So…you’re lower back hurts?

Your back hurts?

Frederick chiropractor for low back pain
Look like you?

Here’s a reasonable course of action:

Step 1. Wait. Does it just go away on it’s own within a few day? If so, great. If not…

Step 2. Home Care. Does stretching it or putting a heat pad or ice pack on it make the pain go away? If so, great. If not…

Step 3. Go to the chiropractor. If, after one to three sessions your pain is not significantly diminished and you are not armed with the knowledge of what is causing the pain and provided with a method to address the issue on your own, then perhaps try…

Step 4. Painkillers/Muscle Relaxers. These should “do the trick” if the trick you want done is for a drug to hide your pain and relax your muscles. Just understand that pain is a useful signal and your muscles may very well be tight as a way for your body to protect your back from further injury. But these pills may certainly make you feel better. If pain is your only concern and healthy bio-mechanics and spinal health is not something you care about, then by all means next time just start at Step 4. If drug use for your back pain becomes a chronic problem and your pain is severe enough to be debilitating, then perhaps consider…

Step 5. Orthopedic or Surgical Consult. Not much fun at all.

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The above steps are not terribly complicated. Most people do not follow that logical path. Most people do something like this:

1. Hurt themselves via injury or via laziness and de-conditioning.

2. Ignore the pain and continue to hurt or de-conditional themselves.

3. Try drugs to make the pain “go away”.

4. If drugs do not work well enough, skip all non-invasive or conservative methods and go straight to your Primary Care Provider who will probably have no clue what to do and whom will then refer you to a PT (a reasonable thing to do) or an orthopedist. If a course of physical therapy doesn’t make the pain “go away” then surgery is on the menu.

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The American Association of Family Physicians, the American Medical Association, and numerous other organizations recognize chiropractic care as an appropriate and safe first-line conservative approach to effectively treat lower back pain (and neck pain). Still, less than 8% of people in the United States see a chiropractor. Most choose the “easy” route of drugs or denying a problem exists. They then mask the symptoms until they are so severe that surgery is the only option, or they just do nothing at all until it’s so bad there are very few options.

Do yourself a favor and if you are experiencing lower back pain, especially if it’s possibly disc or nerve related and is causing pain into the legs or buttocks, go to see a chiropractor (or even a PT or a massage therapist) and treat your very real and potentially very troubling pain in a responsible and conservative manner so that you preserve the useful life of your spine and don’t end up shuffling around when you’re 65 years old and unable to enjoy your retirement because you were too young and dumb or busy or whatever to make a better choice in your 20’s, 30’s or 40’s.

Frederick Pain Management or a Chiropractor

If you’re thinking of going to a pain management clinic, then think about this:

First Visit

You will probably get a painkiller. Probably as in 90% positive.

You will probably get a muscle relaxer. Probably as in like 75%.

You will then feel better, but not actually be any better.

Following Visits

You will probably get epidural injections.

You will probably get your prescriptions for painkillers and muscle relaxers managed.

You may get referred to physical therapy.

Yo probably won’t get referred to a chiropractor, because the chiropractor would get the patient better and then the pain management clinic would lose business.

That being said, all pain management clinics aren’t the same. Some are great and aren’t just drug dispensaries. If you aren’t going to try chiropractic, then go to a physical therapist. And then if that doesn’t work try pain management.

So… my back hurts. Now what?

Pretty much all of us will experience back pain now and again. As a matter of fact, many of us will endure crippling, stabbing back pain, even pain or numbness into the butt or legs.

Another fact is that most people pay very little attention to the physical health of their backs or necks until things are really starting to hurt. That’s why so many people have their first visit to a “back doctor” be a visit to the orthopedic surgeon or neurosurgeon. Of all the “back doctors” to see first, those should not be on your list.

pain descriptive words

I’ll be honest, chiropractic is GREAT for treating simple low back pain. Good ol’ regular biomechanical low back pain responds GREAT to chiropractic adjustments. Countless research studies in proper, well-respected medical journals have confirmed this. Some of that research is here, but that’s not the point of this article.

You have a few things you can try first. Like everyone else in the world, your first attempt at fixing something should probably be a relatively inexpensive option that has the smallest likelihood possible for something bad to happen.

You can try any one of these things:

Chiropractor Visits
Course of Physical Therapy Sessions
Acupuncture
Massage Therapy
Ice or Heat
Stretching or Exercise
Painkillers
NSAID’s
Steroid Injections
Nerve Block
Spinal Surgery

Looking at this list, we can tell right off the bat that some of these are easier, safer and less expensive than others.

Stretching or exercising is free. It’s not necessarily easy, especially if you are in pain, but it’s one way to go. Massage and acupuncture are both safe and natural, so they are good places to start if you want to avoid drugs. Physical Therapy, depending on your therapist, is probably going to be mostly or somewhat natural, and besides needing to have you come in three times a week so they can watch you exercise, it’s a great way to recondition your out-of-shape back.

Painkillers and NSAID’s are, well, drugs. So if you are trying to get the back pain monkey off your back without drugs, they aren’t going to be on the list. For what it’s worth, painkillers will probably do something to get rid of the pain. Of course, when they wear off, you will be back in pain. NSAID’s may be able to deal with the injury in your back by reducing the inflammation, and this may get the pain to disappear for a while even after the medicine has left your system. The problem here is that NSAID’s aren’t safe for everyone, and even if they work for you and are safe for you, whatever caused the inflammation (and therefore the pain) in the first place is still probably causing inflammation just like before, and it’s only time before the pain returns (probably worse).

Nerve blocks and surgery are very poor first-lines-of-defense if your back pain is non-emergency and non-traumatic. In other words, if your back hurts because your posture sucks and you never exercise, then a nerve block isn’t the right way to go unless you are into injuring yourself on purpose. And surgery obviously shouldn’t be on your Christmas list, either.

Since a chiropractor is the author of this article, you can bet I saved chiropractic for last because I was saving the best for last. And it is. Chiropractic is great for so much more than back and neck pain, but our bread and butter is helping people get rid of back or neck pain. People (who have never been adjusted before) are almost always surprised at how effective chiropractic is. The reason chiropractic is so effective is because you and me have bodies that are designed to function normally, and a chiropractic adjustment takes a screwy spine and, for lack of a better description, straightens that spine out. Then the spine works better…and then it doesn’t hurt any more. Rather than cover the pain with medicine we adjust the body so that it will work normally, and since normal function is supposed to be pain-free, the client typically feels better. It’s not magic, it’s actually basic physics, a touch of the basics of mechanics, and some rudimentary biology. The body is supposed to work normally, and without pain, so sometimes it just needs to be pushed back in the right direction.

So, if you want to be pushed in that direction, give us a call. Thanks for reading. -Rob

Antidepressants are now being prescribed by Medical Doctors (MD’s) to treat common lower back pain

In 1996 about 13 million Americans were using antidepressants. By 2005 that number rose to 27 million. Not only are more Americans being prescribed antidepressants, but those individuals are taking more antidepressants. (1)

More than 164 million prescriptions were written for antidepressants in 2008. More than 1 out of 10 Americans are on antidepressants as of 2008.

Researchers Olfson and Marcus examined the clinical data from 1995-2005 and focused on 50,000 people to study. They found that those on antidepressants were more likely to then go on to use more powerful anti-psychotic drugs and less likely to partake in psychotherapy. (2) In that sense, antidepressants are a type of gateway drug and they apparently aren’t effective enough in many cases because more powerful antipsychotic drugs are later prescribed.

Dr. Eric Caine of the University of Rochester in New York said he was concerned by the findings, and noted that several studies show therapy is as effective as, if not more effective than, drug use alone. “There are no data to say that the population is healthier. Indeed, the suicide rate in the middle years of life has been climbing,” he said.

Therapy is not as easy to simply popping pills, though, which leads us to the low back pain issue.

Low back pain is one of the most common and most expensive medical conditions in the United States. Most people will have to deal with low back pain at some point in their lives. The cost of prescription drugs and expensive surgeries are two of the major factors causing an explosion in healthcare costs in the past decade. Surgery is a significant cost associated with treating low back pain, and this is despite the fact that research repeatedly shows that chiropractic care is a safer, less expensive and more effective way to treat most cases of low back pain. (3) Research has also shown that contemporary medical treatment of lower back pain is more likely to lead to disability than is chiropractic care. (4) Still, most people do not know these facts and instead go see a medical doctor.

Medical doctors routinely prescribe painkillers and muscle relaxers to their patients who complain of low back pain, often doing so rather than referring them to a chiropractor. On top of those drugs, now medical doctors have begun to prescribe antidepressants to their back pain patients.

This is where we come to a thought experiment. Think with me for a moment: as anti-depressant use doubled in the United States from 1996-2005, did the incidence of lower back pain decrease alongside it?

If anti-depressant use has more than doubled, and medical doctors consider antidepressants a treatment for lower back pain, then the prevalence of lower back pain should have dropped significantly.

But it didn’t.

That should tell you all you need to know about using prescription psychiatric drugs to treat a problem with your lower back.

1.       http://www.ncbi.nlm.nih.gov/pubmed/19652124

2.       http://www.ncbi.nlm.nih.gov/pubmed/21135326

3.       http://www.ncbi.nlm.nih.gov/pubmed/21036279

4.       http://www.ncbi.nlm.nih.gov/pubmed/21407100

Major New Study Conducted by the U.S. National Institute of Health (N.I.H.) Finds that Raising “Good” Cholesterol DOES NOT REDUCE THE RISK OF HEART ATTACK OR STROKE

In fact, it appears to increase the likelihood of stroke…

So, if increasing the amount of “good” cholesterol doesn’t actually make you any less likely to have a stroke or heart attack, then are we still calling it “good”?

Here is the most important line in the article to digest:

“The results are part of a string of studies that suggest that what doctors thought they knew about cholesterol may be wrong.”

It is a peculiar arrogance of man that allows him to believe that he can fully understand and even outsmart the human body. If there are raised levels of cholesterol in the blood, perhaps this is part of a beneficial or benign function the body is performing, a process more commonly occurring in those with poor cardiovascular health? Cause and effect is unknown.

That is merely a very simple thought, but it is a source of reasonable doubt to anyone weighing that thought without prejudice.

Now, there is no standard measure of doubt which may exist in a doctor’s mind before he or she may prescribe medication to treat a condition, but there is a standard I hold myself to when it comes to me putting things into my body.

NIASPAN (niacin) is an unscored, medium-orange, film-coated tablet for oral administration and is available in three tablet strengths containing 500, 750, and 1000 mg niacin. NIASPAN (niacin) tablets also contain the inactive ingredients hypromellose, povidone, stearic acid, and polyethylene glycol, and the following coloring agents: FD&C yellow #6/sunset yellow FCF Aluminum Lake, synthetic red and yellow iron

The above illustration and accompanying description is that of the medication in question.

What is purely factual is that scientists have discovered a link between high levels of so-called “bad cholesterol” and increased risk of heart attack or stroke, but they still have not uncovered the nature of that link. Scientists and drug companies then made the assumption that since lowering levels of “bad” cholesterol decreased the likelihood of a stroke or heart attack, that then increasing the levels of “good” cholesterol would similarly protect cardiovascular health. This assumption was just proven wrong. In fact, increasing levels of “good” cholesterol was found to expose people to an increased risk of stroke.

Despite the multitude of potentially dangerous drugs on the market to solve the cholesterol “problem”, the problem hasn’t truly been unmasked and defined clearly. Rather, there is a relationship involving cholesterol and heart health, but the relationship is currently not well understood. Perhaps it will be fully understood in time, but presently there are only theories which are currently being tested on millions of Americans who use these medications.

In scientific education, one of the earliest and most important concepts any good thinker must embrace fully is the appreciation that correlation does not equal causation. A relationship between “A” and “B” does not mean one causes the other in a strictly linear fashion. They both may be influenced by another, presently unknown, variable…“C”.

Far too often the other, unseen variable is waiting to be recognized, and that discovery unlocks a whole new level of understanding, and everybody is forced to admit that they had no idea how little they understood the topic previously.

“Not surprisingly, doctors thought that if they could raise H.D.L. levels, their patients would benefit. So far, that assumption is not panning out. Nobody knows why.”

So, what does this mean to the millions of Americans currently taking expensive prescription medication that they were told would help keep them safe from heart attack or stroke? It means you may have been taking that medication unnecessarily. Modern medicine’s best effort may have failed you and millions of others and exposed you to side-effects as-of-yet undocumented.

When you watch the commercials for medications like these types, please notice the warnings about how certain medications are not safe for people with liver problems. This is because the liver is the vital organ that filters toxins out of your body. These medications are viewed by your body as toxic foreign substances, and the liver has to put in additional work trying to cleanse your body of the “hypromellose, povidone, stearic acid, and polyethylene glycol, and the following coloring agents: FD&C yellow #6/sunset yellow FCF Aluminum Lake, synthetic red and yellow iron oxides, and titanium dioxide” inside the pill.

The effectiveness of a medication has to be weighed against any possible toxic effects on the body. If a medication truly does prevent stroke or heart attack, then this certainly can be an important benefit, and is likely a medicine worth taking no matter the extra work your liver has to do to break it down and send it on a one-way trip into your toilet.

In closing, I would like to mention that the drug in question is called Niaspan. It is a slow-release form of Niacin. Niacin is commonly known as Vitamin B3. Yes, you read that right…vitamin B3. Vitamin B3 can be found in a wide variety of fruits, vegetables, and meats. In order to get Vitamin B3 into a slow-release capsule the ingredients and additives listed above in italics were added to a vitamin.

Abbot Laboratories sold just under $1 billion worth of Niaspan in 2010.

The original NY Times article is here.