What causes back pain?
Chiropractic manipulation has been recognised as highly effective in treating back pain, and the Royal College of General Practitioners issued guidelines for GPs in 1996 which recommended manipulation within six weeks of onset for the relief of acute low back pain.
The National Institute for Health and Clinical Excellence (NICE) published guidelines in 2009 to improve the early management of persistent non-specific low-back pain. The guidelines recommend what care and advice the NHS should offer to people affected by low-back pain. NICE assessed the effectiveness, safety and cost-effectiveness of available treatments and one recommendation is to offer a course of manual therapy, including spinal manipulation, spinal mobilisation and massage. This treatment may be provided by a range of health professionals, including chiropractors.
Chiropractors are trained to identify and treat the specific cause of your back pain, and once you have been treated, they may also advise you on an appropriate rehabilitation and maintenance exercise plan to prevent a recurrence.
In order for the spine to be flexible, the vertebrae are joined together by soft tissue structures known as discs. Each disc is made up of two parts - a central soft core and outer rings of tough cartilage. The discs allow movement and also help to absorb shock. A slipped disc is the rather inaccurate term used to describe the condition, often in the lower back, where trauma or 'wear and tear' have caused damage to the outer rings of cartilage, so that the core is squeezed outwards. This can eventually result in a bulge which can press on the spinal cord, the nerve root or the nerve itself. It can cause excruciating pain, either in the back or referred elsewhere - for example in the lower leg or foot, sometimes referred to as sciatica. Chiropractic treatment can mobilise the spine to help reduce pressure on the nerves. Chiropractors are trained to recognise more severe conditions related to herniated spinal disc requiring surgical referral where appropriate.
Trigger points (sometimes referred to as 'fibrositis') are very common and related to back pain. They occur in the neck or shoulders (often caused by bad posture or stress) or sometimes in the sacro-iliac region at the base of the spine. Painful knots form within muscles which have gone into spasm - a reaction which the body triggers in order to tighten muscles round a problem area to prevent further injury. This is why the condition so often occurs in patients who have had a back pain problem for some time, and it can make the treatment of the original complaint more difficult by putting unequal pressures on joints when they have been adjusted. Your chiropractor will therefore use manipulation to adjust the relevant joint, but also deep massage and soft tissue work to relieve the condition. Since the knots of muscle are often very tender, the soft tissue treatment may be painful at first.