No one is surprised by the statistic that eight out of 10 people will experience back pain during their lifetime to a degree greater than an "occasional ache." After all, our population's collision-course trends of aging baby-boomers and increasing obesity patterns make the probability behind this statistic all too easy to understand and explain. Yet, are "probability-based" health care statistics and general wellness principles all we have to rely upon to determine whether back pain will occur? Is there health care data that can actually be of use to understand and avoid back problems?
Say you have a patient in general good health, who never had an injury of any consequence. The patient is neither old, obese nor sedentary. Yet, based on statistics, the patient has most likely experienced severe disabling back pain at some point. The patient is bucking the trend but, in a bad way.
So, what is the best approach to help your client, even though he is feeling okay at this point? How can he avoid becoming apart of this statistic? Should the client join a heath club? Or would an orthopedic physician be of more use? How about a chiropractor? Each of these individuals will actually have an answer but, it will be within the realm of their particular discipline. Perhaps the more complete answer is to combine the medical findings approach central to traditional medical models and non-allopathic considerations to uncover both existing and pre-symptomatic conditions to enable a more thorough range of findings.
An increasing body of research is showing that tissue damage can occur without presenting noticeable symptoms. The ensuing processes our bodies undergo to compensate for and/or heal these injuries begins a cycle that can progressively weaken our musculoskeletal systems to the point of becoming susceptible or pre-disposed to further injury when a repetitive or undue stress is focused on a particular body region. "Pre-disposing" factors are rapidly finding use as the basis for sound predictive medical modeling. More importantly, pre-disposing medical factors are particularly germane to helping translate the probability-based medical statistics geared to an entire population into a confidence-based risk assessment for you individually.
The Future of Understanding the Real Probabilities for Pain
The notion that omitting proper training of the body's core muscle groups can lead nearly anyone to future back problems is a school of thought continually gaining support in peer-reviewed research. Yet, properly exercising core muscles is only one facet of keeping back pain away. One needs to consider if pre-disposing factors are present before a truly accurate determination of future risk for back pain can be made. Pre-disposing factors complicate diagnoses because they manifest themselves in many forms. They can be in the form of active medical conditions such as diabetes; behavioral conditions such as smoking; or even psychological conditions such as attention or activity disorders. All, however, share the common attribute of being pre-symptomatic findings to back pain.
For example, a key pre-disposing indicator to musculoskeletal disorders was recently found in the link between diabetes and carpal tunnel syndrome. A diabetes diagnosis does not mean you will automatically get carpal tunnel syndrome. Yet, if someone has diabetes and then repetitively stresses his or her wrists owing to physical tedium in their job or a hobby, carpal tunnel syndrome will have a particularly high proclivity of surfacing. The small leap of faith is that diabetes has since been shown to be a pre-disposing factor to nearly all musculoskeletal disorders, including those of the back.
Do we foresee a future where local health clubs can intervene to strengthen their customers' inherent weaknesses per a personal pre-disposition profile to avoid specific physical injury and significantly target their member's time and money akin to a treatment plan? We tend to think this will happen. However, at this time, health club staffs are not qualified to execute meaningful pre-disposition testing. Currently, this is an exclusive area of focus for the medical professional because reliable testing must be done under direct and qualified medical supervision. orthopedic and Osteopathic physicians and chiropractors can provide proper testing for pre-disposing conditions. Conspicuously absent is an integration of what health clubs and medical interventions bring together that can get to the very center of identifying and treating back pain this is what we call the Interdisciplinary Clinic Model.
The Interdisciplinary Clinic Model
An Interdisciplinary Clinic Model integrates bio-mechanical education, exercise physiology, pain avoidance techniques and non-surgical treatments within a single facility. It fits on the spectrum between health club facilities who promote pain avoidance via regular and proper strengthening exercises on one end and medical physicians who alleviate pain using more invasive clinical methods on the other end. The model takes a queue from health clubs in using core physical training as a means of back pain avoidance, but also adds use of core muscle training as part of the treatment of back pain. Similarly, the model mirrors the traditional medical intake approach in the way it triages clients.
The Interdisciplinary Clinic Model can combine core strengthening circuit equipment, spinal decompression treatment plans and peer-reviewed, non-surgical pain management treatment techniques under direct chiropractic supervision. Designed to be an interim stop between the health club and an orthopedic physician, its objective is to get individuals on a lifelong path without pain.
Non-surgical spinal decompression helps to achieve treatment goals of increasing pain-free ranges of motion, centralizing pain, reducing intradiscal pressure and increasing intervertebral disc height. It is well documented that weakened spinal core muscles (multifidi, iliopsoas, quadratus lumborum, lumbar paraspinals), along with shortened and contracted opposing muscles leads to poor biomechanics of the spine, and vice versa.
The basis for using the core equipment for both pain avoidance and post spinal decompression treatment in the clinic model is due to controlled, single plane and isolated strengthening movements that help target deconditioned muscles safely, reduce the likelihood of an acute exacerbation or failed rehabilitation attempts. Continuous strengthening sessions are easily followed and take only 20 minutes at the frequency of twice per week to maintain a strengthened core posture. It is proven that this approach highly reduces the likelihood of future re-occurrence and re-entry of pain patients into our clinic.
Obvious and logical general health avoidance techniques still apply when it comes to figuring out whether back pain is in your future. But, as we've seen, it's not the whole story from either a diagnosis or treatment perspective. Each of us may have certain pre-disposing factors that can dramatically increase our probabilities of becoming injured or having a future date with back pain.
Dr. Eric Groteke, DC is the Owner and Staff Doctor at The Back-2-Life Interdisciplinary Clinic, which is an example of the Interdisciplinary Clinic Model. There are two locations in