LOWER LUMBAR BACK PAIN
(Keywords: lower lumbar back pain, chiropractic help, L4 Lumbar spine, Leg length inequality, Slump Test) LBP is a complex multi-factorial syndrome that causes immense pain and suffering, early loss of independence, and inablility to perform those things which bring us pleasure. Gardening becomes impossible, sitting for any length of time is painful, and a gentle amble window shopping is often hopelessly miserable. A weekly game of tennis is pie-in-the-sky. The treatment of LBP is the single high cost to the insurer - hence high monthly premiums for us. Whilst our chiropractic help opinion that we have made an enormous contribution to lower lumbar back pain, the quality of people's lives, and the cost to the insurer, has a high risk of bias, it's interesting that research done by two insurers found that inclusion of chiropractic saved them a vast sum of money. Nevertheless, entrenched medical interests continue to limit the payment to chiropractors despite powerful convincing independent research that manual therapy for LBP is more effective and more cost-effective than pills and surgery. Safer too.
LOW BACK PAIN ...
Roy L. Smith
 Custom Search CHIROPRACTIC TIPS ... for some basic low back exercises. HEALTHY BREAKFAST MENU ... CASE FILEMrs B, a slender and tall 66 year old woman has had low back pain for as many years as she can remember. Five months before her first consult 11 months ago, a fellow player ran into her on the tennis court, and then the pain began to radiate down the side of her left thigh (an ache, 'zeurt' in Dutch), and the top of her foot. Walking became very difficult and painful and she had to stop tennis. She had no difficulty cycling and swimming. Prima! The only other history of significance was a broken left ankle 11 years ago. She had no trouble in her ankle/ foot until recently.
RADIOLOGIST REPORT 2003: LOWER LUMBAR BACK PAINMEDICAL X-RAY REPORT: 2003 LWK: Een links convexe scoliose is aanwezig. Zes lumbale type wervels zijn zichtbaar. Discopathie op niveau L5-L6, mindere mate L4-L5 en L3-L4. Haakvorming spondylose m.n. L3-L4 links. Geen hoogteverlies van de corpora. Paravertebrale arthrose laag lumbaal.In plain English: A left convex scoliosis (the radiologist got it wrong! That should read RIGHT convex, but never mind, we all make mistakes now and then!) is present. Six lumbar-type vertebrae are visible. (FIVE is normal). Degenerative disc disease is present at L5-L6 and to a lesser extent at L4-L5 and L3-L4. Hook-shaped osteophytes (spondylosis) especially at L3-L4 left. No loss of height of the vertebral bodies. Facet arthrosis in the lower lumbar paravertebral joints. To which I would add: A pelvic tilt due to a leg length inequality is seen. A short right leg. Aside: There is no mention either on the X-rays, or in the report, whether these X-rays were taken erect (standing) which can lead to considerable confusion when assessing a heel lift.
LEG LENGTH INEQUALITY ... ORTHOPAEDIC EXAMINATIONLOWER LUMBAR BACK PAINOn examination, a moderate right-convex scoliosis was immediately evident. The global range-of-motion of the lumbar spine was remarkably good and without pain. She could touch her toes, bend backwards and sideways without pain.The sacro-iliac tests were negative. The sciatic stretch test, and the Slump test were both moderately positive in the posterior left leg with a mildly positive Bragards test (for a strongly irritated/ pinched Sciatic nerve.) Reflexes, skin sensation and muscle power were normal. Ranges of motion of the hips was normal.
CHIROPRACTIC EXAMINATIONLOWER LUMBAR BACK PAINThe pelvis was distinctly tilted, low right, the probable cause of the right-convex lumbar scoliosis. A proprioception test showed increased stability with both a 3mm and 5mm heel lift in her right shoe.No obvious sacroiliac fixations were evident on motion palpation. L2 and L5 were markedly fixated. No hip fixations were evident.
LEFT FOOT AND ANKLEEversion of her linker ankle was distinctly limited, but not painful. Both the talar and subtalar joints were tender on palpation.Fixations of the subtalar and cuboid joints were evident.
TREATMENT of LOWER LUMBAR BACK PAIN
PROGRESSNeither the 3mm lift (from me) or the 8mm lift from the podiatrist seemed to help. 8mm increased the back pain, 3mm didn't relieve it. Walking remained difficult. We continued to try different options with the heel lift, that both I and podiatrist agreed were important. Eventually we came to a compromise: he reduced the lift from 8mm to 6mm and now that helps.Within four weeks of treatment (6 treatments) she stated that the pain in her back, leg and foot was at least 50% better. The height of the heel lift was only settled after some months of trial and error. The Slump Test improved markedly. She had some temporary pain and discomfort after the manipulation, but that resolved within a day or two. Ice treatment helped. It's not perfect in Mrs B's back. Of course! She has much spinal degeneration. But she can walk normally again, she's playing tennis twice a week... "het gaat goed". She's happy, it's going well. She does the exercises faithfully.
DISCUSSION of LOWER LUMBAR BACK PAINMrs B had been told that she had a worn out ("versleten") back and there's was nothing to be done. She must learn to live with the pain, and sadly tennis was a thing of the past.Certainly, she has a difficult back (these X-rays were taken 8 years ago, and it's without a doubt worse now). But nothing to be done? Nonsense. Where did the success of the case lie? Correction of her ankle complaint? The correction of her short leg? The rehab exercises? The chiropractic manipulation of her pelvis and lumbar spine? Whilst most problems occur at the L5 or L4 lumbar spine, higher injuries occur, especially if there is an associated short leg.
RESEARCHOnly research done on 500 similar cases would answer this. One group of 100 would get only ankle treatment, another 100 only the heel lift...Instead, the power of Chiropractic is that we address all these shortcomings and the proof of the pudding is in the eating. At 67 in a month's time and she's playing tennis again twice a week. Now that's progress! Generally speaking, research is divided up into
A case-report of this nature should at best be considered Incomplete evidence. I confess without reservation to the charge of being biased! And you have no idea without independent investigation whether I am lying like my feet stink! Perhaps a photograph of Mrs B on the tennis court would give this lower lumbar back pain case report more substance. You be the judge. When she gets back from her summer holiday in the south of France I'll ask whether she would mind a photograph of her on the tennis court appearing on the web!
Custom Search SPONDYLOLYSTHESIS CaseFileSpondylo-lys-thesis is a condition frequently contributing to lower lumbar back pain. One vertebra slides forwards on it's neighbour below trapping the nerve roots, and sometimes the spinal cord causing lumbar stenosis. SPONDYLOLYSTHESIS CaseFile ...50 PERCENT LESS PAINBecause the pain subsides faster than the tissue in your back actually heals, 50 percent less pain is what I call the dangerous time. Relapse is common if you're not particularly careful. 50 PERCENT LESS PAIN ...BASIC LOWER BACK PAIN EXERCISESDone EVERY morning before you get out of bed, it takes less than one minute, these You Tube exercises will have a profound affect on your lower back health. Whether it's L5, the sacroiliac joint or a L4 lumbar spine condition, Chiropractic Help has much to offer you. Watch the video... LOWER BACK EXERCISES ... They take less than one minute.SLUMP TESTBecause the lower spine is supplied by the sciatic nerve, LOWER LUMBAR BACK PAIN should it radiate it into the leg usually follows the L5 or S1 distribution and is best tested with the Slump test for sciatica ...
Bizarre...All of my own life I have experienced periodic lower lumbar back pain since a mishap when a ladder jackknifed my back. I do these lumbar back exercises every morning without fail, but nevertheless need a chiropractic treatment every month or two, sometimes several.Since the last eighteen months, when I went into semiretirement, I have barely felt my back. Why? I am doing heavy work in the garden virtually every day. The more I do... the LESS back pain I experience. For example digging this hole:
Digging a hole 1 metre wide by a 1 metre deep for an avocado tree is seriously hard work. And my back has never been better. But I do the lower back exercises EVERY morning before arising without fail. GROWING AVOCADO TREES I still do my lower back exercises very faithfully every morning before getting out of bed, and I still go for an occasional but regular chiropractic adjustment. It's the chair that does my back in... sitting. The benefits of gardening is not only less back pain, it's also 22 Fuerte avocadoes twice a week. Soon the Hass will be ready. Along with the olive, perhaps the most valuable of fruits for their extremely healthy oils. Not to mention the beta-sitosterol, the cure for an ailing prostate gland.
AVOCADO FAT ... 
SLIPPED DISC RULESShould you have the misfortune to have a severe slipped disc take note of these slipped disc rules ... they may just save you from the ignominy of lower back surgery.
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LOW BACK and LEG PAIN
L4 lumbar spine casefile
FALLS
CHIROPRACTIC HELP How to stop falling
L4 lumbar spine
Lateral disc herniation
BENDING AND TWISTING
DEGENERATIVE LUMBAR DISC DISEASE CaseFile
POSTERO LATERAL DISK HERNIATION
LOWER BACK AND LEG PAIN
SITTING
CHIROPRACTIC HELP FOR SCIATICA PAIN
Short leg?
LEG LENGTH INQUALITY and Low Back Pain
Low back and leg pain
LOWER BACK AND LEG PAIN
LUMBAR FACET SYNDROME
SLIPPED DISC SYMPTOMS Case File
SACROILIAC JOINT TREATMENT
SPONDYLOLYSTHESIS
EXAMINATION
SACROILIAC JOINT Case File
SLUMP TEST
Can you stand on one leg on your heel, and raise the big toe? Can you stand on your toes without your leg shaking?
CHIROPRACTIC TIPS
Prick your foot with a pin. Is the feeling the same in the other foot?
Chiropractic Therapy ...what is it?