Doctors tend to divide back pain into two different categories: lower back pain and upper back pain. This is because the mechanics of the lower and upper spine are different from one another, The upper back is stabilized by the rib cage, and therefore does not flex or rotate as much as the lower back. This explains why the lower back tends to be more prone to sustaining trauma.
Lower back pain tends to be more noticeable than upper back pain in that it is usually more painful and more restrictive of daily activities. This too is a result of the lower back’s greater range of movement caused by not having as much skeletal stabilization and support.
Of the 80% of adults who experience low back pain, over a third are due to a disc injury and most of the remainder are due to pain resulting from facet joints, sacroiliac joint, and/or the muscles of the back. There are also a small percentage of other causes of low back pain (responsible for less than 5% each), those being – in order of prevalence, most to least: compression fracture, ankylosing spondylytis, and malignant neoplasms.
Other causes of low back pain include canal stenosis, sacroiliac sprain or subluxation, piriformis syndrome, reiter’s syndrome, infectious spondylitis, and abdominal aneurysm.
Upper back pain is just as common as low back and neck pain, although it is often less intense.
Upper back pain is most frequently caused by poor posture. More acute pain is generally caused by muscle spasm or compression fracture although there are some conditions especially in children that should be carefully distinguished from postural syndromes and that is scoliosis, hyperkyphosis and scheuermann’s disease. Occasionally Osteoid osteoma causes upper back pain as well as T4 Syndrome.
Upper back pain is evaluated and treated the same way as low back pain.
Chiropractic care can be effective in treating both the symptoms and causes of back pain. Just look at what the experts have to say on the subject:
“Chiropractic treatment is recommended for acute low-back pain and should be pursued before pharmaceutical or surgical treatments.” - The Agency for Health Care Policy and Research (US Dept. of Health & Human Services) 1994
As reported in the Western Journal of Medicine, a study of 283 patients who had not responded to previous conservative or operative treatment and who were classified as ‘totally disabled’ reports that “81% became symptom free or achieved a state of mild intermittent pain with no work restrictions” after spinal manipulations were administered. West J Med. 1989 Jul; 151(1):83-4
In another study, patients who received chiropractic care for their low pain were three times more likely to report being “very satisfied” with the results than those patients who saw a family physician for their low back pain. PMID: 2525303 [PubMed - indexed for MEDLINE]
And in a similar study reported on the American Chiropractic Association website, patients with chronic low-back pain exhibited greater levels of improvement and satisfaction after one month of chiropractic care than patients treated for the same condition for one month by their family physician.
In fact, after an extensive study of all the currently available modalities of care for low back problems, the Agency for Health Care Policy and Research – a federal government research organization – advised low back pain sufferers to choose the most conservative care first, and recommended spinal manipulation as the only safe and effective, drug-free form of initial professional treatment for acute low back problems in adults.
Your chiropractic physician will review your health history and perform a physical exam which may include orthopedic and neurologic testing. In some instances additional studies will be needed to determine the cause of your back pain such as an X-Ray, MRI, CT Scan, and laboratory tests. With this information, the doctor can then develop a customized treatment plan that will target the cause of your pain and address any related symptoms, such as pain and reduced range of motion.
To fully address the cause or causes of your condition, the treatment plan the doctor devises for you may include chiropractic care, physiotherapy, and massage therapy. To address the pain itself, the treatment plan may also include acupuncture and physical therapy modalities. It may include rehabilitative care to restore strength, and preventive care to keep from the condition from relapsing.
Definitions:
Discs are soft, flat, round pieces of cartilage located in the joints between each vertebra (or bone of the spine). With their gel-like texture, discs provide cushioning for the spine, acting as shock absorbers for pressure exerted on the spine from both activity and gravity while they also prevent the vertebrae from rubbing against each other. And although discs are positioned between two ligaments in a joint, discs also serve as ligaments themselves to help hold the vertebrae together.
Facets are the small, smooth surfaces on a bone (in this case, a vertebra) where a facet joint is formed. Because of their appearance, facets are commonly referred to as “bony knobs”. Facet joints connect two vertebrae together while at the same time allowing them move in a limited range of motion against one another. The ligaments and muscles around the facet joints protect the facet joint from injury due to, overflexing or overextending.
Compression fractures are collapsed vertebrae. They can be caused by trauma to the spine, by osteoporosis, or any other condition that weakens the spine.
Ankylosing spondylytis is a chronic and inflammatory type of arthritis as well as an autoimmune disease that primarily affects the spine (and often the pelvis). In its most advanced state, it is commonly referred to as the fusion of the spine, or the spinal column’s complete and total rigidity. As such, it is both painful and uncomfortable, and if not treated, can be detrimental to an active life. Ankylosing spondylytis is a hereditary condition. Symptoms that are associated with this disease include fatigue, nausea, and an inflammation of the eye that causes pain and aversion to light.
Malignant neoplasms are the medical term for cancer. It occurs when cells experience uncontrolled growth and begin destroying the tissue surrounding them. Sometimes these cells also spread to other parts of the body and cause the same cycle to repeat itself in a new location. ‘Malignant’ refers to a condition’s tendency to get progressively worse without treatment. A ‘neoplasm’ is an abnormal clump of tissue resulting from uncontrolled cell proliferation; if left untreated a neoplasm could become a tumor.