Chiropractic case studies

Chronic low-back pain is the most expensive cause of pain and disability in working age adults.  In the drug keen US of A in the eight years from 1997 - 2005 there was a 65% increase in spine care costs, with the biggest increase being in drugs which rose to a vast $19.8 billion - or an increase of 188%.  In 2005 the total health bill for spine problems was over $85.9 billion or 9% of the total national US expenditure on health - only heart disease and stroke were more costly.  However, at the same time as this increase in expenditure occurred the health status of the patients got worse with 1 in 4 patients with chronic low-back pain reporting physical limitations.

It is also pretty badly handled by the NHS, with the rush to surgery being far too fast and little to fill the gap between a fist full of pain-masking pills and a knife in your spine.   

The great journal 'The Spine Journal' (Focus Issue on Chronic Low-back pain - 2008) suggested that "a reasonable approach to CLBP would include education strategies, simple analgesics, a brief course of manual therapy in the form of spinal manipulation, mobilization or massage, and possibly acupuncture".  All of this is provided by skilled practitioners in the clinic, C1 Chiropractic Health Centre.

The report also and adds, damningly, about the allopathic medicine providers: "there is clearly no consensus that commonly used diagnostic tests hold any value in the decision-making process before offering a treatment for CLBP" and this "brings into question the routine use of laboratory testing, x-rays, CT, MRI, discography, nerve conduction velocity and electromyography".

All this is available on www.sciencedirect.com/science/journal/15299430 - vol 8 issue 1. 

So, who’s got the answers – clearly not the medics but I’d suggest the spinal health experts such as those at the clinic.

I lifted this from "Bodybuilders weekly" or some other bodybuilding site as I was so impressed with the content since they are great ones for mad exercises but this lot were talking loads of sense. They said:

Initally about dorsal raises:
"The exercise has other names but this is the most common. It is performed by laying flat on your stomach and raising the upper body and legs off the floor. In this exercise the lumbar spine pays a very high compression penalty to a hyperextended spine (approximately 4000 to 6000 N) which transfers load to the facet joints and crushes the interspinous ligament.[5] This exercise is certainly contraindicated for anyone at risk of low back injury or re-injury due to the high spine loads and the extended posture.[6] In my opinion it should not be prescribed at all."

Then about the dreaded sit-up:
"Also it brings up the question of whether anyone should perform the sit up. Next sit up is the "press the heels" made famous by Czech neurologist Vladimir Janda. The exercise is performed like a typical bent knee sit up except the feet are dorsiflexed and the heels are then pressed into the floor. It has been hypothesized that by pressing the heels into the floor and activating the hamstrings this would neurally inhibit the psoas. Thus there would be increased load on rectus abdominis and decreased low back loading.

Actually EMG data showed that by pressing the heels into the floor the psoas activation actually increased![6] Athletes who are intentionally trying to train psoas will find this information informative. Those with low back injury or risk of re-injury would be wise to avoid the "press the heels" sit up"

The numbers here come from the books by the genius Prof Stuart McGill who has a profound grasp of what's happening in the low back during these sorts of exercises and who is very cautious about the benefits of the sit-up.

My advice is don't do them as there are far, far better things to be doing with your time.