Sunday, March 13, 2011

latest news on low back pain

he study and treatment of low back pain is changing as a result of new research and that’s good news for both Doctors and patients. Diagnosis is increasingly based upon evidence and the latest standards were revealed at the Seventh Interdisciplinary World Congress on Low Back and Pelvic Pain, which recently took place in Los Angeles. This is a symposium of spinal surgeons, chiropractors, physical therapists reviewing a mix of scientific and clinical research.
Some new normal standards were set, such as the ability to stand for two hours pain free; the inability to do so is a good predictor of back problems. Another new standard is for men to be able to hold a side bridge exercise for 83 seconds and for women to be able to hold it for 64 seconds. Previously the normal was set at 60 seconds for both. I use this exercise to help stabilize low back pains of patients by strengthening the core erector muscles.
There were several presentations regarding the hip joint. Patients with hip degeneration are very likely to have low back pain. Some evidence was presented from a blinded study of people with hip pain using hip anesthetic injection and Magnetic Imaging of the hip, which determined that people with tears in the medial hip socket need physical therapy and exercise before and surgical consideration. The inability to perform a deep squat with arms outstretched is an indicator of knee, hip, sacroilliac or low back dysfunction. The Congress reviewed research on evidence-based physical exam of sacroilliac joints to determine them as the source of pain. While finding some of the older orthopedic tests to be non- reproducible, they found some that are consistent and reproducible. These tests are simple for the chiropractor to use .By identifying the sacroiliac joint as the source of the pain, the tests make treating the malfunction less complicated, indicating where the restriction of movement or excess movement is occurring. These joints are located below the waist at the dimples just above the buttocks.
Another new test involves tenderness in the area of the bones one sits on in pregnant women. These areas are an attachment site of ligaments which undergo stress in the widening pelvis of pregnant women. I have found this to be a common problem among my pregnant patients and have helped with this, using very gentle pressure on the ligaments a few centimeters away from this attachment or with instrument adjustments to the other pelvic bone to which this ligament attaches. This other bone is the sacrum, which is the base of the spine. The LA Congress addressed this as another insertion site to be manually worked on for this ligament.
The use of ongoing clinical research by doctors to help diagnose aspects of the different pain syndromes and to influence course of treatment can improve patient outcome. This is a win-win opportunity for the open minded doctor! Here at Better Health Chiropractic (crystalriverchiropractic.com/ ) we offer a full range of physiotherapy, exercise, massage and chiropractic manipulation solutions. Call 352-795-8911 for an appointment.