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On a given day, 6.5 million people remain in bed because of acute back pain. Treatment costs range from $45 to $54 billion per year or higher, including the cost of 500,000 back surgeries performed every year in the US, alone. The colossal waste of man hours can be gauged from the fact that the National Institute of Health estimates that back pain is the most frequent cause of physical inactivity in people under 45, ie, in their most productive years.

Acute lower back pain is caused by several factors. The more common among these are: motor accidents, sports injury, poor body mechanics or some kind of muscle or bone trauma.

People tend to ignore it, at their own peril, hoping it will disappear or auto-correct itself. With time their condition worsens, leaving surgery as the only feasible option. There is however a growing body of recent research that suggests that timely intervention can provide not just quick relief, but if followed through, permanent cure to lower back pains, regardless of the primary cause.

The chiropractic option
In many cases, patients with lower back pains are referred to a chiropractor by primary care physicians, orthopaedic surgeons and neurologists. Encouraging results, obtained via patient medical records and testimonies, have been seen in patients with degenerative disc disease and spinal problems following treatment with a chiropractor. The main benefit is that it is non-invasive, and hence very safe. It is also time and cost effective.

Some chiropractors, like myself, keep before and after X-ray reports of all patients, thus the results of treatment can be quantified and minutely tracked. Based on the meticulously maintained medical records and patients testimonials, almost 85% of my patients report “complete satisfaction”, while the remaining 15% report “satisfaction” with the results. This is unlike the outcomes with surgical treatment, which may often lead to unintended consequences in some patients. Patients are free to quit, at any stage of treatment, if they are dissatisfied with the results, although I have not dealt with any such case to date.

Although some of the equipment that I use have proven efficacy, such as the computer-aided spinal decompression machine, a lot of them are self-improvised and customised for patients with low back pain, sciatica, herniated or bulging lumbar discs, scoliosis, degenerative disc disease or facet syndromes.

Patients who visit the chiropractor usually come from other practices, having tried other remedies such as pills, pain shots, bed rest and physical therapy, with minimal or no relief. In the past, I had no choice but to refer the patients for surgery as their disease would have been too far advanced that rehabilitation alone would not be able to relieve pain or improve their condition.

A medical breakthrough
This led me to intensify my efforts at researching other options. Having spoken to a battery of surgeons and doctors who report encouraging results in treating back pains with new technology, I tested out some of the equipment myself. The response was so encouraging that I spent over a decade investing and building up a solid infrastructure of modern-day rehabilitative equipment.

The main tool in my arsenal is a computerised machine that does non-surgical spinal decompression, and a device that enables the individual to exercise while in a traction. The devices are designed to decompress lumbar discs and relieve pressure on spinal nerves. This helps restore the herniated disc back into place by reversing high intra-discal pressures through application of negative pressure to the exact degree. In other words, the disc compression is controlled by the machine, making the procedure extremely precise and error-free.

Patients are put on a rehabilitation and exercise programme immediately after. The objective is to restore the patient’s core strength, improve motion range and teach proper lifting techniques. After that, patients are encouraged to continue the exercises at home or at work in order to continue to strengthen their lower back muscles and prevent future injuries. The programme concludes with a report on the treatment initiated and the results obtained being sent to the primary care provider or referring physician.

A case study
A 27-year old male patient visited my clinic in December 2007. He had been suffering from chronic lower back pain for the past 3 to 4 years.

A detailed history-taking session revealed that the problem originated several years ago as a dull pain to the right side of his pelvis. Gradually, it began to spread to other parts, whenever he sat in a position for too long or after long walks of over an hour.

Around this time he began to experience difficulty in moving muscles in his lower lumbar region. Palpation betrayed hypertonicity and tenderness along the paraspinal and right piriformis muscles. The chiropractic examination revealed tenderness along the lower lumbar spinous process and joint play L4/5 and L5/S1, thereby restricting motion in these joints and making them extremely painful. An X-ray examination also revealed a reduction of the L4/L5 and more severely at L5/S1 posterior disc space. The patient also had excessive lumbar lordosis.

All these were indicative of lumbar disc lesion with radiculopathy, especially since a positive SLR test was present on the right leg. Based on all these assessments, patient was asked to visit the clinic at least twice a week for a period of 12 weeks. During these sessions he was counselled on how to improve his posture and nutrition.

At each consultation, the patient’s lumbar muscles were adjusted with machines (spinal mobilisation) where signs of subluxation, which was inducing pain, oedema, decreased motion and postural anomalies, were discovered. These corroborated with the radiological evidence.

Spinal decompression was recommended for the patient with the help of a traction device and a three-dimensional traction unit called Meditrac that is known to increase the height of the posterior disc space at L5/S1.

The patient was also treated with interferential or ultrasound modalities, and PNF stretching techniques with trigger point therapy, to release tight muscular tension in the affected region of his back. This was followed by a combination of stretch and rehabilitative exercises that he could practice at home daily in order to completely correct his pelvic imbalance.

Since no true paresis was detected and patient’s muscles were found to be weak on functional testing, he was prescribed rehabilitation exercises to increase functionality in his weak muscles, which would prevent recurrence of symptoms and correct his spinal posture.

The outcome
The two 1-hour sessions each week as opposed to the conventional 15-minute standard chiropractic sessions bore very positive results. Pre and post treatment X-rays (after 3 months of therapy) showed that the patient’s degenerative disc disease had been completely cured.

After the 3 months of regular therapy the patient no longer complained of pain in the low back whether while sitting or walking. The range of motion in his spine was also normal, as were his disc spaces.

The author’s clinic has had 86% to 90% success in treating such patients. Some cases may still require surgery, but that is only when the disease is too far advanced. This can be prevented with early detection and treatment.

Dr Kevin Lau is a chiropractor and nutritionist at the Spinal Correction Centre in Orchard Clinic. To date, he has successfully treated patients with scoliosis, disc herniation, sciatica and other chronic conditions.