A recent series in The Lancet has highlighted the near universal poor management of low back pain and endorses improved methods over what is traditionally low value care. Here are some ways an evidence based chiropractor can help...
Matthew Bulman is a Chiropractor with an interest in musculoskeletal disorders, especially spinal conditions such as low back pain and neck pain. He is a multidisciplinary practitioner using up to date treatment recommendations, advice on exercise, soft tissue treatments, spinal manipulation, gentle mobilisations, stretching and a patient centred approach to self-care. He also has a special interest in rehabilitation of sports injuries.
A chiropractor is a primary spine care practitioner with the tools and knowledge to efficiently treat spinal complaints, particularly low back pain. Low back pain is now recognised as the leading cause of disability in the world. It is commonly recognised in clinical guidelines to utilise up to date advice, soft tissue treatment, exercise, acupuncture, spinal manipulation, heat and other non-drug approaches to care...all of which a chiropractor can administer. While analgesic medication has its place, the evidence has tipped away from pharmaceuticals. The clinical benefit of Paracetamol and Opioids is surprisingly not clinically effective for back pain. NSAIDS have a small effect, however, like Opioids, there are a large number of unwanted, adverse events and risks associated with this medication.
A consultation with a chiropractor will involve a thorough history and clinical exam. This is usually enough information to provide a diagnosis. Chiropractors can refer for scans and images if necessary, however, for low back pain scans are often not necessary and can even be associated with increased health costs and worse prognosis if used indiscriminately. We can triage patients to the correct treatment, and refer patients elsewhere if necessary. In some instances, other allied healthcare practitioners are useful in a team-management approach. Rarely is back pain serious or dangerous, although it can certainly feel painful.
Treatment usually takes place on the first visit with advice on heat, ice, exercise, stretching and practical information for how to move safely. We usually provide treatment options to the patient, weather that be specific corrective exercise, soft tissue treatment, dry needling with acupuncture needles, or spinal manipulation. These are evidence based treatments recommended by recent high quality guidelines. The most important component will be the patient centred approach and shared decision making.
It is important to continue to stay active and move in a way which makes you feel safe. We offer this advice. If spinal manipulation is going to be effective, it is usually apparent quickly, and certainly by the 4th visit. Improvements for low back pain probably max out by 12 treatments for chronic pain. I usually see patients 3-5 times with an emphasis on education and self care.
Low back pain is not well understood, and much of the research has not differentiated between the disease of low back pain, or an episode of low back pain. .This can make a prognosis very challenging. For individuals with a long history of low back pain, it is likely that you may have a chronic condition, similar to how some people have asthma. Just like an asthmatic will have an acute episode, a back pain patient may have an acute episode. The condition is managed during that phase, and may be dormant for some time...but it is likely that the condition will return at some point again in the future. Like all chronic diseases, these patients benefit from healthy lifestyle choices, good nutrition, regular exercise, stress management, healthful sleeping habits.
Dr. Bulman's mission statement is, "Sports & Spine quickly alleviates discomfort from musculoskeletal injuries, and is a valued participant in the local community. Our Evidence based chiropractor provides rapid pain relief, guides patients through ethical, up-to-date rehabilitation and keep patients moving throughout life."
While many patients are from varied backgrounds, Dr. Bulman has also worked with sports teams, rock climbers and runners. He treats and rehabilitates injuries of the entire musculoskeletal system including tendon injuries, foot, ankle, knee, hip, elbow, shoulder, wrist, neck and ribs...
Dr. Bulman will be available in Rockdale starting 9 April 2018 on Mondays and Thursdays. You can book a consultation with him here.