Bad Back?

Chiropractors? Oh, they take care of back problems with spinal adjustments.” That widely held view of chiropractic care is correct, says Dr. Stephen Guild of Laconia, but it’s so much more than that. It also includes neuromuscular skeletal disorders, carpel tunnel problems, lumbar back strain and cervical strain, to name a few.

The aim of chiropractic care isn’t just relieving a specific physical symptom — it’s achieving lifelong health. Dr. Guild, who is president of the New Hampshire Chiropractic Association, says the central nervous system is the key to the functioning of a healthy body. The spine protects the central nervous system and is the primary focus of chiropractic treatment.

The brain coordinates bodily functions primarily through peripheral nerves, which exit the spinal column. Misalignment within that system can impact the whole body, he says. This misalignment, in which one or more of the bones of the spine move out of position and press on or irritate spinal nerves, is called subluxation. There may be pain and loss of function. A chiropractor works to locate and correct or reduce vertebral subluxations in the spine, using the technique called spinal adjustment.

Daniel David Palmer was the first to use adjustments of the spine to treat back problems back in 1895; he is considered the founder of chiropractic care. Dr. Scott Sardonicus, the president of the N.H. State Chiropractic Society, says Palmer’s underlying philosophy of chiropractic care was that “wisdom — innate intelligence — is born in each of us. That intelligence is always there, working for your health.” The aim is to free the body from factors that inhibit a patient’s natural ability to heal.

Today’s chiropractors may use only spinal adjustments or they may include a broad range of treatments — ice, heat, electric nerve stimulation, herbal medicine, ultrasound and massage among them. The terms “straight” and “mixed” that were used to describe different kinds of chiropractic care are seldom used these days.

Patients will encounter familiar tools and techniques when they start chiropractic treatment — stethoscope, blood pressure cuff, x-ray, reflex hammer, neurological and orthopedic tests, observation and palpation. “The fine art of touch can discover a great deal about a patient’s health,” says Dr. Guild.

Chiropractors use their hands (chiropractic is Greek for “done by hand”) to deliver carefully controlled pressure to identified areas of the spine. This is the “adjustment” that is central to chiropractic care. They pose very little risk, Dr. Guild says. There may be some temporary discomfort when pressure is applied. If the adjustment is aimed at a longstanding condition, the body will have to adjust to the change in alignment, which can cause some soreness or discomfort for a short time.

Chiropractic is not disease-based, says Dr. Sardonicus: “We don’t say chiropractic is a good treatment for migraines, for example, though treatment may alleviate the migraines.” Chiropractors don’t treat patients in crisis. If someone has pneumonia, there is a need for antibiotics and perhaps the lungs must be cleared. If a bone is broken, it needs to be set. “Call on emergency medicine for crisis care,” they say. “But if tending to long-term health is the goal, call on chiropractic care.”

Both Drs. Sardonicus and Guild have patients who were referred by medical doctors. They have also referred patients to the medical system. They anticipate that this kind of cooperation will grow. Guild notes that state legislation defines chiropractors as “port of entry providers.”

Such cooperation was not always the case. Medical doctors long resisted chiropractic care because of what the American Medical Association termed a “rigid adherence to an irrational, unscientific approach to disease,” but the resistance gradually faded. In 1997, the AMA adopted as policy the following statement: “Manipulation has been shown to have a reasonably good degree of efficacy in ameliorating back pain, headache and similar musculoskeletal complaints.” Medicare covers chiropractic care, as do many insurance plans, but it’s likely to have a higher co-pay because it’s considered a specialty.

Practitioners say chiropractic care is suitable and beneficial at all stages of life, from infants to frail elders. Many recommend that a newborn infant be evaluated and perhaps treated for subluxations resulting from birth. “When children grow up with chiropractic as the primary mode of health care, they recover quickly from earaches and other childhood problems,” says Sardonicus. “Their immune systems are working as nature intended.” The profession does not recommend vaccinations in childhood — an extremely controversial point of view.

Nancy Hart of Moultonboro turned to chiropractic care for her five children after she was treated for neck pain several years ago. She was also experiencing severe pain in her thumbs and had been told that nothing could be done about either condition. Pleased with the success of her own chiropractic treatment, Hart, a school nurse, decided to have her children evaluated. “They are tall and thin and active,” she says, “and I thought they were vulnerable to spinal problems.” Now they see a chiropractor once a month. She has seen a dramatic improvement in the energy level of her youngest child, who was “always tired and grumpy” before he began chiropractic care.

Chiropractic is said to be the leading component of alternative medicine in this country, but this is difficult to substantiate. A study by Dr. David M. Eisenberg, done in 1991 and updated in 1998, found that 42 percent of Americans had used alternative medicine and 11 percent had used chiropractic care.

Alternative medicine includes chiropractic, acupuncture, herbal medicine, physical therapy, massage, homeopathy, naturopathy, Chinese energy systems, music therapy and other techniques. Another term that’s sometimes used, complementary medicine, usually indicates that the techniques are used in conjunction with allopathic medicine, which treats disease with remedies that produce effects different from those caused by the disease itself.

Nancy Hart, with a medical background, admits that she knew little about chiropractic care. She tried it on the advice of a good friend: “There is definitely something to it. It has worked so well for me and my family.” NH

10 Ways to Avoid a Bad Back

1 Maintain a healthy weight. Excess weight tends to creep up slowly, so we may not be aware of how it affects us. But try carrying a 20-pound pack on your back all day and you’ll have a better idea of how extra weight takes a toll on the whole body.

2 Strengthen the abdominal and back muscles. A strong core — which includes all the muscles of the trunk — is important for avoiding injury.

3 Lift items properly. Protect your back when lifting anything by standing close to the object with your feet apart to give you a stable base. Squat down while keeping the spine in proper alignment and contract your abdominals as you lift using your legs.

4 Strengthen the leg muscles. Along with the core muscles, the leg muscles play a vital role in helping you maintain good posture and body mechanics.

5 Stay flexible. Inflexibility in the form of tight hamstrings and a limited range of motion in the trunk can increase your risk of injury or make existing back pain worse.

6 Maintain good posture. Correct posture and body mechanics play a vital role in preventing back pain because pressure on the discs and strain of the muscles, ligaments and back joints is aggravated by incorrect posture and body mechanics.

7 Buy a comfortable mattress. Most of us spend a good deal of time in bed, which is why a good mattress is such a wise investment. Do some research, test the mattress out at the store and ask for recommendations.

8 Reduce stress. Stress increases tension in all your muscles, including your back.

9 Warm up before activity. Jumping right into intense activity increases your risk of injury, so take the time to get your muscles and joints warm and limber first.

10 Support the lower back when sitting. Use a rolled towel, small pillow or specially designed seat support available at medical supply stores.

Excerpted from guidelines formulated by the American Council on Exercise (www.acefitness.org)