When we are injured and in pain, our natural instinct is to avoid any movements and activities that make us hurt more. As well, we have all been conditioned to be put on bed rest by our doctors when we are hurting. Unfortunately, the majority of the time, this is simply the wrong advice, and many times opposite to what we should be doing to get better quickly.
The Agency for Health Care Policy and Research (AHCPR) recommends treating lower back pain with spinal manipulation in the first four weeks of symptoms, with or without non-prescription pain killers and in conjunction with mild exercise such as walking or swimming, followed by conditioning exercises after about two weeks(1). They stress the importance of resuming normal daily activities as quickly as possible and found that more than four days of bed rest can be counterproductive.
Chiropractors hold as a primary tenet, that biomechanical and structural problems of the spine can adversely affect the nervous system. Because the nervous system is so intimately related to the spine from an anatomical standpoint, determining where the structural problems are 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.
The term “adjustment” refers to the specific manipulation applied to vertebrae that have abnormal movement patterns or fail to function normally. The objective of the chiropractic treatment is to reduce the subluxation, which results in an increased range of motion, reduced nerve irritability and improved function.
The patient history helps the chiropractor to identify the area(s) of complaint. Questions about family history, dietary habits, past history of other treatment(s) (chiropractic, osteopathic, medical and other), occupational history, psychosocial history, and other areas will be asked by the chiropractor to help determine the nature of the illness.
Following the chiropractic consultation and case history, a physical examination that may include laboratory analysis and x-ray examination will be performed in accordance with the chiropractors clinical judgment. There are many different methods that a chiropractor may use for;determining the spinal segments that require manipulation. Most commonly, static and motion palpation techniques are utilized for identifying spinal segments that are hypomobile or fixated.
Many chiropractors utilize a wholistic, biomechanical concept of treating the bipedal structure in its entirety, in an attempt to balance the structure from the feet upward.
Identifying weak links in the kinetic chain, sometimes quite distant from the area of complaint, the chiropractor treats the given area. This chiropractic process may include both articular manipulation as well as muscular balancing through strengthening of under-active muscles and/or inhibiting over-active muscles to acquire a balanced structure. The chiropractor might also stabilize the pelvis by placing a small heel lift in the shoe on the short leg side (which is determined radiographically).
Pelvic stability can also be achieved by the use of corrective; arch supports prescribed by the chiropractor. This chiropractic treatment is typically used when ankle pronation, pes planus (flat feet), and/or subtalar instability are present. Combinations of any of these chiropractic treatment approaches along with exercises that strengthen the weak, underactive muscles of the trunk and pelvis and stretch the tight, overactive muscles usually results in a more beneficial, long term result.
1. Bigos S, Bowyer O, Braen G et al (1994) 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..
