So you threw your back out?
Hi Health Family!
Have you ever "thrown out your back?" If you have, you know it's one of the worst pains you can experience. Some of you might even know this happened to me last weekend! So I'll tell you what I did, as a chiropractor, for my own acute low back pain!
First off, what have you actually done to yourself when you feel totally fine and then suddenly throw your back out?
Turns out this is a surprisingly complicated answer. Our spines are pretty complex structures. To give you a quick recap on spinal anatomy, you have 24 vertebra (not counting the sacrum and coccyx). Each vertebra has multiple joints with the bones above and below it as well as the intervertebral discs and any additional bones connecting at that level. You have a multitude of ligaments connecting the bones together. On top of those ligaments, you have all of the muscles and tendons that support the upper body and some of the lower body that attach to the spine as well. Needless to say, there is a lot going on.
Muscle Strains and Spasms: This is the most common reason
Subluxation/Misalignment of the Spine: More common with people who have congenital abnormalities, (birth defects).
Major Trauma: Major trauma can be a sudden disc herniation, a fall, a motor vehicle accident, or any other sort of severe physical injury.
Muscle Strains and Spasms
Muscle strains and the accompanying spasms are by far the most common drivers of sudden-onset acute low back pain. They tend to start without warning while performing simple, routine actions.
The first time I threw my back out, I had leaned over to pick up my dog's water dish, I heard and felt a pop, and I couldn't stand back up. I knew I had done something terrible, but I wasn't really sure what. I was in my first year of chiropractic school, so fortunately I was surrounded by a lot of amazing chiropractors that had lifetimes of experience helping people just like me! Sadly, this is a mostly chronic condition now, and I deal with an episode about once every year to 18 months.
Muscular strains are like ligamentous sprains. Okay, so what does that mean? Do you know anyone that has sprained his or her ankle? Did you ever hear that after you sprain an ankle it is weaker and more prone to future injury? Well, it's the same basic idea with strains as well. For whatever reason, the first time I strained my low back, I moved in a way my body was not expecting and unintentionally hurt myself.
Treatment for muscular strains involves getting regular adjustments, using ice or heat (depending on whether this a brand new injury or a chronic one, but you're always safer with ice as an option here), electric stimulation, cold laser, chiropractic blocking, trigger point, massage therapy, cupping, acupuncture, epsom salt baths, and if you want to go to an MD, you can also get a prescription for muscle relaxers. Muscle relaxers tend to be fairly addictive though, so it's rare to have an MD write a scrip for more than 7-10 days worth of pills. For most people, that is more than enough to recover if they are following the more natural therapies listed above.
Case courtesy of Dr Omar M. Sultan, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/37616">rID: 37616</a>
Subluxation and Misalignment
This often goes hand in hand with number one. However, it is possible to have just a very bad, pain-generating subluxation and not have the terrible muscle spasms that can accompany it. This is probably one of the scenarios where chiropractic most excels over any other healthcare provider or any other therapeutic modality.
Here's some fun science info about a common example of this condition, as referenced in the x-ray above. Spina bifida occulta is a fairly common birth defect affecting as much as 12% of the general population. With this condition, the vertebra and/or sacrum do not properly ossify. This means that areas that should be bone are still cartilage. When the joints get stuck and you have a hard bone pressing down on softer cartilage, it can cause a lot of pain! When that happens, it tends to be a result of a knife-clasp deformity that goes hand-in-hand with spina bifida occulta. Essentially the lowest lumbar vertebra gets stuck and is pinching the cartilage in the sacrum below. It's incredibly painful, but it's a very easy fix! If you've ever heard of someone telling you that chiropractors are miracle workers, and they cured the person in one visit, it was probably one of these guys.
Major Trauma
Major trauma is the last common form of sudden onset back pain. Typically this happens from falling, being involved in a motor vehicle accident or some other severe physical injury. With any major trauma, you need to do a quick evaluation. If you are bleeding, concerned that you may or may not have broken a bone, or if you lose consciousness, you should skip the chiropractor and head straight to the emergency room for your initial consultation. If they release you and say you're clear, then come on down to the clinic and we'll start whatever treatment you may need!
Often treatment from major traumas like big falls or motor vehicle accidents will be more frequent and more intense than the treatment of other conditions, but chiropractic can greatly reduce the healing time from these accidents.
If you have anything happen to your back and you need someone who will listen to you and try to care for you and solve your problems without masking them with drugs, why don't you make an appointment with me? I would love to help take care of you! I see all types of patients at my primary clinic, but I have another clinic where I treat personal injury, motor vehicle accident patients, workmen's comp, and any other major trauma. Just let me know!
Yours in health,
Dr. William