Date: Fri 20-Oct-1995

Publication: Hea

Author: AMYD

Quick Words:

back-pain-chiropractic-

Full Text:

BACK PAIN: A Condition So Common, But Not So Simple

B Y A MY D'O RIO

Come the weekends in the fall, people dust the cobwebs from their rakes and

from themselves and clean the yard.

"And lo and behold, they find themselves in the doctor's office," said Richard

Coopersmith, a Newtown chiropractor.

The pulling, twisting, carting and bending are just the type of movements that

keep doctor's offices full of low back pain sufferers.

About nine out of ten people will suffer low back pain at some point in their

lives, said Della Schmid, a local chiropractor.

Some are due to traumatic injury, others stem from a build-up of back

problems, and sometimes, the pain is a symptom of a larger medical problem.

The aching back is a common health problem, but it is certainly not a simple

one.

It can be difficult to just chose a doctor.

Local chiropractors said they should be the primary care doctor for lower back

pain, and the American Chiropractic Association backs them up.

Yet, the American Medical Association does not recommend people use the

chiropractor as the primary physician for back problems because they are not

as prepared as medical physicians to diagnosis, treat and refer.

Chiropractor Jerome McAndrews, a spokesperson for the American Chiropractic

Association, said chiropractors receive equal training to general

practitioners in diagnostics, and are trained better regarding the

muscular/skeletal area.

Dr McAndrews said the American Medical Association has always been prejudiced

against chiropractors. When it comes to back pain treatment, chiropractors are

twice as effective at half the cost, he said.

Chiropractors do not use medicines or surgery like medical physicians.

Chiropractors treat patients by physically manipulating the spine and applying

a number of different therapies, such as hot and cold packs.

They also recommend exercises, stretches, diets and lifestyle changes to help

relieve the pain and prevent it from coming back.

Local chiropractors said they will refer patients to a medical physician when

appropriate.

Both medical physicians and chiropractic doctors seem to agree, however, that

if a person has low-back pain, especially a shooting pain down the leg, it

should be addressed by a health-care professional.

This is stressed because Americans do not pay attention to mild back pain, Dr

Schmid said.

The pain may go away, but the problem may still remain and flair up more

frequently in the future, said Eugene Cayer, another local chiropractor.

He said often people are not aware of back problems and how their movements

become restricted. He said he has some people come to his office insisting

they are fine, but when he asks them to turn their heads, they can not.

People adapt and, eventually, consider their altered condition as normal, he

said.

The chiropractors said there are many silent problems that can eventually lead

to a pain. For example, Dr Cayer said many people do not get help when the

back muscles are strained or torn. They rest and wait for it to abate. Yet,

untreated, the muscles can heal improperly, like a bone, and become a weak, he

said.

That weak link may not be a problem initially, but it could become one if the

person gains weight or gets pregnant.

Even the way people position themselves can cause problems, said Dr

Coopersmith.

Dr Schmid agrees. She said a person who constantly has the phone between the

ear and shoulder may develop the muscles on the right side and not the left,

which could irritate the spine.

The lower back is a particularly vulnerable area of the spine.

It is curved inward and is one of three natural, spinal curves. If the lower

back is weak, the entire back loses support and then pressure is put on

joints, nerves and discs.

In general, the American Medical Association says back pain is caused when

people test the limits of the spine's range of movement. Susceptibility to

pain is increased because the spinal cord, a major part of the central nervous

system, is located in a channel that runs the length of the spinal column.

The spinal column also has narrow side channels through which peripheral

nerves pass on their way to and from the rest of the body. Thus, problems with

a vertebra, supportive ligament or disc may lead to pain and weakness in an

extremity.

The medical association details a few types of back pain.

Lower back pain, according to the association's literature, is centered in the

small of the back and is often caused by unusual exertion. It can be severe

and sometimes people can not move.

The most commonly known cause is when people lift a heavy object by putting

the strain on the back instead of the legs.

Physicians disagree about the exact cause of the condition, but the AMA said

it is probably a mixture of pulled or strained muscles, muscle spasms and

sprained ligaments.

Coccygeal pain describes a nonspecific backache located at the base of the

spinal column. It is caused by falling on the buttocks, or sometimes with

women, occurs right after childbirth.

Sciatica pain is caused by pressure on the sciatic nerve, the largest of all

nerves, as it leaves the spinal column. The pain is generally caused by a

prolapsed disc and is characterized by shooting pain.

Dr Coopersmith said people can avoid back pain by taking care of their overall

health. He said people need to eat a balanced diet and keep physically fit.

Posture is important as well as being aware of the body's movements and

positions, he said.

Both he and Dr Schmid suggested people ask assess how they stand, sleep, work,

sit, and try to reduce their stress level. Dr Cayer added that people should

find a good mattress, but he has given up trying to tell patients what a good

mattress is.

And to avoid ending up in doctor's office this fall, the chiropractors

suggested that sedentary people who must rake the yard, do so in short periods

over a series of days instead of all on one day.