Spinal pain is frequently a condition which drives patients to seek chiropractic care. Treatment planning typically includes four primary goals:
- Pain management
- Structural realignment
- Functional restoration, and
- Maintenance or prevention.
PAIN MANAGEMENT: Initially every patient’s desire is to reduce, or if possible, to eliminate all pain. Using the acronym “PRICE” (Protect, Rest, Ice, Compress, and Elevate), the first three apply when it comes to spinal pain. We “protect” our spine by avoiding or changing the way we go about doing things such as driving, working, sitting, sleeping and performing other necessary ADLs (activities of daily living).
If an activity is causing you to notice sharp pain, that’s a “message” from your body to modify WHATEVER it is that you’re doing. With high degrees of spinal pain we typically provide patients with the option of wearing a cervical collar or back brace for a SHORT time to provide additional “Protection” and “Rest” to the problematic region. Special pillows may be helpful and traction may reduce muscle spasm, improves flexibility (range of motion), and reduce pain. Alternating “Ice” and heat may be effective, as it “PUMPS” out inflammation or swelling.
Heat is also a good natural muscle relaxant and cold reduces swelling (inflammation), both of which can help reduce pain. Cold therapy may be used for as many days, weeks, or months that it helps (if you are hypersensitive and frostbite easily you should not use cold therapy). Too much heat (beyond that experienced during a short shower) may cause more swelling and prolong the recover of a new condition. Anti-inflammatory herbs like ginger, turmeric, boswellia, and others are very effective and actually may be BETTER than ibuprofen, Aleve, or aspirin. Recent studies indicate that there may be a delay in healing when over-the-counter pain medications are used, and recommend to AVOID these drugs so healing won’t be delayed.
STRUCTURAL REALIGNMENT: The goal here is to improve less than optimal bony alignment which frequently occurs in the neck, upper, middle back as well as the low back, as all can contribute to spinal pain. This is also a great long-term goal, as it may help PREVENT future episodes of pain.
With aging comes the natural process of osteoarthritis, which is unavoidable, but allowing faulty spinal curves, misalignments and imbalances to persist may actually accelerate this degenerative process. Your Chiropractor may have you lie on a tightly rolled up towel (a frozen water bottle often feels even better) placed behind the neck or low back when it’s comfortable. Even a heel lift in the shoe of a short leg can help the with spinal pain. Spinal manipulation, manual mobilization techniques, and trained exercises all contribute substantially to this treatment goal.
FUNCTIONAL RESTORATION: Restoring function allows the return of pre-injury activities of daily living–which of course is the ultimate goal when managing these conditions! In order for this to happen, it is necessary to have the first two goals described above already accomplished. Here the primary “tool” that we use to accomplish this goal is exercise training. Various options are available to determine which exercise is most needed. A physical performance test can be done, which consists of a series of exercise-like maneuvers that we measure with an instrument that measures degrees (for range of motion), count repetitions (when testing for strength), or count time – usually in seconds (when testing for endurance, balance, and aerobic capacity). We then can compare you to the “norms” that have been published to see if you need help in a particular area. This also establishes a “baseline” or starting point to compare a month later after you’ve performed the proper exercises designed to improve that “failed test.” The three primary goals of exercises include stretching, strengthening, and restoring coordination.
STRETCH: A very effective stretch for the neck is performed by bending the head to the right, reaching over with the right hand, and gently pulling on the head until a good stretch is felt on the left side of the neck. Reaching down with the opposite (left) arm (as if there’s a dollar bill on the ground and you just can’t quite reach it) enhances the stretch. While stretching, tuck in your chin, drop your head forwards and backwards, and turn your head a little from side to side to feel for different tight muscle fibers. Continue this stretch for 10-20 seconds or long enough to feel that you’ve accomplished a good stretch. Then, repeat this on the opposite side. This can be done sitting or standing, and most importantly, do this multiple times a day, especially when you feel tight – like at work, for example. There are other stretches but this actually combines four different exercises into one, so it’s often enough!
STRENGTHENING: An example of a neck strengthening exercise is to place your hand against the side of your head and push your head into your hand using about 10-20% maximum effort (not much pressure!). First, allow your head “to win” by moving your head further until a tight stretch is felt. Second, let your hand “win” by moving the head to the opposite direction while maintaining pressure against your hand. Allow the head to bend ALL THE WAY to the end-range and repeat three times in each direction.
COORDINATION: Motor control, balance, and coordination are further enhanced by balancing on one foot with eyes open AND closed. Stand near a wall to avoid falling!
PREVENTION: Keep exercising and eat right! Consider joining a health club, working out with a friend, riding a bike, walking, and/or swimming. You choose!