Back Pain Treatment

Back Pain Treatment Specialist, Fairfax VA

A Comprehensive Guide to the Chiropractic Treatment of Back Pain

Welcome to our comprehensive guide for chiropractic treatment of back pain. If you're looking for an alternative to drugs and surgery for managing your back pain, chiropractic care might be the solution for you. Chiropractic treatment focuses on restoring the proper alignment of your spine and improving your body's natural healing abilities to relieve pain and discomfort.

Contents

Section 1: Understanding Your Back Pain

Section 2: Causes of Back Pain and Their Symptoms

Section 3: Our Chiropractic Treatment Program for Back Pain

Section 4: Standard Medical Treatment for Back Pain

Section 5: Home Care Tips for Back Pain

Section 6: Red Flag Symptoms of Back Pain

Section 7: Frequently Asked Questions About Chiropractic Treatment for Back Pain

Section 1: Understanding Your Back Pain

Back pain can be caused by many factors, including muscle strain, herniated discs, and arthritis. It can also occur due to poor posture or an injury. It is important for Dr. Zapf to understand the root cause of your pain to determine the most effective chiropractic treatment for your pain. He will carefully and methodically examine you to discover the underlying cause of your pain. This involves 3 steps:

1. Dr. Zapf will begin the examination of your low back with an extensive case history. Sometimes the pain you are experiencing today may have had its origin in your past. Auto accidents, falls, and sports injuries that occurred years ago may be contributing to the pain you are experiencing today.
2. The next step is to perform a thorough but non-invasive physical exam. This will consist of orthopedic and neurologic tests to evaluate your posture, range of motion, spinal alignment and overall condition of your skeletal and nervous systems.
3. Diagnostic Imaging: In some cases, Dr. Zapf may recommend additional diagnostic tests, such as X-rays or MRI, to further evaluate the spine and rule out other potential causes of low back pain.

Based on the results of the case history, physical exam and diagnostic tests, Dr. Zapf will determine the root cause of your low back pain and develop a treatment plan tailored to your specific needs.

Section 2: Causes of Back Pain and Their Symptoms

Low Back Pain can be caused by a myriad of different conditions. Below is a listing of the most common conditions treated in Dr. Zapf’s clinic.

2A. Muscle strain:

Muscle strain is a common cause of low back pain. A low back muscle strain occurs when the muscles in the lower back are overstretched or torn. This can cause a variety of symptoms, which may include:

1. Muscle spasms: Muscle spasms are a common symptom of a low back muscle strain. These spasms can cause sudden, intense pain in the lower back.
2. Stiffness: Stiffness in the lower back is another common symptom of a muscle strain. The stiffness may make it difficult to move or bend the lower back.
3. Tenderness: The affected area may be tender to the touch.
4. Limited range of motion: A muscle strain in the lower back may limit your ability to move your back through its full range of motion.
5. Swelling or bruising: In severe cases, a muscle strain in the lower back may cause swelling or bruising in the affected area.

2B. Herniated disc:

The spinal discs are soft, cushion-like structures that separate and cushion the vertebrae. When the inner part of a disc bulges out and presses on a nerve root, it's called a herniated disc. This can cause a variety of symptoms.

1. Back pain: Pain in the lower back is a common symptom of a herniated disc. The pain may be dull or sharp, and it may worsen with movement or sitting for long periods of time.
2. Leg pain: Herniated discs in the lower back can also cause pain, numbness, or tingling in the legs, which may be felt in the buttocks, thighs, or calves. This is often referred to as sciatica.
3. Muscle weakness: Compression of a nerve by a herniated disc can cause muscle weakness in the affected area. A herniated disc in the low back may cause weakness in the legs.
   
4. Numbness or tingling: Herniated discs can also cause numbness or tingling in the affected area, such as the legs or arms.
5. Bowel or bladder problems: Rarely, a herniated disc can lead to bowel or bladder problems, such as difficulty emptying the bladder or bowel incontinence.

2C. Sacroiliac Joint Dysfunction:

Sacroiliac joint dysfunction (SIJD) is a condition where there is abnormal movement or alignment of the sacroiliac joint, which connects the sacrum (the triangular bone at the base of the spine) to the pelvis. This dysfunction can cause pain in the lower back, hips, and legs.

The pain associated with SIJD is typically located on one side of the lower back or buttocks and may also radiate down the back of the leg. It can be aggravated by certain activities such as standing, sitting for prolonged periods, walking, or running.

2D. Spinal stenosis:

This is a condition that occurs when the spinal canal, which houses the spinal cord and nerves, becomes narrow, leading to compression of these structures. This can cause a variety of symptoms, which may include:

1. Back pain: Spinal stenosis can frequently cause pain in the low back. The pain may be dull or sharp and may worsen with activity.
2. Leg pain: Spinal stenosis can cause pain, numbness, or tingling in the legs, which may be felt in the buttocks, thighs, or calves. This is often referred to as sciatica.
3. Weakness: Compression of the spinal cord or nerves can cause weakness in the legs, making it difficult to stand or walk for long periods of time.
4. Numbness or tingling: Spinal stenosis can also cause numbness or tingling in the legs, feet, or toes.
5. Loss of balance or coordination: In severe cases, spinal stenosis can affect the way you walk, leading to a loss of balance or coordination.
6. Bladder or bowel problems: Rarely, spinal stenosis can lead to bladder or bowel problems, such as difficulty emptying the bladder or bowel incontinence.

2E. Osteoarthritis:

This is a common type of arthritis that affects the joints including the joints of the spine.  It typically occurring in older adults. It happens when the cartilage that cushions the joints gradually breaks down, causing the bones to rub against each other, leading to pain, stiffness, and swelling. Here are some common symptoms of osteoarthritis:

1. Joint pain: Pain in the affected joint(s) is a common symptom of osteoarthritis. The pain may be dull or sharp and may get worse with activity or after sitting or lying down for a long time.
2. Stiffness: Joint stiffness, especially in the morning or after sitting for a long period, is another common symptom of osteoarthritis. The stiffness may last for a few minutes or several hours.
3. Reduced flexibility: As the cartilage in the joint wears down, it may become difficult to move the affected joint through its full range of motion.
4. Swelling: The affected joint may become swollen or tender to the touch.
5. Crunching or popping sound: Some people with osteoarthritis may hear a crunching or popping sound when they move the affected joint.
6. Deformities: In advanced stages of osteoarthritis, the joint may become deformed, which can affect the way you move and use the joint.

2F. Piriformis Syndrome:

Piriformis syndrome is a condition that occurs when the piriformis muscle, which is located deep in the buttock region, becomes tight or irritated and compresses the sciatic nerve. The sciatic nerve is a large nerve that runs from the lower back down to the feet, and compression of this nerve can cause pain, tingling, and numbness in the buttocks and legs.

1. The symptoms of piriformis syndrome can vary from person to person, but they typically include:
2. Pain in the low back and buttocks: The pain may be sharp, burning, or dull, and it may be felt on one or both sides of the buttocks.
3. Pain down the back of the leg: The pain may radiate down the back of the leg, and it may be accompanied by tingling or numbness in the leg or foot.
4. Pain when sitting: Sitting for long periods of time can worsen the pain, and it may be difficult to find a comfortable sitting position.
5. Difficulty walking or standing: Some people with piriformis syndrome may have difficulty walking or standing for long periods of time due to the pain and discomfort.
6. Pain during exercise: Activities that involve hip rotation or bending, such as running or cycling, may aggravate the symptoms of piriformis syndrome.

2G. Spondylolisthesis:

This is a condition that occurs when one vertebra in the spine slips out of position and onto the vertebra below it. This can cause a variety of symptoms, which may include:

1. Low back pain: Pain in the lower back is the most common symptom of spondylolisthesis. This pain may worsen with movement.
2. Muscle spasms: Muscle spasms are a common symptom of spondylolisthesis. These spasms can cause sudden, intense pain in the lower back.
3. Stiffness: Stiffness in the lower back is another common symptom of spondylolisthesis. The stiffness may make it difficult to move or bend the lower back.
4. Nerve pain: In severe cases, spondylolisthesis can cause compression of the spinal nerves, which can lead to pain, numbness, or tingling in the legs.
5. Weakness: Compression of the spinal nerves by a displaced vertebra can also cause weakness in the legs
6. Loss of bladder or bowel control: Rarely, spondylolisthesis can lead to loss of bladder or bowel control, which may be a sign of a medical emergency.

2H. Sciatica:

The Sciatic nerve is the longest nerve in the human body. It run from the lower back to the toes. If it is compressed it can result in a condition known as sciatica. Sciatica can cause a variety of symptoms:

1. Pain: Pain is the most common symptom of sciatica. The pain may be sharp or dull and may run from the low back to one or both legs.
2. Numbness or tingling: Sciatica can cause numbness or tingling in the affected leg or foot.
3. Weakness: Sciatica can cause weakness in in one or both, making it difficult to stand or walk.
4. Difficulty moving: Sciatica can make it difficult to move the affected leg or foot.
5. Burning or tingling sensation: Some people with sciatica may experience a burning or tingling sensation in the affected leg.
6. Bowel or bladder problems: Rarely, sciatica can lead to bowel or bladder problems, such as difficulty emptying the bladder or bowel incontinence.

Section 3: Our Chiropractic Treatment Program for Back Pain

We are redefining treatment for low back pain. We’ve rejected the old notion that you can heal and revitalize your spine, the core of your being, with superficial treatments and quick fixes delivered in a stressful and impersonal manner. We view our therapy as the beginning of a journey for renewal of your body, mind, and spirit.

Using the information gathered in your case history, examination, and diagnostic imaging, we will design a multifaceted treatment program. We view healing as a process not an event. Your treatment is only one element of this process. Relaxation, exercise, and nutrition are also necessary. Therefore, we’ve created an environment that will support optimal healing and renewal. Your treatment sessions will be unhurried, in a private, relaxing space. Therapy will consist of a custom blend of spinal manipulation, physical therapy, exercise, and massage.

Because you are unique, your program will be one of a kind, designed to meet your individual needs. Your treatment duration will depend on several factors including the cause, severity, and chronicity of your illness. Research shows that healing time for most musculoskeletal condition that can be treated with conservative care like chiropractic care is between 6 – 12 weeks. Our treatment programs can be divided into 3 phases:

3A. PHASE 1- Pain Relief

Our goal in the initial stage of care is to quickly reduce your inflammation and pain. Depending on the cause and severity of your pain, each of your therapy sessions will consist of a gentle blend of:

1. Chiropractic Spinal Manipulative Therapy (Adjustments):  Chiropractic manipulation is a procedure used to gently move misaligned vertebrae (known as a subluxation) to relieve pressure spinal nerves. This process increases range of motion, improves function, reduces nerve irritability, and alleviates muscle spasm and pain.
2. Computerized Cervical Decompression (Traction): A computer-controlled device decompresses the neck and upper back gently and precisely. The FDA has cleared this unit to relieve pressure on joints and discs of the spine. It relieves pain associated with herniated discs, protruding discs, degenerative disc disease, posterior facet syndrome and nerve compression. It is especially effective in treating neck pain and low back pain.
3. Electric Muscle Stimulation (EMS): In our clinic this is used to reduce of pain, relax muscle spasms, increase local blood circulation, and maintain or increase of range of motion.
4. Therapeutic Ultrasound: A passive therapy that uses high frequency sound waves to penetrate through the skin into the deep tissues of the body. Research shows that ultrasound waves significantly improve healing of tissues and relieves pain, stiffness.
5. Therapeutic Exercise and Massage: In our clinic, therapeutic exercise and massage are used to improve joint mobility, posture, and recovery time. They are also beneficial for alleviating pain caused by soft tissue strains, inflammation, and muscle tension.

3B. PHASE 2- Healing

During this phase, we move beyond simple pain relief. Your therapy will gradually evolve to match your exact level of progress. The tissues of the back, neck, arms, and legs will continue to be gently mobilized in order to reduce healing time, minimize formation of scar tissue adhesions and reduce pressure on spinal nerves.

3C. PHASE 3- Strengthening

Progressive strengthening of back muscles and supporting tissues stabilizes your back and increases your capacity to perform home, work, and recreational activities. Imagine being able to golf, swim, play tennis, hike – without pain!

Section 4: Standard Medical Treatment for Back Pain:

The “usual medical treatment” by a primary care physician for back pain consists of prescriptions for various categories of drugs. These drugs are designed to reduce pain, decrease inflammation and relax muscle spasms. What they do not treat is the root cause of most types of low back pain.

Furthermore, it should be noted that prolonged use of these drugs is contraindicated because of the increased likelihood of adverse side effects. The exact definition of prolonged use can vary depending on the medication and the individual patient's circumstances, but it typically refers to a duration of use beyond a few days or weeks.

4A. Nonsteroidal anti-inflammatory drugs (NSAIDs):

NSAIDs are over the counter or prescription medications that reduce inflammation and pain. Currently, this is the most prescribed category of drugs for back pain. Examples include ibuprofen, naproxen, and aspirin. They can be effective in relieving low back pain, but long-term use (greater than 2 weeks) can increase the risk of adverse side effects such as stomach ulcers and bleeding.

4B. Acetaminophen:

 Acetaminophen is an over-the-counter pain reliever that is often used to treat low back pain. It is not an anti-inflammatory medication, but it can be effective in relieving mild to moderate pain. Prolonged use of this type of drug can lead to liver damage.

4C. Opioids:

Opioids are prescription pain relievers that work by binding to receptors in the brain and blocking pain signals. They are typically only used for severe pain and are associated with a high risk of dependence and addiction.

4D. Muscle relaxants:

Muscle relaxants such as Cyclobenzaprine (Flexeril) and Methocarbamol (Robaxin) are prescription medications that help to relieve muscle spasms and tension. Muscle relaxants can cause drowsiness and other side effects, so it's important to follow your doctor's instructions and avoid driving or operating heavy machinery while taking these medications. Additionally, muscle relaxants are not recommended for long-term use and should only be used for short periods of time under a doctor's supervision.

It should be noted that these drugs are designed only to treat symptoms like muscle spasms or low back inflammation and pain. Unlike Chiropractic Care they do not treat the root cause of low back pain.

Section 5: Home Care Tips for Back Pain:

There are several things a person can do at home to relieve low back pain. Here are some of them:

1. Stay active: Although it may be tempting to rest in bed, staying active is one of the best things you can do to relieve low back pain. Movement can help to reduce inflammation and improve flexibility.
2. Exercise: Low-impact exercises like walking, swimming, or yoga can help to strengthen the muscles in your back, which can help to reduce pain over time.
3. Cold therapy: Applying an ice pack to your back can help to reduce pain and inflammation. Try applying a towel covered ice pack (gel pack) for no longer than15 minutes and no more often than 2 hours .
4. Massage: Gentle massage can help to relieve muscle tension and promote relaxation, which can help to reduce pain.
5. Stretching: Gentle stretching exercises can help to improve flexibility and reduce stiffness in your back muscles. Stretching can be an effective way to reduce low back pain by improving flexibility, reducing muscle tension, and increasing blood flow to the affected area. A good stretch to start with is the Knee-to-Chest stretch: Lie on your back with your knees bent and feet flat on the ground. Bring one knee up towards your chest and hold it with both hands for 15-30 seconds. Repeat with the other leg. Always perform these stretches slow and only hold them for a few seconds (3-5).
6. Posture: Be mindful of your posture, especially when sitting at a desk or using a computer. Keep your feet flat on the ground and avoid slouching or leaning forward. Sitting is not recommended with certain types of low back pain, such as pain resulting from a herniated lumbar disc. Research has shown that sitting will increase pressure on the discs of the lower back.
7. Over-the-counter pain medication: Over-the-counter pain medication like ibuprofen may help to reduce pain and inflammation. Follow the directions and do not use for more than a few days. Prolonged use may increase your chances of adverse side effects.
8. Sleep: Make sure to get plenty of restful sleep, and try to avoid sleeping on your stomach, which can put additional strain on your back. The best possible positions for sleeping can vary depending on the individual's preference and their specific health conditions.

Here are some general guidelines for sleeping positions:

• Back sleeping: Sleeping on your back with a pillow under your knees can help to keep your spine in a neutral position and reduce pressure on your lower back. This position can also help to reduce acid reflux symptoms.
• Side sleeping: Sleeping on your side with a pillow between your knees can help to align your spine and reduce pressure on your hips and lower back. This position can also help to reduce snoring and sleep apnea symptoms.
• Stomach sleeping: Sleeping on your stomach can put strain on your neck and spine and is generally not recommended. However, if you prefer to sleep on your stomach, try placing a pillow under your hips to reduce pressure on your lower back.

In addition to these sleeping positions, it's also important to use a supportive mattress and pillow that keep your spine in a neutral position. It's also important to avoid sleeping on a mattress that is too soft or too firm, as this can cause back pain and discomfort.

If your low back pain persists or is severe, it's important to seek medical attention from a healthcare provider.

Section 6: Red Flag Symptoms of Back Pain

Red flag symptoms are warning signs that indicate a potentially serious underlying condition that may require prompt medical attention. The following are considered red flags for neck pain:

1. Pain that is severe and constant, especially at night: Severe and constant back pain, especially if it worsens at night, may indicate a serious underlying condition, such as a spinal infection, tumor, or fracture. These conditions can cause nerve damage, paralysis, or other serious complications if left untreated.
2. Pain that is getting worse over time: Back pain that gets progressively worse over time may indicate a spinal condition such as a herniated disc, spinal stenosis, or degenerative disc disease. These conditions can lead to nerve compression and permanent nerve damage if not treated promptly.
3. Pain that is not relieved by rest or changes in position: If rest or changes in position do not relieve your back pain, it may indicate a more serious condition such as a spinal infection, tumor, or fracture. These conditions require immediate medical attention to prevent complications.
4. Numbness or tingling in the legs or feet: Numbness or tingling in the legs or feet may indicate nerve compression in the spinal cord or nerve roots, which can be caused by conditions such as a herniated disc, spinal stenosis, or sciatica. If left untreated, these conditions can cause permanent nerve damage.
5. Weakness in the legs or feet: Weakness in the legs or feet may indicate nerve compression or damage, which can be caused by conditions such as a herniated disc, spinal stenosis, or spinal cord injury. If left untreated, these conditions can lead to permanent paralysis or other serious complications.
6. Loss of bowel or bladder control: Loss of bowel or bladder control may indicate a serious spinal cord injury, which requires immediate medical attention. If left untreated, a spinal cord injury can lead to permanent paralysis and other serious complications.
7. Difficulty standing or walking: Difficulty standing or walking may indicate a spinal condition such as spinal stenosis, herniated disc, or degenerative disc disease, which can cause nerve compression or damage. If left untreated, these conditions can lead to permanent nerve damage and disability.
8. Recent history of cancer or unexplained weight loss: A recent history of cancer or unexplained weight loss may indicate the presence of a spinal tumor, which can cause nerve compression and permanent nerve damage if left untreated.
9. Recent infection or fever: A recent infection or fever may indicate a spinal infection, which can cause severe back pain, nerve damage, and other serious complications if left untreated.

 These conditions require prompt medical attention to prevent serious complications.

Section 7: Frequently Asked Questions About Chiropractic Treatment for Low Back Pain

• Is chiropractic treatment safe?

Yes, research shows that chiropractic treatment is a safe, effective, and natural way of treating neck pain. It is important to choose a licensed and experienced chiropractor to ensure the best possible results.

• How long does treatment take?

The length of treatment will vary depending on the cause and severity of your back pain as well as your overall health. On average, most people experience significant improvement after just a few visits.

• What is the number of visits required?

The number of visits required will vary depending on the severity of your back pain and your overall health. Dr. Zapf will work with you to develop a treatment plan that's tailored to your specific needs.

• Will Insurance Cover Chiropractic Treatment?

Most insurance plans cover chiropractic care for back pain. Be sure to check with your insurance provider to determine the specifics of your coverage.

Our Chiropractic Care offers a drug-free alternative for managing low back pain. It is very safe, effective, and tailored to your individual needs. If you're looking for an alternative to drugs and surgery for your low back pain, our chiropractic care might be the solution for you.

Call Dr. Robert J. Zapf for an appointment (703) 455-9555