If you have neck or back pain and you are looking for an option that will help, two of the most common treatment options are chiropractic and/or physical therapy. But how do you know which one will help your condition?
Chiropractic care and physical therapy are both great options for helping with back pain, but each one addresses very different issues. The treatment you choose should depend upon the condition you have. The first place to start is always a thorough evaluation by a spine care specialist.
At Precision Spinal Care, I do a thorough assessment of you before recommending a treatment plan. Once I have evaluated your condition thoroughly, I will sit down with you and discuss the options to relieve your neck and back pain. If chiropractic is not the best fit for you, I will refer you to a physical therapist or the most appropriate medical professional for your specific condition.
Which Approach Should I Take?
According to the Cleveland Clinic’s Center for Spine Health and the Department of Pain Management, the most appropriate course of action for treating lower back pain is to match the correct provider to the patient through the various stages of treatment.
It’s important to know what the cause of the pain is to get the correct treatment. It is equally important to make sure you and your doctor are looking at short-term and long-term outcomes. Everyone’s body is different. You might choose a treatment that solves the immediate problem, but if your doctor is only treating the symptoms and not the cause, the pain will probably return.
Physical Therapy
Depending upon your condition, your needs may best be served by a physical therapist or nurse practitioner. However, if your pain persists past four to six weeks, according to the Cleveland Clinic’s report, “the care path defines when referral to spine or pain specialists, spine surgeons or behavioral health providers is indicated.”
A physical therapist can apply a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain is relieved, the therapist can teach you exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.
However, physical therapy has its limitations and will not provide the same results as chiropractic spinal adjustment. Physical therapy will fail and disability will continue if the underlying mechanical issue is not treated.
The Role of Physical Therapy in Spine Care
The role of physical therapy is:
- To increase muscle tone for long-term stabilization AFTER the mechanical issues have been treated.
- To focus on strength and flexibility rehabilitation AFTER surgery.
- A better resource for treating non-spine joints (shoulders, knees, ankles).
Chiropractic Care
Adjustment of a spinal joint involves a variety of techniques designed to move the spinal vertebrae back into a more stable position. The adjustment allows the spacer of the facet joint to be moved back in position, thus diminishing the irritation of the pain sensors on the facet surfaces.
The adjustment also may create movement into the joint, which allows for straightening of the ligament fibers (repair of scar tissue). Such straightening of the fibers helps the ligament become stronger, more flexible and less sensitive to pain. Remember, the spinal ligaments are the guidewires to the proper positioning of the spinal bones, so their repair is necessary to allow you to “hold” their adjustments.
Studies have shown that stretching and PT (active and passive motion) do not heal the spinal ligaments as effectively as an adjustment which actually creates motion within the joint itself. Proper spinal correction also helps break the pain cascade. Chiropractic adjustments have shown to release chemicals (neuro-peptides) which affects inflammation and pain.
A study by the U.S. Chiropractic Directory) found that chiropractic care achieved better results compared to other common treatments for spine pain:
- 24% Decrease in disability duration of first episode compared to physical therapy
- 250% Decrease in disability duration of first episode compared to medical physician’s care
- 30.3% Decrease in opioid (narcotic) use during care with medical physician
- 32% Decrease in average weekly cost of medical expenses during disability episode compared to physical therapy care
- 21% Decrease in average weekly cost of medical expenses during disability episode compared to medical physician’s care
“Given that chiropractors are proponents of health maintenance care…patients with work-related LBP [low back pain] who are treated by chiropractors would have a lower risk of recurrent disability because that specific approach would be used.” The authors concluded that, “After controlling for demographic factors and multiple severity indicators, patients suffering nonspecific work-related LBP who received health services mostly or only from a chiropractor had a lower risk of recurrent disability than the risk of any other provider type.”
Given that physical therapy has been the primary non-pharmaceutical conservative treatment for mechanical spine issues (not fractures, tumors or infection) coupled with the contemporary opiate addiction and mortality issues, a more effective care pathway should be sought.
According to a 2014 study, over 100 million Americans experience chronic pain with common painful conditions, including back pain, neck pain, headaches/migraines, and arthritis, in addition to other painful conditions.
In a large study in 2010, 30.7% of over 27,000 U.S. respondents reported an experience of chronic, recurrent pain of at least a 6-month duration. Half of the respondents with chronic pain noted daily symptoms, with 32% characterizing their pain as severe. Chronic pain has a broad impact on emotional well-being and health-related quality of life, sleep quality, and social/recreational function.
A 2013 study in the Journal of the American Medical Association (JAMA) reported on medical and physical therapy back pain treatment from 1999 through 2010, representing 440 million visits. The study revealed an increase of opiates from 19% to 29% for low back pain with the continued referral to physical therapy remaining constant. In addition, the costs for managing low back pain patients (not correcting anything, just managing it) has reached $106 billion ($86 billion in health care costs and $20 billion in lost productivity).
Considering Chiropractic Adjustment vs. Physical Therapy
Chiropractic offers an evidence-based approach in developing an “outcome based “care path for mechanical spine pain focusing on the mechanical pathology, which is the underlying cause of the pain. Chiropractic Care differs from physical therapy in the following aspects:
- Mechanical diagnosis of your pain
- Management of spine pain cases, and imaging when necessary
- Adjusts the spine with specific biomechanical rationale vs. mobilization of joints
- Neurophysiological changes on motor function
- Affects the central nervous system and decreases pain by modulation by the brain (demonstrated on functional MRI)
- Sympathetic influence of adjusting on heart beat, blood pressure and dilation of pupils
- Decreases mechanical sensitivity of the spinal joints
- Targets spinal ligaments for transition of Type 3 collagen (scar tissue) to Type I collagen (healthy).
At Precision Spinal Care we follow best practice guidelines for NUCCA care. It is a safe and painless, evidence-based approach to correct spinal problems. Pinpointing and alleviating the cause of your neck and back pain is our goal.
Before you start any form of treatment:
- Be sure you have a thorough neurological, orthopaedic and biomechanical examination.
- Not all doctors are trained equally. Take a look at your doctor’s credentials.
- Tell the chiropractor about all of your medical conditions.
- Ask if the chiropractor has specialized training or experience treating your condition.
- Tell the chiropractor about any medications (prescription or over-the-counter) and dietary supplements you take.
- If the chiropractor suggests a dietary supplement, ask about potential interactions with your medications or other supplements.
Take charge of your health-talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
At Precision Spinal Care, we will perform a thorough examination of you before any treatment is performed or prescribed. If it is determined that your pain is anatomical, we’ll explain your condition and recommend the type of specialist who is most appropriate for you.
We understand that you need to explore all your options when you look for expert chiropractic care and we are happy to help you determine the best way to address your specific needs.
Call our office at 757-382-5555 to speak to the doctor or set up a consultation. You can also set up an appointment through our webpage.
