Low back injuries are the number one cause of chronic pain and disability in the world today. Our chiropractic office in Fort Walton Beach and Mary Esther is filled with patients suffering with back pain every day.
Low back pain (LBP) is the second most common cause of disability in US adults and a common reason for lost work days. An estimated 149 million days of work per year are lost due to LBP. LBP is the number 1 reason why someone visits a chiropractor and the number 3 reason why they visit a medical doctor. More people suffer from low back problems than any other condition in the world, and almost all of us are affected by chronic low back pain – either we have it or someone we know has it.
In addition to being the most common form of chronic pain, low back pain is also the most expensive condition on the injury market. In fact, it is more expensive than 300 other medical conditions and has a huge financial impact on those who suffer from it. According to the National Safety Council, the medical cost of caring for an injury is $42,000. Total costs of LBP is estimated to be between 100–200 billion dollars annually, two-thirds of which are due to decreased wages and productivity.
Those numbers are simply unsustainable. So how do we lower the cost of caring for those with low back pain? By properly understanding the cause of pain rather than chasing pain or trying to cover it up.
The Problem with Low Back Pain Diagnosis
The most common diagnosis of low back pain or injury is “nonspecific mechanical low back pain.” This means that the cause is a physical thing, but the doctor can’t figure out the cause. Obviously, a vague diagnosis is not helpful. This leads to astronomical costs because doctors don’t know what they are treating or how to properly address it.
Getting Specific with the Diagnosis
If we identify the injured tissue and know what is causing low back pain, then we can specify treatment and get patients back to work and living a normal life faster and with less cost. This is good news for everyone. Spinal instability is a common injury induced problem and often a missed diagnosis. Most doctors today do not understand spinal instability and it is costing us millions of dollars a year.
How to Diagnose Spinal Instability
GOOD NEWS: Spinal instability is easy to diagnose by clinically correlating excessive motion found with stress x-rays with movement dysfunction, a motor problem, or a sensory-pain problem at that spinal motion unit level. Chiropractors trained in injury mechanics will take these special views. Doctors not trained in spinal injury and instability will not take these views.
Stress X-rays are specialized x-rays that show intersegmental motion. Dr. Leatherman and Dr. Bak accurately measure for any motion problems directly from the stress x-rays utilizing specialized computer digitization software that has excellent reliability and validity in measuring these injuries correctly.
Once you have the intersegmental motion of each spinal motion unit imaged, you can then correlate with the patient’s examination findings and determine the level and the severity of any spinal ligament injury and/or resultant spinal instability. This of course leads to more accurate injury analysis and diagnosis so specific chiropractic rehabilitation treatment can be initiated.
Understanding Low Back Ligaments
Spinal ligaments are not super strong and their stability is dependent on the muscles that surround them. If you place a 10-pound weight on your chest, then you add 100 pounds of pressure on your lower back. If you extend it 25 inches from your chest, then there is now 250 pounds of pressure on the lower back. That’s enough pressure of course to damage every single ligament in your spine. But doesn’t your ligament get damaged right then and there?
Because there is a coordinating system embedded in the ligaments called “mechanoreptors” that immediately recognize the pressure and signal the muscle system to instant correction for stability. However, when a ligament is torn or damaged, that system malfunctions and leads to spinal instability.
Patients need chiropractors who understand spinal instability and how to diagnose it. Employers and insurers also need doctors to keep costs down and employees working. That is why Dr. Leatherman and Bak attend specialized training to understand these injuries well. We need doctors who can help patients identify and treat low back pain with a great deal of accuracy.
- From the Centers for Disease Control and Prevention. Prevalence of disabilities and associated health conditions among adults–United States, 1999. JAMA. 2001;285(12):1571–1572. https://www.ncbi.nlm.nih.gov/pubmed/11302137
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- Reliability/Repeatability of Radiographic Positioning – (PCCRP) Practicing Chiropractors’ Committee on Radiology Protocols For Biomechanical Assessment of Spinal Subluxation in Chiropractic Clinical Practice – http://www.pccrp.org/docs/PCCRP%20Section%20IX.pdf