Headaches, Prevention and Treatment

Headaches are more common in adults, although they can develop at any time in life. Approximately 4 out of 5 children have headaches at some point, but most are benign and self-resolving. In fact, many adults who suffer from headaches report having the first headache in childhood.

Headache symptoms usually begin gradually. In fact, the sudden onset of severe headache may signify a serious problem and requires immediate medical attention. Common headache is often described as achy, dull or throbbing pain. It typically begins at the base of the skull/upper part of the neck and may radiate into the eye(s), the temple, or other locations. Headaches may be felt on one or both sides of the head. Often loud noises or bright lights may make them worse. Some patients may become nauseated or experience odd smells, sounds, or sights before and during the headache attack.

How Is a Headache Evaluated?

Early diagnosis and treatment are important in identifying a serious underlying cause for your headache. In most cases, an in-depth history and physical examination can help determine if your symptoms are related to an easily treated problem, or if it is more serious.

Your doctor can use other tests that reproduce the symptoms of your headache to help develop a specific management plan for your condition, or refer you to another health care provider. X-rays, laboratory tests and even advanced imaging studies like magnetic resonance imaging (MRI) may be necessary. Your doctor may ask you to complete a headache diary, recording:

• day and time of the headache
• headache location
• what the headache feels like
• what you were doing when the headache began
• how long the headache lasts
• what makes it feel better or worse
• anything else you notice before, during, or after the attacks

What Is the Treatment for Headaches?

Headache treatment is cause-related. Doctors of chiropractic often treat patients with tension-type headaches and headaches caused by problems with the joints and muscles in the neck, as well.

Joint manipulation and mobilization of the neck, along with stretching and strengthening exercises, have been demonstrated to be effective in the treatment of this type of headache.

Massage and other forms of soft-tissue treatment can sometimes be helpful.

Scientists are also investigating other therapies, such as acupuncture, to prevent and treat this disorder. Over-the-counter pain relievers, such as acetaminophen, can be used for an occasional headache, but not for long-term headache management.

More serious causes of headache require aggressive treatment, and your doctor of chiropractic can assist you in finding a medical headache specialist.  The majority of patients with headache recover completely after treatment. Unfortunately, the recurrence rate is relatively high, particularly with tension-type headache. If you have any questions or concerns about headache, feel free to discuss them with your doctor or chiropractic.

What Causes Headaches?

Headaches can be primary and secondary. Primary headaches do not result from some other health condition.

The most common type of primary headache is caused by problems with the neck muscles. Changes in the blood vessels inside the skull usually cause migraines. Other common types of headache include “cluster” headaches—headaches grouped together over weeks at a time; sinus headaches, associated with allergies and/or sinus infection; and headaches from poor vision.

Secondary headache results from some other cause or condition—head injury, concussion, blood vessel problems, or high blood pressure—or from side effects of some medications, infections in the head or sinuses or elsewhere in the body. Rare headache causes include tumors, aneurysms and other abnormal growths inside the skull, and toxic substances in the blood. Certain foods, such as monosodium glutamate (MSG), a food flavor enhancer, may cause headaches, as well.

How Can Headaches Be Prevented?

Muscle-tension headaches can often be avoided by maintaining proper posture and neck movements while performing your normal activities. You should:

• Avoid slouching
• Avoid reading with your neck bent forward
• Keep your computer monitor at eye level
• Take frequent breaks from reading and working on the computer.
• Try a low-fat, high-complex carbohydrate diet. A recent study demonstrated that such a diet can dramatically lower the frequency, intensity, and\duration of migraine headaches.

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At Chiropractic Care, we determine the cause of your headache and prescribe a customized treatment plan for you. Therapies may include combinations of manipulation, massage therapy, traction, trigger point therapy, ultrasound and acupuncture. Dr. Kruse has published an article on the successful treatment of headaches utilizing chiropractic manipulation and acupuncture.

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Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury

Your neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.

The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear. Neck pain can be very bothersome, and it can have a variety of causes.

Here are some of the most typical causes of neck pain:

Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash.

Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.

Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion.

Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally.

Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Over time, a disc may bulge or herniate, causing tingling, numbness, and pain that runs into the arm.

Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms.

Chiropractic Care of Neck Pain
During your visit, your doctor of chiropractic will perform exams to locate the source of your pain and will ask you questions about your current symptoms and remedies you may have already tried. For example:

When did the pain start?

What have you done for your neck pain?

Does the pain radiate or travel to other parts of your body?

Does anything reduce the pain or make it worse?

Your doctor of chiropractic will also do physical and neurological exams. In the physical exam, your doctor will observe your posture, range of motion, and physical condition, noting movement that causes pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your shoulder area is also in order. During the neurological exam, your doctor will test your reflexes, muscle strength, other nerve changes, and pain spread.

In some instances, your chiropractor might order tests to help diagnose your condition. An x-ray can show narrowed disc space, fractures, bone spurs, or arthritis. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and herniations. If nerve damage is suspected, your doctor may order a special test called electromyography (an EMG) to measure how quickly your nerves respond.

Chiropractors are conservative care doctors; their scope of practice does not include the use of drugs or surgery. If your chiropractor diagnoses a condition outside of this conservative scope, such as a neck fracture or an indication of an organic disease, he or she will refer you to the appropriate medical physician or specialist. He or she may also ask for permission to inform your family physician of the care you are receiving to ensure that your chiropractic care and medical care are properly coordinated.

Neck Adjustments
A neck adjustment (also known as a cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness, and stiffness.

Of course, your chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs. In addition to manipulation, the treatment plan may include mobilization, massage or rehabilitative exercises, or something else.

Research Supporting Chiropractic Care
One of the most recent reviews of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation.

As part of the literature review, published in the March/April 2007 issue of the Journal of
Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported as having remained unchanged, and all groups showed positive changes up to 12 weeks post-treatment.

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Housework...

Household chores can be a pain in the sacroiliac. Unless you're careful, routine activities around the home - washing dishes, vacuuming, even talking on the phone - can strain your back, including the sacroiliac area near the tailbone, and result in debilitating discomfort.

But you can protect your back by knowing the right way to go about such activities, according to the American Chiropractic Association (ACA).

Consider lifting. It doesn't matter whether you're picking up your child or a heavy bucket of water, you need to do it the proper way to avoid injury.

How? Bend from the knees, not the waist. As you lift, hold the item as close to your body as possible. If you have to turn to place it, step in the direction of the turn. That way, you're not twisting your body and straining your spine.

Back-Saving Tips
The American Chiropractic Association suggest the following do's and don'ts for chores and relaxation:

When you wash dishes, open the cabinet beneath the sink, bend one knee and put your foot on the shelf under the sink. Lean against the counter so some of your weight is supported in front.

When ironing, raise one foot a bit. Place it on a small stool or a book to take some strain off your back.

To vacuum, use a "fencer's stance." Put all your weight on one foot, then step forward and back with the other foot as you push the vacuum forward and back. Use the back foot as a pivot when you turn.

While talking on the phone, don't cradle the phone between your ear and shoulder. That can lock up the spinal joints in the neck and upper back, and cause pain. Instead, hold the phone with your hand or use the speakerphone.

While watching television or relaxing, don't use the sofa arm as a pillow. The angle is much too sharp for your neck.

Use a cold pack if your back begins to hurt. Wrap an ice pack in a towel moistened with warm water. The warmth gives way to gradual cold, which likely will alleviate the discomfort. (No ice? Try frozen veggies instead.)

If pain persists for more than a day or two or if you experience numbness, tingling or weakness in your arms or legs, see a doctor of chiropractic.

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Back Pain and Chiropractic

 

Walking upright on two feet has advantages, but it also puts intense pressure on the spine, as well as on other muscles and bones. Add to this improper sitting, lifting, or reaching—and the normal wear and tear of working and playing—and you have the perfect recipe for back pain. That’s why back pain is the 2nd most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. In fact, some experts say, as many as 80% of us will experience a back problem at some time in our lives.1

Back injuries are a part of everyday life. They can cause a sharp pain or a dull ache and can be accompanied by a tingling, numbness, or burning sensation. You may also feel weakness, pain, or tingling in your pelvis and upper leg—a condition known as sciatica. The spine is quite good at dealing with back injuries. Minor injuries usually heal within a day or two. Some pain, however, continues. What makes it last longer is not entirely understood, but researchers suspect that stress, mood changes, and the fear of further injury may prevent patients from being active and exacerbate the pain.

Tips for Back Pain Prevention:

• Maintain a healthy diet and weight.
• Remain active—under the supervision of your doctor of chiropractic.
• Avoid prolonged inactivity or bed rest.
• Warm up or stretch before exercising or other physical activities, such as gardening.
• Maintain proper posture.
• Wear comfortable, low-heeled shoes.
• Sleep on a mattress of medium firmness to minimize any curve in your spine.
• Lift with your knees, keep the object close to your body, and do not twist when lifting.
• Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
• Work with your doctor of chiropractic to ensure that your workstation is ergonomically correct.
• Chiropractic Treatment for Back Pain

If you experience back pain, consult your doctor of chiropractic. More than 30 million Americans sought chiropractic care last year alone. Past studies have indicated that consumers are very happy with the chiropractic care they receive.

With a thorough knowledge of the structure and functioning of the human body, doctors of chiropractic make diagnoses and take steps to correct problems using spinal adjustments, dietary and lifestyle advice, and other natural tools. Spinal manipulation—the primary form of treatment performed by doctors of chiropractic—is a recommended option for back pain treatment, rated as such by many state and workers’ compensation guidelines.

Research has shown that manipulative therapy and spinal manipulation are not only safe and effective, but can cut costs and get workers back on the job faster than other treatments. A recent medical study has also pointed out that manual manipulation offers better short-term relief of chronic back pain than medication.2

References

1. Vallfors B. Acute, subacute and chronic low back pain: Clinical symptoms, absenteeism and working environment. Scan J Rehab Med Suppl 1985;11:1-98.

2. Giles L, Muller R. Chronic spinal pain: A randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine 2003 July 15;28(14):1490-1502.

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Sports Injuries

Participation in sports or exercise is an important step in maintaining your health. Exercise strengthens your heart, bones, and joints and reduces stress, among many other benefits. Unfortunately, injuries during participation in sports are all too common. Often, these injuries occur in someone who is just taking up sports as a form of activity, doesn’t use proper safety equipment, or becomes overzealous about the exercise regimen.

The more commonly injured areas of the body are the ankles, knees, shoulders, elbows, and spine. Remember that you should discuss any exercise program with your doctor of chiropractic before undertaking such activities.

Strains and Sprains
Although bones can sometimes be fractured with acute sports injuries, the most commonly injured structures are the muscles, tendons, and ligaments. Tendons attach muscles to bones, and ligaments attach one bone to another.

An acute twisting or overextension of a joint can lead to tears of muscles and tendons, called “strains,” and tears of ligaments result in “sprains.” These tears range from mild to severe. In mild injuries, just a few fibers are torn or stretched. Severe injuries, where there is a tear through the full thickness of the structure, are most often considered unstable injuries and frequently require surgical intervention. The intervertebral disc, a ligament between the vertebrae of the spine that works as a shock absorber, can also be torn, resulting in a disc bulge and/or herniation.

Ankle sprains most often involve tears of one or more of the ligaments along the outside of the ankle. Knee ligaments, including the larger external supportive ligaments and the smaller internal stabilizing ligaments, can also be torn. The cartilage on the back of the patella (knee-cap) can also become eroded from overuse, leading to a condition termed chondromalacia patella.

Tendinosis
In those who are training too much, overuse of a particular joint or joints in the body can result in pain and dysfunction. These injuries are called “overuse syndromes.” A common overuse injury is tendinosis, also called tendinitis. In this condition, the tendon becomes inflamed from repetitive use. In the shoulder, the rotator cuff (a complex of muscles that stabilizes and moves the shoulder) becomes inflamed, resulting in rotator cuff tendinitis. Tennis elbow is another form of tendinitis that occurs along the outside of the elbow, most commonly in tennis players. In golfer’s elbow, the tendons on the inside of the elbow are affected.

Stress Fractures
Some athletes may experience a stress fracture, also called a fatigue fracture. This type of fracture occurs when an abnormal amount of stress is placed on a normal bone. This might occur in a runner who rapidly increases the amount of mileage while training for a race. Stress fractures also occur in people who begin running as a form of exercise but overdo it from the start, rather than gradually progress to longer distances.

One final common injury is worth mentioning, and that is shin splints. This overuse injury is caused by microfractures on the front surface of the tibia (shin bone). This is most often seen in runners, although other athletes can also be affected.

Diagnosis and TreatmentSports injuries are most often diagnosed from the history of the activity that brought on the pain, along with a physical examination. In some cases, x-rays are necessary to rule out a fracture. Magnetic resonance imaging (MRI) and diagnostic ultrasound are also used in finding soft-tissue injuries, like tendinitis and sprains.

Fractures require the application of some stabilizing device, such as a cast, after the bone is put back into position. Rarely, surgical intervention is required. There is a relatively standard treatment protocol for most of the other overuse types of injuries. This protocol involves the following:

Rest
Generally no more than 48 hours of rest and/or immobilization is needed, depending on the severity of the injury. In most cases, the sooner the person becomes active after an injury, the more rapid is the recovery. In fact, long-term immobilization can sometimes be harmful to recovery. Your doctor of chiropractic will guide this process, as too early a return to activity, choosing the wrong type of activity, or excessive activity can be detrimental.

Ice or heat
Ice or heat can be helpful with pain reduction and tissue healing.

CompressionCompression of the area may reduce the amount of swelling from the injury. Your doctor of chiropractic will determine if this will be beneficial in your case.

Elevation
Elevation of the injured arm or leg above the level of the heart is thought to be helpful in reducing swelling.

Pain relievers
Recent research has demonstrated that some nonsteroidal anti-inflammatory drugs may actually slow the healing process by restricting the body’s natural healing mechanisms, so they should be used sparingly.

Joint manipulation
Recent research has shown us that, in some cases, joint manipulation can be helpful with pain reduction and more rapid recovery. Your doctor of chiropractic will determine if this procedure will be helpful in your case.

A Word about Prevention
In many cases, sports injuries can be prevented. Proper conditioning and warm-up and cool-down procedures, as well as appropriate safety equipment, can substantially reduce injuries. Understanding proper techniques can also go a long way toward preventing injuries.

Sufficient water intake is also an important preventive measure.

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Not getting enough sleep?

A good night’s sleep is essential for good health and many of the body’s functions. Sleeping helps our bodies recharge and prepare for the next day's mental and physical activities. It is important for the brain, nervous system, and the hormonal system to operate properly.

Although individual sleep needs vary, most healthy adults need an average of eight hours of sleep.  However, the quality of sleep is as important as the amount of sleep. Having enough uninterrupted, restful sleep helps maintain the body's natural sleep pattern and results in more restorative sleep.

Inadequate amounts of sleep can lead to reduced productivity, poor concentration, impaired memory, decreased learning and reasoning abilities, and difficulty in all areas of life due to stress. Irritability, looking tired, reduced reaction times, too much dependence on caffeine, and difficulty concentrating are some of the signs of inadequate quality sleep.

Insomnia is the most common sleep-related problem affecting up to 40% of the population according to the National Institutes of Health (NIH.) Insomnia includes difficulty falling asleep, waking up often with difficulty falling back asleep, waking too early in the morning, or poor quality of sleep.

Chiropractic care can help reduce sleeping disorders by providing treatments that offer the promise of a better night's sleep. Chiropractic adjustments help to restore the natural flow of nerve impulses to every area of the body. This helps to improve natural deeper relaxation for a more restful sleep. Many of the underlying causes of poor sleep such as stress, back pain, neck pain, and headaches can be controlled through chiropractic therapy. Massage therapy and acupuncture are also effective methods of promoting relaxation and reducing stress.  

Without enough quality sleep, the body is unable to heal properly thus perpetuating illness. This may become a vicious cycle with pain preventing sleep and lack of sleep preventing proper healing. Chiropractic care is a good option if you don't want to rely on prescription drugs. Give us a call if you would like to discuss treatment options such as chiropractic care, massage therapy and acupuncture.

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Free Valentine's Day Massage!

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Preparation for Outdoor Winter Activities... Prevents Injury!

When snow, ice and frigid weather blast into town, watch out, says the American Chiropractic Association (ACA). Winter recreational activities and chores can pose problems for the outdoor enthusiast whose body is not in condition. Winter sports like skating, skiing and sledding can cause painful muscle spasms, strains or tears if you're not in shape. Even shoveling snow the wrong way, clambering awkwardly over snow banks, slipping on sidewalks and wearing the wrong kinds of clothing can all pose the potential for spasms, strains and sprains.

Simply walking outside in the freezing weather without layers of warm clothing can intensify older joint problems and cause a great deal of pain. As muscles and blood vessels contract to conserve the body's heat, the blood supply to extremities is reduced. This lowers the functional capacity of many muscles, particularly among the physically unfit. Preparation for an outdoor winter activity, including conditioning the areas of the body that are most vulnerable, can help avoid injury and costly health care bills.

"Simply put, warming up is essential," says Olympic speedskating gold and silver medalist Derek Parra. "In fact, when pressed for time, it's better to shorten the length of your workout and keep a good warm-up than to skip the warm-up and dive right into the workout. Skipping your warm-up is the best way to get hurt." Parra, who took both the gold and silver medals during the 2002 Winter Olympics in Salt Lake City, UT, adds that, "You can complete a good warm-up in 15-20 minutes. And believe me, it will make your workout more pleasant and safe."

Derek Parra and the ACA suggest that you start with some light aerobic activity (jogging, biking, fast walking) for about 7-10 minutes. Then follow these tips to help you fight back the winter weather:

• Skiing - do 10 to 15 squats. Stand with your legs shoulder width apart, knees aligned over your feet. Slowly lower your buttocks as you bend your knees over your feet. Stand up straight again.
• Skating - do several lunges. Take a moderately advanced step with one foot. Let your back knee come down to the floor while keeping your shoulders in position over your hips. Repeat the process with your other foot.
• Sledding/tobogganing - do knee-to-chest stretches to fight compression injuries caused by repetitive bouncing over the snow. Either sitting or lying on your back, pull your knees to your chest and hold for up to 30 seconds.
• Don't forget cool-down stretching for all of these sports - At the bottom of the sledding hill, for instance, before trudging back up, do some more knees-to-chest stretches, or repetitive squatting movements to restore flexibility.

Shoveling snow can also wreak havoc on the musculoskeletal system. The ACA suggests the following tips for exercise of the snow shoveling variety:

• If you must shovel snow, be careful. Listen to weather forecasts so you can rise early and have time to shovel before work.
• Layer clothing to keep your muscles warm and flexible.
• Shoveling can strain "de-conditioned" muscles between your shoulders, in your upper back, lower back, buttocks and legs. So, do some warm-up stretching before you grab that shovel.
• When you do shovel, push the snow straight ahead. Don't try to throw it. Walk it to the snow bank. Avoid sudden twisting and turning motions.
• Bend your knees to lift when shoveling. Let the muscles of your legs and arms do the work, not your back.
• Take frequent rest breaks to take the strain off your muscles. A fatigued body asks for injury.
• Stop if you feel chest pain, or get really tired or have shortness of breath. You may need immediate professional help.

After any of these activities, if you are sore, apply an ice bag to the affected area for 20 minutes, then take it off for a couple of hours. Repeat a couple of times each day over the next day or two.

If you continue to feel soreness, pain or strain after following these tips, it may be time to visit a doctor of chiropractic. "I've always believed in chiropractic care," says Parra. "I've used a lot of other treatments for injuries and pain, but the problem doesn't get fixed until I go to a doctor of chiropractic."

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So...how are you doing?

Now that it is the middle of January, many of our new year’s resolutions are either in full swing or are falling by the wayside. Most of us make promises to ourselves to start exercising and dieting and to basically get healthier. Some of us resolve to spend more time with family and friends, get organized or even to save money to finally go on that vacation. Unfortunately our hectic lives, pain, or possibly our own lack of will power can interfere with these resolutions and we may often feel like we have let ourselves down. 

Sometimes, making too many resolutions makes it difficult to keep them all. It's easier on us, and gives us the opportunity to succeed, if we tackle one or two tasks at a time. Once you are in the habit of getting and staying healthy, it no longer is a resolution, but a way of life.

If exercising, losing weight, quitting smoking, and getting healthier is on the top of your things to do this year, let Chiropractic Care help you succeed.  We can help you to stop smoking with acupuncture, work with you to develop a safe exercise program and assist you to live a healthier life.  If pain is preventing you from exercising, then we can help determine the cause of your problem and take steps to correct it. Then, you'll have the time, the energy and the drive to have fun with your family, complete those unfinished projects and maybe even take that well deserved vacation to paradise!

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Back Pain...strikes again!

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Back Pain Facts & Statistics

Although chiropractors care for more than just back pain, many patients visit chiropractors looking for relief from this pervasive condition.  In fact, 31 million Americans experience low-back pain at any given time.¹
A few interesting facts about back pain:

• One-half of all working Americans admit to having back pain symptoms each year.²
• Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
• Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
• Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.³
• Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.⁴

What Causes Back Pain?
The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.
Manipulation as a Treatment for Back Problems
Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today's growing emphasis on treatment and cost effectiveness, manipulation is receiving more widespread attention.
Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.⁵
In fact, after an extensive study of all currently available care for low back problems, the Agency for Health Care Policy and Research—a federal government research organization—recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.⁶
The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how chiropractic manipulation may help you, contact a Doctor of Chiropractic in your area.   Search our online database of ACA members to find a doctor of chiropractic near you.
Tips to Prevent Back Pain

• Maintain a healthy diet and weight.
• Remain active—under the supervision of your doctor of chiropractic.
• Avoid prolonged inactivity or bed rest.
• Warm up or stretch before exercising or other physical activities, such as gardening.
• Maintain proper posture.
• Wear comfortable, low-heeled shoes.
• Sleep on a mattress of medium firmness to minimize any curve in your spine.
•  Lift with your knees, keep the object close to your body, and do not twist when lifting.
• Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
• Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

---

References:

1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

3. This total represents only the more readily identifiable costs for medical care, workers compensation payments and time lost from work. It does not include costs associated with lost personal income due to acquired physical limitation resulting from a back problem and lost employer productivity due to employee medical absence. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville,

4. In Vallfors B, previously cited.5. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

6. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health