Chiropractic care is one of the safest, most effective methods for the treatment of low back pain. If you have low back pain and have never been to a chiropractor, here is what you can expect, along with some of the most common chiropractic methods of treatment.
When you have your first visit, your chiropractor will take a detailed health history that covers your current condition, previous conditions, overall health, and family history. This conversation is crucial to not only begin to determine the origin of the low back pain but to also build a relationship with your chiropractor. After the health history is taken, your chiropractor may recommend an MRI or X-ray to further examine the area to be treated, making sure there are not underlying issues such as fractures or other more serious issues, such as cancer.
Once serious conditions are ruled out by MRI or X-ray (if necessary), the chiropractic adjustment can begin. Chiropractors utilize a variety of techniques to manually manipulate the spine into correct alignment. Sometimes a patient will hear a popping noise. As an adjustment is done, this can sometimes release tiny gas bubbles that get trapped in joints. The popping nose is harmless and painless, much the same as cracking knuckles.
There are six main types of controlled force application in chiropractic.
- Direct thrusts: Fast, firm pressure applied directly to the spine.
- Articulatory technique: Slower movements that take a specific joint through its range of motion.
- Indirect positional technique: A passive technique used to ease and lengthen stiff muscles.
- Functional technique: Gentle, steady pressure on a joint to release tension.
- Muscle energy technique: This technique uses isometric movement instead of thrusting to increase range of motion.
- Myofascial release technique: Stretching or light pressure held for a period of time to help release tension.
These six techniques are applied in very precise ways to relieve low back pain.
- Toggle drop: The chiropractor crosses his or her hands to press firmly down on a specific area of the spine. With a quick, direct thrust, the spine is adjusted. This technique is used to improve mobility in specific vertebral joints, such as the ones that may be causing low back pain.
- Motion palpation: This technique is more diagnostic and helps determine if joints are moving freely. The chiropractor will manually palpate areas of the spine to locate any joint dysfunction or constriction. This can be useful to help confirm a diagnosis in cases where an MRI or X-ray may not be indicated.
- Lumbar roll: This technique uses a quick, direct application of force to re-align the spine, with the patient lying on his or her side.
- Release work: Release work is a finer application of touch, using the fingertips and gentle pressure to separate the vertebra.
- Table adjustments: For a gentler way to apply direct pressure for spinal adjustments, your chiropractor may use a special table that has a drop piece. This piece releases at the same time as the chiropractor applies a direct thrust to the spine. This allows for the same type of adjustment as a toggle drop but with less force applied.
- Instrument adjustments: This is a gentle option that is often used for chiropractic work on animals. The chiropractor uses a spring-loaded activator instrument to perform the adjustment instead of his or her hands.
- Manipulation with anesthesia: Adjustments under light anesthesia are only indicated when a patient is unresponsive to traditional adjustments. Patients who are tense, nervous, or unable to relax the muscles surrounding the bone for treatment may be candidates for this. This is an outpatient technique that is performed in a hospital by a chiropractor who is expressly certified in this technique.
There are also two additional techniques that are helpful specifically for low back pain.
- Flexion-distraction technique: Widely used for disc pain that is often accompanied by leg pain, flexion-distraction uses a special table that stretches the spine while at the same time uses a pumping motion to flex it. This is a pain-free technique that can offer substantial relief as the discs are moved away from any involved nerves. The pumping, flexing action helps increase space between discs and re-positions the gel-filled cushioning between each disc. Flexion-distraction is a series of treatments that follows the 50% rule: if a patient has not improved after 12 sessions by at least 50%, imaging is recommended, and a referral to a spine specialist is made. If a patient’s pain increases during treatment, the treatment is stopped and imaging is recommended, as is neurological assessment.
- Pelvic blocking: Cushioned wedges are placed under a patient’s body, and a chiropractor uses gentle adjustments and techniques to move the disc away from the nerve. The wedges offer gravity the opportunity to assist in changing the mechanics of the spine and allow the chiropractor to be more gentle in adjustments. As with flexion-distraction, if improvement is not seen, imaging is recommended, as is a spine specialist referral.
Chiropractic care is remarkably safe, with the most common side effect of treatment being mild soreness around the adjustment area. One serious but extremely rare side effect is stroke related to high-velocity neck manipulation, seen in one out of every 5.85 million adjustments. In many cases, the stroke is not actually caused by the manipulation itself but is coincidental to the treatment.
Chiropractic treatment for low back pain is one of the safest, most effective ways to help ease your pain and restore mobility in the spine. Have you tried this treatment for your low back pain, or would you consider it?
Image by Jenni C via Flickr