chiropractic FOR
LOW BACK PAIN
chiropractic Cox Technic Flexion
Distraction and Decompression spine manipulation is
validated by vast research
and provides
genuine outcomes. chiropractic spinal
manipulation is a standard of care for low back pain and leg pain. Its benefits
are well documented in the
literature, and research literature citations are reviewed here.
Low Back Pain
First let us
go into
what low back pain is to you, the
patient. Which of the following do you feel:
- Pain
localized to the low back only
- Pain
localized to the low back and buttock
- Pain
localized to the low back, buttock, and thigh
- Pain
localized to the low back, buttock, thigh and leg and even going
down to the foot and toes
Every single one of these descriptions are paired with low back pain and are but types
of what is commonly thought of as
low back pain. It
can be said accurately that the further the pain extends
down the lower extremity, the more serious the spine problem is, and the
more challenging it is to relieve. The reason being
that with total leg pain -- sciatic nerve pain down
the back and side of the thigh, leg, and bottom of the foot or femoral nerve pain down the front of the groin, thigh, leg
and foot -- there is
irritation of the spinal nerve as it exits the spine in the low back. This is
more complex and typically
involves disc herniation or spinal stenosis.
The Patient
We will begin
with looking at the patient who has only low back pain which
may travelspread to the buttock and thigh but not travel further down the leg below the knee.
This condition
reacts more effortlessly to
treatment.
The Effects of Care
Below
are the changes in the spine that relieve pain when this
form of spinal adjusting is available:
- The
intervertebral disc space is enlarged, that
is, it is increased in height
- The
pressure within the intervertebral disc is decreased.
- This
scales down the pressure on the nerve it is
compressing.
- This
lessens pressure inside the disc stops the nerve
irritation which soothes low back pain and leg pain.
- The
size of the nerve opening within the spinal column, called the foramen, is raised
up to 28% in size.
- The
joints of the spine are moved into their usual
ranges of motion to regain normal mobility
and freedom of motion without suffering.
The Benefits of
Conservative, Spinal Manipulation Care for Low Back Pain
Spinal research
literature continues to record positive
results of conservative
care for low back pain and that surgery may not always be needed.
- The
United States Public Health Service, U.S. Department of Health and Human
Services guidelines state that spinal manipulation is safe and recommended for
acute low back pain. (1)
- 33%
of 27,810 people chose chiropractics as their treating
physician for low back pain in the National Health and Nutrition Examination
Survey (NHANE). (2)
- Spinal
manipulation is recommended for low back pain. (3)
- Spinal
manipulation is recommended by the American Pain Society and the American College of
Physicians for primary care of low back pain. (4)
- Prolotherapy,
facet joint injection, intradiscal steroid injection, and percutaneous
intradiscal radiofrequency thermocoagulation are not effective for primary care
of low back pain. (4)
- Epidural steroid injections give short term but not long-term relief of low back
pain. (4)
- Spinal cord stimulation is moderately effective for failed back surgery syndrome
with persistent radiculopathy, though device-related complications are
common. (4)
- Surgery
for leg pain (radiculopathy) with herniated lumbar disc and symptomatic spinal
stenosis is associated with short-term benefits compared to non-surgical
therapy for low back pain, though the surgical benefits diminish with long-term
follow-up. (4)
- For
patients with no leg pain (non-radicular back pain), with disc
degeneration, fusion is no more effective than intensive rehabilitation, but
associated with small to moderate benefits compared to standard non-surgical
therapy. (4)
Recorded
Results of Cox Technic Flexion Distraction and Decompression For
Low Back Pain
- A
study of 1000 patients with low back and lower extremity pain treated with Cox
Flexion Distraction and Decompression spinal manipulation by
30 chiropractic physicians is shown in the following
chart. Note that diverse diagnoses of low back and leg
pain are administered such as sprain/strain,
spondylolysis, etc., and every one these diagnosed
conditions are described elsewhere in this website as to their diagnosis and
treatment.
- The
number of visits and days to obtain relief
of these conditions, regardless of the individual diagnosis, was found.
- the average number of days was 29 days
- the number of office visits for spinal manipulation was
12 (5,6,7)
- In
a comparison study of Cox Flexion Distraction and Decompression spinal
manipulation to active exercises for chronic low back pain with and without
lower leg pain (sciatica), a total of 235 subjects were studied; 123 were
assigned to Cox Flexion Distraction and 112 to active trunk exercise protocols.
- Subjects
randomly allocated to the flexion distraction group had significantly greater
relief from suffereing than those allocated to the
exercise program.
- Subjects
categorized as chronic, with moderate to severe symptoms, improved most with
the Flexion Distraction protocol.
- Patients with radiculopathy (leg pain) did significantly better
with Flexion Distraction.
- Overall,
Flexion Distraction provided more pain relief than active exercises. (8)
- Applying
axial distraction to the spine is shown to cut
back disc stress on the anulus and nucleus. This is anticipated to lower
the compressive disc stresses in back pain. (10)
Why you
should Try Conservative Care for Low Back Pain Before Surgery
- 95%
of patients with low back pain and leg pain will be cleared of it in 1 to 12 months with non-surgical care. (9)
- A
trial of conservative non-operative care is encouraged
before surgery for patients with lumbar disc herniation. 95% of low
back pain and leg pain patients are well in a time period of one to 12 months
without surgery. (11)
- A comparison
of surgically treated with non-surgically treated patients with
chronic low back pain of 349 chronic low back pain patients aged 18-55 years showed
no evidence that surgery was any more beneficial than intensive rehabilitation.
Surgery cost more, had potential risks, and was not cost effective. (12)
- Cost
and clinical outcome comparisons of chiropractic versus medical
care for low back and leg pain showed that chiropractic care is affordable when care
extends beyond primary care. (13)
- Spinal manipulation gave
better short and long-term functional
improvement as well as more pain relief in the follow-up than
either back school or individual physiotherapy in a study of 210 patients with
chronic, non-specific low back pain.
- Spinal manipulation was associated with higher functional [[improvement/recovery]108]
and long-term pain relief than back school or individual physiotherapy.
- Spinal
manipulation provided better short and long-term functional
improvement, and more pain relief in the
follow-up than either back school or individual physiotherapy. (14)
- Traction
with relatively low magnitude was found to have significant beneficial effect
in maintaining disc height of degenerated disc. (15)
- Lumbar
fusion for disc degeneration, herniation with or without radiculopathy is
associated with significant increases in disability (11%
of fusion vs 2% for non-surgical), opiate use (by 41%
after surgery with 76% continued to use opioids after surgery), work
loss (1140 days for fusion vs 316 days), reoperation (27%
needed another surgery), and poor return to work status (26%
of fusion vs 67% non-surgical were back at work 2 years later). (16)
- Under conservative care, quality of life for lumbar
radiculopathy (leg pain) patients improves. (17)
- There
are currently no clear indications
for surgery in non-specific low back pain. (18)
- Chronic
low back pain patients without severe
neurological deficits can be treated with manipulation,
acupuncture, exercise, education, self care. (19)
- Chiropractic care of worker’s compensation patients shows
acute, subacute and chronic back and neck pain patients showed
improved subjective and functional status under chiropractic spinal manipulation. (20)
- Second opinions by spine surgeons for a recommended back surgery show
that 60.7% were “not needed,” 33.3% were “wrong,” and only 6% were “right.” (22)
Conclusion
60-80% of health-care consulting patients will continue to
deal with pain after a
year. There are
some who say that 90% of patients suffering from back and
leg pain will be better in 90 days if no treatment is
provided. This simply is not true
as the datay shows that a third to 72% of
them will have pain a year later. Chiropractic treatment isessential and recommended
(21). Conservative,
chiropractic care has a spot in healthcare for
effective, affordable,
recorded treatment for low back pain alleviation.
Schedule an appointment
with your Murfreesboro chiropractor now.
"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the
DISCLAIMER page. Content is reviewed by
Dr. James M. Cox I."