Low back pain is a common healthcare and social problem associated with disability and absence from work.
One 2005 medical study of chronic spinal pain stated that the lifetime prevalence of spinal pain has been reported as 54% to 80%, with as many as 60% of patients continuing to have chronic pain five years or longer after the initial episode.
The long-term and disabling conditions of chronic and recurrent low-back problems are of major concern, from both costs and morbidity aspects.
Chiropractic care has been shown to compare favorably to medical care with respect to long-term pain and disability outcomes in many cases, but the chiropractor should carefully consider the optimum treatment plan for each patient on an individual basis.
For most cases of chronic low-back pain, I recommend a three-step program of spinal adjustments, postural stabilization, and rehabilitative exercise.
Combining these three elements can make the difference between a successful care program and a lingering, recurring low back condition.
Spinal Adjustments As far back as 1985, medical research was reporting that a two to three week regimen of daily spinal manipulations by an experienced chiropractor brought significant improvement in 81% of totally disabled patients with chronic low back and referred leg pain.
The patients in the study were from a university back pain clinic for patients who had failed to respond to previous conservative or surgical treatment.
The researchers stated that anything less than two weeks of daily manipulation is inadequate for chronic back pain patients.
Postural Stabilization A significant factor in reducing excessive biomechanical forces on the lumbar spine is frequently overlooked by practitioners - the use of external supports to decrease external forces.
Positioning aids such as sitting postural supports (examples are postural back rests or ischial lifts for chairs and car seats), standing postural supports (such as foot orthotics and heel lifts), and sleeping postural supports (such as mattresses and pillows) can all greatly assist in the long-term management of painful lumbar spine conditions.
Rehabilitative Exercises Corrective exercises done at home to strengthen supporting muscles are recommended as an adjunct to chiropractic adjustments and postural stabilization.
Active involvement of the chronic low back patient in an appropriate exercise program has been found to be very beneficial, even for patients with herniated discs.
Flexibility and strength exercises can bring about rapid improvements in lumbar spinal function as well as decreases in pain levels.
Activity should focus on developing strength in the abdominals and supporting pelvic and low-back muscles.