Lower back pain seriously neglected in the defence force

Have him bend slowly forwards. Is there a rib hump?

Have him bend slowly forwards. Is there a rib hump?

Lower back pain seriously neglected in the defence force is a tale of woe.


My partner has been having lower back issues for around 18 months. As he is in the defense force and gets free healthcare, it's a lot harder to get any issues or symptoms resolved. At the beginning he had been told by his doctor to that he just needs to take panadol, however, after having to go back repeatedly telling them it's not working (at least 4-8 weeks) they finally referred him to their physio. When physio hadn't helped, his physio suggested and noted he should get X-rays however when he went back to his defence doctor they said it was fine and he didn't need any. So back and forth this went (with his back getting worse, some days its so painful) until recently he managed to finally get them to refer him to get X-Rays.

The Radiologist reported these:
Clinical History: Lower Back Pain Thoracic Scoliosis
Report: Mild loss in the neck offset on the right.

Report: Three views of thoracic spine show slight convex left curvature. Vertebral body height is maintained. Disc space height is preserved.

Report: Two views of the lumbar spine are submitted. Slight 5% loss of the anterior vertebral body height at the T12 vertebral body is identified.

As this has occurred with deference, the fact they have taken so long to get him diagnosed with anything and his doctor was being very vague and unhelpful, we weren't sure what this all really meant in terms of treatment and pain relief. Can anyone help explain this better?

Being a defence issue, we plan to put in a claim but weren't sure the severity of his back problems and were wondering whether it was worth putting anything in as it was caused by his position in the defence force.

Hello Stephanie,
Your partner's lower back pain seriously neglected in the defence force really is a tale of woe. And alas it's the story of 'free healthcare'. Doctors are forced to keep costs down, and sometimes are downright lazy. Just ask him how thoroughly he is examined when he sees the doctor; does the latter even get up from his chair before reaching for the prescription pad?

That radiological report, if that's really all that was written is a case in point. The analysis of the lumbar spine is shockingly inadequate; it tells us nothing.

My first question is such matters is, is he every single day doing lower back exercises? They should start in bed before arising, and then be added to during the day. Seeing Medicine, at least the way it operates in the Defence Force, isn't going to help him, he has to focus on helping himself; and there's much he can do.

Secondly the cause of a scoliosis is often a short leg; kneel down behind him, placing your hands on the top of the iliac crests and simply eyeball them. Are they more or less level? A few millimetres is difficult to gauge, but is one side obviously lower than the other? If he bends slowly forwards, with no shirt, is there obviously a list to port? Or starboard?! Is the ribcage obviously unlevel? Getting the correct insert for his boot is no easy matter, but that needs to be sorted out if he has a significant leg length deficiency. Is there a family history of back pain? It's strongly hereditary.

I wish I could tell you that chiropractic has a quick fix to offer but after all these months which ever way he turns is going to be difficult. A true 'cure' is unlikely and a lifetime of exercise and care with bending, twisting and lifting lies ahead. One good thing is that there's no mention of radiating leg pain.

Sitting often is the greatest enemy.

I hope this contributes. Let me know what comes up and feel free to add more specific questions. Please revisit that radiological report; is that really all that was offered about the lumbar spine and pelvis?

Dr. Barrie Lewis

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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.

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