
How do you know whether your pain needs to be evaluated by your
chiropractor? This is the age-old question. The answer needs to be
specific to your particular problem, rather than a one-size-fits all
solution. But there are good guidelines that everyone can follow.
First, is your pain deep and boring (that is, does the pain feel
like it's boring into you)? Deep and boring pain usually means something
is seriously wrong. If you're woken up at night by this type of pain, a
visit to your chiropractor or family physician is in order. Kidney
stones and inflamed gallbladders are common causes for deep, boring pain
that causes a person to awaken from sleep. Severe heartburn is in this
category, too, and should be evaluated by your doctor.
But these types of problems are easy to categorize. You'll
probably know, instinctively, that something is wrong. Musculoskeletal
pain is rather more difficult to analyze. For example, you lean over in a
twisting motion to grab the glass of water on your nightstand and you
feel a sharp pain in your lower back. Next morning you have great
difficulty getting out of bed. Your lower back is stiff and sore. What
should you do?1,2
Your best course of action will be based on a self-assessment. If
you're experiencing pain that radiates down your leg, or numbness or
tingling sensations traveling down your leg, you should call your
chiropractor's office and ask to be seen right away. Or, if you don't
have any radiating pain, but sneezing or coughing does provoke a
radiating sensation, take the same action. Similarly, the amount of pain
you're having will determine what you do. If the pain is severe, see
your chiropractor.
If none of these criteria are present, decision-making gets a
bit murky. How you handle your problem will depend on your tolerance for
pain. If you have low tolerance, make an appointment to see your
chiropractor and get some expert treatment. If you have a higher pain
threshold, you might still call for an appointment just to make sure
that nothing is seriously wrong. Certainly, if you haven't improved at
all after 48 hours, you need to see your chiropractor.
There is another important scenario. If you have a medical
condition such as cancer, an endocrine disorder, or a systemic
infection, a sudden occurrence of back pain needs immediate attention,
regardless of how or why you think the pain occurred.3 This
is not to be an alarmist, but rather the recommendation is based on
precaution. If there is an existing problem, then new issues need to be
looked at closely, just to be sure.
These guidelines provide a sound basis for decision-making, but
please remember they are just that - guidelines. Each person needs to be
comfortable with their own process. And, of course, it's always much
better to be safe than sorry. Your chiropractor is always available to
help you sort out these kinds of problems.
In the field of medicine, the term pain management is code for drugs
and intraspinal steroid injections. Pain management drugs are almost
always opioids such as Vicodin, OxyContin, and morphine. Intraspinal
steroid injections are at best a temporary fix, are often based on best
guesses, and can have devastating side effects if done incorrectly.
On the other hand, chiropractic pain management always uses
conservative methods of care. Chiropractic care does not introduce
foreign substances or instruments into the body. The power of
chiropractic care lies in its ability to facilitate the body's own
healing mechanisms. In essence, based on a systematic analysis of the
person's biomechanics and physiology, chiropractic care removes
roadblocks to normal functioning of the nerve system. When the nerve
systems pathways are free and clear, the body can begin to heal itself
from the inside-out.
Your body is very smart. For many problems involving pain,
all your body needs to heal itself is a freely functioning nerve system.
The goal of chiropractic care is to enable such normal functioning.
1Smart KM, et al: The discriminative validity of
"nociceptive," "peripheral neuropathic," and "central sensitization" as
mechanisms-based classifications of musculoskeletal pain. Clin J Pain
27(8):655-653, 2011
2Arendt-Nielsen L, Graven-Nielsen T: Translational musculoskeletal pain research. Clin Rheumatol 25(2):209-226, 2011
3Casazza BA: Diagnosis and treatment of acute low back pain. Am Fam Physician 85(4):343-350, 2012