When seeking a pain management physician, it is often advantageous to find one that practices in a multidisciplinary and multimodal manner. These physicians can offer their patients more options and can provide them with an array of services, allowing an individualized treatment plan to be created.
Chiropractic care can tie in closely with pain management. With the rise in the abuse of prescription pain medications, many patients are wary of managing their pain with medications. Chiropractic care is minimally invasive, non-pharmacological, and can be repeated with minimal if any side-effects.
Disc decompression is a common treatment provided by chiropractors and is a process that gradually lengthens and decompresses the spine. The intervertebral discs within the spine are filled with a jelly-like fluid called the nucleus pulposus, which get compressed throughout natural processes during the day. Eventually, through age and/or injury, the discs will not fully “re-inflate" at night when sleeping as they do when a person is young and in good health. Additionally, as the discs in the spine are constantly under pressure, this can slow the rate of healing
Decompression causes “negative pressure" within the discs, which help them to re-hydrate and creates a better cushion within the spine. The decompression machine can be set by the doctor per your individual medical needs and can be set up to focus on the cervical (neck) spine or lumbar (lower) spine. Spinal disc decompression can offer pain relief or can work in conjunction with ongoing procedures and other interventional pain management treatments.
There are some alternative treatments within chiropractic care that are widely used but not well understood by the public. Gua sha, a treatment that raises a millet-like skin rash, but has been shown to work extremely well for painful and sore spots on the body. Gua sha treatments should always be administered by a professional. The area to be gua sha-ed will first be treated with an oil so that the process is not painful. Then, the skin is rubbed with a round-edged tool in downward motions. The rash that is raised can tell the practitioner the severity of the existing condition. For most patients, relief is felt immediately after treatment.
Chiropractic care can include acupuncture, the practice of placing sterilized, very fine grade needles strategically to relieve pain. By stimulating these areas with the needles, endorphins are released, which are the body's natural painkillers. In addition to that, it has been shown that acupuncture can cause lowered blood pressure, lowered core body temperature and can help with a variety of health issues.
Back pain is extremely common; it is estimated that as many as 70% of the population will experience this type of pain at some time in their lives1. Further, half of all working Americans admit to having back pain symptoms each year2, and back pain is the second most common reason for visits to the doctor's office, outnumbered only by upper-respiratory infections3.
One way to combat back pain is through chiropractic care. According to the American Chiropractic Association (ACA), chiropractic is a health care profession that focuses on disorders of the musculoskeletal and nervous systems, and the effects of these disorders on general health4. It is used most often to treat neuromusculoskeletal complaints such as back pain, neck pain, joint pain of the arms or legs, and headaches5. Chiropractic is typically considered a form of complementary and alternative medicine (CAM). It is well established in the US, Canada, and Australia and is the third largest health profession, behind medicine and dentistry6. Further, it is covered by most insurance carriers.
The most common reason people seek chiropractic treatment is for low back pain7. Although back pain can be caused by certain serious conditions such as inflammatory arthritis, infection, fracture and cancer, most cases of back pain are mechanical in nature8. Mechanical means the source of the pain may originate from the spine or surrounding tissues, including spinal joints, discs, vertebrae, or soft tissues, which can become damaged, irritated and inflamed9. According to the Cleveland Clinic, a specific trauma or strenuous activity may cause mechanical back pain; however, 80% of the time, the specific source of the pain is not found10.
Chiropractors are concerned with the biomechanics, structure, and function of the spine along with its effects on the musculoskeletal and nervous systems and what they believe to be its role in health and disease11. Most assert that the spine and health are fundamentally related and that this relationship is mediated through the nervous system12. In addition, most endorse conservative management of the neuromusculoskeletal system without the use of medicines or surgery13.
Chiropractic treatment primarily involves manual therapy, including manipulation of the spine and other joints, soft tissue therapies, rehabilitative exercises, health promotion, electrical modalities, complementary procedures, and lifestyle counseling14. The chiropractor may also employ certain diagnostic methods including skeletal imaging, observational and tactile assessments, and orthopedic and neurological evaluation15. As in other branches of healthcare, a chiropractor may also refer a patient to a specialist, or co-manage a patient with another health care provider16.
A term heard often in chiropractic care is “subluxation." The World Health Organization (WHO) definition of chiropractic vertebral subluxation is: “A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity." The chiropractic subluxation is not necessarily large enough to be perceptible on imaging studies such as a X-rays. It therefore differs from the common medical definition of a spinal subluxation which, according to the WHO, is a “significant structural displacement" that is visible on X-rays. One of the chief goals of chiropractic is to correct subluxations, which is thought to reduce pain and improve overall health. This is achieved mainly through chiropractic “adjustment," which is another term for spinal manipulation.
In many people, chiropractic care provides an excellent, conservative solution to back pain and may improve overall health. It is a well-known, established branch of health care, and is safe when performed by a certified, experienced practitioner. Many individuals find chiropractic reduces their pain and improves functionality, leading to a better quality of life.
1. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
3. “Back Pain Facts & Statistics." American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 30 Jun 2011. www.acatoday.org/level2_css.cfm.
4. “Back Pain Facts & Statistics." American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 30 Jun 2011. www.acatoday.org/level2_css.cfm.
5. “Back Pain Facts & Statistics." American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 30 Jun 2011. www.acatoday.org/level2_css.cfm.
6. Smith M, Morschhauser S. (2008). “Establishing a database of U.S. chiropractic health manpower data: furthering the development of research infrastructure.". National Library of Medicine. gateway.nlm.nih.gov/MeetingAbstracts/. Retrieved 2011-06-30.
7. Homola S. (2006). “Chiropractic: history and overview of theories and methods". Clin Orthop Relat Res., 444, 236–42.
8. “Back Pain Facts & Statistics." American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 30 Jun 2011. www.acatoday.org/level2_css.
9. “Acute Mechanical Back Pain." Cleveland Clinic. Cleveland Clinic, 2009. Web. 30 Jun 2011.my.clevelandclinic.org/disorders/Back_Pain/hic_Acute_Mechanical_Back_Pain.
10. “Acute Mechanical Back Pain." Cleveland Clinic. Cleveland Clinic, 2009. Web. 30 Jun 2011.my.clevelandclinic.org/disorders/Back_Pain/hic_Acute_Mechanical_Back_Pain.
11. “History of Chiropractic Care." American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 30 Jun 2011. www.acatoday.org/level2_css
12. Gay RE, Nelson CF (2003). “Chiropractic philosophy". In Wainapel SF, Fast A (eds.). Alternative Medicine and Rehabilitation: a Guide for Practitioners. New York: Demos Medical Publishing.
13. “History of Chiropractic Care." American Chiropractic Association (ACA). American Chiropractic Association (ACA), 2011. Web. 30 Jun 2011. www.acatoday.org/level2_css
1. Mootz RD, Shekelle PG (1997). “Content of practice". In Cherkin DC, Mootz RD (eds.). Chiropractic in the United States: Training, Practice, and Research. Rockville, MD: Agency for Health Care Policy and Research. pp. 67–91. OCLC 39856366. chiroweb.com/archives/ahcpr/chapter3. Retrieved 2008-10-10. AHCPR Pub No. 98-N002.
15. World Health Organization (2005). WHO guidelines on basic training and safety in chiropractic. ISBN 92-4-159371-7. [PDF]www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf. Retrieved 2011-06-30.
16. Meeker WC, Haldeman S (2002). “Chiropractic: a profession at the crossroads of mainstream and alternative medicine". Ann Intern Med., 136 (3), 216–