| ![]() Clinical
Therapies Used to Restore Spinal Function
The Chronic Back Pain Clinic offers a wide
mix of therapeutic services in the management of chronic back pain,
all of which have been medically proven to be effective therapies
in managing individual chronic back pain complaints.
During the course of treatment in the Chronic Back Pain Clinic,
depending on the initial medical examination and diagnosis, you
can expect one or more of the following therapies to be used in
the management of your chronic back pain problem.
![]() Spinal
Manipulation and Other Manual Therapies
Manual therapy is a general term which describes
specialized Orthopedic therapeutic maneuvers used to introduce movement
into specific spinal segments, which following examination demonstrate
a loss of normal range of motion. When spinal segments do not move
freely, they will often be associated with spasm of the supporting
spinal muscles resulting in chronic back pain.
Many different therapists are trained in manual therapy techniques.
Osteopathic physicians, chiropractors, and many physiotherapists
all use manual therapy techniques in treatment of the chronic back
pain syndrome.
When most people hear the term “spinal manipulation”,
they associate the therapy with High Velocity / Low Amplitude techniques,
the most common technique used by chiropractors. There are however
also more gentle manipulation techniques which do not use "thrust
forces", such as Muscle Energy Techniques and Functional Range
of Motion techniques, all of which work equally well in the treatment
of chronic back pain, although the treatment course may be longer
to achieve the end result of restoration of normal spinal movement
and function. Each individual case is assessed and manual therapies
are carefully selected to produce the best clinical result and benefit.
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![]() Neural
(Medical) Acupuncture
The use of acupuncture in traditional Chinese
medicine dates back several thousand years and has been used successfully
in the treatment of chronic back pain syndromes. Most acupuncture
points are closely applied to nerves as they course throughout our
musculoskeletal system. By identifying the muscle groups that are
the source of pain, the acupuncturist identifies the nerve that
is responsible for enervating the involved muscle group and applies
a needle in close proximity to the nerve that supplies it. Historically,
the needle was manually stimulated by twirling it in a clockwise
or counter clockwise fashion. Over the past several decades however,
manual stimulation of needles has largely been replaced by attaching
the needle to a low voltage source and stimulating the nerve with
low-grade voltage for a period of 30 minutes or more.
Neural Acupuncture or Medical Acupuncture involves the injection
of small dosages of Lidocaine 1% at acupuncture points. Lidocaine
is a local anaesthetic used by dentists before dental procedures
or used for anesthetising skin prior to getting stitches. The procedure
of Neural (Medical) Acupuncture which can be carried out only by
a medical physician has the unique advantage of immediate relief
of pain following the procedure, with individual treatment sessions
being considerably shorter in time than the traditional Chinese
acupuncture sessions.
When identified as the appropriate modality of therapy, Neural (Medical)
Acupuncture also offers the advantage of requiring fewer treatments
as the local anesthetic infiltration around the nerve appears to
potentiate the acupuncture effects; a medical term indicating
that the pain relief is quicker in onset and lasts longer.
When effective, very seldom are more than two or three treatments
required to treat even resistant and well entrenched Myofascial
Pain Syndromes. [
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For
more information on Myofascial Pain Syndromes and Neural (Medical)
Acupuncture . . .
![]() Prolotherapy
Prolotherapy is a specialized medical procedure
of injecting weakened and stretched ligaments supporting unstable
joints to strengthen the supporting ligaments, increase the stability
of the joint movement and prevent ongoing dysfunctional joint movement
problems which may be a contributing underlying cause of chronic
back pain. [
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For
more information on Prolotherapy and chronic back pain . . .
![]() Kinesiology
Spinal Conditioning Sessions (One-on-One)
Kinesiologists are graduates of university
programs which focus on muscle, bone and joint physiology as it
relates to movement, applying this knowledge in the rehabilitation
of musculoskeletal injuries.
In the work of chronic back pain rehabilitation,
kinesiology therapy involves the application and teaching of specific
muscle exercise programming after careful examination for evidence
of muscular imbalance and weakness. Each patient will receive individually
designed specific rehabilitative stretches and exercises to improve
spinal core strength weakness patterns identified during the examination.
The exercise program will result in correction of postural abnormalities,
improvement in flexibility and healing of the necessary spinal supporting
musculature and ligaments.
It is very important for chronic back pain patients to realize that
without rebuilding the spinal core strength that controls vertebral
movement and the correction of posture, there is little hope that
long-term improvement of chronic back pain can be achieved.
This restoration of normal spinal movement and spinal core strength
is the key to prevent re-injury and repeated entry into therapy
with the same symptoms of chronic back pain syndrome.
Kinesiology Spinal Conditioning Sessions are provided to patients
in time blocks of 30 minutes. Each session is a focused educational
program with assigned homework complete with written instructions
and illustrated diagrams to be practiced prior to the next appointment.
Completion of a block of appointments results in a confident understanding
and "user's manual" of how to manage each individual's
specific chronic back pain syndrome, taking the mystery out of how
to keep your back healthy.
Every Kinesiology Spinal Conditioning Session is combined with a
review by the attending physician to ensure coordination of treatment
goals.
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![]() Prescribed
Medical Drugs, Complementary Alternative Medicines (CAM’s),
Vitamins and Nutritional Supplements
Most patients with chronic back pain presenting
to the Chronic Back Pain Clinic will already be using a combination
of medications. Some of these medications will have been prescribed
by their physician and these are very commonly combined with other
medications that the patient may have purchased over-the-counter
from a pharmacy. It is also not uncommon for these prescribed medications
to be combined with other Complementary Alternative Medications
(CAM’s) which the patient may have introduced themselves.
Unfortunately, there is very little scientific evidence that any
of these medications whether prescribed by physicians or complementary
alternative medicines introduced by patients themselves, are helpful
in resolving chronic back pain complaints. They may be of assistance
in reducing some of the discomfort associated with chronic back
pain, but the duration of effect is only as long as the drug is
active within the body. With wearing off of the drug, unless the
dosage is repeated, symptoms tend to return with the same level
of intensity.
Anti-inflammatories, narcotics and pain killers, muscle relaxants
and other physician prescribed drugs as noted earlier, unfortunately
fare no better with little expectation of resolution of the underlying
etiology causing chronic back pain, with the primary therapeutic
effect being described as palliative rather than curative.
Regrettably, most medications when used over an extended period
of time will be responsible for significant side effects, often
causing medical problems far more serious than the chronic back
pain itself.
The Chronic Back Pain Clinic policy towards
the use of drugs is to trial all other forms of therapy first. When
necessary, most prescribed medications will usually be for only
short courses, usually 10 to 14 days, and are likely to be prescribed
for management of acute pain when patients first come to the clinic.
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