Ongoing lower back issues

[maxwolfie]

I've had some very localised lower back pain for quite some time, and am now considering starting a Chiropractic plan for about 3 months to see if anything improves. X-rays and viewing my general posture front on and side on show some fairly glaringly obvious misalignments at the top of my legs or pelvis, my shoulders and also my neck. So far I've been told that correcting these misalignments will give a good chance of my pain substantially reducing or disappearing altogether. So far I've been 3 times, and had two adjustments. No real noticeable changes but I guess it will take time.

I've tried physiotherapy but tens machine, traction, dry needling, deep tissue massage and core strength exercises have no effect.

Has anyone had any experiences with Chiropractors in the past? So far they seem be either loved or hated.
Why did you start going?
Did it help/not help/make things worse?

 

[Minlak]

I started to have lower back issues around 9 yrs ago. this was a result of working as a brickies labourer and a mechanic for several years in my younger years. All the leaning over the car in one position and constant bending of the labouring finally took its toll in a tug of war challenge between 2 of our local gyms.

I went the first time when I couldnt even stand up straight anymore (was great for finding money but not so great for comfort) they did an assesment and suggested a treatment plan.

What I have found in the following 9 years is my wallet is a lot, lot lighter but my back wasnt a whole lot better it now seems to go out more easily than before and talking to some physio friends they suggest that the constant pushing the spots back in create wear and allow it move out of allignment easily too.

I have learnt to avoid most things that would have created an issue for me over the last few years but now I only go to the Chiro when i am in extreme pain to get it realligned and ease the swelling of the surrounding flesh.

There are some excercises you can do to help strengthen problem areas and reduce occurence of the issue.

So in my experience following the maintenence plan of my chosen Chiro was expensive but far less effective than the correct excercises, The Chiro only treated the symptoms for me not prevention or cure.

Of course helps I now go out with a Physiotherapist so free treatment helps

 

[Trickymac]

Hey maxwolfie, you should look into seeing an osteopath, much better at fixing the source of your problem and giving you exercises to help strengthen and maintain rather than symptom relief
Google Australian osteopathic association, some good info and they will point you in the right direction

 

[Norco Maniac]

i started seeing a chiro about 12 years after a spinal compression injury when the heavy lifting work i was doing had become too painful to cope with any longer. initially i saw him fortnightly or monthly, and combined it with a comprehensive health plan of my own - i began studying massage and remedial therapies so i utilised the student clinic at the college as well. i had the compression injury to my occiput/C1, a birth deformity to L5/S1, and fibromyalgia, so my monthly routine was acupuncture, kinesiology, massage, chiropractic in that order, plus homeopathy andherbs from the naturopathy clinic. i also did a lot of stretching to realign my muscles. i was still working hard between gardening, study and warm-up massage for an osteopath, and got into BMX the second year into the routine. i kept up that plan for three years in total, and now really only get adjusted when something goes out, which is usually about twice a year now or if i have a major stack.

i would recommend seeing a Rolfer if you have alignment issues, i was fortunate enough to have a practitioner as one of my teachers and i learnt a great deal from him.

good luck!!

 

[jumpers]

Hey maxwolfie, you should look into seeing an osteopath, much better at fixing the source of your problem and giving you exercises to help strengthen and maintain rather than symptom relief
Google Australian osteopathic association, some good info and they will point you in the right direction

I agree with trickymac. Look at what is causing the problems rather than physio/chiro practises of just giving pain relief. Everything can be realigned, doesnt need physio machines etc.

Maybe not for you but - i think you need look at yoga. As yoga teacher we have cured heaps bad backs etc that physios/ chiros say are unfixable. Website for yoga therapy should be able direct you to therapists. Check Simon Borg Olivier - awesome with injuries like this (YogaSynergy)

 

[willsy01]

Hey maxwolfie, you should look into seeing an osteopath, much better at fixing the source of your problem and giving you exercises to help strengthen and maintain rather than symptom relief
Google Australian osteopathic association, some good info and they will point you in the right direction

This.

Chiros tend to want to see you once a week for the rest of your life. Osteos take the time to warm up all your muscles before they start treatment........the bloke I see puts a hot towel on the area he's going to work on then a 20mins massage THEN starts treatment. Makes a big difference in my experience.

 

[Arete]

Properly conducted surveys of chiropractic patients overwhelmingly indicate that patients think that the treatment assists in back pain.

Use of video x-ray, EMG, MRI and thermal imaging has failed to show that chiropractic manipulation actually results in any physical change to the spine.

Randomized control trials using "sham" manipulation provide conflicting results as to whether or not prescribed chiropractic treatment is more effective than a placebo, although a placebo and chiropractic treatment were both shown to be more effective than a consultation with a GP. In summary, Chiro seems to be somewhat effective at treating back and neck pain.

"Chiropractic has endured, grown, and thrived in the United States, despite internal contentiousness and external opposition. Its persistence suggests it will continue to endure as an important component of health care in the United States. In response to the countless requests for the treatment of pain, chiropractors have consistently offered the promise, assurance, and perception of relief. Chiropractic's ultimate lesson may be to reinforce the principle that the patient-physician relationship is fundamentally about words and deeds of connection and compassion."

http://archinte.ama-assn.org/cgi/content/full/158/20/2215#SEC7

With that in mind if chiro works for your back pain, awesome.

Where it gets funky is when SOME chiropractors/chiropractic organizations deny germ theory and claim that disease is caused by spinal misalignment, and they can treat it. Take this article: http://www.planetc1.com/search/the-germ-theory-of-life.html vs http://www.ncbi.nlm.nih.gov/pubmed/11619007

"Germs are everywhere – if they caused disease, we'd all be dead instantly! Louis Pasteur was a liar, big pharma is a giant conspiracy! But never fear I can treat EVERYTHING by cracking your back! Just sign the check out to Dr. Chiroscam and I'll see you next week."

 

[my02]

Some good advice in here. You have to treat the cause, not the symptoms.

I went to see a chiro (no names but based on Harris St, Pyrmont) and the pain caused to me was severe. However the pain the following day was utterly excruciating. Her response when I called the next day was "its not unusual to have some discomfort after having your first adjustment"

Oh really? How about the inability to breathe anything more than a shallow breath whilst lying down? Is that that sort of pain usual??

I could go on....

I did find an excellent osteopath (Greg Amer - based in Edgecliff - and is a keen triathlete so has a good understanding of cycling). He was always very good at relieving pain but admitted he couldn't find the reasons behind my particular issues. He told me what they were - rotated and twisted pelvis - he just couldn't explain why.

I was going to write about my experiences with the other practitioners i've seen around Sydney however that doesn't really help you.

My first recommendation would be to see your doctor.

I'd also suggest having a close look at your training programme and ensure that it, along with your riding, doesn't contribute towards muscular imbalances. I know that I neglected the strength in my hip flexors in my training and this has been the cause of my back problems.

Unfortunately, what I have learned over the last few years is that 100 people could present pain in the same area of the lower back but have 100 different reasons as to what caused it. Its always well meaning when someone says "try yoga / pilates / Eastern Medicine etc" but often they can range from ineffective through to contraindicative.

The language that is thrown in there also adds to the confusion.

- Adjustments. WTF? The clicking that occurs in the spine during this is the same as cracking your knuckles. Nothing actually changes. There can be temporary relief but this doesn't change something that is possibly or probably muscle related. There are certainly many, many other causes but I believe you're still quite young (under 30), very active and a gym goer, I'd put my money on a muscular imbalance as opposed to neural issues or disk degeneration.

- Realigning your muscles? I've not heard that before but your muscles are always aligned unless you've experienced MASSIVE trauma.

- You cannot lengthen your muscles through Pilates (not unless they thrown in free surgery)

- Your back doesn't actually move when it goes out. Or if it has, you're looking at something VERY serious because you probably hucked the Opera House.

Dr Stuart McGill has performed a HUGE amount of research and is generally lauded as the world's leading authority on lower back disorders. He's done some great podcasts and written several books. A lot of his research with athletes (I'd almost put you in this category per my above comment) points to simple, easily treated muscular imbalances as being the cause in a lot of LBP patients.

But with all of that in mind, I'd still be very keen to understand your symptoms eg - pain when bending forward, standing up after sitting for longer than 30 mins, pain when sitting or other movements.

 

[maxwolfie]

I have mild scoliosis and my posture is out of whack (one shoulder higher than the other, pelvis slightly out as well, neck straight instead of natural curve). After standing up straight and the chiro taking a photo, he was easily able to draw some lines showing disparities with my posture. I'm doing Rippetoes (what I would consider to be overall strength training) and that hasn't helped much/at all. As mentioned, tens machine, massage, dry needling/other physiotherapy methods have not worked.

The pain is not what I would call "debilitating", but it's certainly not fun on some days. Very rarely, I can't actually bend over to tie up my shoelaces. If I had to describe it, I would say it is a very localised inflamed muscle feeling in one spot only (like 2cm x 2cm at most), L4-L5 just on my right hand side, 3-4cm from the centre of my spine.

I called 5 mins ago to put off any more Chiro visits until I obtain further research either way. To be honest I have no idea what an osteopath does (without googling and finding out)? Is it a sports specific physio or??

 

[my02]

If you think it is inflamed, there would be no harm in putting ice on the area.
Re your pelvis, do you know if there is any tilt or rotation? Your scoliosis and shoulder height are undoubtedly linked.

Do you also spend a lot of time sitting?

 

[botch]

Hmm....to go against most on here, I think it can help. I also think the chiro doing the treatment is a major factor in its success.

I used to work for a car manufacturer, and spent 8 hours a day standing on my feet, working under the cars, so looking up. Caused a fair bit of pain in from between my shoulder blades and up. Got to the point where I couldn't do any weights, which was something I did 3-4 times per week. Went and saw a chiro, and it improved.

However, a year or so ago, he sold his practice to another chiro, who is much younger, and has studied a few other remedial remedies...he fixed me up real quick. Started with 2-3 weekly visits, and am now going every 3 or so months, if I need to.

He also worked absolute wonders on my wife during her pregnancy...she had really bad sciatic pain about half way through, to the point where she couldn't walk. Half carried her in, while she hobbled in pain, and she literally walked out!!! Was amazing

 

[Norco Maniac]

If I had to describe it, I would say it is a very localised inflamed muscle feeling in one spot only (like 2cm x 2cm at most), L4-L5 just on my right hand side, 3-4cm from the centre of my spine.

what's happening there i would say is a slight quadratus lumborum spasm. specific stretches will help, especially with a mild scoliosis. i use facilitated stretching on my clients and often teach it to people i train with. the book is comprehensive, easy to read, has plenty of diagrams, and is relatively cheap, one of the best investments i ever made.

 

[maxwolfie]

If you think it is inflamed, there would be no harm in putting ice on the area.
Re your pelvis, do you know if there is any tilt or rotation? Your scoliosis and shoulder height are undoubtedly linked.

Do you also spend a lot of time sitting?

Not sure what you mean by the tilt/rotation thing?

Yeah, I spend heaps of time sitting. I'm either sitting in the car, or sitting in an office chair, sitting on my bike, or sitting at home at the dinner table or in front of the computer.

 

[my02]

Pelvic tilt = the pelvis can be rotated forwards or backwards. If you stick your bum out, thats anterior tilt. If you do the opposite (as one might do in part of an ab curl or similar), thats posterior tilt. Like rolling your handlebars

Rotation = where the pelvis twists to one side or the other. Like turning your handlebars

If you Google both phrases plus "test" there are some good sites that can allow you to test if you are experiencing these.

You can also have one side of the pelvis tilted which is what I have (but is now getting better). My right hip flexor is stronger resulting in LB pain on my left and a badly aligned pelvis. Such a simple fix but one missed by so many practitioners.

As SV said, you could have a spasming QL. Stretching may indeed help but if it is tensing to protect something else, you may just get short term relief or possibly aggravate it. Exercise caution. The body had a very good way of compensating in order to allow you to function at a basic level. This may not be ideal and could be considered a "limp home" reaction. Tensing or spasming muscles often support an injury.

The sitting thing could be a big part of the issue. The body isn't well designed to sit for long periods irrespective of what you sit on. Frequent movement is always good. Try a simple test for your hamstring flexibility and hip flexor flexibility as these are two muscles shortened by sitting and riding. These muscles being tight in unison could affect the pelvic position.

A simple way to attempt to remedy this (along with stretching) is fast walking. Mall walking won't cut it, in fact it has been studied that slowly ambling along doesn't allow your walking muscles to move and synchronise properly. You need to get out and do some fast walks. Try 30 mins every day. And walk tall! This could be a good warm down after riding or gym work. Throw in (once properly warmed up) dynamic stretching. *Caveat - learn proper dynamic stretching as it has the potential to cause injury however done properly it has been shown to be way more effective than static stretching in achieving long term flexibility.

If you sit asymmetrically (not square on to your desk, right hip positioned further forward for the accelerator in your car, twisted to watch tv or reach a mouse etc) for long periods of time, this could be a possible cause of your one sided pain.

Also research muscle balance. Riding along with weights (squat, DL, BO Row, SLDL) can really work the posterior chain. If this isn't balanced, injury can be just around the corner. Also consider that a lot of weights work only hits muscles in the sagittal plane. There are two others to consider!! The QL that SV mentioned is a good example of a muscle worked in the frontal plane. Its also vital for proper stability and plays a huge role in MTB.

 

[shakes]

The chiro may re-align you.... But what good is that if the supporting muscle system has learnt to hold your body in place where it currently is and pull's itself back to where it thinks it's meant to be? more chronic pain and more trips to the chiro.

By all means try it, but look at your body as a whole and treat the problem not the sympton.

 

[maxwolfie]

Still having issues, no idea where to go from here. I am now sometimes getting continuous pain from my left hand side lower back right down to the arch of my foot. This never used to happen.

Do I try to find a local Osteopath? Who/where near Parramatta?
Do I continue doing three day split at the gym?
Do I look at integrating some hip flexor-specific exercises?
Do I take up pilates or yoga?
Do I revisit the chiroscam and take up his scamplan?

I don't want to waste my time with the above if it's not going to help - I wish I could just go see a specialist and he could point me in the right direction (which I've done, but he's just told me to do an overall body strength plan at the gym, which I've been doing for 4 months with no sign of improvement. If anything, it's worse!).

 

[Trickymac]

hey maxwolfie
do yourself a favour, go here
http://www.parramattasportsmedicine.com.au/index.html
see the osteopath sami karim, he will sort you out, and give you an honest answer to your problem
itll be the best money you ever spend
and it will fix you up

 

[Trickymac]

and maxwolfie, if sammy doesnt fix you up or give you the answer you are looking for ill treat you for free...since your a fellow cyclist
im an osteopath, but im in chatswood/hornsby if you can get there
i treat the bernard riders racing team and keep all those cyclists in top working order
hope it all works out for you
if not pm me

 

[maxwolfie]

Thanks mate, I'm seeing Sami this Saturday, let's see how we go

 

[my02]

So how did you go?

Back all sorted?