Patients typically wonder why I am working on their neck when their low back hurts. It is not because I’m forgetful about what they just told me hurts. I have a 200 times better probability of success of fixing their low back issue by including the neck because those upper joints contain 200 times more mechanoreceptor nerve endings than the joints in the low back.
In school, doctors are taught to divide the examination of the spine into three regions: neck, mid-back, and low back. This is the reason why so many people continue to have back pain. These three units are strongly interrelated structurally and functionally. We are whole people with a whole spine. The neck may be symptomatic because of a mid or low back abnormality. It can also be the other way around. Sometimes treating the low back will relieve a neck complaint. Proper management of the neck has often relieved low back pain.
An article from The Lancet, June 2nd 1990 British Medical Journal by Meade has something invaluable to point out regarding low back pain of mechanical origin. A review of randomized comparisons of chiropractic and hospital outpatient treatment with a study of 741 patients revealed a strong and clear advantage for patients with chiropractic treatment. The advantage for chiropractic over conventional hospital treatment was “not a trivial amount” and “reflects the difference between having mild pain, the ability to lift heavy weights without extra pain, and the ability to sit for more than one hour, compared with moderate pain, the ability to lift heavy weights only if they are conveniently positioned, and being unable to sit for more than 30 minutes.”
“This highly significant difference occurred not only at 6 weeks, but also for 1, 2, and even (in 113 patients followed so far) 3 years after treatment.” “Surprisingly, the difference was seen most strongly in patients with chronic symptoms.” “The trial was not simply a trial of manipulation but of management” as 84% of the hospital-managed patients had manipulations. “Chiropractic treatment should be taken seriously by conventional medicine, which means both doctors and physiotherapists.” “Physiotherapists need to shake off years of prejudice and take on board the skills that the chiropractors have developed so successfully.”
Seriously, I didn’t make that up. That was 1990 and sadly for the consumer, the patient with low back pain, none of that information has been absorbed by the people that need to perhaps read it again. That would be the medical doctors, that almost always will prescribe physical therapy than chiropractic.
I brought this up because a few weeks ago, a new group of medical doctors that I had to go to for a routine examination warned me about the dangers of going to a chiropractor after I told them that I had a good experience with one lately. That came about because they wanted to refill my narcotics prescription and couldn’t understand why I would decline the pills. They didn’t see on their questionnaire that I was a chiropractor and no red flags went off when I spoke at a high level of medical proficiency. In their defense, they were young kids out of medical school. Their level of understanding how to achieve good health was frightening, but they were excellently trained to sell drugs.