So, what is the best approach for back pain? Well, that depends upon who you ask, but it shouldn’t. The facts are what they are, regardless of who delivers them.
If you look to the insurance company, it appears that epidural injections and surgery are what work best, because that seems to be what they are most will to pay for, at least for the long-term.
If you ask your medical doctor, it seems to depend on what decade they graduated from medical school.
The facts don’t change, but our understanding of them certainly does.
What are the Facts? – Short version
Recently, 2 studies1,2 came out that shed some light on this.
Adjustments are good and injections are bad..
Okay, that’s not really fair.
A few more details:
Common (epidural) steroid injections are not effective for back or leg pain associated with narrowing of the spinal canal (canal stenosis), despite the fact that they are widely used.1
The next study compared spinal adjustments to “usual medical care” for people with lower back pain that started within the last 12 weeks. 28% more people had significantly less pain and disability at 4 weeks if they received the spinal adjustments, compared to if they received “usual medical care”.2
There was an extra little note in the details of the second study. The treatment lasted 4 weeks. At 3 and 6 months, there was no difference between any of the treatment groups, compared to each other. This could be interpreted as, “Well, even though adjustments are best in the short-term, they don’t last.” Actually, I agree with that. This is why I give at least 2 other recommendations:
- Address the cause: Weakness, Instability, Spinal imbalances, Postural stresses/Ergonomics, Nutritional Deficiencies
- Maintenance adjustments: Most people do well with 1 time per month.
Real-Life Experience:
Just a few minutes ago, I treated a an 82-year-young lady for lower back pain. She came to me by recommendation of another patient, her daughter. When she started, she told me her MD had recommend physical therapy for her, what did I think?
After taking x-rays and finding that she has severe degenerative disc disease, I said that physical therapy (done with an excellent therapist) would be a great combination with my adjustments and specific therapies we do.
Some would have told her: “Well, you have arthritis. We have several anti-inflammatory and pain medications to choose from.”
She has been reasonably diligent with doing her home therapy. Her treatment plan with me is tapering off. With our treatment, she has improved consistently. The patient and I both are hoping for further improvement. The next step is to do a one-month trial of Theramine. That is a supplement which supplies the nutrients that support the pain and inflammation pathways. Sometimes chronic pain persists due to these deficiencies.
Not everyone fits into a little tidy box of ‘one treatments fits all;’ in fact no one does. That’s why we use a Synergistic approach.
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For more information on how we deal with lower back pain, whether it be a little strain or a herniated disc pressing on a nerve, click on over to our Back Pain page.
You might also be interested in reading about a patient who had lower back pain and infertility.
References:
- A randomized trial of epidural glucocorticoid injections for spinal stenosis. ; N Engl J Med. 2014 Jul 3;371(1):11-21; (http://www.ncbi.nlm.nih.gov/pubmed/24988555)
- Comparison of Spinal Manipulation Methods and Usual Medical Care for Acute and Subacute Low Back Pain; Spine (Phila Pa 1976). 2015 Feb 15;40(4):209-17 (http://www.ncbi.nlm.nih.gov/pubmed/25423308)
