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Low Back Pain, Arthritis and Chiropractic, A Clinical Correlation

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Low Back Pain, Arthritis and Chiropractic, A Clinical Correlation

A report on the scientific literature 


By

Mark Studin DC, FASBE (C), DAAPM, DAAMLP

William J. Owens DC, DAAMLP

 

The American Chiropractic Association (2010) reported that 31 million Americans experience low back pain. This is an epidemic at a staggering rate because what most of the public and doctors alike do not understand is what that sets the patient up for later in life that can be prevented. Stupar, Pierre, French and Hawker (2010) found that 49% of the general population reported a 6 month prevalence of low back pain, with11% reporting the back pain to be so significant that it seriously limited their activities.

Low back pain and arthritis have now been linked. According to Dawson and Shaffrey (2009), the most common form of arthritis is called osteoarthritis. It is also known as degenerative joint disease. It affects more than 20 million American adults. The cause of osteoarthritis is a breakdown of cartilage, the connective tissue that provides a cushion between the bones of the joints. Healthy cartilage is what permits bones to move over one another and acts as a shock absorber during physical activity. Those afflicted with this disease experience a breakdown of cartilage in which the cartilage wears away. As a result, the bones under the cartilage rub together, resulting in pain, swelling, and a loss of motion in the joints.

Osteoarthritis often begins at a slow rate. Early on, joints may be sore after physical work or exercise. The pain of early osteoarthritis dissipates and then returns over time, particularly as a result of overuse of the affected joint. Other symptoms may include:

1. Swelling or sensitivity in one or more joints, especially when related to a change in the weather

2. Loss of joint flexibility

3. Stiffness in the joint(s) after getting out of bed

4. Either a crunching feeling or a sound that results from bone rubbing on bone

5. Bony lumps on the finger joints or at the base of the thumb

6. Intermittent or regular pain in a joint


As Stupar et al. (2010) reported, osteoarthritis or OA has long been associated with back pain and reported comorbidity (they exist together). 40% of hip or knee osteoarthritis patients have had low back pain. That is a significant number and associated with hip arthritis. The 2010 study concluded having hip osteoarthritis and low back pain is a conclusive predictor for future leg pain and disability and suggested that alleviating low back pain may impact future hip pain and function.

Clinically, the authors have seen in patients with low back instabilities and persistent pain the degeneration of the spine and hips over a lifetime. This has been termed "subluxation degeneration." The Association of Chiropractic Colleges has defined subluxation as "...a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health" (The Association of Chiropractic Colleges, 2010, http://www.chirocolleges.org/paradigm_scope_practice.html). Simply put, subluxation is a diagnostic entity that denotes the vertebrate is out of position, is fixed or stuck in the wrong position to some degree and has a negative neurological effect. Once the vertebrate is out of position, the body automatically tries to stabilize the spine and mobilizes calcium to use as cement or glue to prevent further malpositions. This is one of the causes of the degeneration or osteoarthritis as a sequella to malpositions of the vertebrate.

A 2009 study by Aspegren, Enebo, Miller, White, Akuthota, Hyde, & Cox concluded that 81.5% of workers with an acute injury causing low back or neck pain reported immediate post-treatment relief. That doesn’t take into account those patients who got better over time.

In 2009, Painter reported that Consumer Reports conducted an independent survey of 14,000 subscribers who rated hands-on therapy as the #1 treatment of choice for low back pain. The report went on to say that 88% of those who tried a chiropractic adjustment reported positive outcomes  and 59% were "completely" or "very" satisfied. The complete results are:

Professional

Highly satisfied

Chiropractor

59%

Physical therapist

55%

Acupuncturist

53%

Physician, specialist

44%

Physician, primary-care doctor

34%

 

We have concluded that there is a definitive clinical correlation between low back pain and osteoarthritis as a prognostic indicator of significant future problems if the low back pain is not resolved. We have also concluded that chiropractic care is a safe, highly effective treatment choice for low back pain patients and as a result, low back pain cannot be ignored. These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with low back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.



References:

1.  American Chiropractic Association. (2010). Back Pain Facts & Statistics. Retrieved from https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
2.  Stupar, M., Pierre, C., French, M. R., Hawker, G. A., (2010). The association between low back pain and osteoarthritis of the hip and knee: A population-based cohort study. Journal of Manipulative and Physiological Therapeutics, 33(5), 349-354.
3.  Dawson, E. G., & Shaffrey, C. I. (2009, December). Osteoarthritis: Degenerative spinal joint disease. Spineuniverse. Retrieved from http://www.spineuniverse.com/conditions/spondylosis/osteoarthritis-degenerative-spinal-joint-disease
4. 
The Association of Chiropractic Colleges. (2010). Bylaws. Retrieved from http://www.chirocolleges.org/paradigm_scope_practice.html
5.  Aspegren, D., Enebo, B. A., Miller, M., White, L., Akuthota, V., Hyde, T. E., & Cox, J. M. (2009). Functional scores and subjective responses of injured workers with back or neck pain treated with chiropractic care in an integrative program: A retrospective analysis of 100 cases. Journal of Manipulative and Physiological Therapeutics, 32(9), 765-771.
6.  Painter, F. M. (2009). Consumer reports survey shows hands-on therapies were the top-rated treatments. The Chiropractic Rescue Organization. Retrieved from http://www.chiro.org/LINKS/ABSTRACTS/Hands_on_Therapies.shtml

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