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What causes back pain?

What are the symptoms of back pain?

Why does back pain come and go?

What is the difference between acute and chronic pain?

Why does my back cause leg pain?

How can chiropractic help?

How long will it take to feel better again?

How much will it cost?

 

 

Dull aches, sharp pains, throbbing, pulsing, lancinating, pins, and needles, stabbing, burning, deep and swollen are many of the words patients use to describe their pain here in Cardiff. Back pain is a real issue of suffering all over the world. The latest statistics report that 1.5 billion people are suffering from lower back pain. That would be a pandemic crisis if it were the latest coronavirus. Back pain is not infectious although it does seem to have a hereditary link. Chronic low back pain has been studied intensely and although we know a fair bit there is no one cause to chronic lower back pain. An acute injury is very explainable but when the pain lingers for more than 3 months, the waters get muddy.

 

What causes back pain?

 

As mentioned above, an injury (like a car accident) explains how back pain can be initiated. We still are not fully sure why long-standing back pain lingers for months and even years. We do know that lack of movement is a driver of pain. We are a finely tuned machine that needs lubricating like a car. Our spine gets much of its nutrition through movement, our knee joints are healthier with movement and we get fewer headaches if we take regular breaks from a work desk. If we put ourselves under continual stressors then the perpetual cycle of chronic pain can linger for a long time. Our mental health also has a heavy link with chronic pain. Many people suffering from depression have chronic pain which poses the question, did the pain cause the depression or vice versa. Research shows that treating someone as a whole has better outcomes than just treating one of the other. There are structural reasons why we can get chronic back pain as follows:

 

Osteoarthritis: The natural wear and tear of skeletal joints. From the age of 21 onwards, our joints will slowly and gradually change shape. The linings of the joints that create cushioning and lubrication deteriorate causing stiffness and for some people's pain. The interesting thing is that for some there can be a large amount of deterioration and yet not suffer from pain at all. Often these findings are found on routine X rays or MRI’s. Pain research suggests that soft tissue damage does not always equate to pain.

 

Disc herniation: Within each spinal segment of the spine lies the spinal disc. A very robust rubber-like cushion that aids in movement, feeds nutrition to the bone and act as shock absorbers during movement. Injury, age, and disease can lead to deterioration of these discs. They can become dehydration shrinking in thickness (more age-related), they can herniate where part of the disc will bulge sometimes pressing on a nerve. They can split in more severe cases entering the spinal canal and causing nerve compression. Caught early with the right education they can clear relatively quickly.

 

Degenerative disc disease (DDD): This is an age-related wear and tear of the spinal discs. They can narrow, become less hydrated and cause stiffness of the lower back. The lowest joints L3-L5/S1 are the most commonly affected discs. The latest research shows that exercise is the gold standard for pain relief and that includes running. It is a natural part of aging but can be problematic in some cases.

 

Degenerative joint disease (DJD): Age-related again, the wear and tear of the spinal joints. The endplates of a spinal vertebra are where the discs lye. They can degrade, morphing in shape creating stiffness and in some cases pain. Exercise therapy is also the gold standard. Yoga, Pilates and running keep the spine supple, creating confidence in movement which has shown to reduce pain for long term sufferers.

 

Sacroiliac joint (SIJ) sprain/dysfunction: Sacroiliac joint pain is a common presentation here at Corbin chiropractic. This joint is like the keystone of a bridge locking the lower back together with the spinal column. The pain can be and is very intense. Getting up from long hours of sitting is a classic symptom of SIJ pain. Often the pain experienced is due to muscle guarding and spasms of the lower back muscles. Again this type of issue can be short or long-lived. Chiropractic treatment is very effective for these issues with acupuncture, spinal manipulation, and home exercise. It is more common in women than men especially during and after pregnancy.

 

Facet dysfunction: From early teens to the elderly, facet dysfunction is a big player in back pain. Facets are parts of the spinal anatomy that create stability and have multiple attachments for ligament and muscle. They are very tough but prone to strain. When someone says “my back is out again” they are referring to a strain or sprain. A serious injury needs to of occurred to cause dislocation. Pain can be sharp and sometimes dull. The facets can refer pain to other areas of the body which can be concerning but generally is never a medical emergency. Spinal manipulation helps normalize the motion of the joints and reduce pain.

 

Stenosis of the spine: Stenosis means the thinning of the spinal canal or the spinal foramen. This can lead to spinal compression of the main spinal cord or the smaller branches exiting the spinal cord. Symptoms are pins and needles of the legs, leg weakness, or leg weakness from a short walk, back pain, and leg pain. Another sign of stenosis is called claudication where certain muscle and vascular functions have been compromised. In certain cases surgery is needed to prevent long term disability. A referral is made is a patient presents with these symptoms. Some cases can be managed conservatively where others need an orthopedic referral.

 

Cauda equina: Cauda equina should be treated as a medical emergency. I have had a few cases that have come into the clinic that I referred to A&E straight away. The Cauda equina is a bundle of nerves in the lower back that looks like a horsetail. If compressed it can cause leg pain, weakness, numbness of the buttocks and groin and can also affect the bowels. Losing control of the bowels is a telltale sign of cauda equina. This is not an issue chiropractic should be dealing with.

 

Spondylolisthesis: A bit of a tongue twister, Spondylolisthesis is where one vertebral disc has moved forward or back compared to the above or below spinal segment. In some cases, it can cause cord compression needing surgery. It is common in people who are flexible such as gymnasts. Many people do not know they have them and cause no pain. They are often found on routine X-rays or MRI scans.

 

Serious but rare causes of back pain are tumors, infection and spinal fractures.

 

What are the symptoms of back pain?

 

Symptoms are varied from person to person, the following bullet points make it easier to read:

 

• Sharp or dull pain, ache or a dull ache

• Pain referring from the lower back to the buttocks, legs, and groin. Most people would only experience this on one side.

• Pain bending forward, backward, side bend and twisting

• Pain getting up from sitting

• Pain rolling over in bed at night

• Back pain going up or downstairs, or pain worse with walking

• Night pain, if night sweats are reported then referral is needed.

 

Why does back pain come and go?

 

It is frustrating for people who get bouts of pain. Some may get bouts that last a few weeks, every few months, some may get a bout of back pain once every few years. But why? We have to know that back pain is a pretty normal occurrence like getting a common cold. It could be times of stress, times of less movement, a long flight, poor diet, poor mental health, sleeping on a new mattress, lying on a sun lounger on holiday or something simple like stepping off a curb that you did not know was there. Our job is to get people better with the pain they present with. Every patient has the option of receiving home exercises and only 20% do them. I have learned many verbal techniques to get people to do them because they are so effective. I cannot blame the patient for not doing them but can be frustrating at times. When patients are feeling better they stop treatment. Those who continue to do the prescribed exercises have better outcomes than the ones that do not. Our maintenance patients are the ones who opt for monthly or bi-monthly sessions and have the least bouts of back pain. The key is to form a positive outlook on back pain. Saying to one’s self that this has happened before and will get better as it did before. Back pain is a normal issue and rarely signs of something serious.

 

What is the difference between acute and chronic pain?

 

Acute pain, for example, would be hitting your thumb with a hammer. The pain is intense, you may scream a few swear words and it would soon fade away. You may have a bruise for a few weeks and a nail may fall out but after a month it would be back to normal. Chronic pain is pain that lasts more than 3 months. Most injuries and fractures (broken bones) take 4-8 weeks to heal. Chronic low back pain is now thought to be a faulty pain signaling issue. The brain thinks the area is damaged and causes guarding and hypersensitivity. Chiropractic aims to alter this guarding with the right language and manual treatment. Chronic pain is definitely harder to treat as there are many more factors to take into account from patients' mental state to their activity levels, job satisfaction and their own personal beliefs on what is going on. A good amount of time is taken during the initial consultation to determine these factors.

 

Why does my back cause leg pain?

 

There are a few causes why can we get leg pain. A tight muscle in the lower back and buttocks, muscles can shoot or make pain travel down the leg which is called a referral pattern. Nerve compression from a herniated disc, sacroiliac joints can also do this. Certain muscles on the calf such as the peroneal can cause pins and needles and numbness. If you ever feel heat, see swelling or a change in the color of skin tone see a medical doctor immediately to rule out a tumor or a blood clot.

 

How can chiropractic help?

 

Chiropractic specializes in the treatment of musculoskeletal diagnoses. We also help with certain neurological issues. We are trained in anatomy, physiology, biomechanics, orthopedics, neurology, nutrition and many other things with ology on the end. Corbin chiropractic looks at not only the body but a patient's beliefs about pain. Treatment a person as a whole has much better outcomes. Treatments vary from person to person. We may perform acupuncture, acupressure, muscle relaxation techniques, stretching, mobilizations, spinal manipulation, deep tissue work, and exercise therapy. Advice is given on sleeping, posture, basic nutrition and also have other therapists to refer out to if needed. All treatments are natural with no prescribing of medications. Our aim is to get people off of pain medication with GP approval.

 

How long will it take to feel better again?

 

Most people get better quite quickly. It is always patient dependant. An acute episode of back pain can be cleared in as little as 3 treatments. Chronic back pain 6-8 sessions. For some regular treatment is needed. A patient is always offered homework, this will help speed up recovery. It is nearly impossible to put a date on recovery time as we cannot always predict what obstacles could get in the way.

 

How much will it cost?

 

Our prices are very competitive and can be seen here.

 

How can I make an Appointment?

 

We have many ways to book. Send us an email at health@corbinchiropractic.co.uk

Book online here.

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References:

 

1. https://www.who.int/news/item/07-12-2023-who-releases-guidelines-on-chronic-low-back-pain#:~:text=Low%20back%20pain%20is%20the,a%2060%25%20increase%20from%201990.

2. https://www.spine-health.com/blog/relationship-between-chronic-pain-and-inactivity-disuse-syndrome

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396190/

4. https://en.wikipedia.org/wiki/Cauda_equina_syndrome

5. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain

6. https://www.verywellfit.com/average-healing-times-for-common-sports-injuries-3120819

7. https://link.springer.com/chapter/10.1007/978-3-319-99912-8_8

8.https://journals.lww.com/clinicalobgyn/Abstract/2019/03000/Psychology_of_Chronic_Pelvic_Pain__Prevalence,.5.aspx

9. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200510/