What do we treat?

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.

Studies have shown that chiropractic is effective in the treatment of lower back pain with 83% of patients reporting being satisfied or very satisfied with their chiropractic care (Gaumer, 2006). Chiropractic treatment for chronic or severe lower back pain has also been shown to be 30% more effective than hospital outpatient treatment in terms of long term benefit and satisfaction (Meade et al, 1990; Meade et al 1995). 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).

Sciatica/Leg Pain

There are many causes of leg pain, one of which is spinal nerve entrapment or compression in the lumbar spine. When the sciatic nerve in particular is compressed as it exits from the lumbar spine it can be called sciatica. Pain from nerve root compression accounts for less than 5% of back pain. Leg pain can extend as far as the buttock, knee or all the way to the foot. Occasionally leg pain can be present without any back pain although the cause of the pain can still be in the lower back.

Chiropractic may help with treatment of leg pain caused by nerve compression (Christensen et al, 2008) and also referred pain from the joints and muscles of the lumbar spine and pelvis.

Disc Injuries

The intervertebral disc is found in between each vertebra of the spine. It contributes to spinal flexibility, stability and weight bearing, therefore it is an important structure in the spine.

Injury to the disc can be caused by an acute compressive force such as a lifting injury or chronic stress caused by poor posture and repetitive movements over a number of years. When injured, the disc does not 'slip' as is commonly thought but rather it becomes torn or ruptured. Depending on the injury, the correct terms can be a disc bulge, herniation, protrusion or sequestration. These disc injuries can be extremely painful and debilitating and can lead to nerve compression.

Chiropractic has been shown to be very successful in the treatment of disc injuries. A study of patients with cervical and lumbar disc herniations receiving chiropractic treatment showed 80% improvement in terms of reduction in pain and resolution of abnormal examination findings and 63% of patients on follow up MRI investigation following chiropractic treatment showed a the disc herniation had reduced in size or completely resorbed (BenEliyahu, 1996).

Chiropractors have the skills to monitor for signs of nerve injury and to recognise when referral for medical attention is necessary.

Neck and Arm Pain

Neck pain, as with back pain, can be either 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 (Guzman et al, 2008). Another study published in the Journal of Manipulative and Physiological Therapeutics showed that chiropractic treatment for acute neck pain reduced pain levels and activity restriction with an overall patient satisfaction rate of 94% (Haneline, 2006).

Some Types of Headaches and Migraines

There are many different types of headaches and many different causes. Some headaches are caused by altered function of the joints of the spine and irritation of the spinal nerves (cervicogenic headaches) or by muscle tension in the neck, shoulders and back (tension headaches). Chiropractic treatment may help to correct joint function and muscle tension and has been shown to be more effective at reducing the need for pain killers as well as frequency and intensity of the cervicogenic headache than soft tissue therapy (Nilsson et al, 1997). Migraines can be triggered by hormonal changes, certain food and stress. Dysfunction of the joints in the neck and irritation to the nervous system 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.

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 whiplash can cause prolonged pain and discomfort with symptoms including neck and arm 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 whiplash-type injury that may require treatment.

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 (Guzman et al, 2008).

Shoulder, Elbow and Wrist Pain

A chiropractor may help with treatment and advice regarding the management of a number of extremity complaints including carpal tunnel syndrome, tennis elbow, golfers elbow and other causes of elbow, wrist and arm pain. Chiropractic can also help with various types of shoulder pain from tendonitis to frozen shoulder. A chiropractor may even find that the shoulder pain is caused by a problem in the neck and upper back which may be relieved by chiropractic treatment (Bergman et al, 2004).

Hip, Knee and Foot Pain

Chiropractic may help with hip and knee pain such as muscle strains, ligament sprains and meniscus injuries and by improving joint function and range of motion with chiropractic treatment the symptoms of hip and knee osteoarthritis may also be reduced. A review in 2002 showed that manually therapy was effective at treating uncomplicated lateral ankle injuries (Pollard et al, 2002).

Sports Injuries

Chiropractic may also help with sports injuries such as ankle sprains, pulled muscles, tendonitis and many more complaints caused by sporting injuries whether acute or chronic injuries. Chiropractic treatment may help to accelerate recovery, improve performance and prevent recurrences in the future (Hoskins et al, 2005).

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 (Beyerman et al, 2006).

Musculoskeletal Symptoms Associated with Pregnancy

Pregnancy can cause a significant change in posture due to an increase in weight at the front of the body. This, combined with the changes in hormone levels, can result in lower back, buttock, groin or leg pain. Chiropractic is a safe form of treatment to have during pregnancy. It may help to make the pregnancy more comfortable by reducing back pain and improving the function of the lumbar spine, pelvis and surrounding musculature (Stuber et al, 2008).

Children

A survey carried out by the British Chiropractic Association in 2008 showed that 32% of 6 to 7 year olds are suffering with back pain and 72% of school children carry heavy bags with books or sports equipment all day which may be a contributing factor (British Chiropractic Association 2008). Chiropractic is safe for children and can help with sports injuries, back pain and neck pain.