Despite the overall dominance that COVID has taken with regards to our concern and our attention, the health problems that plagued us prior to the pandemic still affect us during it. Low back pain is one of those problems, affecting 80% of our population at some point during their lives. This makes it the second most common reason for a visit to a doctor’s office, and costs at least $50 billion in health care costs each year! It’s also an extremely varied issue, with pain stemming from postural strains, car accidents, sciatic issues, disc herniations, arthritis and more.
The push in Delaware right now is to get patients away from utilizing medications for treatment and to focus on more conservative measures. This makes sense; medications, even besides the obvious opiates, can be dangerous, addictive, and are not an effective option for management of low back pain issues, especially chronic ones. As a result, most patients will find themselves with the choice of doing chiropractic or PT to treat any spine pain problems. But which one is better, and how do you know?
As a chiropractor, I face this question day in and day out from my patients and I’m always confused as to why our healthcare has developed this paradigm that we need to pick one lane and stick to it. My patients usually have stories like “Well, I tried PT and that didn’t work, then I tried an injection and that helped a little, so I now I want to try chiropractic.”
Let me try and clear this up a little bit. Chiropractic is an effective treatment for lower back pain. Physical therapy is an effective treatment for lower back pain. It’s not “which” one should be used; they both should be! The question then becomes “when” should they be used?
The general rule of thumb with chiropractic is that we will focus on dysfunction in the spine stemming from structural issues, like misalignments of the spine. We do this with adjustments, either hands on or with instrumentation. Physical therapists will utilize exercises, stretches, and other modalities to focus on the soft tissue, ex: muscles and ligaments that run through, around, and over the spine. All of these structures are involved in lower back pain, and all must be addressed to properly treat it.
This is why in our office, we utilize both treatment options but in a sequential manner. First we begin with chiropractic treatment. A lot of our patients are in significant pain, so having them start doing exercises or stretches immediately can be a difficult, and sometimes an impossible, task. The chiropractic adjustment, in addition to passive therapies like electric stim, cryotherapy, low level laser, ultrasound, etc., allow us to reduce the patient’s pain, improve their motion, and improve their overall function. However, one of the basic rules of our practice is that true health is done with you, not for you. What that means is once the patient starts feeling less pain and moving better, we need to capitalize on that by introducing therapeutic exercises. These exercises will allow us to retrain the muscles that support and stabilize the spine, to effectively “hold” the improvements in alignment and position that have been achieved with the chiropractic treatment up to that point Ideally, our patients learn these exercises so as the need for in-office treatment decreases, they are able to supplement their care with at-home work. This last step is critical. For example, we all know how to brush our teeth, floss, etc. at home every day, but how many of us know what to do to keep our spine healthy on a daily basis?
So this is why we believe that it’s not chiropractic OR physical therapy for lower back pain; it’s chiropractic AND physical therapy, just in the proper order. I like to say to my patients that we need to utilize every tool at our disposal to help correct their problem, whether it’s chiropractic, physical therapy, supplementation, diet changes, etc. Anything that helps get them better, is affordable, and doesn’t cause additional problems by using it. Medication does not fall into this category, surgery does not fall into this category; chiropractic and PT both do and should be utilized whenever necessary.
If you or someone you know is suffering from lower back pain, sciatica, pinched nerve pain, or more, please call our office at 302-368-1300 or email me directly at email@example.com for help or additional information. We can help!