Home Blog What Does the Research say is the Best Treatment for Chronic Low Back Pain; A Review by Dr. Timothy Harcourt ?

What Does the Research say is the Best Treatment for Chronic Low Back Pain; A Review by Dr. Timothy Harcourt ?

Jun 21, 2021 -- Posted by : Dr.Harcourt
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When it comes to treating patients with chronic low back pain (cLBP), doctors of chiropractic commonly use a multi-modal approach that involves manual therapies, like spinal manipulation and mobilization, combined with supervised and/or home-based exercises. Why is that?

In many cases, the superficial paraspinal muscles of patients with back pain will tighten as a reflex in an effort to restrict movement and protect the area from further injury. Unfortunately, such a restriction can result in altered movement patterns that raise the risk for further injury (and pain) elsewhere in the lower back (or even in other areas of the body). On top of that, because the superficial back muscles have abnormally assumed the job of maintaining posture, the deep muscles in the back can become deconditioned and weak, which only raises the risk for further back issues.

So, when it comes to chronic back pain, the job of a chiropractor is two-fold: restore proper joint motion to “turn off” this abnormal reflex muscle spasm and to strengthen the deep muscles so the superficial muscles can return to their normal function.

In a 2011 study, researchers randomly assigned 301 cLBP patients (adults over 65 years old with a five or more year history of chronic low back pain) to one of three treatment groups: supervised exercise therapy (SET); spinal manipulative therapy (SMT), or home exercise and advice (HEA).

Researchers monitored each participant’s progress for over a year and found that members of each group achieved similar short- and long-term improvements with respect to pain, disability, global improvement, general health status, and medication use. Though the patients in the SET group experienced greater gains with respect to trunk muscle strength, endurance, and range of motion in comparison with the home-based exercise group, the difference in results is understandable as the SET protocol was much more intensive.

Though this study did not specifically look at the effect of combining exercise and spinal manipulation for the treatment of cLBP, several guidelines that have looked at the available evidence recommend using such a multi-pronged approach for this group of patients. For example, in 2018, the Canadian Chiropractic Guideline Initiative wrote, “A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain.”

So, if you are experiencing back pain and type in pain management near me, you may find Coast Chiropractic Centers with Dr. Timothy Harcourt, me, comes up. 

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.  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 and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment.


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