Thursday, March 12, 2015

Acute Vs. Chronic Back Pain (And What To Do About It)

There is a lot of confusion and misinformation surrounding the best way to treat back pain. This health issue is a very common problem affecting an estimated 20 million Americans every year. It's so common in fact that the current scientific literature says more than 80% of us will suffer severe back pain problems at least once during our lives. So what should we do about it when it happens? What's the best course of action?

The first thing we need to discuss is whether the problem is acute or chronic. What do these terms (acute and chronic) mean? Acute means it's a new problem, typically having occurred within the past three weeks. Chronic means it's an old problem, typically going on for more than three weeks. Whether the spinal pain issue is acute or chronic will determine which treatments are appropriate. Believe it or not, the problems are managed very differently.

Before I present the ideal treatments for acute and chronic back pain problems, I want to bring up another variable. That is the issue of intermittent pain. Intermittent means the pain comes and goes. In other words, the person doesn't have pain all the time. Perhaps they feel okay during the morning. But as time goes on during the day their back starts feeling worse and worse. Or perhaps they wake up from their sleep and their back is troubling them with pain and stiffness - but by mid day the problems seem to ease up.

Acute back pain involves back pain that has been occurring for three weeks or less. Common causes of acute back pain include overdoing it with sports, slips and falls, and minor sprain / strain injuries. To treat this problem, many people will take pain medications (such as aspirin, ibuprofen or acetaminophen) ice, compress and rest the affected area. These treatment approaches (medications, ice, compressions and rest) are often appropriate as these types of problems are self-limiting anyway (meaning that they will go away on their own in most cases).

Chronic back pain involves back pain that's been going on for more than three weeks. The causes of chronic back pain may include more severe injuries (such as an automobile injury involving whiplash), degenerative changes (such as arthritis, degenerative or herniated disc), repetitive stress injuries (carpal tunnel syndrome), peripheral nerve problems (sciatica), structural problems (forward head posture, scoliosis, etc.), and strength problems (deconditioning, core weakness & core instability). These problems are not self-limiting (meaning that they will not go away on their own). They also do not respond well to drug therapies (mean over the counter and/or prescription strength pharmaceuticals will not cure the problem). Rather than a palliative (symptom relief only) approach, I believe a corrective approach works best. For these problems - as well as intermittent (comes and goes) back pain, I recommend a physical medicine method.

The best physical medicine approach involves a program of care which serves to restore motion (to the joints and muscles), re-aligns the spine and pelvis and then strengthens and stabilizes all of the supportive structures. This approach is what I refer to as "MAS Correction". MAS is an acronym which stands for Motion-Alignment-Strength. By restoring motion, alignment and strength, you have the best chance of achieving long-lasting relief from even the most stubborn chronic pain syndromes. Restoring motion to the joints as well as re-aligning the spine and pelvis is most effectively accomplished through chiropractic adjustments. Improving muscle function and movement is accomplished through a combination of stretching and manual therapies (such as muscle stripping, cross friction massage and manual compression techniques). Strength & stability enhancements come from exercises which target the specific muscle groups that have limited strength and function. This cannot be accomplished by way of a generalized, one-size-fits all work out. Instead, the individual must undergo specific functional tests to ascertain which muscles are weak. And then specific exercises are prescribed to target weak and dysfunctional regions.

By restoring motion, alignment and strength, the back pain suffer has the best chance of getting out of pain and staying out of pain.

Dr. Kevin Smith is a chiropractor and medical writer in Bethel Park, Pennsylvania. Dr. Smith's areas of expertise include chiropractic, functional medicine and spinal rehabilitation. He is the author of the book "Modern Chiropractic: The Way To A Pain-Free Lifestyle". Dr. Smith is also the owner & clinic director of Red Apple Wellness & Chiropractic which is located at 2409 South Park Rd. Bethel Park, PA 15102. For more information please visit or call 412-212-8880.
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