Is it possible to identify which low back pain patients might experience the most benefit from spinal manipulation combined with exercise? In a 2011 study, researchers identified which patients might respond best to this combination of care and which patients might need a more aggressive approach.
Directional preference (DP) describes a situation in which it feels better for the patient to move in one direction versus another. For example, if a patient feels worse bending forwards (which is quite common) and feels better bending backwards, then “extension-biased exercises” are preferred.
If leg pain is present, the DP that reduces or eliminates the leg pain (called centralization, or CEN) is the exercise-biased direction, and it’s important to avoid any exercise that increases leg pain (peripheralization).
In the study, which involved 584 patients with low back pain, the researchers found that 60% of the participants had a DP and of those patients, 60% had CEN. The researchers found that the patients with a DP that reduced CEN responded the best to care (in this case, spinal manipulation combined with exercise) in regards to improved pain and function. On the other hand, the patients who had no DP experienced the least overall improvement.
The value of using a classification system like this allows a doctor of chiropractic to determine which exercises will help each individual LBP patient the most. It also provides them with the ability to identify those most likely to respond favorably and those patients who may need a more comprehensive treatment.
So, if you feel best bending backwards and/or leg pain lessens, the preferred exercises include bending backwards (extension) from standing, prone press-ups (“saggy” push-ups) or hugging a gym ball, and/or extending your back over a gym ball or a stack of large pillows. Of course, there are many additional exercises but ANY position that reduces LBP and/or leg pain will help.
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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