back pain -- fact or fiction?
There are a lot of misconceptions surrounding back pain and effective treatment for this common complaint. It can be difficult to know the difference between fact and fiction, and without the correct information you could actually do more harm than good. Let's take a look at some of the common beliefs and tackle them one by one.
“Bed rest will help the pain resolve”. False. The pain will feel better if you rest, but too much rest leads to loss of muscle support, the same muscles needed to hold you up when you do get out of bed. Studies have shown that too much rest can cause more chronic back problems. The best option is to keep moving while trying to avoid positions or actions that cause more pain.
"I'm only going to get better with surgery". Fortunately this one is usually false. There are certainly some people who need surgery, but all of the current research recommends a prolonged trial of "conservative" care such as chiropractic, rehabilitation, physiotherapy and/or massage therapy before resorting to surgical intervention. The general finding is that surgery is not very effective for back pain, but does work well if needed for nerve pain into the legs.
"I need X-rays to see what's wrong". Once again this is false, and the same goes for MRI and CT scans. The problem is we don't have any imaging technique that can show us pain. Studies show many people have spinal abnormalities and yet have no pain at all, while others have severe pain but no abnormality. Imaging can be a useful tool, but is often over used and doesn't give us a full picture.
“The pain will go away on it's own”. This is partially true. Often the pain, or at least this particular episode, does go away but research tells us that many people slip into a rollercoaster pattern with pain that comes and goes for years. It's best to get the problem properly diagnosed and resolved rather than continuing on that coaster.
"My dad had a bad back, I knew this was coming". Several studies have shown genetic links to back pain, one recent study found that having an immediate family member with disc problems made it 4 times more likely that you would have disc problems. Even a genetic link is not a life sentence, it's all about choices. If you know diabetes or heart disease runs in your family you can choose to stay active, watch your weight and eat well to minimize your risks. It's the same with a history of back issues. If you stay active, maintain a healthly weight, diet and a strong core you will minimize your risk of injury and future pain.
"Once you start going to a chiropractor you have to keep going forever". This is one of the biggest complaints we hear about chiropractic care – but is it true?. The simple answer is NO, you don't have to keep going forever. The more complex answer is that chronic or recurrent pain will only go away if you change something. Ideally treatment will resolve the pain, then you can use exercises and lifestyle changes to keep it away. With dental care, if you don't brush and floss at home you will need more fillings. Similarily, with chiropractic care, if you don't do appropriate exercises and avoid unhealthy habits you will need more treatment.
“ You need a strong stomach to protect your back". This one is partially true, but the stomach is only one quarter of the core muscles. To have a really strong and stable core area you need to have good coordination, balance and endurance of the muscles all the way around your midsection. In addition to the abdominal muscles, the “core” also includes the back muscles and the lateral muscles. While a strong core is very important, the wrong exercises can lead to injuries Talk to your chiropractor about safe and effective abdominal exercises or check our website for ideas.
“Once you have back pain, then you have it forever”. Thankfully false. Most back problems are not signs of major damage, rather minor injuries to the muscles, discs and joints in the spine. If these minor injuries are repeated year after year, it can turn into a serious problem. With proper care, back problems can be managed or even avoided completely. Combined with modest exercise efforts of appromately 10-15 min per day and correcting bad habits such as poor sitting posture or poor lifting techniques, most people can keep back problems at bay. The problem arises once the pain disappears and the exercises stop. If you go back to the same bad habits you'll end up with the same bad pain!
Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet. Contact us today at 902 835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.
graston technique
Graston technique, or technically Graston Augmented Soft Tissue Mobilization (GASTM), is a new approach to managing the challenging problem of chronic pain. I know... it seems we are constantly bombarded with advertisements touting the latest and greatest invention. With everything from rock hard ab's without the workout effort to back pain relief in a simple pill, I can understand some skepticism with another "new" technique. It should help if I explain the theory behind GASTM.
When faced with an injury (tissue damage) our body repairs the area by laying down scar tissue. Ideally the scar tissue will repair the injury, effectively binding the torn tissue back together.
Unfortunately, sometimes we re-strain the injured area when the scar tissue is too weak to provide sufficient support. The same area is re-injured and the body starts the process of laying down scar tissue all over again. This process can repeat itself over and over if successive repair attempts fail.
The problem is compounded by our body's initial repair approach. The body lays down weak, random strands of scar tissue all over the injury site, then later as the area resumes it's normal function, the scar tissue strengthens by orienting in-line with the underlying tissue. The initial, irregular scar tissue can adhere to surrounding healthy tissue, creating adhesions that tie everything together into the same bundle of scar tissue. Worse still, our body never goes back and clears the old, unstable scar tissue out of the way. With each injury we are trying to build new scar on the fragments of the last attempt.
The result is often a bulk of scar tissue that is poorly anchored making it too weak to provide the needed support and making it painful with adhesions to the surrounding muscles, nerves and blood vessels or skin. Imagine you have a hole in the bottom of a boat. Your first reaction is to plug the hole as fast a possible, then you can go back and clean up the repair once you're no longer worried about sinking. But, if the initial repair starts to fail before you reach land you throw another patch over the top. After several attempts the patch has become thick and unstable, getting stuck to everything and causing more problems than it's resolving. If you had to fix the boat in my example you would pull it out of the water, remove all of the failed patch attempts, and repair the area properly. GASTM is the same approach to repair the scar tissue and adhesion problems inside your body.
Using a variety of specialized stainless steel instruments, Graston certified doctors manipulate the area of injury, inducing microtrauma and breaking down the excess scar tissue. Research has shown that Graston technique can break down adhesions, improve superficial circulation and increase the strength of healing tissue by 30% while recreating the normal inflammatory response and stimulating the body to lay down new scar tissue. Treatment combined with the right stretching and strengthening exercises will make sure the new scar tissue is strong and stable without adhering to the surrounding healthy tissue.
While Graston Technique is not a cure all, it is a very effective technique for addressing many chronic pain injuries. In my clinic we have seen great improvements in pain levels and function even with chronic injuries. Everything from whiplash problems that have been dragging on for years, down to ankle or elbow injuries can benefit from this approach. We even have one patient who was able to cancel his carpal tunnel surgery as almost full feeling and strength has returned to his hand after completely a course of GASTM.
If you are interested in learning more or exploring treatment options with a certified Graston Technique provider, contact the clinic at 902 835-6865 to make an appointment with Dr. Bodnar or Massage therapist Dawn Evong.
Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet. Contact us today at 902 835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.
FAQ
No. While we see many patients in the clinic referred from their medical doctors, a referral is not necessary. Similar to a dentist, chiropractors are primary health care providers, able to evaluate and diagnose issues on their own.
Is chiropractic safe?
That's a bit of a loaded question! The simple answer is yes. Multiple research studies have shown the different treatment modalities we use to offer safe and effective help for muscle, joint and nerve problems.
Everyone has heard stories about chiropractic manipulations causing injury, but the most recent and best available evidence tells us the vast majority of “chiropractic side effects” are minor soreness or stiffness related to hands on treatments. Those severe stories are likely problems that started before ever seeing the chiropractor and were likely progressing on their own.
Does treatment hurt?
No, our goal is to always have people leaving the clinic feeling better than they did on the way in. That said, in some cases, because the areas in need of treatment can be quite tender there can be some discomfort in treating them. We can adjust the intensity of treatments to minimize any discomfort, but sometimes that equates with slower results. The goal is to find a balance with minimal discomfort and maximum results.
How long do chiropractors go to school?
Professional chiropractors take seven years of post secondary education This includes four years of chiropractic college, with 4,300 hours of contact time and 1,500 clinic hours. A chiropractic degree is comparable to dentistry.
Does insurance cover cost of care?
Yes. The majority of private health plans cover chiropractic care similar to dental coverage. Chiropractic care is not covered by provincial health insurance in Nova Scotia.
I've heard some chiropractors claim to treat or cure a wide range of diseases - is that accurate?
Traditional chiropractic was based on the idea that treating the spine could effect all the nerves and in-turn affect many different internal organs and diseases. While there have been some interesting anecdotal reports about these different treatments they have not stood up to the challenge of scientific scrutiny.
To quote Carl Sagan "Extraordinary claims require extraordinary evidence", and we don't see adequate evidence to promote those treatments.
Our goal at Bedford Chiropractic is to provide sound evidence based treatments, and our focus is on the joints, nerves and muscles throughout the body, especially the spine. In our view chiropractors are non-surgical spine care specialists.
What is the best treatment?
That question has no simple answer, the ideal treatment for any particular problem is really based on the individual problem and person. We do know for “uncomplicated” low back pain the first three research-based recommendations are to stay active, try over the counter medications and spinal manipulation.
In our clinic we try to combine several well recognized and researched treatment modalities together for the fastest resolution - activity and exercise, soft tissue massage, and manipulation/mobilization, in addition to other therapies where appropriate (Kinesotape, Graston, Rehabilitation, US/IFC)
upper back & chest
Upper Back PainAlthough not as common as lower back problems, when it does occur pain in the upper back can be a source of serious discomfort and affect mobility.Midback and chest pain can develop as a result of an injury or as a referral from an internal organ problem. Initial focus is to rule it is possible organ problems. Problems with the gallbladder, kidneys or intestines can refer pain into the back. Lung and heart problems can cause chest pain.
More commonly the problems stem from the muscles, ribs, nerves and spinal joints in the area.
- muscle strain or myofascial irritation
- muscle pain can be dull or sharp
- often aggravated with active movements
- possible in any of the muscles around the upper back, chest or even between the ribs
Chest PainRib joint "sprain"- often pain under the shoulder blade and/or into the chest
- frequently feel pain with deep breaths
- very common
- typically sore more centrally
- can be sharp or dull pain
- often aggravated with different movements
Nerves travel around the chest between ribs, and depending on the location of the injury pain can also refer into the shoulder, arm, neck, abdomen or lower back.
Treatment
Treatment must always start with an appropriate diagnosis.
Treatments should focus on the underlying cause of the pain - both the tissue causing the pain as well as the factors that are triggering the problem. A combination of treatments, such as, massage, soft tissue treatments (Graston), manipulation/mobilization and/or home stretching exercises can be effective ways to reduce the tissue irritation.
We identify any aggravating factors and help you manage any issues through a program of self-care and prevention.
For a clinical assessment of your upper back and chest pain, the triggers and best treatment options, please contact Bedford Chiropractic for an appointment.