Does Back Pain Go Away on Its Own?

Eighty percent of people suffer from back pain at some point in their lives. Back pain is the second most common reason for visits to the doctor's office, outnumbered only by upper-respiratory infections. Most cases of back pain are mechanical or non-organic, i.e., not caused by serious conditions, such as inflammatory arthritis, infection, fracture, or cancer.

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments, and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements-for example, picking up a pencil from the floor-can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Back injuries are a part of everyday life, and the spine is quite good at dealing with these often "pulled" muscles. These very minor injuries usually heal within 1 or 2 days. Some pain, however, continues. What makes some pain last longer is not entirely understood, but researchers suspect that the reasons may include stress, mood changes, and the fear of further injury that may prevent patients from being active. In addition, sometimes a painful injury or disease changes the way the pain signals are sent through the body, and, even after the problem has gone away or is inactive, the pain signals still reach the brain. It is as if the pain develops a memory that keeps being replayed.

Will Back Pain Go Away on Its Own?

Until recently, researchers believed that back pain will "heal" on its own. We have learned, however, that this is not true. A recent study showed that when back pain is not treated, it may go away temporarily but will most likely return. The study demonstrated that in more than 33% of the people who experience low-back pain, the pain lasts for more than 30 days. Only 9% of the people who had low-back pain for more than 30 days were pain free 5 years later.1 Another study looked at all of the available research on the natural history of low-back pain. The results showed that when it is ignored, back pain does not go away on its own.2 Those studies demonstrate that low-back pain continues to affect people for long periods after it first begins.

What Can I Do to Prevent Long-Term Back Pain?

If your back pain is not resolving quickly, visit your doctor of chiropractic. Your pain will often result from mechanical problems that your doctor of chiropractic can address. Many chiropractic patients with relatively long-lasting or recurring back pain feel improvement shortly after starting chiropractic treatment.3 The relief they feel after a month of treatment is often greater than after seeing a family physician.4

Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

How Can I Prevent Back Pain?

• Don't lift by bending over. Instead, bend your hips and knees and then squat to pick up the object. Keep your back straight, and hold the object close to your body.
• Don't twist your body while lifting.
• Push, rather than pull, when you must move heavy objects.
• If you must sit for long periods, take frequent breaks and stretch.
• Wear flat shoes or shoes with low heels.
• Exercise regularly. An inactive lifestyle contributes to lower-back pain.

What Should I Tell My Doctor of Chiropractic?

Before any treatment session, tell your doctor of chiropractic if you experience any of the following:

• Pain goes down your leg below your knee.
• Your leg, foot, groin, or rectal area feels numb.
• You have fever, nausea, vomiting, stomach ache, weakness, or sweating.
• You lose bowel control.
• Your pain is caused by an injury.
• Your pain is so intense you can't move around.
• Your pain doesn't seem to be getting better quickly.

References

1. Hestbaek L, Leboeuf-Yde C, Engberg M, Lauritzen T, Bruun NH, Manniche C. The course of low-back pain in a general population. Results from a 5-year prospective study. J Manipulative Physiol Ther 2003 May;26(4):213-9.
2. Hestbaek L, Leboeuf-Yde C, Manniche C. Low-back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003 Apr;12(2):149-65.
3. Stig LC, Nilsson O, Leboeuf-Yde C. Recovery pattern of patients treated with chiropractic spinal manipulative therapy for long-lasting or recurrent low back pain. J Manipulative Physiol Ther 2001 May;24(4):288-91.
4. Nyiendo J, Haas M, Goodwin P. Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study. J Manipulative Physiol Ther 2000 May;23(4):239-45.
5. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today February 2003;23(2):14-15.

Stop Dreaming About Quality Sleep and Do Something!

An old Chinese proverb states, "Only when one cannot sleep does one know how long the night is." Anyone who's ever experienced an occasional bout with insomnia-and that's most of us-can relate to this all too well.

In fact, surveys have shown that between 40 and 60 percent of the general population has trouble sleeping. Daily stress and worries, pressures from job and family, body aches and pains caused by uncomfortable beds or pillows, and a host of other issues can keep a person from getting enough quality sleep.

Sleep is critical to good health and functioning, so lack of it is a serious matter. "Sleep is one of the most important functions of the brain." Through it, our bodies recharge and renew for the next day's challenges.

As wellness experts, doctors of chiropractic can provide patients with a different approach to their sleeping problems-without the use of sleeping pills, which leave many people in a mental haze the next morning. To start, here are a few helpful tips they would recommend for the sleepless in Seattle (or any city, for that matter):

• Exercise regularly. Exercising in the morning is best, but if you must exercise in the evening, do so at least two or three hours before bedtime. Any later, and your increased heart rate can interfere with your sleep.
• Limit your intake of caffeinated beverages such as coffee, colas and tea-try to avoid them altogether late in the day and near bedtime. In addition, for each cup of caffeinated beverages you drink each day, drink an equal amount of water.
• If you have trouble sleeping and then get thirsty, drink tap water at room temperature (cold water may disturb the digestive system).
• Eat an early dinner. Eating after 6 p.m. may interfere with sleep as your body works to digest the food you've eaten.
• Go to bed at the same time each night and get up at the same time each morning. The routine will help your body know when it is time to rest.
• Keep your bedroom at a cool, comfortable temperature and try to make it as dark as possible when you're ready for bed.

Creating a comfortable place to sleep by choosing the correct mattress and pillow is also essential to getting the quality sleep that your body needs to function at its best.

A mattress, for instance, should support the body's weight evenly and allow the spine to stay in its natural alignment. Choosing the right one is a personal matter. "There are a wide variety of comfort preferences. It's very subjective." Give your mattress a good trial run before you buy it. We recommend lying down on a mattress for a minimum of three to five minutes to get a good feel. Sitting on it simply won't do.

Useful mattress facts...

• A mattress should provide uniform support from head to toe. If there are gaps between your body and your mattress (such as at the waist), you're not getting the full support that you need.
• If you do have back pain and your mattress is too soft, you might want to firm up the support of your mattress by placing a board underneath it. But do this just until the pain goes away; such firmness is not good for "routine" sleeping.
• Every few months, turn your mattress clockwise, or upside down, so that body indentations are kept to a minimum. It's also good to rotate the mattress frame every so often to reduce wear and tear.
• If you're waking up uncomfortable, it may be time for a new mattress. There is no standard life span for a mattress; it all depends on the kind of usage it gets.
• Be aware that changes in your life can signal the need for a new mattress. For example, if you've lost or gained a lot of weight, if a medical condition has changed the way you sleep, or even if you have changed partners, it could mean that it's time to find a new mattress that will accommodate those changes and help you sleep more soundly.
• If you're not in the market for a new mattress, and your current mattress is too firm, you can soften it up by putting a 1- to 2-inch-thick padding on top of it - usually available at mattress and bedding stores.

Next, pillow talk...After investing in a quality mattress, don't forget to choose an equally supportive pillow. "People will spend thousands of dollars on a mattress and then skimp on a pillow that doesn't support their head and neck properly." A good pillow will keep the cervical (neck) section of the spine aligned with the thoracic and lumbar (chest and lower back) sections. "[The sections] move together and should be supported together."

• When choosing a pillow, be selective. When lying on your side, your head and neck should remain level with your mid and lower spine. When lying on your back, your head and neck should remain level with your upper back and spine. In other words, your pillow should not be so thick that it causes your head and neck to be propped up or angled sharply away from your body.
• Be wary of pillows that are made out of mushy foam materials. The weight of your head can displace this kind of foam, leaving little support. Choose firmer foam and materials that press back and support the head.
• If you find yourself sleeping on your side with one hand propped under your pillow, that's a clue that you're not getting the support you need from that pillow.
• There is no such thing as a universal fit when it comes to pillows. Find one that is consistent with the shape and size of your body.

Chiropractic Care Can Help... If you continue to experience pain and discomfort at night or have difficulty falling asleep, visit your doctor of chiropractic. Doctors of chiropractic are trained to treat spinal problems that can interfere with a restful night's sleep. They can also offer nutritional and ergonomic advice that can help improve the quality of your sleep.

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The Rear End Collision

These are becoming more frequent now and you need to know what to do if you are hit from behind or slip into someonw else. Follow these simple rules if you are involved in a car accident and are not hospitalized:

• Stay calm and reduce movements of the spine
• Ice packs on the spine and neck for 5 minutes per hour will help for the first few days
• See your chiropractic physician right away - He is the only provider trained to evlauate spinal subluxations

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