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Acute and Chronic Low Back Pain

Low back pain is often the most common presenting complaint in a chiropractic clinic. A survey carried out by the British Chiropractic Association in 2008 showed that 52% of people in the UK are currently suffering from back pain and 23% have been suffering for more than 10 years (British Chiropractic Association, 2008). People of any age, from teenagers to pensioners, can suffer from back pain. In fact, a US National Survey reported that back pain was the third most commonly reported symptom in people aged 75 and over (Cypress, 1983).

A few of the many causes of lower back pain include poor posture, sedentary lifestyle, lifting injuries and degenerative changes. The pain can vary from acute pain that has been present for less than 6 weeks (often sudden onset, short lived and severe) to chronic pain (long lasting or recurrent). Low back pain is not always the only symptom of a low back complaint. Stiffness, backache, tightness, leg pain, pins and needles, tingling, numbness and weakness can also indicate a problem in the lower back.

A recent review of the available scientific evidence showed that spinal manipulation/mobilisation is an effective treatment of acute, sub-acute and chronic low back pain in adults (Bronfort et al, 2010). Also National Institute For Health And Clinical Excellence (NICE) Guidelines for health professionals published in May 2009 recommends offering a course of manual therapy including manipulation for treatment of low back pain lasting longer than six weeks (Savigny et al, 2009). European Guidelines developed for health care providers, recommend that chiropractic should be considered in the treatment of acute and chronic low back pain (European Commission Research Directorate General, 2004).

Acute and Chronic Neck Pain

Neck pain, as with back pain, can be mechanical in nature (caused by the function of the joints, ligaments and muscles) or caused by nerve root compression (pressure onto the spinal nerves). Mechanical neck pain is more common than nerve root pain. Between 10% and 20% of the population in Europe suffers from chronic or persistent neck pain (Lars Lidgren, 2008).

A common cause of neck pain is poor posture (rounded shoulders and forward head carriage) in particular while sitting at a desk, using a computer and driving. An object feels much heavier when you hold it further away from the body. This is why sitting with the head hanging forwards whilst looking down at a desk puts a lot of stress on the neck and upper back. Also lifting children and carrying bags put strain on the neck. Sleeping on your front with the head turned to one side is another cause of neck pain.

It may take a long time before the body starts to show any symptoms as the body can deal with occasionally adopting these postures. However, with time the body's ability to adapt decreases and each time the poor posture is adopted the body becomes more and more likely to become symptomatic.

A report published in a journal called Spine by the Bone and Joint Decade Task Force on Neck Pain recommends manipulation and mobilisation as a safe, effective and appropriate treatment approach for neck pain (Hurwitz et al, 2009).

Some Types of Headaches and Migraines

There are many different types of headaches and many different causes. Cervicogenic headaches can be caused by altered function of the joints of the spine and irritation of the spinal nerves. Migraines can be triggered by hormonal changes, certain food and stress. Dysfunction of the joints in the neck and irritation of the spinal nerves can also be a contributing factor. In these cases chiropractic treatment may help to improve joint function and reduce nerve irritation, therefore reducing the frequency of the migraines and headaches. A recent review of the effectiveness of manual therapies revealed that spinal manipulation is an effective treatment for migraines and cervicogenic headaches (Bronfort, 2010).

Pain Following a Car Accident

During a car accident the head, which weighs on average 4 to 5 kg, is thrown forwards and then backwards. The heavy head is suspended on a thin neck and as the head is thrown forwards and backwards it exerts significant stress on the muscles, ligaments and joints of the cervical spine causing significant injury. Often symptoms can include neck pain, pins and needles, headaches and dizziness.

Sometimes the symptoms can have a delayed onset, sometimes even months after the original injury. Even a fall or a slip can cause a similar type of injury.

Early treatment may help significantly to resolve the symptoms and restore function to the muscles, ligaments and joints. Manipulation for pain as a result of a car accident has been recommended in a report by the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders published in Spine in 2008 (Hurwitz et al, 2009). Manipulation has also been shown to be an effective treatment in a recent review of the effectiveness of manual therapies (Bronfort, 2010).

Shoulder Girdle and Elbow Pain

A chiropractor may help with treatment and advice regarding the management of a number of extremity complaints including shoulder girdle pain (Bergman et al, 2004), frozen shoulder (Vermeulen et al, 2006) and tennis elbow (Bisset et al, 2006). A chiropractor may even find that the shoulder pain is caused by a problem in the neck and upper back (Bergman et al, 2004).

Hip, Knee and Foot Pain

Chiropractic treatment can help to relieve the symptoms of hip, knee and foot pain, such as hip and knee osteoarthritis (Brantingham et al, 2009, Hoeksma et al, 2004), patellofemoral pain syndrome (Brantingham et al, 2009) and plantar fasciitis (Cleland et al, 2009) by improving joint function, range of motion and muscle function.

Arthritic Pain

From the moment we stop growing our bodies start the very slow process of degeneration (wear and tear). As we get older the degenerative process tends to speed up. Degenerative changes in the joints of the spine can also be called spondylosis, osteoarthritis or degenerative joint disease.

Some joints are more prone to degenerative changes than others. A history of trauma or chronic injury such as poor posture or repetitive strain can predispose an area to degenerative changes later on in life. This can cause a reduction in normal movement and function within the joints and as a result the area takes on abnormal stress which can develop into inflammation and pain. Often these degenerative changes can start without any symptoms at all or just with stiffness, particularly in the morning or when getting up after sitting for prolonged periods of time.

Although these degenerative changes cannot be reversed chiropractic can help to improve joint function and muscle strength which may relieve the symptoms of degeneration and osteoarthritis (Brantingham et al, 2009, Hoeksma et al, 2004).