Back pain treatment needs a rethink

photo (1)Back pain patients in Brighton and Hove might be able to access chiropractic and osteopathy on the NHS next year. The local Clinical Commissioning Group is currently considering this option. This will give local residents access to a wider range of treatments than are available currently.

An article in the British Medical Journal two years ago suggested that back pain treatment needs to be changed. The opinion piece, entitled We Need to Rethink Front-Line Care for Back Pain was authored by a team including Dr Nadine Foster, Professor of Musculo-skeletal Health in Primary Care at the Arthritis Research Centre at Keele University. I saw Dr Foster speak at the recent BCA conference on this topic.

Dr Foster says that patients with back pain are not well managed by GPs who get little training in common muscle and joint problems. We know from other areas such as North East Essex that uses chiropractors and osteopaths alongside physiotherapists to provide back care, that given a choice more than half of back pain patients would prefer to go to a chiropractor or an osteopath rather than to the physiotherapist.

This echoes recommendations from the new Harvard Medical School booklet entitled Low Back Pain: Healing Your Aching Back, which endorses chiropractic care as one good option for back pain treatment. The booklet says chiropractic care ’improved short and medium-term pain more than other treatments including exercise physical therapy and medication’. People who saw chiropractors also reported being less disabled compared to people who received standard medical treatment. The report also states that chiropractic care tends to be satisfying and effective for acute low back pain.

Many patients now demand access to treatment not widely available on the NHS, including chiropractic. As more areas commission chiropractors and osteopaths to provide specialised spine care around the UK is clear that chiropractors and osteopaths can help treat back pain safely, effectively and cost effectively. Hopefully the back pain patients of Brighton and Hove won’t have to wait too much longer to be able to access this care themselves.

Soreness after chiropractic care

Chiropractic care -safe and effective
Chiropractic care -safe and effective

Mild adverse reactions to chiropractic care are quite common. Sometimes this is normal, in much the same way that soreness after unaccustomed exercise can occur. A new study sheds further light on what might be considered normal in conditions like back and neck pain that tends to come and go anyway.

Researchers at Murdoch University in Australia took a new approach to investigating reactions after chiropractic care. They divided chiropractic patients who were in their 20s all the way up to their 80s into two groups. Both groups had spinal pain but one group received normal chiropractic care and the other group received sham treatment. Neither group knew whether they received the real treatment or not.

12 chiropractic clinics and 180 people took part in the trial. Each patient received two treatment sessions and then filled in a questionnaire some while after each one. In this sort of study you might expect at the group that had received the real treatment would have the usual incidence of soreness and the group that didn’t receive treatment would feel fine. But was this the case?

In fact what happened was the group that had the sham treatment had nearly the same incidence of soreness (33%) afterwards as the group that had received the real treatment (42%). In other words, the temporary soreness that many people put down to chiropractic treatment may in fact be the normal ups and downs that their symptoms go through from week to week anyway.

What do we do to limit soreness after treatment?

Here at Sundial, we always aim to treat you as gently as we possibly can. When you first start treatment we will be using the most gentle techniques we can such as table assisted spinal decompression which gently stretches the discs. Here, light pressure is applied to your spinal vertebra as you lie on your tummy and the lower part of the treatment table rocks up and down.

Another gentle treatment we use here at Sundial Queens Road involves using precision electronic instrument adjusting such as the Impulse iQ. The iQ gently mobilises individual spinal bones and senses when movement has been restored. We are the only clinic in Brighton and Hove to use this leading technology. A similar technique involves using a spring-loaded adjusting instrument called the Activator. Most people who have experienced the Impulse iQ or Activator absolutely love it.

Selecting the right technique for you comes down to several factors. How severe your problem is combined with how long you’ve had it as well as your level of general fitness and overall body size and shape are all important. Sometimes, however, it just boils down to your personal preference. Some people don’t like the clicking type of spinal adjustments and fortunately we have several other options. We will discuss this with you before treatment begins.

Reference

Outcomes of Usual Chiropractic; Harm (OUCH). A randomised controlled trial. Spine 2013 Jun 17.
Walker BF, et al