Get Back Your Back Health

Your backbone's connected to your…well, just about everything. An unhealthy back doesn't just mean bad posture or back aches and pains it can affect your mood, ability to deal with stress or disease, and ability to function at work and play.

People looking for relief, whether from lower back pain, repetitive strain injury, or acute or chronic pain and tension, often turn to a health-care practitioner. But which one?

The following therapies take varying approaches to back health, but the goal is the same: to offer drug-free pain relief and rehabilitation in order to bring your body into alignment. This contributes to your ultimate well-being. After a session you should feel relaxed and energized.

This information is meant as a starting point and is by no means a complete list of professionals. Consult with your health-care practitioner before beginning a new treatment program.

Chiropractic

A recognized and regulated health profession in all provinces, chiropractic currently has more than 5,000 practitioners in Canada, with a combined clientele of an estimated 4.5 million.

Chiropractic manipulation or adjustment focuses on the spine treating areas or specific joints where movement is impeded. Practitioners are trained to diagnose, treat and prevent disorders related to the backbone, nervous system and joints of the extremities.

During treatment, the client remains clothed. The chiropractor will use her hands for much of the session, supplementing with other methods including heat, light, ultrasound and specific adjusting instruments. Not confined to the treatment table, complete chiropractic care can include personalized exercise and nutrition programs, and muscle and balance testing.

Many patients report improvements after one session. Generally, though, a series of treatments is required.

Massage Therapy

It's not just a treat at the spa. According to the American Massage Therapy Association, the number of people who turn to massage therapy to help ease back pain doubled between 1997 and 2001. If you're looking for help in managing chronic pain or the effects of stress, or if you're recovering from an injury, registered massage therapists (RMTs) can help.

Massage may directly help your back in a few specific ways. Firstly, the massage therapist's kneading and stroking increases blood circulation, which aids in recovery of muscle soreness, particularly from physical activity. Along the way, your muscles relax, which improves range of motion great for anyone with lower back aches and pains. Those who suffer chronic back pain will also enjoy the increase in endorphin levels a massage can bring about. (Endorphins are "feel good" chemicals the body produces.)

Different types of massage therapists will use different techniques and have varying requirements. Some may ask you to remove your clothing, while others including shiatsu will use their elbows, wrists and knees to work the (fully clothed) client's muscles.

Massage used to treat an injury may cause discomfort, which should ease quickly but should rarely be painful. Clients should alert the therapist to any severe discomfort.

Alexander Technique

Perhaps used most often by actors, musicians and dancers who want to improve their performance, Alexander Technique (AT) is also popular among those suffering carpal tunnel syndrome (which causes pain and numbness in the fingers and weakness in the thunb), repetitive strain injury and poor posture. In fact, correcting posture is fundamentally what this therapy is all about.

More of an educational or re-educational technique than a physical therapy, AT is taught in a series of private or small groups. A certified teacher begins the sessions by observing the posture and movement of her clients. Using a combination of verbal instructions and light, guiding touch, the teacher aims to improve everyday habits, encouraging efficient ease of movement.

Clients remain clothed throughout the session and may be asked to move around the room, take a seat or lie down. The teacher focuses on the relationship between the head, neck and spine in her effort to restore natural balance, flexibility and ease of movement those innate habits we've lost over years of sedentary jobs, tension and improper posture. When you learn to take care of your back, you can improve health and performance.

Physiotherapy

Developed in the first half of the 20th century mostly by innovative women during the First and Second World Wars physiotherapy is now an accepted part of the health-care system. Physiotherapists may treat more back injuries than any other health professional and use a variety of techniques to do so.

Physiotherapists evaluate patients' physical abilities, including reflexes, movement patterns and respiratory status, and their ability to function at home and at work.

Treatments include specific exercises (at home or supervised) to strengthen and improve muscles. Physiotherapists may also incorporate manual therapy, electrical modalities and education in their treatment plan. Therapists focus on what the patient can do for himself, as well as on preventing future injuries and fostering independence.

Craniosacral Therapy

This therapy is often used to correct scoliosis, numbness, and back and shoulder pain, particularly for patients who experience frequent headaches or migraines. Craniosacral therapy (CT) is based on the work of osteopath Dr. W. Sutherland, who, in the 1920s, is said to have discovered "cranial rhythm," or that the brain makes rhythmic movements in cycles.

This work came to the forefront again in the mid-70s when Dr. J. Upledger, another osteopath, began to actively promote and refine CT. Craniosacral therapists say they can feel the pulsations emanating from the brain and spine with their fingertips. A disruption or irregularity in the rhythm could be the source of a client's pain or dysfunction.

During treatment, clients lie fully clothed on a table. Using a light touch, the therapist will focus work on the head: the skull, membranes and cerebral spinal fluid. By sensitively applying pressure, she can guide her client's body in self-correcting. CT works so gently to relieve restrictions in the connective tissue surrounding the brain and spinal chord that it is unlikely to aggravate any condition.

Resources

Canadian Chiropractic Association: ccachiro.org, 1-800-668-2076
Massage Canada: massage.ca, 416-929-9759, 1-866-789-9271
Ontario Massage Therapists' Association: omta.com, 1-800-668-2022
The Guild for Structural Integration: rolfguild.org, 1-800-447-0150
Canadian Society of Teachers of the Alexander Technique: canstat.ca, 416-487-0567
Canadian Physiotherapy Association: physiotherapy.ca, 1-800-387-8679
Craniosacral Therapy Association: craniosacraltherapy.org, 416-755-7734

The Truth About Chiropractic and Neck Manipulation

For the most part, chiropractic care and conventional medicine have co-operated effectively, which is evident in the abundance of multidisciplinary clinics. But recently a small group of medical doctors have created fear in the public by connecting neck manipulation with stroke.

The fact is that chiropractic procedures are among the safest in health-care services, and the incidence of stroke associated with neck manipulation is extremely rare. Two chiropractic studies estimate that the risk of stroke is, in Canada, one out of 3.8 million neck adjustments. To put this is perspective, the risk of a stroke is approximately one per 100,000 annually for patients who take non-steroidal anti-inflammatory drugs such as Advil and Aspirin.

Dozens of studies have shown chiropractic care to be superior to conventional medical care for neck and back complaints. And although most medical procedures contain certain risks, a chiropractor is thoroughly trained to look for risk factors. A diligent chiropractor will perform a comprehensive patient history, physical exam, possibly take diagnostic X-rays, and devise a treatment plan that will benefit or resolve your specific condition. If any risk is thought to be present, he would not manipulate the neck. Should he feel that your case does not require chiropractic care, he will refer you to an appropriate specialist. Many chiropractors also practise alternate techniques that may be used to mobilize the vertebrae in the neck without "high velocity" manipulation.

Dr. Robert Farnworth practises chiropractic in Toronto. Call 416-935-0971.