An overview of chiropractic treatment for lower lumbar back pain, how it works, how safe it is, and how often treatment is necessary. Along with the principles of chiropractic for the relief of lower/lumbar back pain, whether acute or chronic. Seeing a doctor of chiropractic/DC, a chiropractor or a chiropractic physician can be highly beneficial towards effectively treating low back pain.
Chiropractic medicine utilizes a variety of treatments/therapies that are designed to manipulate/adjust the:
These treatments focus on the entire body to relieve pain and improve functional ability. This is referred to as spinal manipulative therapy or SMT, but there are many other treatment methods and techniques.
Every chiropractor has a personal treatment approach based on the patient’s condition/s, medical history, and personalized treatment plan. A chiropractor will begin traditionally starting off with soft, natural, less-invasive treatments. If these do not generate positive results they will move on to more aggressive techniques.
At every stage of the chiropractic process, there is a strict emphasis maintained on proactively discussing with the patient exactly what is taking place and what is going to happen. A chiropractor makes sure that the patient understands everything that occurs during:
This is all done in order to educate the patient and receive direct permission to start the treatment. The emphasis on informed consent is essential. This is because some chiropractic techniques could carry material risk. This means that a certain technique or particular procedure could possibly cause injury.
A chiropractor also informs the patient of the possible risks of not being treated. It is not meant to scare a patient. It is to eliminate any misunderstandings and make sure that the patient has full control over their body, so they can make an informed decision, as to which way they want to go.
A chiropractor will thoroughly examine a patient before making any sort of diagnosis or treatment plan. The assessment can include:
The characteristics of the pain, any red flag symptoms that require further diagnostic testing will be conducted to remove any potentially serious medical issues that can be associated with neck or lower lumbar back pain-like:
- Neurological disorders
There can be many reasons as to why low lumbar back pain happens. A chiropractor will investigate and develop a personally customized treatment plan. Next, a physical exam will be performed. This includes an orthopedic and neurological exam. These will test the:
- Sensory nerves
- Other areas of the body
Advanced Diagnostic Testing
Severity/Duration of Condition
Chiropractic medicine looks at the symptoms and conditions of an injury or ailment and classifies them on how severe they are, and how long they last. Symptoms can be divided into degrees of severity: They are:
For the duration period, pain and other symptoms are referred to as:
- Acute pain – lasts for less than 6 weeks
- Subacute – lasts between 6 and 12 weeks
- Chronic – lasts for at least 12 weeks
- Flare-ups – the same symptoms happen irregularly or from an exacerbation of the original injury
If an individual is dealing with acute or subacute lower lumbar back pain, then a chiropractic trial could be an option. This could be two to three weekly sessions over the course of two to four weeks adding up to twelve total sessions. This can be a sufficient treatment to completely alleviate the pain. However, when the pain does not go away then additional treatments could be necessary, especially if an individual has other issues/conditions.
Outcome measurements are a valuable tool because they help determine whether or not the treatment is producing significant results. Some outcome measurements of treatments include:
- Numeric Pain Scale for patients to rate the pain
- Pain diagram so patients can describe the location and character of the pain
- Increases and decreases in normal daily practices, like work, exercise, and sleep
- Testing functions
- Lifting ability
For some low lumbar back pain could last and go over the 12-week mark making it a chronic pain condition. A chiropractor will look for signs/symptoms to see if there is a risk of developing chronic pain.
Chiropractic How Often
When the pain is acute lower lumbar back pain, a standard treatment plan can be six to ten sessions over the course of two to four weeks. These treatments emphasize the passive non-exercise approach of manual therapy for relieving pain and improving function.
If the non-exercise method doesn’t deliver positive results then a more active exercise-based treatment can be utilized to increase function and return an individual back to normal life.
Back Pain That Doesn’t Go Away
Often acute symptoms are resolved within the first 4-weeks. But it is possible that the pain can become chronic, meaning that it lasts longer than 12 weeks. Some individuals can hit a plateau during the recovery process.
This is referred to as MTB or that the patient has met the therapeutic benefits. A chiropractor will want to see if pausing/stopping chiropractic treatment will have a residual effect, exacerbate the pain, or reduce function and activity.
Example: If mild to severe chronic lower lumbar back pain has worsened, a patient could need one to six more visits with each pain episode. And this would be two to three weekly treatments for two to four weeks. However, patients rarely need continuing or ongoing care of one to four visits per month.
Chiropractors will not continue treatment/s if they are not helping the patient. Therefore, every 2 to 4 weeks there is a re-evaluation of the patient to see if the treatment is still having a positive and beneficial effect. Here are some of the criteria for continuing treatment:
- Individual still responds positively to the treatment
- The individual has met the therapeutic benefits and worsens when they are not treated
- Proof shows that self-care alone will not be sufficient to maintain the therapeutic benefits
Living with chronic lower lumbar back pain can be a challenge, but chiropractors want to emphasize to individuals that self-care is an essential component for pain management. This includes physical rehabilitation combined with range-of-motion exercises. A chiropractic physician may encourage a variety of treatment options, like:
- Massage therapy
- Crossfit Rehabilitation
- Health coaching
- Psychosocial counseling
- Other beneficial treatment options
Chiropractic treatment and the benefits are different for everybody. This is why it is important to communicate with your chiropractor every step of the way and to be open-minded about the different treatment options they offer.
Why Chiropractic Works
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