Back Pain Treatment

As many as 80% of Canadians will experience back pain in their lifetime, and as many as 70% of those individuals will experience recurrence – where the pain comes back.

Many conditions can present with back pain as a symptom. Back pain is associated with muscle strains, sprains, injuries, disc herniations or bulges, arthritis, psychological factors like stress & depression, osteoporosis, cancer, stiffness from poor posture, or a sedentary lifestyle. There is no one singular reason why everyone gets back pain, and most people have multiple contributing factors to their back pain. This is also why all back pain cannot be fixed with a single intervention.

Back pain is best addressed by getting to the root of the issue and addressing all of the compounding factors to reduce pain and reduce the incidence of recurrence, and this often requires a diagnosis from a healthcare professional.

No. For many individuals, back pain will resolve within 6 weeks, but it’s often self-limiting, meaning that people with back pain must limit their own activity because of the pain. Some less severe back pain can last up to 3 months and drastically affect activities of daily living – such as walking, sitting in a car, bending down, or lifting. 

Because back pain may go away on its own, it can be tempting to wait it out and deal with the discomfort. However, you don’t have to put up with it; seeking help can speed up recovery and help prevent future recurrences.

Arthritis is an umbrella term for conditions that result in inflammation in the joints. The most common type of arthritis is osteoarthritis, also known as degenerative joint disease. DJD develops over time and is often noted as an ancillary finding on X-rays – meaning that there is evidence of bony changes to the joints long before pain or other symptoms present. For instance, arthritis in the SI joint can start in your 20s. 

Now, many people think of the inflammatory arthropathies when they think of arthritis – they think of rheumatoid or psoriatic arthritis, which are both different diseases that can progress to affecting the joints, and because all of these get grouped under “arthritis”, the general public views them all the same way.

The good news is that osteoarthritis does not have the same progression as inflammatory arthropathies and that x-ray findings of degenerative joint disease are poorly correlated with symptoms. So you may have arthritis, according to your x-ray, but that does not mean that you have to live with pain. Motion is one of the best ways of managing pain related to arthritis – making sure that the joints are moving well within healthy ranges of motion to encourage blood flow and reduce stiffness.

A back spasm can take your breath away, tightening when you least expect it. There are a few different contributing factors, including unguarded movements in overworked or fatigued muscles, weakness, dehydration, emotional stresses, injuries, or irritation of the nerves in the area. Ultimately, muscles anywhere in the body spasm to protect – if the brain perceives a threat to an area of the body that it wants to protect, it will cause the muscle to spasm to guard and protect against that risk. Muscles in the back will spasm to reduce motion when the brain perceives that motion to not be safe. 

Treating muscle spasms requires addressing the perceived threat – the motion that’s not believed to be safe, the fatigue, the dehydration – whatever the root cause is. When that cause is addressed, only then will the brain allow that muscle to move again. However, in the meantime, that may have caused trigger points in the muscles or other stiffness that’s best addressed by a health care professional.

Preventing back pain is not as simple as a checklist; even people who do all the “right things” may have episodes of pain. However, there are many things that have been shown in the research to be correlated with back pain, and so addressing those things may help prevent back pain. These are things like

• Regular exercise – strengthening the muscles of the spine & other joints to prevent injury
• Good lifting mechanics – to prevent lifting injuries
• Being aware of workplace ergonomics to reduce postural strains
• Sleeping on a supportive and comfortable mattress
• Managing stress to reduce the perception of pain
• Taking regular breaks from work/sitting
• Maintaining a healthy lifestyle – limiting smoking and alcohol consumption

These best practices will reduce risk factors associated with back pain, which may reduce the number of occurrences of pain you experience. 

If you’re working from home, here’s what you can do to stay active and prevent back pain:

Broadly speaking, sciatica is the irritation of the sciatic nerve. “True Sciatica” results from pressure on the nerve roots that make up the sciatic nerve. Most commonly, this pressure is due to a bulging or herniated lumbar disc. This type of sciatica usually includes symptoms like sharp and electrical pain down the leg, paresthesia (pins & needles) in the leg, numbness, or muscle weakness, and is best addressed by addressing whatever is causing the compression on the nerves in the back.

However, many other conditions can cause sciatica-like symptoms, such as tightness in the piriformis muscle or other glute muscles, trigger points in the lower back muscles, compression in the lower back, or tension in any of the muscles along the path of the sciatic nerve. In this case, the best treatment is to identify the location of the compression and reduce it, either with massage, dry needling, or other techniques, improving the tone of the muscles and allowing the nerve to slide past the muscle, like with nerve flossing exercises.

The popping sound associated with a Chiropractic adjustment is the formation and popping of nitrogen gas bubbles in the fluid around a joint. When a Chiropractor adjusts a joint, they’re doing so to optimise movement—identifying joints that aren’t moving well and providing a quick thrust to stretch the joint capsule ligaments, send nerve impulses to the brain, and help the body use that joint better.

When a person pops their own back, they’re usually over-stretching and forcing joints to move further than they would naturally to create a sensation of release. Although it’s possible to pop your own joints, it’s usually not advisable to do so, as there’s a risk of injury and a risk of continually popping the same joint, creating a relative hypermobility in the body. These hypermobilities cause the brain to tighten muscles around that joint to create support for the joint. But then most people perceive that the joint is tight and pop it again, creating a vicious cycle of hypermobility & tightening, which is why a Chiropractor will always assess the body for which joints are tight and need to move more, and ones that are hypermobile, and should be stabilized to move less.

Disc herniations occur in up to 20/1000 adults annually (2%). Disc herniations are often the result of a specific incident, and the symptoms that present are related to the location of the herniation. For example, symptoms may include sciatica (burning pain down the leg), muscle weakness, or numbness and tingling. If the herniation is located in the middle of the spine instead of near a nerve root, the symptoms may occur on both sides of the body.

However, not all disc herniations are symptomatic, and many times, the herniation is found on an MRI as an incidental finding—meaning the MRI was conducted for another reason, and the radiologist happened to see the herniation. As such, it’s important that Chiropractors and other manual therapists treat the person, not the image, addressing the pain and dysfunction of the complaint instead of solely looking at imaging findings. The findings of an X-ray or MRI inform the treatment so that you can get the best possible care for your concern.

The discs between the vertebrae of the spine are made up of fibrous rings (annulus fibrosus) that surround a gel-like center (nucleus pulposus). These discs act as shock absorbers because they can bend and compress and then recover their shape with rest (i.e., overnight). Because there’s a fluid-like substance in the center of the disc, over time, they can bulge. This bulge can be just the rings of the disc extending past where they usually lie, or it can involve some of the nucleus pulposus as well. 

The size and location of the disc bulge will correlate to some of the symptoms—if it’s large and near a nerve root, it may cause sciatica. If the bulge is small, it may not cause any symptoms at all and may only be discovered on an MRI that was done for another reason.

Tension is often a protective mechanism in the body. Muscles tighten when they are overloaded to protect against injury. This can be true after a heavy workout, where muscles tighten as a result of the micro-tears that are often associated with working out and then loosen again as the muscle heals. It’s also true in the midback, where a muscle that is chronically stretched from a rounded-shoulder posture feels tight because the body is reacting to that constant stretch. In the lower back, the tightness often results from the body trying to stabilize the lower back, protecting vital organs. If a muscle is tight, a joint can’t move, which is good if the muscles that control that joint are too weak to support the movement. 

That’s why strengthening is such a great treatment for tight muscles – muscles that are strong will not be tight due to weakness, and strengthening requires muscles to contract and relax, the exact opposite of what they do when they’re tight.

Pain in the back when you wake up can have multiple contributing factors. At the most minor and most common, this discomfort may be because your mattress is not properly supporting your hips & back, and as a result, your muscles have to work hard overnight to create that support. 

Additionally, our intervertebral discs also swell overnight, replenishing fluid that was lost due to gravitational compression throughout the day. More severe, morning stiffness may be a sign of a few different forms of arthritis, which would diagnosed based on other symptoms and patterns & tests. An evaluation from a healthcare professional can help identify the root cause of your morning pain and set you up with a plan to help reduce it.

A pinched nerve can be an incredibly painful experience, with sharp and shooting pain in your arm or leg and any numbness or tingling that accompanies that pain. True pinched nerves are a result of compression on the nerve from the spine, either from a disc bulge or herniation or by changes in the vertebrae that press on the nerves. Muscles can also create compression on the nerves when they are tight, which can cause similar symptoms as a disc or bony protrusion, but often in slightly different areas It is a healthcare practitioner’s job to identify if the pain you are experiencing is from a pinched nerve, or from some other cause. Identifying the source of pain is important to focus treatment on the root cause.

A Chiropractor can help with back pain with a few different approaches. For starters, a Chiropractor can identify some of the reasons that you’re experiencing back pain, pinpointing the sources and causes of pain to help get you better. 

Additionally, once the cause has been identified, if it’s musculoskeletal in origin, a Chiropractor can help joints move better (through adjustments), help with muscle tone and function through manual work on these muscles, or utilise modalities like Dry-needling, Acupuncture, Shockwave, or Low-level Light Therapy (laser) to help with inflammation, and help you recover from your pain. Chiropractors can also recommend exercises and stretches for you to do at home to reduce future occurrences of pain and help you recover should you experience a flare-up.

Research shows that people get better faster and stay better longer when a multi-faceted approach to pain is used. These approaches might include adjustments to help joints move better, muscle work to reduce tension, exercises to strengthen healthy movement patterns, and modalities like Dry needling, Acupuncture, Shockwave, or Low-level Light Therapy (laser). The best techniques are going to be the ones that address your unique problem and solve it in a way that works for you.

The best treatment is the one that is tailored to you and the reason you are experiencing pain. Research shows that people get better faster and stay better longer when a multi-faceted approach to pain is used. These approaches might include adjustments to help joints move better, muscle work to reduce tension, exercises to strengthen healthy movement patterns, and modalities like Dry needling, Acupuncture, Shockwave, or Low-level Light Therapy (laser). A health care provider can help identify why you have pain and create a care plan that meets your needs.

The research on heat and ice for low back pain is mixed – some people find it tremendously helpful, and others notice minimal benefit. We recommend trying both, seeing if either is more effective for you and using the one that’s most helpful.

• When using heat, we recommend applying it for 15–20 minutes at a time, and trying to increase your movement afterwards, being careful not to burn yourself.
• When using ice, use it for 10–15 minutes at a time, and wrap any ice packs in a towel so that you do not risk freezing the skin.

Tiger Balm has been shown to be safe and effective at reducing pain in muscles and joints. The precautions that should be taken when using a product like this are available from the manufacturers themselves. We understand that pain can be limiting and difficult to deal with and understand why people often turn to topical products to reduce their pain. We always recommend assessments from healthcare professionals to diagnose the cause of the pain so that you can reduce your reliance on topical products in the long term.

Sometimes, back pain will go away on its own. The research suggests this can take anywhere from 6 weeks to 3 months, depending on the cause of the pain. Over the course of this time period, you should experience a gradual reduction in pain and should be more able to do the things you love. If that’s not the case, we recommend a thorough assessment from a healthcare practitioner to identify the cause of pain and recommend a care plan that will help resolve the underlying issue. Waiting for the pain to go away may not work, and research also indicates that there’s a high rate of recurrence within 1 year when the pain is not treated.

While back pain will often eventually go away, it can take a long time (6 weeks–3 months), and it often comes back within 1 year when not properly treated. The underlying issues that lead to the pain are often the cause of this, as the pain has gone away, but the underlying dysfunction remains. Our Practitioners are trained to identify the underlying dysfunction and focus care there so that not only does your pain go away, but it is less likely to return.

Throwing out your back is essentially a sudden onset of lower back pain, likely due to a muscle strain. When a muscle is strained during an activity, like shoveling snow, the muscle will spasm, and it is this spasm that hurts. A muscle spasm is the brain protecting the area from further damage – if a muscle is too tight to move, it’s not likely to be overloaded, and it can heal. 

When you throw out your back, the best thing to do is encourage the healing of the area. This can be done with heat or ice, rest, gentle stretching, or a visit to a care provider to diagnose any specific strains, treat the area, and recommend exercises to strengthen your back so that it doesn’t happen again.