Back pain

Many of us have experienced back pain that is serious enough to require a doctor visit at some time or another. Additionally back pain is also a leading cause of disability worldwide, and furthermore with the backdrop of the opioid crisis an effective and safe treatment for back pain is sorely needed.

1. MID-SPINE

This is a very general word, caused by hundreds of different chiropractic conditions. Most of them originate in the spine, the rib joints or muscles, but a referred ache from the organs does occur occasionally.

A stomach ulcer can give you discomfort between the shoulder blades; so can a tumour in the pancreas. That is rare, fortunately, being 100 percent fatal, even if diagnosed early, which it only occasionally is. Steven Jobs, the Apple-Mac man, had access to the very best treatment, and still succumbed.

The upper part is a particularly troublesome area, being a transitional zone between the cervical and thoracic spine. It is subject to deep upper back-pain that may radiate to the arm.

Because the term back-pain is so general, click on the links to the relevant part of the spine.

The mid-back is called the thoracic spine. The name comes from thorax which is that part between the neck and the diaphragm, the large muscle separating the chest from the abdomen.

The thoracic spine has twelve bones, and a myriad of joints and muscles relating to the ribs. Each of them makes three connections with the back and one with the sternum, where so-called costosternal chest pain occurs.

There are twelve pairs of ribs; do you get it?

12 vertebrae x 2 ribs x 3 joints in the back, plus one in the front with the sternum, which gives one hundred, give or take a few. Yes, you do get it; pain.

Pain in the breastbone (sternum) is known as costosternal chest pain.

This page was last updated by Dr Barrie Lewis on 2nd February, 2020.


Midback and rib pain treatment


There are few things more discomforting than a sprung rib, causing very severe mid-back pain, often after a sneeze. Every breath becomes a nightmare; it feels like someone is stabbing you with a rusty screwdriver.

The treatment of rib pain is something that chiropractors specialise in.

Rib pain treatment CaseFile gives a typical scenario.


Scheuermann's disease

Kyphosis causing midback pain.

Scheuermanns disease is a not uncommon condition causing back pain, and affecting about 5 percent of teenagers. Sadly, parents have often been told it is growing pains, a condition which does not exist in my opinion, and by the time they get to us, it is already chronic, and a spinal deformity is inevitable.

Like all conditions, from diabetes to hypertension to Scheuermann's disease it comes in very mild to severe stages; catch it early.

This need not be so. As with adults, any pain that your child experiences which does not of itself go away should be investigated. When it comes to back pain too, prevention is better than a cure.

Interestingly, researchers have shown that people with Scheuermann's disease have a much higher incidence of conditions of the stomach. This is because the stomach, which is really just a specialised muscle, is innervated in part from the mid thoracics, where the condition is usually found.

Are you suffering from indigestion and related heartburn? Part of the solution may be found in a probiotic like kefir that will overwhelm any pathogens like Heliobacter by their sheer numbers.

The remedy gelatine powder has proved to give enormous help to everything from ulcers to the cartilage in conditions such as Scheuermann's disease. Make your own at home; it is so easy.


2. LOWER MID-BACK: THORACO-LUMBAR REGION.


Maigne's Syndrome

The junction between the very stable thoracic spine (owing to the ribs) and the highly mobile lumbar spine is a vulnerable area often causing back pain that may spread into the buttock and side of the leg, giving the appearance of a sciatica.

This is also the area incidentally where kidney stones can cause severe pain. This is a typical Maigne's syndrome casefile. 

These Maigne's syndrome exercise feature prominently for a long term good prognosis.

Maigne's Syndrome Casefile



Thoraco lumbar spine showing muscles.

3. THE LOWER BACK and Tomato Prostate ...

The lower-back or lumbar spine stretches from the diaphragm to the pelvis, and consists of five bones. This is where most serious back pain comes from.

Low back pain used to be called lumbago, but we do not use the word any more. It is too vague. It can be caused by anything from a slipped disc, to a sacro-iliac joint problem, to arthritis, or a tumour so forget the word.

Referred pain can also occur, for example menstrual cramps often refer to the back.

Every man must, it is compulsory, eat a tomato a day. Whilst metastatic disease in the spine and pelvis is relatively uncommon in comparison with all the other causes of back pain, prostate cancer is still the most common terminal tumour in men.


Van Gogh's gardeners would have suffered from low back pain.

In Vincent van Gogh's days probably nobody knew about back exercises, but today every gardener should do a few exercises before venturing out. Gardening and back pain are so synonymous that in Holland they use the same word for gardening (spitten) and acute back pain (spit).

If you sign up for Chiropractic Tips (they are free), you will get a simple set of basic back exercises.

Slipped disk and a SLIPPED DISC SYMPTOMS Case File

The so-called slipped disc, a very broad layman's term for a very complex syndrome, is a condition that Chiropractic excels in. The trick is to prevent a Grade I from progressing to a Grade 4. If you suffer from low back pain, then you ought to know about the FOUR grades of slipped disc.


Lumbar facet syndrome

Small joints in the spine are probably the most common cause of LBP, the lumbar facet syndrome, characterised by back pain when bending into extension and to the side.


Spondylolysthesis and a casefile

A lateral lumbar x-rays showing a spondylolysthesis.

Good chiropractic is all about, in part, a find understanding of anatomy, and particularly that pertaining to the joints of the body. Henry Gray was the first doctor who systemised the subject and Gray's Anatomy still stands as a tribute to this giant redwood in the forests of doctors.

This is one cause of chronic low back pain. It may be caused either by a stress fracture (usually in early childhood) or by degenerative change in the older person. These abnormalities allow one vertebra to slide forwards over the vertebra below it. This can also trap the nerves travelling to the legs causing pain and weakness in the legs.

Read more about the Chiropractic management of spondylolysthesis. It is not at all uncommon; a stress fracture in the low back.


Leg pain with NO low back pain

There is an unusual condition called Intermittent Claudication that causes pain in the leg, with exercise, with no low back pain. Read more about INTERMITTENT CLAUDICATION; LEG PAIN caused by an artery blocked with cigarette ash.


Chiropractic help

Chiropractic help is a very large website covering many aspects of back pain, as well as other parts of the body such as the lumbar facet syndrome, or the slumped, aching teenager who may be suffering from Scheuermann's disease.

There are today, at the time of writing 436 pages; finding your way around can be a nightmare. Use the site search function in the navigation bar at the top left if you are hunting for something.

At the bottom of this page you will find a section where you can pose questions about your health.


FROM THE CHIROPRACTIC COALFACE

Mrs S taught me a new Dutch word. I have ontiegelijke pijn. I had no idea what the word meant, but I grasped her meaning; totally unbearable. And, she had had it for two long miserable years.

At 83 she had been told by numerous doctors that she had arthritis, and at her age simply had to live with the pain. Little do doctors know.

Bending over backwards caused severe pain, so she walked like she had a carrot up, to put it crudely, you know where.

In chiropractic terms, Mrs S had what is described as lower back and leg pain.

Her various doctors had refused to take x-rays of her low back, and so I really don't know just how severe the wear-and-tear in her lumbar spine is. Quite advanced I expect. Thank goodness it's not cancer. The long and the short of it is that Mrs S has about 60% less back pain (after about two months of treatment) and she can now walk upright, like the good God-fearing woman she is.

Is she cured? Certainly not, chiropractic help cannot totally fix back pain, and she will have to wait for heaven for the new spine that brings no tears. She now comes in once every three weeks, and we are both well pleased. The carrot is out, and the two-year of totally unbearable pain is of the past.

She has a good understanding of what I call the 50 percent less pain rule; the dangerous time.

She is doing my exercise program faithfully, and knows that digging in the garden, and even vacuuming her home, is a thing of the past. Luckily Mr S is in good spirits.


4. THE PELVIS and SacroIliac joint anatomy

The pelvis , a ring of three large bones below the lumbar spine, is also a source of low back pain. A very common source actually. For more information about the sacroIliac joints , click here, SACROILIAC JOINT ANATOMY.

Financial burden of LOW BACK PAIN

Low back pain is causing an enormous financial burden on society, a burden that is rapidly increasing, despite so-called progress.

Oscar Wilde was the first to promote the idea that the great problem with progress may be that it goes forwards rather than backwards. Medical 'progress', yes and perhaps even chiropractic progress I hear you saying, may in fact be adding to that burden.


MAINTENANCE CARE

For chronic back pain, like other chronic conditions such as diabetes, high blood pressure, hypothroidism there is unfortunately no substitute for maintenance care.



And faithfully done lower back exercises are a vital part of that maintenance care. A minute and half every morning (and better evenings too, but the morning before getting out of bed is the vital time) that is all they take.

There is lots of research showing that the joint cartilage will not heal without a proper supply of oxygen. The best medication, surgery and chiropractic in the world will not succeed in treating back pain satisfactorily if you are a smoker.

Stop smoking permanently by Allan Carr is one way to do it. This is especially important in 2020 with the corona virus honing in on with poor lung function.


FOOT PAIN


In the practice, we often find a problem in the foot or ankle may be the underlying cause of back pain. It may be frank pain causing you to limp, or simply a dysfunctional joint.

If you back pain, or your neck for that matter, is not responding the way you would like it too, ask your chiropractor to look at your foot, and the length of your leg.

Have A Question about your lower back?

I receive many questions about Chiropractic. It might be help with a spinal condition, but it might also be from a person who can't walk after a hip operation, or some such thing.

I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like.

However, do understand that, in the main, I'm going to be directing you, should it be pertinent, to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give as much detail as you can.

Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.



Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

Do you want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.