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.

Can regular chiropractic care prevent back pain here in Brighton?

If you are one of the four out of five people will go on to develop regular bouts of back pain after an initial attack, this is an important question to answer. For over 100 years chiropractors have claimed that regular treatment can prevent recurrences of back pain. Are we right?

For most of the 20th century, medical treatment, including here in Brighton, consisted of bed rest and painkillers for back pain. Unfortunately, this contributed to an increase in the cases of recurrent back pain. From 1980 until 2000 the number of days off work in the UK due to back pain doubled every decade.

Eventually, GPs stopped treating back pain this way and accepted what chiropractors and others had been saying that active treatment is best. It is also true that chiropractors accepted that painkillers and anti-inflammatory medication are also helpful, whereas up until then old school chiro’s often shunned drugs.

Medical Treatment for Back Pain

Even now, however, back pain treatment from the doctor consists of a brief course of physio or medication which stops as soon as the symptoms stop. If you have had recurrent back pain you will be all too familiar with the trips to the doctor, prescriptions for strong drugs, referral to the physio (after a wait of many weeks) then being given a few exercises. You are probably fed up with your back feeling vulnerable and about to go at any time. You may even find that you’re limiting your activities to avoid the things that bring it on. If so, what can be done to prevent the dreaded back pain from returning?

Well, new medical research, published in 2011, suggests that an initial intensive course of manipulation such as our chiropractors in Brighton do here at Sundial, followed by periodic checkups and treatment may help prevent long-term back pain from re-occurring. Interestingly, those that did not receive the continuing course of care lost their earlier improvements.

Preventative Chiropractic Treatment Works

So the evidence seems to point to an initial course of treatment over a few weeks to get rid of the initial pain and improve function followed by a course of care over the next few months to make sure that those improvements are maintained. Here at Sundial we use the best available evidence to guide our treatment and we generally stick to this sort of plan in helping you get better.

If you would like to know if preventative chiropractic care can help you then give us a call for an initial chat, at no charge.