Lower back pain a is common condition that is thought to affect up to 80% of the population at some point in our lives. There are many different causes of low back pain one of which is compression of spinal nerves that can result in radiating pain that travels down one or both of your legs. Many patients visit their primary care doctors only to receive NSAIDS or pain medication and potentially a referral for physical therapy. For many patients, this approach fails as the underlying cause of the nerve compression is never addressed. When this traditional approach fails, patients are then told to consider back surgery. It is widely known that back surgeries are invasive and often fail making patients reluctant to pursue this type of treatment.
At the San Diego Sports and Running Injury Clinic we have developed an effective and science based approach that addresses both the patient’s symptoms and underlying cause of their painful lower back condition and it all starts with an accurate diagnosis.
Step 1: We perform a thorough and comprehensive history to understand what factors caused the problem to begin and what factors help worsen or improve your condition. Typical doctors’ visits last than 10 minutes. It is impossible to perform step 1 in this small amount of time.
Step 2: We perform an in-depth orthopedic and neurological examination to rule out improbable diagnosis and narrow it down to the most likely diagnosis. This is known throughout the world as common sense, critical thinking and deductive reasoning. It is common knowledge that most primary doctors or “GP’s” are not competent in the arena of musculoskeletal diagnosis and usually do not even touch the patient during their “exam”. For this reason, many lower back pain patients are mis-diagnosed from the outset.
Step 3: If necessary we discuss with the patient the need for X-ray or MRI imaging to help confirm a diagnosis. Often these tests are not necessary but in some instances, they can be useful. X-ray will only show bones and are not very good at helping diagnosis lower back conditions despite what you may have heard. MRI on the other hand is exceptional at helping us visualize nerves, discs and cartilage.
These 3 structures are often contributing to the underlying cause of your back pain making MRI studies useful in some circumstances. Primary doctors or “GP’s” will often order X-rays and declare to the patient that nothing is wrong. This is misleading and even dishonest as X-rays do not show nerves, cartilage or discs. For some reason, MRI’s are discouraged and the patient is then relegated to a physical therapist and told to “fail PT” before the primary GP will consider a referral to a “specialist”.
Step 4: After reviewing your condition with you we discuss all the possible options based on the likelihood of their effectiveness to treat your lower back condition. Together we arrive at a treatment plan that has a high probability of success.
Step 5: Our comprehensive approach includes;
Therapeutic Modalities: We utilize ultrasound, electrical stimulation, heat and myofascial release to address the pain resulting from the underlying condition.
Chiropractic adjustments: We use gentle chiropractic adjustments to help align the bones, joints, muscles and discs to promote healing.
Inversion Therapy: This oft forgotten therapy is highly effective at helping decompress the spine and relieve pressure on the nerves resulting from swollen or herniated lumbar discs. In a study done on 24 patients (13 with physical therapy and inversion vs. 11 in physical therapy alone) 10 patients (76.9%) avoided surgery while only 2 patients (22.2%) in the physical therapy alone group managed to avoid the same fate. When done properly and at the right degree of inversion this intervention is critical in helping patients address the underlying cause and recover from their lower back condition.
Lower back, core and hip strengthening: As you are getting out of pain we instruct you on proper strengthening and conditioning of your lower back, core and supporting hip muscles. Instead of having you come to our clinic and make you pay us to watch you exercise (a waste of your hard-earned money in our opinion) we instruct you on site but then send you a tutorial video for you reference so you can do the PT in your own home at your own convenience.
Lifestyle Modifications: There are times when painful circumstances cannot be avoided such as sitting while at work. In this case, we write a letter to your employer with a prescription for a stand-up desk/work station. There are many other examples of lifestyle modifications but the list is to extensive to address in this short page.
Without a proper diagnosis effective treatment cannot be initiated. Effective treatment addresses not only your pain but the underlying cause. A comprehensive treatment approach addresses both. SDRI takes most major health insurance and can help you recover from your painful lower back injury. If you have any questions please email DrAllen@sdri.net or to schedule an appointment call 858-268-8525 or visit our website at www.sdri.net