Back, neck and spine pain syndromes are some of the most common conditions seen by doctors. Despite billions of dollars in research over the years, no one treatment approach has been proven to be superior to others.
Chiropractic certainly is a proven method of spine pain relief. Physical therapy, massage and acupuncture can be quite effective for many folks. But if you have had back pain, the recurrent chronic kind, you know that none of these treatment approaches works in the long run.
Applying engineering principles to spinal research might be changing all of that. You see, studying the spine from an engineering point of view allows researchers to have a better understanding of the stresses that occur in spinal ligaments and the strain placed on the muscles that support the spine. As strange as it may sound, normal spinal configuration really has never been determined. Without knowing what the normal spine is and looks like, doctors, myself included, have had a really tough time in formulating an effective and long-lasting treatment approach. That is the bad news. Finally however, there is an emerging model of the normal spine. It based on a concept called spinal balance. Spinal balance means just what it says, the components of the spine, including the pelvis, lumbar spine or lower back, the mid-back or thoracic spine and the neck and head are all aligned and in balance. Chiropractors have looked at the spine this way for years. The problem was and still is, we really didn't have a way to measure the spine and when we did see something that looked unbalanced, there was not much we could do about it. Despite what chiropractors have claimed over the years, very few could actually show structural changes in a patient's spine after treatment.
Sure patients felt better after chiropractic treatment, but rarely did they look any differently. The pain would go away but the structure seldom would change. Typically because the structure or balance of the spine was rarely truly corrected after a chiropractic treatment, more often than not, the pain soon returned. This failure to actually correct the basic problem causing the spine pain, then either lead to more chiropractic visits or a trip to the physical therapist's office. The physical therapist would look at the patient, recognize that something wasn't quite right and exercise the heck out of the patient.
Intense exercise just like chiropractic, also rarely really corrects anything. Exercise sometimes does help to relieve the pain, but usually only if the patient religiously worked out 3 hours per day five days a week. Once they stopped the intense exercise, the pain more than likely returned. Leading to a visit to the acupuncturist. Now the modern acupuncturist is usually quite skilled at using his or her needles to block the pain messages going from the back and neck to the brain. But tiny needles no matter how expertly placed, typically do nothing to restore spinal balance. So you guessed it. You end up with one very frustrated patient with recurrent back or neck pain. And the merry-go-around starts again with a call to another chiropractor: around and around she goes!
At this point I have to give some credit where credit is due. It was the spine surgeons that really started the scientific study of spinal balance. Perhaps after cutting and grinding and drilling the spine, only to have the pain, way too often return in their patients, they too realized they were missing something important. Often times surgeons would fuse a patent's spine and support it with nuts bolts screws and rods. Some patients were improved, many other were no better and too many were worse after their surgery. Even though the surgery was a success, the back pain returned.
So some surgeons, particularly the orthopedists in France started to look at the spine as a single unified structure. They looked at how the mid-back and head and neck could possible influence the movement and function of the lower back. They looked at their surgical failures to see how their fusion surgeries in a patient's lower back effected that levels of the spine far removed from the site of surgery. What they found was the various parts of the spine were (or at least should be) in balance. Change the head and neck and you will see compensations in the lower back. Fuse the lower back with surgery and you will see compensations in the mid-back and head and neck.
What they found was that all the parts or regions of the spine influenced and effected that other parts. Now when they did surgery and fused the spine in such a way that considered spinal balance, there surgical results often were much better. What they discovered was that good spinal balance resulted in less chronic recurrent back pain. This newly discovered concept of spinal balance can be applied to chiropractic and physical therapy treatment for chronic back pain. Now instead of the chiropractor treating the patient to restore motion to the spine, he or she can manipulate the spine to restore spinal balance. Now instead of the physical therapists working to strengthen weak spinal muscles, he or she can stretch tight muscles and strengthen those need to promote and restore spinal balance. It changes the intent of treatment. The goal is not to suppress pain but try to eliminate the abnormal balance in the spine that is the stimulus that causes pain. Restoring spinal balance is an approach that seeks to identify the cause of chronic neck and back pain, then rehabilitate the balance of the spine. Can changes in spinal balance really occur after chiropractic spinal correction? You be the judge.
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