Transcript
CHARLIE: Welcome back to Spine Cast, we’re visiting with Dr. Sean Riley. Dr. Riley thanks for being here today.
DR. RILEY: You’re welcome Charlie.
CHARLIE: Tulsa Spine and Rehab is an integrated clinic providing chiropractic and physical therapy, massage therapy, yoga, natural pathic medicine, including acupuncture and many others. Sean, while you deal with lots of different back pains as a chiropractor, let’s spend some time today discussing lower back pain, specifically acute lower back pain. What are some of the warning signs we know where we’re feeling acute lower back pain.
What’s the difference between acute lower back pain and chronic lower back pain?
DR. RILEY: Sure. So acute low back pain versus chronic pain that most of us are aware of acute low back pain would be an episode or an instant Charlie, where it’s very quick and onset. For example, I was raking leaves in my backyard and I went to pick something up and I had instant low back pain. Acute typically deals with quick and onset maybe within the last 24 to 48 hours. Whereas chronic type conditions we think of those things ongoing and lasting for a much longer time. So that’s the difference between an acute and a chronic type of an issue.
CHARLIE: What would cause that? I mean one day we’re going along fine. Also we have a lower back pain problem. What’s the cause of acute back pain?
DR. RILEY: Well, it’s funny you ask it, daily in my clinic I have patients that come in and they say, well I really didn’t do much and I’m not really sure what caused this issue and I try to back them up. Are you sure nothing changed with your exercise routine. Where you sitting more, were you traveling? Whatever the case may be. Many times it’s more of a cumulative type of fact. And what I mean by that, Charlie, is that over time we have poor posture, we sit too much, we develop weak course we’re lazy throughout our trunk. Bio mechanically we might not lift correctly and I talk to patients about overtime that margin for error starts to kind of close in and shrink. And then many times we’d been down to pick a piece of laundry up off the floor or transition out of a chair, get out of bed, whatever the case may be. And Boom, we have significant we have an episode, one of those significant acute low back episodes.
CHARLIE: so. It’s really a matter of almost like literally the straw breaking the camel’s back.
DR. RILEY: Yeah. And I think it’s frustrating for many patients in that not, hey listen, I wasn’t involved in a traumatic event and it wasn’t in a car accident or I didn’t fall, whatever the case may be. It seemed pretty simple. And so then I talked to patients about how do we resolve these acute type conditions? And I want to mention Charlie that the first kind of lead in I have with these types of cases, first off, obviously going back, very important to get it properly diagnosed. We’re dealing with just acute general low back types of conditions. We’ve talked about all kinds of low back conditions in the past, whether it’s a disc problem or Sciatica or whatever the case may be. So very important to get it properly diagnosed and for this discussion we’re talking about mechanical or general low back pain. Anyway, going back to the lead in first comment that I’ll make to the patient, it is imperative that you stay active. We want you to keep moving. Years ago you’d go to your physician and with acute low back pain and your doctor, your primary care doctor would recommend some type of anti-inflammatory may be a pain medication and that he would tell you to go home and take it easy. Could not be worse for you as far as going home and taking it easy because the more I lay around, okay, the healing process is slower the recoveries going to slow down and so forth. So it’s imperative that we keep upright moving to a certain degree. And obviously we’re sensible about the way we’re moving. We’re not bending, lifting, doing those types of things, but it’s important that we try to maintain somewhat of a regular routine throughout the day and stay active and keep moving.
How can I prevent acute lower back pain?
CHARLIE: But let’s talk about that before it actually happens. You say moving is a good way to handle it is if you feel it keep in motion, but what can we do to prevent these acute lower back pain problems from coming on in the first place?
DR. RILEY: Well, I think first and foremost, we need to take a look at what we do on a day to day basis. We sit for extended periods. We obviously need to focus on our ergonomic changes, standing throughout the day, possibly looking into a sit stand station, focus on getting into the gym and now I’m not suggesting getting to the gym seven days a week, but trying to be efficient with our time and maybe spend some time on reactivating our core in stabilizing those structural muscles around our spine that their primary role, Charlie’s to give us support and the bracing system and when that system goes lazy, it potentially sets us up for injury and irritation. So I’d say look at what we’re doing day to day, get into the gym, work on stability. On that note, we need to pay attention to mobility and flexibility. Have your hip flexors gotten a little tight? Are you tight through your hips? Is that thoracic spine or that mid back area a little tied as well? So that is something else that I really preach to my patients. Not only stabilizing certain areas but focusing on flexibility and stretching and mobility in certain areas as well.
CHARLIE: It sounds like a morning or afternoon walk is probably a really good place to start.
DR. RILEY: Very common question I get from my patients. If I’m able to do one thing a day, what should I be doing? And that’s it. You’re exactly right. I would tell them to get out and move and walk. We don’t need to be running. We need to stay upright, unloaded and walking. The corresponds well just to general walking and more importantly it’s very safe for most of us. So carve out 30 minutes a day and then I talked to patients about focusing on increasing the duration and let’s shoot for three times a week getting out and moving the back responds well to that. The hips respond well to that. Even the thoracic spine and the neck responds well to that and for the most part, barring any significant orthopedic injuries or issues that we’re dealing with, walking is particularly safe.
CHARLIE: Just to be clear, you’re not talking about like getting our heart rate up and trying to hit a target rate and all those, you’re talking about putting left foot in front of right foot and repeat.
DR. RILEY: Yeah, we all have different fitness goals and this is speaking more to just avoiding those acute low back type injuries. Obviously when I’m working with different types of patients, we all had different goals. We have weight loss goals and we might want to run a five k or a longer race, a much different type of situation where we’re going to be very specific with reactivation and running. How far those types of things. This is just simply getting out and moving and walking. If we can carve out 30 minutes, very safe and effective for the spine and those acute low back type injuries.
How can chiropractic treatment help acute lower back pain?
CHARLIE: Let’s say we’ve suffered one of these acute back pain problems. We have it. What can you do about it?
DR. RILEY: I mentioned I’m really big in this clinic on self-management and what that means is visiting with the patient on what they can do on their own, and I talked about obviously movement and some of these different things with flexibility and stability. Something else that the patient can do on their own is ice. Ice is a very good option to decrease inflammation, but within the clinic proper diagnosis. We’re going to make recommendations on very specific exercises that are controlled and what I mean by that is controlled obviously we have folks that are watching you perform these types of exercises and rehab, try type techniques. In the goal of a lot of these techniques, Charlie, is to kind of reset the stability system, get your brain understanding on how to reactivate a certain area, a certain stabilizer. If you were to put me in an elevator and say, Sean, what is your favorite thing? What would you say you’re really, really good at? Acute low back pain is one of my favorite types of issues to treat because it’s relatively easy to manage and I know the outcome is going to be pretty good and what I mean by that is typically if I get a patient early onset, it’s two to three visits and the outcome’s going to be very good, meaning that they will essentially have full resolution of their complaints, those types of cases also, I really try to take advantage and educate the patient on look, we don’t want this thing to come back, let’s do x, y, and z throughout the day to prevent you from getting back in this office and prevent these episodes from coming back. So we talk about reduced frequency and then obviously as a chiropractor, joint manipulation and adjustments are very helpful, soft tissue massage to manage tightness and a tissue. There’s a whole host of things that we can do here in the clinic to help speed up that recovery time, but more importantly it’s about preventing recurrence and those are it doesn’t take much. It’s about education. A lot of times Charlie, we don’t know what to do. The first thing that we do is we go get on the computer. We Google something. The problem with that is that what you’re googling might not be good for you. It might be good for me, but it’s not very good for you, and that’s the key when you see someone as they’re able to make a proper assessment of where you may have a deficiency and make the appropriate recommendations.
CHARLIE: The best way to treat acute lower back pain is not to get it. Stay in motion, take care of yourself, and if you feel it coming on, get walking and if becomes acute and there’s pain, then it’s time to call. Dr. Riley. Set about to sum it up.
DR. RILEY: Absolutely.
CHARLIE: All right. You can learn more about lower back pain causalities and therapies at TulsaSpineandRehab.com. You can also subscribe to Dr. Riley’s weekly newsletters filled with tips and suggestions and it comes to you free to help get you moving. Thanks again for taking time to share with us today. Dr. Riley.
DR. RILEY: Thank you Charlie.
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