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Effective Diagnosis and Treatment of Low Back Pain

Here's an all-too-common situation. You develop low back pain that lasts for more than a few days and you're uncomfortable enough to go see your primary care physician. He or she tells you it's not clear what's going on and sends you for a magnetic resonance imaging (MRI) study of your lumbar spine. The study comes back showing one or two herniated intervertebral discs. [Intervertebral discs are cartilaginous shock absorbers interspaced between pairs of spinal vertebras.] Your doctor informs you that you have "herniated discs in your back" and prescribes medications and a course of physical therapy. Your doctor may even refer you to an orthopedic surgeon to evaluate the need for surgery on your back.

Now, all of these recommendations may be necessary. Or none of them may be necessary and all that's needed is some rest and an exercise rehabilitation program that you could do on your own if you were given the proper instructions. The culprit here is how the presence of the herniated disc or discs is interpreted. It's important to remember that not all herniated discs are a problem requiring a solution. In fact, a sizable proportion of such disc herniations (30% or more)1 represent the progression of natural processes and are not a problem at all.2,3 But many family doctors and even specialists are not appropriately trained in accurate differentiation among the various possibilities. When faced with MRI evidence of a herniated disc, such doctors see it as a disorder or disease that needs to be treated and fixed. Such an approach results in significant stress and leads to unnecessary procedures and financial hardship for many patients.

Given the frequency of occurrence of such instances of "over-diagnosis", how can a person with back pain expect to receive appropriate care? Of course, people as patients are usually not in a position to be able to overrule their doctor's recommendations. The answer lies in obtaining relevant information. Let your doctor know you're aware that up to one-third of normal persons have herniated discs, and ask whether it's possible that your disc herniation is in fact unrelated to your back pain and merely an incidental finding. Further, if your back pain is not accompanied by leg pain radiating below your knee, it may be that the disc herniation is not affecting spinal nerve roots and may be treated by very conservative measures such as rest followed-up with exercise.

Thus, not all disc herniations have the same impact on a person's health. Some represent normal findings, even if they are present in a person who has back pain. Let your doctor explain to you exactly why your particular problem requires more than watchful waiting. Your local chiropractor will be able to provide you with the very best expert advice and recommendations for any necessary treatment.

1Takatalo J, et al: Does lumbar disc degeneration on magnetic resonance imaging associate with low back symptom severity in young Finnish adults? Spine (Phila PA 1976) 36(25):2180-2189, 2011
2Spontaneous regression of herniated lumbar discs. Kim ES, et al: J Clin Neurosci 2013 Oct 24. pii: S0967-5868(13)00552-3. doi: 10.1016/j.jocn.2013.10.008. [Epub ahead of print]
3Endean A, et al: Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila PA 1976) 36(2):160-169, 2011

Multicare Health Clinic

3930 STADIUM DR
SIOUX CITY, IA 51106
Phone Number: (712) 276-4325

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8:30 am-6:30 pm

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  • "At night my right hand would go painfully numb at least 2-3 times where I could not sleep. Now, I don't have that pain and can get a full night sleep."
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  • "Not only is my pain level down to zero, but what I'm really thrilled with, is that I have normal feeling in my hands."
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  • "I'm now a believer now! I didn't think chiropractic could help my foot problems. But after meeting with Dr. Pistello and Dr. Dave for a few weeks, I'm feeling so much better!"
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    Ellen E.
  • "I wasn't able to use my hand the way I should. After working with Dr. Sneller and the physical therapy team, I can use my hand again."
    Ivy I.
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  • "My company encouraged all of us employees to get screened at Multicare. I didn't know what to expect. It was easy and I learned so much. The orthotics they prescribed really help me to feel more stable and confident at work."
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    Lisa L.
  • "After an accident at work I didn't think I'd ever get relief from my aching shoulder. But, the doctors at Multicare gave me adjustments and physical therapy and now I feel normal again."
    Cliff C.
  • "I wasn't able to use my hand the way I should. After working with Dr. Sneller and the physical therapy team, I can use my hand again."
    Henry H.
  • "Dr. Sneller helped. I haven't been feeling dizzy anymore."
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  • "There couldn't be a better physical therapy team in Siouxland! Not only did my knee feel so much better after six weeks, but I feel like I made new friends."
    Karla K.
  • "After my consultatin with the doctors at Multicare Health Clinic, I understand how to address my balance issues."
    Anna A.
  • "I leave here feeling confident that I have the resources to manage my pain and live normally, and that's priceless."
    Alycen V.
  • "After my knee surgery I was asked where I wanted to do my physical therapy, I chose Multicare Health Clinic and I'm so glad I did! Dr. Steve and the therapy assistants (Sara and Megan) are fabulous! They know what they're doing and they all really seemed to care about my recovery. I'm feeling fantastic! I'll definitely go back again whenever I need therapy or adjustments."
    Sheri J.
  • "My shoulder and neck feel so much better. I now have the knowledge, motivation, desire and tools to keep up the exercises."
    Barb B.
  • "Being able to present my back pain to three different professions in one place and knowing that they are working together to make me better is very comforting."
    Charlie P.