Low Back Pain: Bread And Butter

Important? Low back pain is a leading cause of disability in the United States today. Due to many compounding factors, traditional allopathic medicine is not suited for low back care. Modern physical medicine specialists (Chiropractors, Physical Therapists, Trainers) are best for caring for low back pain patients. They have the time, skill, training, and education on the subject leading to proper diagnosis and treatment of one’s low back.

Presentations:

Pain can range from debilitating, can’t get off the floor pain, to discomfort while one sits at their desk. It can be located as specific to one spot or as broad as general discomfort down the leg (sciatica). No matter it’s presentation, the sooner one seeks professional advice the better the outcome.

Mainstream Management: Typical management for low back pain is vague and non-specific; involving rest, medications, and imaging (X-ray, CT, MRI). While imaging helps clarify part of the clinical picture, it does not bring it to complete focus. 

Image Terminology: Words associated with image findings can include: Spinal Stenosis, Osteoarthritis (other arthritic diseases), Degenerative Disc Disease (DDD), Disc Herniation.

Image Meaning: The image findings above are common and synonymous with “wear and tear” on the joints. This is unavoidable as we age. The image does not constitute the pain and certainly does not dictate treatment. These findings are regular for an asymptomatic patient as well. Thus, it’s the clinician’s job to make correlations and dictate care. Here are two sources regarding low back imaging on asymptomatic (no pain) people [1,2].

Physical Medicine Treatment: Treatments include specific movements for pain reduction, strengthening and mobility work for better function, and core education/training for preventative care. With multiple visits, the conservative model ables providers to continuously monitor and change programs as needed.

Provider Consulting: In the world of conservative care, there are many different styles of treatment. I urge a consumer to vet their provider. Trusted styles of treatment with solid education behind them include the listed modalities below. By no means are these a pre-requisite for a “good provider” and or does a provider need a certification in all these; However, this will help narrow the search when in the vast realm of conservative treatment.

Treatment Modalities: Mechanical Diagnosis and Treatment (MDT), Dynamic Neuromuscular Stabilization (DNS), Active Release Technique (ART), Postural Restoration Institute (PRI), Motion Palpation Institute (MPI), Functional Range Conditioning/Assessment/Release (FR-C/A/R)