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Conservative Care

Article by Dr. Dennis Spurgin – Doctor of Chiropractic

I’d like to discuss something we all have experienced at one time or another — back pain. Low back pain is one of the major causes of disability worldwide. About 75-80% of Americans experience back pain in their lifetime, with 20% turning into chronic low back pain. About 80% have neck pain, and 50% becomes chronic neck pain.
Back and neck pain usually result from problems in one or more parts of the back including muscles, ligaments, nerves and the spine itself. Most cases of back pain are acute or short term and may last for several days to a few weeks. Others develop chronic pain, which may continue for months or years.

When a patient comes to me for treatment, I have a conversation with them about where the pain is, what kind of pain and how severe it is. I try to get to the bottom of when and why it started. Sometimes there is no answer for why. Sometimes it’s as simple as how someone may stand, sit or walk. Often small changes in behavior can make treatment far more effective and go a long way toward resolving future pain before it happens.

I typically recommend all patients start with a conservative course of care. Conservative care includes chiropractic, physical therapy, exercise therapy, over-the-counter medications, massage, acupuncture, nutrition, counseling and psychological treatment – anything that’s non-invasive. Invasive care includes prescription medication, shots, epidurals, minor surgeries and major surgeries.

A patient recently came to see me after being diagnosed with sciatica by her primary care physician. Sciatica occurs when a herniated disk, bone spur on the spine or narrowing of the spine compresses part of the nerve causing inflammation, pain and sometimes numbness from the lower back through the hips and down the leg. Disk herniation is most often the result of gradual, age-related wear and tear called disk degeneration. As we age, our disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist.

My patient’s primary care physician ordered X-rays and prescribed gabapentin, a non-opioid medication sometimes prescribed for nerve pain and sciatica. After no relief from the gabapentin, she quit taking it and came to see me with X-rays in hand.
At her first appointment, I discovered that she walked her 67-pound pit bull a couple of miles every day with the dog’s leash wrapped around her waist. The dog was a puller and she explained wrapping the leash around her waist took the pressure off of her shoulders and elbows leaving her hands free. There are so many things wrong with this method of dog walking I couldn’t even begin to explain the impact on her spine. Repetitive lifting, pulling, pushing, bending sideways and twisting can aggravate or increase the risk of a herniated disk.

Exasperated, I said, “You’ve got to get that dog to a trainer to teach it to heel.” She did, and after a few office visits and a couple of dog training sessions, I was able to get my patient to a pain free place without prescription medication
or invasive treatment.

Multiple examinations are always appropriate by multiple practitioners of other disciplines. Back pain can come from the alimentary, digestive, genitourinary, circulatory, lymphatic, neurological, respiratory, endocrine, reproductive, excretory, and other areas of the musculoskeletal systems. Back pain includes neck, upper, middle and low back, and pelvic pain.

In the case of the patient with the dog, the source of the problem was pretty clear: certain behaviors led to acute back and leg pain. In this situation, the source of the problem was identified and rectified through a course of conservative treatment for the patient and a few training sessions for the dog. My patient still has a herniated disk, but no symptoms.

All conservative care should be for a trial run of one to three weeks. In the trial run, decisions can be made on whether the treatment protocol will be effective. If the treatment shows effectiveness, then there may be reason to expand the care. As progress continues, the treatment should be less often to see if recurrence happens. I educate and counsel my patients all through treatment to ensure the best possible outcome for the patient — even if that means suggesting a dog trainer for the source of the patient’s problem.

Call Dr. Spurgin 760-347-6822 or visit
www.palmspringschiropractor.net

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