Home Blog People Ask Me, Dr. Timothy Harcourt at Coast Chiropractic Centers, Frequently, "Low Back Pain: Who Will Respond Best to Care"?

People Ask Me, Dr. Timothy Harcourt at Coast Chiropractic Centers, Frequently, "Low Back Pain: Who Will Respond Best to Care"?

Jul 5, 2021 -- Posted by : Dr.Harcourt

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 backward, 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 more comprehensive treatment.

So, if you feel best bending backward and/or leg pain lessens, the preferred exercises include bending backward (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.

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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