Identifying the source of low back pain, incorporating specific and targeted chiropractic adjustments, physical therapy, and strengthening exercises are all part of implementing a comprehensive treatment plan to help patients find relief from low back pain.
For a new patient complaining of low back pain, what are the preliminary steps you take and questions you have to ask before you start treatment?
Dr. Luke Stringer: Yeah, great question, Liz. It’s all got to start with a really solid health history, right? What’s your main concern? Low back pain. How long has this been going on? Is it acute or chronic? A new and old issue? How frequent is the issue throughout the day, week, month? And then we can shift on to previous health history of the spine. Have you had any significant trauma? Have you been in a car accident, you have a slip or a fall, you’ve been involved in any kind of contact injuries for sports? That all negative, we’ll then look to the job background. Are you working for UPS where you’ve got to be up and down and shifting boxes all day? Or are you a corporate executive where you’ve got to sit for 50, 60 hours a week? That always seems to give us a good indicator of what type of mechanism caused the injury.
Then we’ll also discuss the pain, the quality of it. Is it sharp? Is it referring? Is it more of a dull, achy pain? Is it localized? And obviously what’s the pain scale of it. Then you’ve got to shift into function. How’s it getting in the way of people’s ADL’s, active daily lifestyle? Is it pain as soon as you wake up? Are shoes and socks difficult to get on? Or does it come after you have been working for several hours? Or is it just doing exercise?
And obviously from there we need to figure out putting some goals for our patients. So, as a team of clinicians you can get the patient to a goal. Obviously, everyone’s would be pain free, but it might be a little bit deeper than that. Something like I want to run a marathon or I want to lose weight or I want to be able to pick up my son and play pickup football, baseball in the park without having to deal with low back pain.
And then once you go through the consultation, you’ve got to shift into an orthopedic examination. You can try and pinpoint the joint or the tissue that’s essentially causing this. And so, it’s got to be some range of motion checks, check the integrity of the joint and the tissue, see how well it’s moving, see if it’s compromised because that needs to be diagnosed. Then obviously you’ve got to take the joint and the tissue through some stress checks. So, is it a joint issue? Is it a soft tissue issue? Is it a disc or nerve issue?
Once you go through the evaluation, how will you like to practice? Because there are objective findings by shooting some x-rays. And x-rays are really great at evaluating the structure of the spine. If you’ve had a bad car accident, and you’ve lost over 60 percent of your low back curve that needs to be diagnosed and addressed. Because if you don’t, then you’re going to just create compensation issues through poor weight bearing. And once you figure it all out, then obviously you can create an achievement plan themed on your examined diagnostic findings.
Can you describe some of the specific manual treatments used to help someone with low back pain?
Dr. Luke Stringer: Absolutely, so the way we handle it in our offices, we kind of incorporate three main areas. So, the first thing we’re going to do is you’ve got to improve joint range of motion because if you improve the joint range of motion, you can take the stress off of the joint tissue nerve. And we do that through a number of ways, but specifically we adjust the spine. Again, through our examination, we can figure out what joints aren’t moving and we can get those joints moving through adjustments through the spine. You’ve also got to address the soft tissue or the muscles linked in tendons that essentially are designed to stabilize and move the joint. That can be done through a number of ways, but a specific sort of soft tissue treatment that’s going to specifically break down any scar tissue in the joint and the tissue which is designed to improve your range of motion.
And then again based on their x-rays and what’s going on in the structure of the spine, you’ll address it through a technique we use called chiropractic biophysics where we put the spine through traction, that’s goal one. And then once you have better mobility and less pain and you see saw small improvements in the function just like we spoke about on a previous podcast, then you can certainly start layering on the treatments, so you start with the stability work and then eventually push into lots of the functional movements. We’re just going to create better strength in the low back.
What type of technology tools or devices do you use to treat patients?
Dr. Luke Stringer: Yes, the biggest tool essentially that we use is just clinical knowledge and obviously having the knowledge to be able to thoroughly evaluate the condition and figure out what type of treatment is going to be the best for that specific issue. And then if you’re talking about more instruments and apparatus, when you adjust all manual, we use our hands to get those joints moving. And then we are essentially using our hands to improve tissue health, to improve the mobility of the joint and the tissue. And then the biggest instrument we use, this is what we call all spinal decompression, or traction equipment, which was specifically done through a technique called chiropractic biophysics. And that’s where you can objectively address and change the shape of the spine, offer more of a long-term kind of objective improvement than just the quick fix. So that said, a lot of it’s really hands on, but the traction equipment is really unique and we get super good results with it.
Do you include exercise plans, nutritional counseling, or any other holistic approach to treating your patients along with the chiropractic treatments?
Dr. Luke Stringer: Absolutely, yeah. Our plans are really comprehensive. You’re going to be doing lots of physical therapy and that’s going to be starting, as we’ve discussed, to improve mobility in the joint and the tissue. So, we’d be breaking down scar tissue using foam rollers and myofascial sticks. And we’re getting the lacrosse balls in the area. We use power plate therapy to increase muscle fiber recruitment when you’re doing stretching, both static and dynamic. We do lots of pelvic floor activation for your core. You’ll be activating your posture chain, all the muscles that are essentially designed to keep you upright and move you. And obviously once you add that to the chiropractic adjustment and the chiropractic traction, that’s going to get super good results. And essentially that’s probably why we are one of the busiest clinics in Chicago.
How does the treatment protocol you follow at Advanced Health Institute make you unique from other clinics in your area?
Dr. Luke Stringer: Yeah, exactly. It’s kind of just a follow-up from that question. So, we don’t just do one or the other. We don’t just adjust the spine and perform chiropractic adjustments. Or we don’t just perform physical therapy and do lots of stretching and stabilizing. We incorporate all the above.
We’re going to be adjusting. You’re going to be doing lots of stretching and stabilizing. And what really separates us apart is we do a specific soft tissue treatment that can break down the scar tissue within the muscle and the joint, which you just get great results in terms of restoring range of motion.
And also, again what separates us is we do something called chiropractic biophysics, which is specifically designed to address structural changes in the spine. Because like we discussed in our previous podcast, when you have structural shifts, it creates way too much stress and tension into the joint and onto the disc and over time you can really break this down and have issues within the disc and joints, such as degeneration or herniation. So, when you combine the traction component with the other components, we just, our patients just get great results.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.