the function of the spinal nerves that run up and down going to the body and back to the brain. This turns a mechanical back injury into a problem that affects the function and health of the body. So think twice before neglecting your spine!!
Cameron Finlayson is a Chiropractor in Auckland, New Zealand. He has 21 years of experience.