A new poll from Canada points to snow shoveling as the leading cause of back and neck pain during the winter months. In the poll, 73 per cent of Ontario chiropractors surveyed say improper shoveling technique tops the list of reasons for winter back pain problems.

The story, reported in the January 9, 2003 Canadian News Wire, Quotes Dr. Dennis Mizel, President of the Ontario Chiropractic Association, who said, “Chiropractors are finding that some patients experience back and neck pain as a result of improper snow shoveling technique. Improper technique can be anything from bending at the waist instead of the knees to throwing snow instead of pushing it. When you combine improper technique with the average weight of one shovelful of snow (five to seven pounds) it becomes even more evident that this is a serious problem for both adults and the children who help them.”

Dr. Kristina Peterson, a chiropractor in Thunder Bay was also quoted in the article, “Back problems can surface in patients during the winter, especially those who are unaccustomed to participating in challenging physical activity on a regular basis. Activities requiring exertion that is higher than one’s daily routine such as winter sports or pushing stuck cars can cause back injuries. However, snow shoveling is the number one reason patients present with back pain in the winter.”

The Ontario Chiropractic Association offers the following preventive measures to help keep backs in shape:

Warm-up. Before beginning any snow removal, warm-up for five to ten minutes to get the joints moving and increase blood circulation. A good warm-up should include stretches for the back, shoulders, arms and legs. This will ensure that your body is ready for action.

Don’t let the snow pile up. Removing small amounts of snow on a frequent basis is less strenuous in the long run.

Pick the right shovel. Use a lightweight push-style shovel. If you use a metal shovel, spray it with Teflon first so snow won’t stick.

Push, don’t throw. Push the snow to one side and avoid throwing it as much as possible. If you have to throw, avoid twisting and turning – position yourself to throw straight at the snow pile.

Bend your knees. Use your knees, leg and arm muscles to do the pushing and lifting while keeping your back straight.

Take a break. If you feel tired or short of breath, stop and take a rest. Stop shoveling immediately if you feel chest or back pain.

A study published in the July / August 2004 peer-reviewed scientific journal, “Journal of Manipulative and Physiological Therapeutics”, compared the effects of chiropractic adjustments to muscle relaxants in a group of patients with subacute low back pain.

This study defined subacute low back pain as lower back pain (LBP) with a duration of 2 to 12 weeks. The study noted that in the United States the incidence of low back pain is as high as 75% to 85% of the population being affected at some time in their lives. On a yearly basis, the study noted that between 15% to 20% of the adult population can expect to experience LBP in any given year.

In the study, conducted at Life University in Georgia, 192 subjects with LBP from 2 to 6 weeks were separated into three groups. One group received Chiropractic adjustments with placebo medication. The second group received muscle relaxants with sham (fake) adjustments. The third group was a control group and received both placebo medication as well as the sham (fake) adjustments. Care was rendered to the group for a 4 week period with evaluations being done at the 2 week and 4 week marks.

Results were measured in terms of patient reported pain, severity, disability and depression, as well as measured flexibility and the patients self usage of over the counter acetaminophen (Tylenol). The results of this short study showed that for the two primary indicators of pain and severity, the chiropractic group did better than the other two groups. No significant differences were seen for disability, depression, flexibility, or acetaminophen usage across groups in a study of this short a period of time. All three groups showed improvement in the areas of depression, disability and drug usage.

The authors of the study did note that a longer study could have yielded more differences in recovery. However, in the area of pain, a primary patient concern in subacute LBP cases, the group that received the chiropractic adjustments faired the best. Their comments were: “Statistically, the chiropractic group responded significantly better than the control group with respect to a decrease in pain scores.”

The above is a direct quote from a headline that appeared in of all places, the November 17, 2005, Medical News Today. The article, also picked up by UPI news and several other sources, was reporting on a new study published in the October 2005 issue of the scientific journal, The Journal of Manipulative and Physiological Therapeutics (JMPT).

In this study 2780 patients with mechanical low-back pain referred themselves to 60 doctors of chiropractic and 111 medical doctors. These cases were reviewed for effectiveness of care and for costs. One of the articles noted that back pain care in the United States alone is estimated to reach $48 billion this year, and, at any given time, 80 percent of the U.S. population suffers from back pain.

The results of the study showed several interesting facts. With regards to the outcomes, the study showed that both the acute and chronic patients showed better outcomes in pain and disability reduction and higher satisfaction with their care after undergoing chiropractic care, as compared to medical care.

The costs of the care for the medical and chiropractic showed different results depending on the usage. Without adding the costs of any over-the-counter drugs, hospitalization, or surgical costs, when you simply compared the costs of in-office chiropractic to in-office medical care, the chiropractic care was slightly more expensive. If you then add in the additional costs for any referrals made by the chiropractor or the medical doctor, the chiropractic care costs for chronic patients were then 16 percent lower than medical care costs.

The authors of the study, noting that the satisfaction for the chiropractic care was higher, and the overall total costs were lower, made a concluding statement urging more chiropractic utilization in the health care system. They stated, “With their mission to increase value and respond to patient preferences, health care organizations and policy makers need to reevaluate the appropriateness of chiropractic as a treatment option for low-back pain.”

In April 2009 Consumer Reports released the results of a patient survey study, that will be published in their May 2009 paper edition, showing that chiropractic rated highest among patients in satisfaction of relief of back pain. Results of the study were reported on in several news articles including an April 6, 2009 WebMD article and an April 8, 2009 CBS news story.

The survey noted that 80% of US adults report having back pain some time in their life. Of those responding to the survey chiropractic received the highest grade with 59% saying that they were “highly satisfied” with their results. Physical therapy and acupuncture rated second and third with 55% and 53% respectively. In comparison, satisfaction with medical specialist and primary care medical physicians rated only 44% and 34% respectively.

CBS News medical expert Dr. Jennifer Ashton commented that the results of this study reflect what she is seeing in her practice. She noted that back pain is the most common ailment in the country and it is difficult to treat. Dr. Ashton stated that her patients are looking elsewhere, “They’re staying away from things like medication, prescription drugs and surgery.” Dr. Ashton also warned against a “quick fix” to get rid of the pain. She noted, “A lot of times that’s prescription narcotics, which is actually probably the worst thing for you.” She also warned, “Surgery is another option, but one that should be used as a last resort.”

American Chiropractic Association President Glenn Manceaux, DC, responded in a press release, “For the treatment of back pain, few options are better than chiropractic. As shown in this latest survey, chiropractic spinal manipulation is an evidence-based and effective treatment for low-back pain and other musculoskeletal injuries. Coupled with the high levels of patient satisfaction, patients should turn to chiropractic as their first choice.”

Dr. John Maltby, President of the International Chiropractors Association added, “For well over 100 years chiropractors have been seeing a large number of patients suffering with back problems. And although chiropractic does not directly treat the pain, we do work to correct the underlying structural and neurological problem that in many cases is causing the problem. This study shows what we have known for a long time. Chiropractic get results and helps people lead normal and healthier lives.”

A study published out of Canada in the winter 2006 issue of the Journal of Chiropractic Medicine shows that sleeping on a new mattress can significantly reduce stiffness and back pain. The study was conducted at Oklahoma State University and is the first of it’s kind.

The published report notes that sleep deficiency interferes with daytime activity, social interactions, mood, and even loss of work production resulting in 48 million lost hours of productivity every week due to poor sleep.

In this study researchers looked at a control group of 59 healthy participants (30 women and 29 men) who slept on their own five-plus year-old mattresses for four weeks and then slept on a new bedding system for the same time period. They then analyzed the difference in lower back discomfort, spine stiffness, sleep quality, comfort and efficiency.

The results showed that the volunteers reported immediate and sustained benefits in all areas of measurement after sleeping on a new mattress, regardless of their age or weight. This was especially true of participants who entered the study with high back pain complaints, as they reported a 63 per cent improvement in back discomfort with a new mattress.

Dr. Stacy Irvine, chiropractor and fitness expert, stated on behalf of the Better Sleep Council Canada, “There are many ways to treat back pain, but people may not realize that an answer might be right under their noses, literally, in the age and state of their mattress.” Dr. Irvine continued, “This research shows that a new mattress could hold a key to unlocking some of that pain and discomfort.”

Gary Baskerville of the Better Sleep Council Canada added, “On average, Canadians spend more than 2,000 hours each year sleeping. The mattress is one of the hardest working pieces of furniture in our home. And now we have further proof of its very real contribution to our personal health and comfort.”

The above headline comes from an October 10, 2010 article on the website Health Reform. The article, by Stephen Kelly, starts off by saying, “Research has shown that chiropractic care provides greater improvement and satisfaction to patients with chronic lower back pain. Patients who have been taking medicinal help have reported their back pain to be worse or much worse, whereas chiropractic patients felt more satisfied and their back pain was much better.”

The article is a general overview of chiropractic care as it relates to back and musculoskeletal health problems. The author discusses how back pain creates problems in daily life including disruption of sleep. He points out that not only the sleep of the victim is affected, but also that of the whole family. Kelly then offers some comfort by saying, “The good news is you can again sleep peacefully like a baby.”

In his lay-person description of chiropractic, Kelly says, “Spinal manipulation and chiropractic care is a safe, effective treatment for acute lower back pain.” He also reported that, “Not only does chiropractic care improve your spinal pain, but it can also bring relief to those killing headaches. Spinal manipulative therapy is an effective treatment for tension headaches.”

Dr. Gary Walsemann, president of the International Chiropractors Association noted that many articles use terminology that is not entirely accurate when describing chiropractic. Dr. Walsemann noted, “Chiropractors have maintained that they are correcting the underlying cause of health problems and not directly treating them. In response many authors describe chiropractic in terms that suggest chiropractic is a treatment for certain health issues.” Dr. Walsemann continued by clarifying, Chiropractors do not treat conditions directly, we also do not manipulate, we deliver specific chiropractic adjustments to the spine to correct nerve system interference caused by spinal subluxations. As nerve interference is corrected, the body’s own innate healing abilities correct the person’s health issues and help return that person to good health.”

In the conclusion of his article, Kelly noted other reasons “Why Chiropractic Care Might Be a Better Option for Your Back Pain”. He concluded, “Furthermore, chiropractic care is a more cost-effective option because it eliminates the pain, and improves the sleep cycle in much lesser time than conventional medicines or other alternative methods. Patients receiving manipulative treatment have shown better sleep patterns and fewer absences from work”.

From the March 11, 2008, issue of the the scientific periodical, the Journal of Vertebral Subluxation Research (JVSR), comes a case study involving a pregnant women who was suffering from back pain and therefore sought out chiropractic care. This was her third pregnancy and the previous two pregnancies resulted in cesarean births. The 29 year old woman was hoping to deliver this baby vaginally.

In this case, the woman started chiropractic care in her 34th week of pregnancy because of suffering from back pain. She reported having experienced on and off lower back pain throughout her pregnancy. She had also had similar problems in the third trimester of her previous pregnancy.

A chiropractic examination was performed and the determination of subluxations was made. Care was initiated focusing mainly on the lower spine. On the patient’s 4th visit, she reported that her low back pain had improved significantly and she was “getting around better” than before the care.

In the 40th week of her pregnancy, the woman went into labor. She labored 12 hours at home with her husband before going to the hospital. Although she reported that the medical staff was extremely anxious, given her previous birth history, she delivered a healthy baby girl, naturally and without the use of medications or a Caesarean surgical procedure, as had been the case in her prior births.

The study authors, Joel Alcantara, BSc, DC and Ingrid Hamel, DC, FICPA, concluded, “This case report described the successful chiropractic management of a patient with pregnancy-related low back pain and possibly facilitated a successful vaginal birth despite two previous Caesareans.”

A new study from Italy published in the March issue of The Spine Journal, showed that chiropractic care was effective in helping patients with acute back pain and sciatica with disc protrusion. This randomized double-blind clinical trial involved 102 ambulatory patients with at least moderate pain or radiating pain, who had an MRI study showing disc protrusion.

The patients were divided into two groups. One group received chiropractic adjustments 5 days per week by experienced chiropractors, with a maximum of 20 visits. The second group received what the study termed, “simulated manipulations” in order to have a group for comparison to those receiving real chiropractic care.

The results showed that those who got the real chiropractic care improved significantly over the group that received the simulated manipulations. In the group that received the chiropractic care, 55% were free of radiating pain in the follow ups compared to 20% of patients who got the simulated manipulations. Additionally, when measuring local pain, 28% of those who received real chiropractic were free of local pain, versus only 6% of those who got the simulated manipulation.

The results also showed improvements in days of pain with the group that received the real care reporting 6 less days of pain than those in the simulated care group. In addition to these benefits the group with the real care reported using less medications to help with the pain as a result of the chiropractic care.

In this study none of the patients in either group had any adverse effects, and one from each group did report no results at all and were listed as “treatment failures”. The researchers conclusions were, “Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion.”

Published in the February 1st 1999 issue of “Spine” research magazine, was a study that showed a link between chronic low back pain and slower reaction times, reduced short term memory, and certain motor tasks. The study measured subjects with chronic lower back pain using a computer to test their short term memory and reaction time to certain items that appeared on the screen.

The conclusion was that chronic Lower Back Pain hampers short term memory and decreases the patients speed of process of certain information.

In a related note the “Journal of Manipulative and Physiological Therapeutics” July August 1999 issue published a pilot study comparing chiropractic care to acupuncture and medication for patients with chronic low back problems. The results were that no change took place with the acupuncture and medication group while significant changes occurred in the chiropractic group. Considering the information above about memory and reaction times we can see the profound positive effect chiropractic can have on these patients.

The above is the essence of a release from the American Chiropractic Association (ACA). It was in response to a report titled, “Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society” released on October 2, 2007 by Roger Chou, MD and other researchers.

The report was published in the scientific journal, the Annals of Internal Medicine and offers several suggestions for patients with back pain. One such suggestion is for patients who do not improve with self-care options. In these cases the report recommends that doctors should consider the addition of nonpharmacologic therapy with proven benefits, one of which they suggest is spinal manipulation.

Glenn Manceaux, DC, President of the ACA issued comments as a result of the report and stated, “As shown in the literature, chiropractic spinal manipulation is a very effective treatment for low-back pain and other musculoskeletal injuries.”

Although several of the recommendations in the American College of Physicians report do suggest the use of medications, the ACA release points to several previous studies promoting a non drug approach. They noted that in one study published in 2003 in the medical journal Spine, manual manipulation showed better short-term relief of chronic spinal pain than did a variety of medications.

Dr. Manceaux, ACA president recommended, “If your back pain is not resolving quickly, visit your doctor of chiropractic.” He continued, “Many chiropractic patients with relatively long-lasting or recurring back pain feel improvement shortly after starting chiropractic treatment. The relief and return to function they experience after a month of treatment is often greater than after seeing a family physician.”