IS MY PAIN SERIOUS?

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

Headaches and Chiropractic

If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea.

What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

Research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

Headache Triggers

Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern.

“The greatest majority of primary headaches are associated with muscle tension in the neck,” says Dr. George B. McClelland, a doctor of chiropractic from Christiansburg, VA. “Today, Americans engage in more sedentary activities than they used to, and more hours are spent in one fixed position or posture. This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.”

What Can You Do?

The ACA suggests the following:

• If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
• Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
• Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
• Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

What Can a Doctor of Chiropractic Do?

Dr. McClelland says your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:

• Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
• Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
• Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

“Doctors of chiropractic undergo extensive training to help their patients in many ways – not just back pain,” says Dr. McClelland. “They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.”

Decompression

Did you know that your spinal column's spongy intervertebral discs (IVDs) comprise 25% of this segmented structure's entire length? Did you know that an adult's spinal column is approximately 24-28 inches in length? A little quick math shows that the total height of your spinal discs is approximately between 6 and 7 inches. But most of us don't get to enjoy the maximum height, springiness, or shock-absorbing capabilities of our spinal IVDs.

Why is that? Another fact known to anatomy students is that IVDs begin losing their total water content at the early age of 2. If you're a young adult, that water-losing process has been going on for 20 years. If you're older, tack on a couple of decades. But this is a natural process. Whether we like it or not, our body parts are not built to last forever. They are designed to keep us healthy and fit for about 150 years (another little known fact). What's not natural is the sedentary lifestyle associated with living in an economy driven largely by the service sector.

Until very recently (75 years ago or so), most adults worked at jobs which required physical labor. Employment in agriculture and industry required actual work using one's body. Those jobs had a built-in exercise component, all day, every day. In contrast, 21st century jobs require a lot of sitting. For many jobs, workers are sitting all day, every day. When you're sitting or standing in an unchanging position, the relentless force of gravity bears down on your spine at a steady, never-changing rate of 32 ft/s². The long-term result on one's spinal column is compression. Natural water-losing forces are unopposed and your spinal discs just keep getting thinner.

We need to reverse these trends. We need to find ways to pump our discs back up. We want to regain the health of our spinal discs, regain lost stature, and be able to stand up tall, achieving our full physiological height.  We need to identify and engage in decompressive activities, activities that will restore fluids to our IVDs.

Fortunately, a highly decompressive set of activities is readily available and has been in use for thousands of years. Yoga is a system of exercises that provides a broad range of health benefits including spinal decompression.^1,2,3 In fact, done correctly, all yoga exercises (known as postures, poses, and asanas) result in spinal lengthening. The key is to make the yoga posture active, constantly engaging, working, and lengthening your core muscles while you're doing the pose.

Regular yoga classes (even once a week may be sufficient) will lead to noticeable benefits, including a sense of being taller. The spinal decompression obtained through regular yoga practice will help increase your flexibility, balance, and coordination. Yoga can be done at home. The only equipment needed is a rubber mat. The long-term payoff is big, in more ways than one.

¹Jeng CM, et al: Yoga and disc degenerative disease in cervical and lumbar spine: an MR imaging-based case control study. Eur J Spine 20(3):408-413, 2011

²Williams K, et al: Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain. Spine 34(19):2066-2076, 2009

³Goncalves LC, et al: Flexibility, functional autonomy and quality of life (QoL) in elderly yoga practitioners. Arch Gerontol Geriatr 53(2):158-162, 2011

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