Low back pain in Endicott

There are many causes of low back pain: strained muscles, bulging, herniated and degenerated discs, irritated facet joints, sacro-iliac problems, leg length inequalities and are the most common.  To understand them lets start with a brief anatomy lesson.

 The ball of the thigh bones insert into the sockets of the pelvis.  The tops of the pelvis  are called the iliac bones. Wedged between the  iliac bones like a load stone in an arch is the sacrum sitting on top of the sacrum is the stack of lumbar vertebrae.  Each vertebra has front and back parts. 

At birth the sacrum is five bones that fuse by age five.  Normally the sacrum curves with the middle curving backwards and the front and back forwards.  If a toddler sleeps exclusively on the belly with the butt stuck up in the air excessive sacral curvature will develop and a permanent excessive lumbar curve will follow.  If the toddler is exclusively a back sleeper the sacrum will fuse flat and a flat lower back will follow.  But in 85% of cases, the sacral curve is close enough to normal to allow for a relatively normal lower back curve.  Nonethelsess, many have excessive or inadequate lumbar curves.   Few doctors (even among chiropractors) have the training necessary to measure and calculate this pelvic morphology accurately. 

Because the sacrum is firmly wedged between the pelvic bones like the load stone of an arch, it takes severe trauma to displace it, but it does happen and it is correctable. 

One leg being longer than the other can contribute to scoliosis and back pain, but rotation of the pelvis distorts films unless they are taken a special way to eliminate this problem and give accurate information.  Sometimes there are compensations for leg length inequalities that have been present for decades, sometimes not.  How to correct the compensation patterns, what it takes to do so and whether a patient and doctor are willing to follow through as necessary must be considered carefully: sometimes it is better not to fully correct.

Research by a chiropractor who is also a mechanical engineer and mathematician, (Dr. Donald Harrison), shows that the ideal alignment of the lower back as seen from the side view is elipse shaped with the  top and bottom towards the back and the curved middle in the front, fat part of the curve closer to the bottom. When the lumbar spine has this shape, there is less stress on the muscles that help support the body.  Half of the weight is being born on the front parts of the vertebrae called the bodiesand thedisks that act as shock absorbers beteween them, and half is on the back  parts of the vertebrae (facet joints). The spinal cord is in a nice loose configuration, there is no uneven wear and tear and the lumbar spine can last for many decades without any interference to the nervous system and without any arthritic changes. The technique that has developed from Dr. Harrison’s work is called Chiropractic Biophysics (CBP).  His son taught pelvic morphology mensuration at the advanced CBP lumbo/pelvic seminar.

If your car is out of alignment the tires will wear unevenly.  If you wore out some of the trend but still had some left, correcting the alignment (to the extent it could be corrected) would not make your tires perfect again, but it would prolong the life of them considerably.  It is the same way with your spine.

Activities that diminish lumbar curves include slouching, especially in a chair with the buttocks forward and the torso back, lying on your back without lumbar support, especially in a hammock or recliner, sleeping in fetal posture (knees bent up towards the chest), sitting in general, sittups and bending from the waist.  This is unfortunately encouraged in anyone over the height of 5'2" by the fact that houses were designed for 5'2" housewives Strengthening back extensor muscles can help (for information on how to protect yourself, especially if tall, come to my Back School or spinal care class). 

 After decades of uneven wear and tear from loss or reversal of lower back curves, the discs thin, bulge or herniate. As the discs thin, the body lays down more bone to support the excess stress and this additional bone forms spurs.  These spurs can close in on nerve roots that come off your spinal cord and innervate all parts of your body, and can also close in on the spinal cord (canal stenosis).  Bulges, herniations and bone spurs pressing on nerves can affect whatever part of the body that nerve goes to.  Many people have symptoms they do not associate with their spines: high blood pressure, asthma, urinary incontinence, constipation etc..  Many have  back pain.  Others have numbness, pain, weakness or tingling in a leg, buttock or foot (sciatica).

The main activities that increase lumbar curvature are sleeping on your belly and reaching up.  This condition can be aggravated by weak abdominal muscles.  This can put excessive weight and stress on the posterior facet joints and can lead to arthritic spurring in these joints. Nerves can be irritated or choked by these degenerative changes causing sciatica as well.

Today Arthritis is the number one cause of disability in senior citizens in America and puts more people into nursing homes than heart disease, cancer and stroke combined. It is very common for someone with back pain to go to a medical doctor, have an x-ray taken and be told that "You’ve got arthritis in your back, that’s perfectly normal for your age," (just as it was normal to have false teeth seventy-five years ago at that same age) and to be given a prescription for pills to help cover up the pain caused by the arthritis that was caused by the uneven wear and tear of the bones that had been out of alignment for decades.

 Clinical Biomechanics of Posture has raised this bar, just as dentists raised the bar on the standards of health for teeth. It says that ideal alignment of the spine allows for better function of the nervous system- no uneven wear and tear, no premature degeneration- and that most degenerative arthritis of the spine, is completely preventable with proper correction and maintenance of alignment.

Only one or two percent of the chiropractors in this country have been properly trained and have the equipment necessary to follow through with the Harrison model. Some chiropractors are advocating pain management, free up the motion in the joint, enable it to move freely, get the person out of pain and allow it to continue to wear unevenly and to degenerate and decay. Some chiropractors are saying, yes let’s adjust the spine until we have ideal alignment, but there is one problem with that: it will never happen without the appropriate protocol of exercises and very specific traction along with a different type of adjusting than most are doing to restore proper alignment to the spine.

If a carpenter wanted to bend a straight piece of wood into the shape of a circle, hitting the piece of wood in the middle with a hammer three times per week would never accomplish the task. To do so would require bending and clamping the wood repeatedly into shapes progressively closer to a circle. The ligaments along the spine are like that piece of wood. To change the shape of the spine requires three things: adjustments or manipulation, to mobilize the frozen joints, exercise to balance the muscular forces pulling the bones in different directions, and traction to stretch ligaments to correct improper alignment. The type of adjustments, traction and exercise will not only vary from patient to patient, but will change in the course of an individual patient’s corrective care program.

To find a chiropractor who practices chiropractic biophysics (CBP), go onto the internet to www.cbppatient.com, go to the top of the screen and click on resources, find a chiropractor, look to see who is available in your area and choose the one who has attended the most training seminars, as they have the greatest expertise.

In the Broome County area, only North Endicott Chiropractic practices CBP.