Chronic Back Pain


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Chronic Back Pain

Chronic Back Pain affects a huge number of Americans. Let's see what the problem is:

Musculoskeletal conditions cost our society an estimated $254 Billion every year. This, from watching 28.6 million American incur musculoskeletal injuries each and every year. Back/spine impairments, which number 18.4 million, are the most common musculoskeletal conditions for people 18 years of age and older. When added all together, musculoskeletal issues and injuries account for over 102 million visits to physician's offices and that includes 10.2 million hosptial outpatient visits. Add to that, 25 million ER visits.

One out of every seven Americans reports a musculoskeletal impairment, More than half of all injuries are to the musculoskeletal system. Over 43 Million people have some form of arthitis. It has been estimated that the number of people affected by arthritis will increase to 60 Million by 2020. One out of every two women and one out of every eight men older than 50 will have an osteoporosis-related fractuer in the lifetime.  (United States Bone and Joint Decade:

More research is being done all the time to help better understand the problem we all have with aging and existing in a graviational world.

See: Panjabi MM, "A Hypothesis of Chronic Back Pain: Ligament Subfailure Injuries Lead to Muscle Control Dysfunction," (2005) European Spine J, 668-676.       *Upshot here was a sizeable literature review about the causes of Chronic Back Pain. The hypothesis is that poor healing of spinal ligaments accelerates degeneration of dics and facet joints which leads to chronic back pain via inflammation of neural tissues. The paper concluded that a) an injured spine behaves differently, b) the subfailure injuries of the ligaments disrupt and/or injur the embedded mechanoreceptors, c) when the spine performs a routine task or responds to an external challenge, the disrupted/injured mechanoreceptors produce corrupted neuro signals describing vertebral position, motion, spinal loads, etc. for each and every spinal level, d) the neuromuscular control unit, although not affected by the injury itself, senses a mismatch between the normally expected feedback and what is actually received and thus, has difficulty in choosing the appropriate muscular response. e) the neuromuscular control unit produces a transducer neuro signal.  Two things cause abnormal mechanics of the spine: 1) Degenerative Joint Disease (DJD) and 2) Injury to the spinal ligaments due to a singal trauma or from repetitive aberrant motion microtraumas over time.

See: Kado D, Huang MH, et. al., "Hyperkyphotic Posture Predicts Mortality in Older Community-Dwelling Men and Women: A Prospective Study," J of American Geriatrics Soc., 52; 1662.   *Upshot here was a sizeable stufy of 1353 adult patients. Persons with hyperkyphotic posture had a 144% INCREASED rate of mortality. Hyperkyphotic posture is associated with restrictive pulmonary disease and poor physical function. As well, hyperkyphotic posture is more prevalent in men than in women. Patients with athersclerosis and hyperkyphotic spines had an increased rate of death to those without.

You're asking, "What is the world is hyperkyphosis?" When we look at the human spine from a side view, it has (or should have) a series of normal curves. The neck and the low back curve forward normally and this is called a "lordosis." The mid back and sacrum curve towards the back and that is called a "kyphotic" curve. The problem occurs when the normally lordotic neck curves backward into a kyphotic curve. As well, when the normally kyphotic mid back becomes too kyphotic we have a problem. Hyperkyphosis is just as it says, an exaggerated kyphosis. See graphics below. These two graphics show the human spine, below the neck, from a side view. The person is looking to our left here:  


The picture on the above right is normal and shows the normal kyphosis of the mid back as well as the normal lordosis of the low back followed by the normal kyphosis of the sacrum. The picture on the above left shows us an exaggerated kyphosis in the mid back, which in turn affects the low back and adds to the lordosis in that region.

   See also, "A re-examination of the whiplash associated disorders (WAD) as a systemic illness," (2005) Annals of Rheumatic Disease, 64; 1337-1342.    *Upshot here was a study of a sizeable population of people, 7462 to be exact. They all had a motor vehicle crash (MVC)  and filled out a general health questinaire on month after the initial crash. Findings were as follows: a) Spinal injury can result in body/systemic malfunction, b) patient's scores on the 36 item GHS (general health survey) showed low physical and mental functioning is as little as one month AFTER a MVC, c) what is commonly referred to as whiplash associated disorder (WAD) is be appreciated as a syndrome extending well beyond what can be labeled as a neck injury, d) the researchers concluded that: "more research is needed for a better understanding of the underlying mechanisms involved, so that treatment can be directed at a broad spectrum of symptoms rather than focusing on finding a focal neck injury."

>So What Can Be Done? Chiropractic manipulation of the spine can help a great many of the chronic back pain sufferers in the population including scoliosis, hyperkyphosis, disc issues, DJD (degenerative joint disease -formeraly osteoarthristis), headaches and many other syndromes. Chiropractors are the leaders in treating uncomplicated spinal degeneration issues, whiplash issues and general back pain syndromes. Please, if you have a chronic back pain situation, at least get yourself checked by a licensed chiropractor and you may be pleasantly surprised.


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