low back pain – Page 2 – Flynn Chiropractic Blog

Lower Back Pain During Pregnancy

Low back pain is common during pregnancy. Researchers estimate that between 45-80% of pregnant women will experience low back pain at some stage of their pregnancy.^1-8 The pain may be mild for some and not require treatment. For others, the low back pain can be so severe that it interferes with daily activities and work. Although pain is usually experienced sometime between the fifth and seventh month of pregnancy, it can begin as soon as eight to twelve weeks after becoming pregnant.⁹

Pregnancy-related back pain is usually due to a combination of functional stressors such as weight gain, postural changes, altered walking patterns, and hormone changes that cause ligamentous laxity. As the baby develops, a woman’s center of gravity changes. The abdomen and pelvis shift forward to accommodate for the growth of the baby. This causes the lumbar curve in the lower back to increase which puts increased strain on the joints of the low back and pelvis. This can also cause alterations to balance and walking patterns.¹⁰ These postural changes may lead to increased pain, muscle tightness, tenderness, and discomfort.⁹

Some women can experience low back and pelvic region pain the year after birth, and even up to three years after labor and delivery.^11-12 Pregnancy-related low back and pelvic pain, as well as post-partum spinal disorders, are not only common, but they can impede recovery, nursing, and caregiving.⁵

Symptoms of pregnancy-related low back pain are usually located in the lower back, pelvis, or hips, but may radiate into the buttocks or back of the thigh. Symptoms are often aggravated by activity, including standing, sitting, coughing, sneezing, and straining during a bowel movement. Symptoms often increase throughout the day. Many women also have pain at night that disturbs sleep.

Pregnancy can be a challenging time to deal with pain as most women do not want to take pain medications for fear of harm to the baby. Pregnancy is a time when safe non-drug options are needed.

Chiropractic is a safe and effective non-drug option for the treatment of pregnancy-related low back pain. The goal of chiropractic care is to restore normal joint motion and reduce muscle tension. Spinal manipulation (adjustments) is an important component in the management of pregnancy-related low back pain. Almost 75% of women undergoing chiropractic manipulation report significant pain reduction and clinically significant improvements in disability.^14-15 Postpartum low back pain also responds to spinal manipulation- approximately 10 times greater than watchful waiting.¹⁶ Treatment can improve functional activities such as standing, walking, sitting, and sleep.

Low force chiropractic adjustments work well for pregnant women. Hormone changes during pregnancy create a looseness in the ligaments so very little force is needed to adjust the pelvis and lower back. Tables with drop away abdominal pieces accommodate the growing abdomen so pregnant women can still lie down on the treatment tables.

Chiropractic table with the abdominal piece lowered. This allows pregnant patients to lie face down comfortably.

Other common treatments for pregnancy-related low back pain include exercise, education, acupuncture, and pelvic belts. Maintaining optimal function and reducing pain levels are goals that should be discussed with a doctor of chiropractic as well as an OBGYN when it comes to pregnancy-related pain.⁹ A detailed history and clinical examination are essential for determining what biomechanical source is causing a pregnant woman’s low back or pelvic pain.¹³

Low back pain and pelvic pain do not have to be an inevitable part of pregnancy. If you are one of the 45-80% of pregnant women experiencing pain during your pregnancy, there are options for treatment available to help make your pregnancy more comfortable.

Sean Flynn, DC
Sioux City, IA Chiropractor

1.Wu WH, Meijer OG, Uegaki K, Mens JM, Van Dieen JH, Wuisman PI, Östgaard HC. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. European Spine Journal. 2004 Nov 1;13(7):575-89.

2.Pierce HM. Pregnancy-related low back and pelvic girdle pain: listening to Australian women (Doctoral dissertation).

3. Diakow P.R.P., Gadsby T.A., Gadsby J.B., Gleddie J.G., Leprich D.J., Scales A.M. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14(2):116–118.

4. Berg GÖ, Hammar M, Möller-Nielsen JE, Lindén UL, Thorblad J. Low back pain during pregnancy. Obstetrics and gynecology. 1988 Jan;71(1):71-5.

5. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine. 2005 Apr 15;30(8):983-91.6.

6. Weis CA, Barrett J, Tavares P, Draper C, Ngo K, Leung J, Huynh T, Landsman V. Prevalence of low Back pain, pelvic girdle pain, and combination pain in a pregnant Ontario population. Journal of Obstetrics and Gynaecology Canada. 2018 Aug 1;40(8):1038-43.7.

7. Saxena AK, Chilkoti GT, Singh A, Yadav G. Pregnancy-induced low back pain in Indian women: Prevalence, risk factors, and correlation with serum calcium levels. Anesthesia, essays and researches. 2019 Apr;13(2):395.

8. Weis CA, Barrett J, Tavares P, Draper C, Ngo K, Leung J, Huynh T, Landsman V. Prevalence of low Back pain, pelvic girdle pain, and combination pain in a pregnant Ontario population. Journal of Obstetrics and Gynaecology Canada. 2018 Aug 1;40(8):1038-43.

9. Montgomery, S.P. “Management of back pain during pregnancy.” (2009). Retrieved March 2020 from: https://www.spine-health.com/conditions/pregnancy-and-back-pain/management-back-pain-pregnancy

10. Verstraete, V.H., Vanderstraeten, G., and Parewijck, W. (2013). Pelvic Girdle Pain during or after pregnancy: a review of recent evidence and a clinical care path proposal. Facts Views Vis Obgyn. 2013; 5(1): 33–43.

11. Yoo, H., Shin, D., and Song, M. (2015). Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. J Phys Ther Sci. 2015 Jan; 27(1): 279–284.

12. Maiers, M., et al. (2018). Chiropractic in Global Health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic. Chiropr Man Therap. 2018; 26: 26.

13. Katonis, P., et al. (2011). Pregnancy-related low back pain. Hippokratia. Jul-Sep; 15(3): 205–210.

14. Shaw G. When to adjust: chiropractic and pregnancy. J Am Chiropr Assoc. 2003;40(11):8-16.

15. Murphy DR, Hurwitz EL, McGovern EE. Outcome of pregnancy-related lumbopelvic pain treated according to a diagnosis-based decision rule: a prospective observational cohort study. Journal of Manipulative and Physiological Therapeutics. 2009 Oct 1;32(8):616-24.

16. Schwerla F, Rother K, Rother D, Ruetz M, Resch KL. Osteopathic manipulative therapy in women with postpartum low back pain and disability: a pragmatic randomized controlled trial. J Am Osteopath Assoc. 2015 Jul 1;115(7):416-25.

17. Chiroup

18. Chiropractic Success Academy

Low Back Pain Myths And Facts

Low back pain (LBP) is the leading cause of disability worldwide. It is important to remember low back pain can be a normal experience in life. About 80% of Americans will have low back pain at some point in their lives.

“Unhelpful beliefs about LBP are associated with greater levels of pain, disability, missed work, medication use and healthcare seeking. Unhelpful beliefs are common in people with and without LBP, and can be reinforced by the media, industry groups and well-meaning clinicians.¹” How many of these myths do you believe? How many of the facts do you believe? Belief in the facts will help you recover and function better. Sometimes it is hard to give up the belief in the myths. I admit there was a time I used to believe myths 6,7, and 8.

Low-Back-Pain-Myths-And-Facts

The Facts

Low back pain is almost always due to non-threatening causes. Low back pain is rarely an emergency. It is an emergency when there is a loss of bowel or bladder control, worsening weakness or numbness in legs, inner thigh, groin, or buttocks, sudden or gradually paralysis/difficulty walking, or occurring with a fever.

Most episodes of LBP tend to improve and it does not get worse as we age.

Think your LBP is caused by tissue damage? Think again. Believing “you will have to live with it” because your back is damaged and avoiding activity because you don’t want to make it worse, actually causes more pain than tissue damage.

People tend to place too much importance on x-rays and MRIs. They can show you what the spine looks like. They cannot determine the prognosis of your current episode of back pain or tell you the likelihood of future episodes of low back pain. They have not been shown to improve LBP treatment outcomes. They are a tool that works best when combined with a proper exam and history. It is well known that people without any history of LBP will have degenerative, bulging, or herniated discs on MRI.

Pain with movement is not a warning sign that you need to stop. This is one of the most common and harmful myths that I see. It’s very common in people with chronic pain. They fear exercise will make the pain worse, so they avoid all exercise, which unfortunately leads to more pain in the long run. Avoiding exercise leads to deconditioning, weakness, and stiffness. Movement and exercise are key components in helping low back pain.

People are always looking to improve their posture to prevent pain. They should be focused more on consistently changing their position. Any position held for too long can cause pain, even positions with perfect posture. The body was designed to move, not sit or stand in the same position for hours at a time.

People with a strong core can have back pain. While it is good if you have strong core muscles. It is also helpful to relax them when they aren’t needed.

Bending, lifting, and carrying can be safe when you start off slow and gradually increase weight and time as you adapt. Injuries occur when we do too much too fast after doing too little for too long.

Pain flare-ups are not fun, but they are normal. They are not sign of tissue damage. They can occur when doing a new activity that you aren’t used to or when doing a repetitive activity when your body is fatigued.

Effective care for back pain includes such things as engaging in physical activity and exercise, social activities, healthy sleep habits, healthy body weight, and remaining in employment.

If you suffer from low back pain, stay positive, stay active, and seek safe and affordable non-drug options including chiropractic. Chiropractic care is a safe and effective way to treat back pain.

Sean Flynn, DC
Sioux City, IA Chiropractor

Does Tylenol Help Low Back Pain?

Tylenol also known as paracetamol or acetaminophen is commonly taken for lower back pain. It may be recommended for people who are unable to take non steroidal anti-inflammatory medication (NSAIDs) because of stomach irritation or risk of bleeding.

Is Tylenol an effective pain reliever for low back pain? Most likely not. It is important to remember that everyone responds differently to medication. I do see some people that say it helps decrease their low back pain. While Tylenol may be effective for some, research shows for most who take it that it is probably not effective at relieving lower back pain.

A 2016 review found that for low back pain lasting less than 6 weeks, “there is high-quality evidence that there is no difference between paracetamol (4 g per day) and placebo (sugar pill) at 1 week, 2 weeks, 4 weeks, or 12 weeks. There is high-quality evidence that paracetamol has no effect on quality of life, function, recovery, and sleep at any point in the study. We found that paracetamol does not produce better outcomes than placebo for people with acute low back pain, and it is uncertain if it has any effect on chronic low back pain.”¹

A 2015 review in the British Medical Journal found “there was high quality evidence that paracetamol is ineffective for reducing pain intensity and disability or improving quality of life in people with low back pain. Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis.”²

A 2019 study compared ibuprofen alone against ibuprofen plus acetaminophen in emergency department patients with low back pain. It found “adding acetaminophen to ibuprofen does not improve outcomes within 1 week.”³

Low back pain is mainly a movement related pain. The joints and/or the muscles of the spine, pelvis, or hips are not moving or supporting the lower back properly which can lead to irritation and pain. Low back pain typically responds better to movement based treatments. At Flynn Chiropractic we have treatments to get you moving and feeling better. We give you things you can do at home to help yourself improve. Many times people find they do not need as much pain medication or they are able to stop taking it altogether after chiropractic care.

If your pain medication is not working or you are tired of living on pain medication, give the office a call to see how we can help.

Sean Flynn, DC
Sioux City, IA Chiropractor

1. https://www.ncbi.nlm.nih.gov/pubmed/27271789

2. https://www.ncbi.nlm.nih.gov/pubmed/25828856

3. https://www.ncbi.nlm.nih.gov/pubmed/31811673

Avoid Opioid Use with Chiropractic

Chiropractic has long been used by those wanting to avoid taking pain medication. Research is now showing how effective chiropractic is at helping those with low back pain avoid opioid use.

A study with nearly a quarter million low back pain patients compared initial and long-term opioid use with choice of initial provider (medical doctor, chiropractor, physical therapist, or acupuncturist).The study concluded:“Patients who received initial treatment from chiropractors or physical therapists had decreased odds of short-term and long-term opioid use compared with those who received initial treatment from medical doctors.”¹

Another study looked at opioid use of those with spinal pain who used chiropractic and those who did not. Chiropractic users had a 64% lower chance of receiving an opioid prescription than nonusers.²

opiod-crisis-chiroup

Sean Flynn, DC

Sioux City, IA Chiropractor

1. Kazis LE, Ameli O, Rothendler J, et al. Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use. BMJ Open 2019;9:e028633. doi: 10.1136/bmjopen-2018-028633.

2. Corcoran KL, Bastian LA, Gunderson CG, Steffens C, Brackett A, Lisi AJ. Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis. Pain Medicine. 2019 Sep 27.

Lumbar Facet Syndrome

The facets are located on the left and right side of the back of each vertebra. Facet syndrome means that your facet joint has become irritated and inflamed. This can be caused by sprains, strains, or joints that are not moving properly. People are more likely to develop facet syndrome if they have suffered an injury, overuse their back, have arthritis, or are overweight.

The symptoms of lumbar facet syndrome are felt on one side of your low back and may radiate into your flank, hip, and thigh. Symptoms of facet syndrome usually do not go past your knee. The pain may come and go. Your pain may increase when you arch backwards or return to an upright position after bending forward. Many patients report relief when they sit or lie down.

Chiropractic adjustments help relieve lumbar facet syndrome by opening the joint spaces, restoring motion, and breaking up adhesion between the joints.

Flynn Chiropractic
2300 Hamilton Blvd
Sioux City, IA 51104
(712) 224-2747

Sciatica

Sciatica is pain down the back of the leg that follows the path of the sciatic nerve, the largest nerve in the body. The pain can occur with or without lower back pain and may travel from the buttock, down the back of the thigh and calf, and into the foot.

Symptoms can be mild to severe and may include aching, burning, sharp, shooting, or dull pain, numbness or tingling. With increasing compression, people may have a loss of sensation or muscle strength. You may notice an increase of pain while coughing, sneezing, straining, and sitting. Symptoms can occur suddenly or gradually over time.

Sciatica is caused by irritation or compression of the sciatic nerve. Common causes include herniated or bulging discs, degenerative discs, stenosis, piriformis syndrome, or spondylolisthesis.

Sciatica can be extremely painful and worrisome, but it is also treatable. Very few cases will require surgery. It can respond well to conservative treatments like chiropractic. In this office, I use a special adjustment, Cox Flexion Distraction, that lowers disc pressure and creates space for the irritated nerves. It has been shown to be more effective than an exercise program for relieving leg pain.¹

An at home exercise that can help is nerve flossing. Irritated nerves are more sensitive to pressure and are wider than normal nerves due to swelling. This sciatic nerve flossing technique can help decrease pain and improve the mobility of the sciatic nerve. Flossing may release adhesions along the path of the nerve.

Do the flossing on the painful side. Do 10 repetitions or about 30 seconds. Start with your chin tucked to your chest and knee flexed. Then look up to the ceiling as you extend your leg. Then return to the starting position. The movements are the same for the side lying position. You may feel a stretch but you should not feel an increase in pain. Stop immediately if this causes an increase in your symptoms. If your sciatic nerve is very irritated, you may have to wait for the irritation to lessen before attempting this move.

Call the office if you need help and you are tired of letting sciatica stop you from doing the things you want to do.

Sean Flynn, DC
Sioux City, IA Chiropractor

https://www.ncbi.nlm.nih.gov/pubmed/16341712

Lumbar Stenosis

Lumbar Spinal Stenosis Sioux City Chiropractor

Lumbar stenosis is the narrowing of the spinal canal in your lower back. The narrowing can put pressure on the spinal cord and nerves. It most commonly occurs in those over the age of 50. It can be caused by wear and tear, injuries, and age-related changes such as degenerative discs, ligamentous thickening, or spinal arthritis.

Symptoms can include chronic lower back pain that may radiate into the buttocks or legs. Numbness, burning, fatigue, weakness, and heaviness may occur in the legs. Symptoms are aggravated by standing and walking.

Sitting or bending forward when standing decreases the pain. Many will find leaning forward on a shopping cart decreases the pain and allows them to walk longer in stores. Those with stenosis may find sleeping on their sides in the fetal position is more comfortable than sleeping on their back.

Surgery has not been shown to be significantly better than non-surgical treatments, so it is best to try conservative methods such as chiropractic first. Chiropractic treatment goals include restoring mobility, improving function, and decompressing nerves. Forceful adjustments may increases symptoms for those with stenosis so it is important to use gentle adjustments. Flexion-distraction is a low force adjustment that has been proven to increase the area in the spinal canal during adjustments, which takes the pressure off the nerves.

A study comparing the effectiveness of nonsurgical treatment methods in patients with lumbar spinal stenosis looked at 3 nonsurgical interventions. Medical care consisted of medications and/or epidural injections provided by a physiatrist. Group exercise classes were supervised by fitness instructors in senior community centers. Manual therapy/individualized exercise consisted of spinal mobilization, stretches, and strength training provided by chiropractors and physical therapists. The care provided by the chiropractors and physical therapists resulted in greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercise.¹

In addition to in-office care it is also important to do at-home exercises. Water aerobics and exercise bikes are tolerable for those with stenosis. The following stretches can help provide relief for lumbar stenosis. It is best to consult your doctor before beginning any exercise routine. Stop immediately if the stretch causes an increase in your symptoms.

Knee To Chest Stretch Sioux City Chiropractor

Seated Lumbar Flexion Sioux City Chiropractor

Sciatic Nerve Floss. Seated and Side Lying.

Cat Camel Stretch

This article is for education purposes and is not intended to replace diagnosis or treatment by a healthcare provider.

Sean Flynn, DC
Sioux City, IA Chiropractor

https://www.ncbi.nlm.nih.gov/pubmed/30646197