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CHIROPRACTORS OFFER ALTERNATIVE TO NSAIDS
FOR BACK PAIN
People suffering from back pain should consider first trying chiropractic services and other non-drug therapies in light of a new research review that found common over-the-counter and prescription pain medications have limited effectiveness for back pain and raise the risk of side-effects, according to the American Chiropractic Association (ACA).
The review, published in Annals of the Rheumatic Diseases, examined 35 randomized, placebo-controlled trials, encompassing 6,000 patients, to determine the effectiveness and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for spinal pain. The authors of the report found that NSAIDs provided “clinically unimportant effects” when compared with patients who received only a placebo. Meanwhile, those who used NSAIDs had a 2.5 times greater risk of experiencing gastrointestinal disorders.
“At present, there are no simple analgesics that provide clinically important effects for spinal pain over placebo,” the authors noted.
The news about NSAIDs follows reports last year that prescription opioids also have limited effectiveness for back pain—one of the most common causes of disability worldwide.
The American Chiropractic Association urges people to try non-drug approaches to back pain relief first, before resorting to over-the-counter or prescription medications. In addition to spinal manipulation, chiropractors can offer a range of non-drug therapies for back pain and recommend exercises and important lifestyle changes to help prevent future back pain and injury.
CHIROPRACTIC TESTS AND DIAGNOSIS
When you visit your chiropractor for the first time, he/she will probably ask you to perform a series of simple tests to evaluate your posture and range of motion. You may be asked to bend forward, backward or side-to-side. The chiropractor will also check the way you walk and how your posture looks sitting down and standing up. Other tests may include:
• Piriformis Test: The patient flexes and bends the knee while lying down.
• Straight Leg Raise: One leg at a time is raised in a locked-knee position to check the sciatic nerve and flexibility of the hamstring muscle.
• Measuring the length of each leg helps determine if there is a discrepancy in leg length or if the pelvis is out of balance.
• Hand strength (grip)
• Evaluation of reflexes and muscle testing
Sometimes you might hear a pop while the chiropractor is testing or adjusting you, which is perfectly normal. This is caused by small pockets of air or bubbles in the fluid that surrounds your joints. When joint tissues are stretched, those pockets of air “pop,” which creates the cracking sound you hear.
Once the chiropractor identifies the problem, he/she can recommend treatment options, and explain how many chiropractic visits are necessary to reach an expected outcome (e.g., resolution of pain). He/she may also suggest improvements to your diet and lifestyle, such as quitting smoking or increasing/modifying certain activities. A chiropractor may also recommend certain types of exercises in conjunction with chiropractic treatment to stretch and/or strengthen the back and neck.
Treating lower back pain in school-aged children
While some lower back pain needs to be treated by a specialist, chiropractors can help children and adolescents prevent and manage lower back pain. Most pain with no specific cause responds to rest, rehabilitation and identification of predisposing risk factors.
Although the causes of lower back pain in school-aged children are most often benign, according to the literature, a thorough evaluation performed by a chiropractor can help rule out a more serious condition. Obtaining a full clinical history, asking certain questions associated with an inflammatory cause of lower back pain, examining the back for signs of deformities, performing neurologic workups, and ordering imaging tests if deemed necessary could all be parts of the overall evaluation.
Based on the review, because children and adolescents’ musculoskeletal systems are still developing they are at an increased risk to trauma and explosive muscle contractions, especially during periods of rapid growth. For this reason, evidence suggests the importance of pre-season sports conditioning programs and neuromuscular training that will allow the athlete to gradually increase his or her training intensity and help reduce injuries. Additionally, rest should be incorporated into the training regimen, especially for athletes who perform repetitive motions, such as tumbling in gymnastics. Young athletes should not participate in more hours of sports in a week than their number of age in years.