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  • John K Maltby II, D.C.

Why won't my back pain go away?

Back Pain

I will never forget a question that was asked on my national board examinations: What is the number one indicator that a person will have low back pain in the future? The reason this question is so memorable is because if its answer. The number one reason that a person will have low back pain in the future is because they have had it in the past. Yes, you read that correctly, the pinnacle of western medicine’s ability to predict that you will have low back pain is the fact that you have had it before. As ridiculous as this sounds, this is considered a fact. Almost 80% of the general population will experience back pain during their adult life. At any given time 20-30% of adults suffer from back pain.


Our bodies are designed to adapt to its environment, and most of the time it is adapting in response to a negative input. The most common thing one does when they have back pain is to take a pill, usually a NSAID (non-steroidal anti-inflammatory drug, i.e. Advil, Aspirin, etc), after a few days or weeks the pain goes away and they stop taking the pill. Eventually the pain comes back and they go back to the NSAID, and again the pain goes away after a few days or a week. This pattern continues until the NSAIDs are no longer working at taking the pain away, and after a few weeks it is not going away “on its own.” The next most common step people take is to go to their MD and get a stronger pill to make the pain go away. They get their prescription and are told the pain should go away in about two weeks. Sometimes the pain goes away, and sometimes it does not. Whatever caused the pain originally (the root cause) was never addressed the first time the back pain appeared and is still not being considered. The pain was masked with a pill and after a certain amount of time the body decided to turn off the nerve signals (pain) to the brain that indicates there is an injury. The ignoring of the pain/symptom told your body that it was not important and it adapted accordingly. Over time the body kept giving them reminders (return of pain) that something is wrong, and each time these reminders came, they decided to cover them up with pain medication. The pain is not because the Aspirin gland was low or is malfunctioning.


Now we come to the point when the pain no longer goes away with over-the-counter NSAIDs, or even prescription NSAIDs. This is when other commonly offered options from a MD are offered. These are prescription opioids, a steroid shot, or referral for surgery or physical therapy. Usually, the Chiropractor is not on the list of options for the MD, when drugs have not worked. What about an X-Ray, MRI or orthopedic examination? Most of the time these are not performed in a MD office unless the pain pills are not working right away or there is a concern of a serious injury, like a fracture or disc herniation. The problem with this order of care is that these things (X-ray, MRI, orthopedic examination) should be done first to find the cause of the pain, not just give out drugs in the hope that the pain/symptom will go away, and hopefully never come back without addressing the root cause of that original pain.


This is where Chiropractors come in. Chiropractors are primary care providers and do not need a referral. Chiropractors are also interested with finding the root cause of an issue. The actual reason you are feeling a symptom. This can be frustrating to people at times, because the Chiropractor might not seem to be addressing the symptom/pain directly. A Chiropractor will do a series of hands on orthopedic and Chiropractic examinations and possibly a series of X-Rays. Also, the Chiropractor will usually examine the whole body and not just the “problem area.” For example; here at White Pine Chiropractic, I specialize in upper cervical care, where I focus on the top 2 bones in the spine (Atlas/C1, Axis/C2). My very first upper cervical patient came to me with pain in both knees. Upon examination I noticed that C1 was subluxated (out of alignment) and I adjusted that only. To the patients surprise the knee pain went away immediately and has not returned. This is one example of the pain being in one place, but the cause being another. Now if this did not seem to clear up these issues, I would have looked elsewhere to see what else was going on. I have many cases that are similar to this one. This phenomenon is called referred pain.


Referred pain is when an injury in one part of the body puts pressure on a nerve that sends the pain to another place on the body. Below is a classic chart that shows referred pain patterns of the cervical spine.


Back Pain
Referred Pain



One of the most common pain patterns in a Chiropractors office is pain under or just along the inside of the shoulder blade. This is a classic pain referral area for cervical spine issues, and the Chiropractor will probably focus on the neck as well as the shoulder area. The chart below is a simple diagram of how each segment of the spine can affect many different things.


Back Pain
Subluxation Chart

That back pain that you are having could be telling you that more is going on than just tight muscles and inflammation. Chiropractors are primarily focused on getting to the root cause of those symptoms, correcting it, and allowing your body to adapt properly to your environment. What are you waiting for? Get to a Chiropractor as soon as possible. We are always accepting new patients here at White Pine Chiropractic. You can schedule through our website with the schedule now button or call the office to get in.





References:


Valkenburg HA, Haanen HCM. The epidemiology of low-back pain. In: White AA, Gordon SL, eds. American Academy of Orthorpaedic Surgeons Symposium on Idiopathic Low Back Pain. Toronto: CV Mosby Co., 1982:9-22.


White AA. Introduction. In: White AA, Gordon SL, eds. American Academy of Orthopaedic Surgeons Symposium on Idiopathic Low Back Pain. Toronto: CV Mosby Co., 1982:1-2



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