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Northwest Pain Relief Center
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DIAGNOSIS AND TREATMENT OF LOWER BACK PAIN

The American College of Physicians recommends that evaluation of lower back pain should include a focused history and examination of the patient to place the patient in one of 3 broad categories.

1- Non-Specific Low Back Pain (this is 85% of patients, and includes low back pain that cant' be attributed to one specific event)
2- Back pain associated with pinched nerves or narrowing of the spinal canal.
3- Back pain associated with another specific cause such as cancer, fracture and dislocation (the lease amount)

No evidence has been made that diagnosing a patient with a specific type of lower back pain makes a difference in recovery.

They also found that x-rays and MRIs do not improve outcomes at 3, 6 and 12 month follow ups

They suggest that health care providers should not x-ray individuals with acute and sub-acute lower back pain. This means they shouldn't x-ray your back if you're having a flare up of an old lower back pain condition or if you're having it for the first time.

They also stated that imaging can lead to unnecessary invasive procedures such as surgery.


As a chiropractor at Align Integrative Health in Seattle I agree it is not necessary to x-ray a patient with acute lower back pain. However I do not agree with foregoing x-rays on an individual with chronic lower back pain. even though we know it will not change the outcome it does help with determining prognosis and duration of care needed to correct a spinal problem with chiropractic.

If you have questions or hesitation about visiting a chiropractor or receiving pain management it's best to give us a call to determine if you're a good candidate for our services.

We'll give you an honest over the phone opinion regarding weather we can help you.

WHY DO CHIROPRACTORS TAKE X-RAYS?

The British Medical Journal published a study in 2006 that categorized low back pain into 2-types; "Specific" and "Non-Specific".

Specific back pain is caused by something you can usually see on X-Rays such as fracture, cancer, dislocation, or infection. This makes up only about 8% of back pain cases.

90% of back pain is "Non-Specific", meaning it cannot be seen on an x-ray and is without a clear specific cause.

The study went on to say that most abnormalities on x-rays have nothing to do with pain and that %40-%50 of people without pain have abnormalities on x-ray, and that many people WITH back pain have No abnormalities.

Wo why then do chiropractors take x-rays?

Red Flag Conditions warranting x-rays are as follows:

1-Onset of pain is less than 20 and over 55 years old.
2-Non-mechanical pain (not related to time or activity)
3-Thoracic pain (middle back)
4-History of cancer, steriods, HIV or "feeling unwell"
5-Weight loss
6-spinal deformity
7-pinched nerves

In addition to these "red flag" conditions that warrant x-rays, there is a huge educational aspect involved. Most people have never seen their spine on an x-ray and have little understanding of anatomy and what's inside their body.

To have x-rays taken and explained to them regarding mechanics, posture and ergonomics is very helpful in understanding the problem, what it looks like and what needs to be done to fix it.

So while x-rays may not be "necessary", the patient education and awareness that is gained is huge.

At Align Integrative Health in Seattle we take x-rays on most of our patients because we want to educate and instruct our patients on posture correction and proper body mechanics. In addition they set up expectations. If a patient has stage 3 arthritis and they don't know it, it will help them understand why they may never fully recover.

Please call Align Integrative Health if you have any questions about your health or x-rays.

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ARE CHIROPRACTIC & EXERCISES COST EFFECTIVE?

The British Medical Journal reported in 2004 that in a population of 1287 patients with low back pain, chiropractic and exercises were a cost effective addition to "best care" practices in general practice.

This means that patients who sought care in general practice did better with the addition of chiropractic and exercise than taking pills and getting advice alone.

Align Integrative Health in Seattle works with you and your primary care doctor to achieve the best result possible for your health.

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EFFECTIVENESS OF CHIROPRACTIC AND EXERCISE

The British Medical Journal reported in 2004 on the effectiveness of chiropractic + exercise VS chiropractic + exercise advice.

The study concluded that patients who received chiropractic AND exercise in combination did better at 3 and 12 month follow ups, VS chiropractic with advice, in the form of education and a book.

What we see at Align Integrative Health in Seattle is that patients who perform in office exercises in combination with chiropractic do better over time than patients who only receive chiropractic alone.

Chiropractic is wonderful for reducing pain, stiffness and increasing joint mobility, but it needs to be reinforced through exercises too.

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CHIROPRACTIC AND EXERCISE
The journal Spine reported in 2003 comparing the effects of manual therapy/chiropractic to exercise therapy in chronic lower back pain patients.

They took 49 people all on 100% sick leave, 27 of them got chiropractic and 22 got exercise therapy.

In the results; improvement was noted in each group, but the chiropractic group showed significantly greater improvement than the exercise group at follow up which included 4 weeks, 6 months and 1 year.

The study concluded that manual therapy/chiropractic performed better than the exercise groups in all measures both short and long term.

DYNAMIC STABILITY TRAINING AND CHIROPRACTIC CARE

Slosburg reported in 2008 that injury and pain may lead to poor motor control changes which perpetuate problems and may lead to chronic pain and stiffness.

The major goal of dynamic stability training is to recruit core and stabilizing muscles to improve control through the full range of body movements.

He also concluded that chiropractic helps to restore restricted movement in muscles and joints therefore resetting motor programing and helping joint and muscle function.

Align Integrative Health in Seattle provides chiropractic adjustments to restore proper joint and muscle movement and also provides exercises to restore proper muscle motor control.

PREVALENCE OF DOCTOR DIAGNOSED ARTHRITIS IN THE USA

The journal of Morbidity and Mortality reported that arthritis is the most common cause of disability and the number of adults with doctor diagnosed arthritis is increasing at 1-million people per year.

With the aging it is expected to further increase by 2030.

Arthritis increased with age, females, obesity, physical inactivity and smokers.

The Chiropractors and Medical Doctors at Align Integrative Health in Seattle can help with arthritis pain. We provide supartz joint injections for the knees that help to lubricate the joint and decrease arthritis caused pain.

Call today to speak with a doctor about your health concerns.

206-397-3457

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THE PROGNOSIS OF ACUTE NECK PAIN IS POOR

In 2011, the "Archives of Physical Medicine & Rehabilitation" reported that most episodes of neck pain are of unknown origon (referred to as non-specific) and are frequently recurrent.

In the groups studied, at the onset of neck pain, subjects rated their pain at 64 (100=the worst). At 6.5 weeks the pain was 35.

The concern is this; at 52 weeks the pain did NOT resolve further, and at 1 year it actually became worse!! 

The study concluded that the prognosis for acute neck pain (not receiving treatment) is surprisingly worse than previously recognized, and resolution is complete.

Keep in mind these were patients NOT receiving treatment for their problem.

The chiropractors at Align Integrative Health in Seattle can help. Call today! 206-397-3457

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NECK PAIN IN THE GENERAL POPULATION.

The journal Spine reported in 2008 that neck pain is common with 30% - 50% of adults experiencing it. Among adolescents it ranges from 21% - 42%.

They stated that among adults 50% - 85% of them will experience it 1-5 years later.

The evidence is clear that most people with neck pain do not experience a complete resolution of their problem.

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1-YEAR RECURRENCE OF LOW BACK PAIN. MOST IS NON-SPECIFIC.

The journal Spine reported in 2010 that the 1-year recurrence of low back pain was 20%.

They stated that most back pain is "non-specific" without an objective cause. 

Their study found that among acute low back pain patients, 27% resolved the problem quickly, but 40% developed long term problems. Even among those whos back pain initially resolved, 29% had it come back within 6 months. Other studies have found similar recurrent trends.

Although it's difficult to predict if acute low back pain will become a long term problem, most factors that lead to chronic long term problems appear within the first 14 days of onset.

This says to me that treating even acute low back pain correctly is very important from the beginning.
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