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AVAILABLE TREATMENTS FOR BACK PAIN: MASSAGE AND MANIPULATION
Massage
Massage of the muscles, tendons, and other “soft tissues of the back can be very helpful. Gentle rubbing and a “rubdown” at home can relieve painful and stiff muscles. If this cannot be done as needed at home, you may want to see a massage therapist.
Find a licensed professional massage therapist who has training and experience. Good massage can give relief that lasts hours to days. Massage can greatly help your treatment program by allowing your exercises to be easier and more effective.
Manipulation
Spinal manipulation for back pain has been practiced for several thousand years. Hippocrates, the father of medicine, used spinal manipulation for treatment of his patients. Over the centuries, treatment in which manual manipulation is used has led to the development of chiropractic and osteopathy.
Spinal manipulation (sometimes referred to as spinal adjustments, by chiropractors) attempts to relieve pain by increasing the mobility between spinal vertebrae that have become abnormally restricted or “locked” and/or slightly malpositioned (subluxation).
After taking an appropriate medical history and performing a physical examination, the doctor of chiropractic, osteopathy, or medicine additionally palpates the spine to detect areas of restricted movement between vertebrae. Then, by applying specific manipulative procedures by hand, the doctor attempts to restore the lost mobility to the joint, thus allowing the vertebrae to settle into the most normal and natural position for them. The manipulations can range from a gentle stretching or pressure maneuver to multiple repeated motions at the same area or to specific high-velocity thrusts to affect the joints properly.
Patients may sense anything from a stretch or pressure sensation to a slight popping sensation as the vertebral motion and position are corrected. As with most physical medicine procedures, the doctor may prescribe that you have a series of manipulations performed until maximum relief is obtained.
These are some of the ways in which spinal manipulation works to decrease back pain:
1. Improves the mobility between two or more vertebrae, thereby reducing the temporary inflammation that occurs as a result of the locked spinal joint.
2. Often, reduces nerve irritation as a result of the improved mobility.
3. Allows surrounding soft tissues-including, but not limited to, the smaller spinal muscles attaching one vertebrae to another-to relax, thus reducing spasm and the pain that accompanies spasm.
4. According to some studies, manipulation causes the body to temporarily release endorphin, a pain-relieving chemical manufactured in the body.
There may be some temporary increase in back pain after the manipulation procedure, but that usually passes and the patient finds relief from the pain. Many patients note immediate relief after the treatment, without any exacerbation of their pain. If the pain continues to worsen after subsequent manipulations, the doctor will usually re-evaluate the condition before proceeding.
Manipulation is typically not done when the treating doctor determines that there is fracture, infection, cancer, severe arthritis, or other possible conditions that would contraindicate its use. As with other treatments discussed, there is no definite proof that regular spinal manipulation prevents future attacks or cures the acute back pain problem. But, for some patients, a periodic evaluation by doctors skilled in manipulation for the detection of any potential problems is part of their total health care plan, along with their regular physical examinations and dental checkups. Additionally, some patients once treated with manipulation never have problems again with the treated area of their spine.
Patients who get significant relief from spinal manipulation find that it helps them to continue with their basic treatment plan of heat and exercises, and allows them to resume a more normal life-style. Spinal manipulation by their doctor of chiropractic, osteopathy, or medicine may be part of a total team approach to the treatment of some of the more chronic, permanent spinal conditions. The skilled doctor of manipulation would then work in concert with a neurologist, orthopedic surgeon, or rheumatologist to bring about the best total results for that patient.
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