When patients present with low back pain (LBP), they are frequently nervous and worried about whether they’re going to respond to the treatment—especially when it comes to getting out of pain and returning to their normal activities. A variety of studies have shown chiropractic care to be an effective option for the LBP patient, and though there is no “crystal ball”, there are some tests that doctors of chiropractic can perform during an examination that can help predict outcomes!
In fact, a meta-analysis of data from 43 studies published since 2012 suggests that centralization and directional preference, which may be present in 60-70% of LBP cases, offers important prognostic clues. Directional preference means that it’s possible to move the body in a manner that feels better to the patient. Centralization implies that it’s possible to move in a way that reduces the range of the pain to a specific region.
Here’s an example… Let’s say an LBP patient presents with radiating leg pain from their lower back with numbness and tingling in the leg and foot. The focus is to find a movement that REDUCES the leg pain/numbness, so their doctor of chiropractic asks the patient to bend forward, backward, and sideways, and to rotate their torso, looking for which direction is preferred, i.e., directional preference. When pain decreases AND centralizes (the leg pain disappears), then extension is the directional preference.
When centralization occurs, this is a favorable prognostic sign indicating that improvement can be expected. Likewise, when all positions or directions increase leg pain, this is a poor prognostic sign, meaning this is likely a more challenging case.
This helps doctors better advise patients about their condition and what to expect from care in both the short and long term so the patient can make REALISTIC goals and timely plans. Over or under reassuring patients is simply not appropriate! Directional preference also allows providers a means of determining what type of treatment to emphasize. For example, if the patient feels better bending backward and leg pain disappears, the provider will approach treatment and exercise recommendations from that direction.
Patient education is an important part of treatment, and educating patients on how this process can predict treatment outcome instills trust and places realistic goals in perspective so patients know what to expect. This improves compliance with care and confidence for both the healthcare provider and the patient.
You may wonder, “Do I need an MRI scan of my back.”
Also, if you feel leg pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your back. Some people will try stretching the lower back first to see if they get relief from their back pain. Pain very low in the lower back may be originating from the coccyx or tailbone. A pulled muscle in the back generally will get better with rest. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
Call me, Dr. Tim Harcourt, at (239) 278-3344 or stop by on your day off for a walk in visit and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment. So if you find yourself experiencing lower back pain while running or doing physical activities.
If you are suffering from back pain that is affecting your quality of life and allowing you to enjoy Fort Myers Beach. Come see us at Coast Chiropractic Centers located on 7270 College Parkway.
If you would like to avoid getting back pain in the first place or to take a proactive approach to your health and wellness, our membership program called Club C may be just the thing for you with great cost savings, convenience, and even more importantly, a plan to get your health back and keep it.
Don't let back pain stop you from enjoying the beautiful SWFL! Dr. Tim Harcourt is here to give you the relief you need.
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