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Effective Diagnosis and Treatment of Low Back Pain

Here's an all-too-common situation. You develop low back pain that lasts for more than a few days and you're uncomfortable enough to go see your primary care physician. He or she tells you it's not clear what's going on and sends you for a magnetic resonance imaging (MRI) study of your lumbar spine. The study comes back showing one or two herniated intervertebral discs. [Intervertebral discs are cartilaginous shock absorbers interspaced between pairs of spinal vertebras.] Your doctor informs you that you have "herniated discs in your back" and prescribes medications and a course of physical therapy. Your doctor may even refer you to an orthopedic surgeon to evaluate the need for surgery on your back.

Now, all of these recommendations may be necessary. Or none of them may be necessary and all that's needed is some rest and an exercise rehabilitation program that you could do on your own if you were given the proper instructions. The culprit here is how the presence of the herniated disc or discs is interpreted. It's important to remember that not all herniated discs are a problem requiring a solution. In fact, a sizable proportion of such disc herniations (30% or more)1 represent the progression of natural processes and are not a problem at all.2,3 But many family doctors and even specialists are not appropriately trained in accurate differentiation among the various possibilities. When faced with MRI evidence of a herniated disc, such doctors see it as a disorder or disease that needs to be treated and fixed. Such an approach results in significant stress and leads to unnecessary procedures and financial hardship for many patients.

Given the frequency of occurrence of such instances of "over-diagnosis", how can a person with back pain expect to receive appropriate care? Of course, people as patients are usually not in a position to be able to overrule their doctor's recommendations. The answer lies in obtaining relevant information. Let your doctor know you're aware that up to one-third of normal persons have herniated discs, and ask whether it's possible that your disc herniation is in fact unrelated to your back pain and merely an incidental finding. Further, if your back pain is not accompanied by leg pain radiating below your knee, it may be that the disc herniation is not affecting spinal nerve roots and may be treated by very conservative measures such as rest followed-up with exercise.

Thus, not all disc herniations have the same impact on a person's health. Some represent normal findings, even if they are present in a person who has back pain. Let your doctor explain to you exactly why your particular problem requires more than watchful waiting. Your local chiropractor will be able to provide you with the very best expert advice and recommendations for any necessary treatment.

1Takatalo J, et al: Does lumbar disc degeneration on magnetic resonance imaging associate with low back symptom severity in young Finnish adults? Spine (Phila PA 1976) 36(25):2180-2189, 2011
2Spontaneous regression of herniated lumbar discs. Kim ES, et al: J Clin Neurosci 2013 Oct 24. pii: S0967-5868(13)00552-3. doi: 10.1016/j.jocn.2013.10.008. [Epub ahead of print]
3Endean A, et al: Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila PA 1976) 36(2):160-169, 2011

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Testimonials

Reviews By Our Satisfied Patients

    I have been going to Discover Life Chiropractic for 5 years. I am an athlete who went in with low back pain and some knee issues. It did take time but to this day I do not have low back pain or knee pain as long as I am staying healthy with periodic adjustments. Dr. Dave knows his stuff and is attentive to concerns (if you are feeling something make sure you tell him). I feel so aligned and feel like I am functioning at a high level each day. If I can, I like to use Dr. Daves partnering doctor for extremity adjustments (feet, arms, legs) he is exceptional especially with those! Like with anything you have to be consistent, can't just go 3 times and expect to be healed. Hope this was helpful! Best, Alex

    Alexandria B

    So... I have had back pain all my life and neck pain from a car accident causing severe and frequent migraines. Other chiropractors just did a "quick fix" that lasted a couple days at most. This chiropractor, David, has practically eliminated my neck pain and migraines and my back pain had decreased tons. Now usually when I have pain it is because I have bad posture or I need to stretch or build up muscle to keep my spine in place. I understand he can only do so much but to be pain free you have to put in work also. WITH ALL THAT SAID, the pain has gone down from constant to occasional and from severe pain to mostly mild and we are still working on it. Would recommend the chiropractic service there to anyone.

    Ken R

    I have experienced fairly sever neck pain for the last few years. Have been to my doctor, had ultrasounds etc. Nothing was working. I started going to David at Discover life a few months ago as a last resort to deal with the pain and the difference is amazing even with just this short amount of time. He explains everything very clearly and even has me doing stretching and work while at home. His staff is great and always friendly when I come in. I would highly recommend Discover Life Chiropractic.

    Jennifer D