Chiropractors play a role in the management of mechanical low back pain (also called common, simple or non-specific back pain), the type of back-pain suffered by over 90% of patients.1-6
What structures cause common back pain?
Common acute back pain is due to chemical abnormalities created by a soft tissue tear. The tear represents a mechanical disruption which is usually microscopic.7 The tear is normally in the muscle fibres and/or ligaments.8 X-Rays often demonstrate no changes after an acute back pain injury. MRI scan may often show evidence of underlying tissue damage to discs, facet joints, muscles and ligaments but are not always recommended in the first instance. MRI can certainly be of value when there are signs of weakness or ongoing pain that has not responded as would have been expected with conservative management.
Recurrence of Back Pain
In a study of 373 patients under 40 years of age, 89% had a recurrence within 10 years and only 33% had no lost time from work from future back problems.9 Another study suggests that two thirds of the people who have had back pain in the past can be expected to have some symptoms every year.10
While this all sounds very negative it is our goal at Shirley Rd Chiropractic to work with people in such a way that helps to minimise recurrences and help people take a more pro-active role in their care.
- Hadler, N.M., Curtis, P., et al. (1987) A benefit of spinal manipulation as adjunctive therapy for acute low back pain: a stratified controlled trial. Spine 12: 703-706.
- Meade, T.W., Dyer, S. et al. (1990) Low back pain of mechanical origin: a randomised comparison of chiropractic and hospital outpatient treatment. British Medical Journal 300: 1431-1437.
- Meade, T.W., Dyer, S. et al. (1995) Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow-up. British Medical Journal 311: 349-351.
- Shekelle, P.G., Adams, A.H., et al. (1991) The appropriateness of spinal manipulation for low back pain: project overview and literature review. Santa Monica, California: RAND; Monograph No. R-4025/1 – CCR/FCER.
- Kirkaldy-Willis, W.H. & Cassidy, J.D. (1985) Spinal manipulation in the treatment of low back pain. Can. Fa. Phys. 31: 535-540.
- Bronfort, G. (1997) Efficacy of manual therapies of the spine. Amsterdam: Vrije universiteit EMGO Institute.
- Mooney (1995) J. Musculoskeletal Medicine. Oct: 33-39.
- Drezner & Herring (2001) Managing Low Back Pain. Phys. & Sports Med. 29(8).
- Frank (1993) British Medical Journal. April 3: 901-909.
- McGorry, R.W. (2000) Spine 25: 834-841.