Got Back Pain? Think Neck! Some specific information your doctor probably does not know

by Michael D. Allen, DC, NMDBackache. Pain in the lower back
Functional Neurologist

Of all the conditions I have treated in my almost five decades of practice, lower back pain is probably the most common complaint. In fact, lower back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010. Thirty-one million Americans experience low-back pain at any given time; one-half of all working Americans admit to having back pain symptoms each year. It is one of the most common reasons for missed work and the second most common reason people visit their doctor, outnumbered only by upper-respiratory infections. In fact, most low back complaints are mechanical, unrelated to other serious conditions like inflammatory arthritis, infection, fracture or cancer. Experts estimate that as many as 80% of the population will experience a back problem at some time in their lives.

Chiropractic doctors treat more than just back pain. In fact, many of my patients consider me their primary doctor and they only see their medical doctor if they require medications or surgery. They come to see me now as a first resort because of the benefit they received when they saw me as a last resort.

Many new patients tell me that they have taken pain killers or muscle relaxers to relieve their pain, but their pain keeps coming back, and with greater frequency and intensity over time. Most of these patients, if they have seen their medical doctor for their pain, are referred to have physical therapy and the physical therapist works on their lower back; that’s where the pain is, right?

I cannot count the number of new patients who make appointments to see me because of their persistent lower back pain. Most of the time, after my examination, I am clearly able to tell them that although they are experiencing pain in their lower back, the problem is in their neck.

Let me tell you about Matthew. He was an All-Star goalie for a nearby high school soccer team. Matthew had such severe lower back pains that he could only wait for me by lying on the floor of my reception area because sitting upright caused him too much pain. When it came time for me to see Matthew, his mom tried to help him but all he could do was crawl into the examination room and drag himself onto my treatment table.

After understanding Matthew’s history I did a thorough examination to confirm my considerations. The many doctors who previously examined Matthew and the many tests he had undergone—including lower back x-rays and MRI—were unable to come up with a diagnosis. As a result, Matthew was scheduled to have exploratory lower back surgery the next day. So, understandably, Matthew’s mom was watching me like a hawk. At the time, I did not know that she was a nurse at a well-respected nearby hospital.

When I finished my examination, I told the two of them that I could clearly see that Matthew was having severe lower back pain, but the cause of his pain was not in his lower back. Matthew’s problem was coming from his neck. I wondered if Matthew’s mother thought I was out of my mind. Did I miss her son writhing in lower back pain? I told them both that most doctors miss the fact that the neck controls what the lower back does. Patients may experience lower back pain, but the cause of their pain is in their neck. When the neck is unable to control what the lower back does, the patient will have lower back pain.

da1cspinal_cord_disordersff12

A cross section of the cervical spinal cord. C=Cervical; T=Thoracic; L=Lumbar; S=Sacral.

Now, if that sounds strange to you, please let me explain. In the spinal cord of the neck, the leg fibers (the S and L in the drawing to the left) are generally arranged toward the outer part of the cord while the arm fibers (the C and T in the drawing to the left) are more generally located more toward the center of the cord. Anatomically, those fibers that come out first are placed more central and the ones that travel a longer distance are more peripheral. As a result, any issue that affects the outer parts of the spinal cord in the neck will display itself in the center-line structure below the level of the shoulder blades and lower extremities before it shows up in the upper extremities.

As a result of my examination, I asked Matthew’s mother to give me a chance to help relieve his pain and correct his spinal problem before he went under the knife. The rest is history. In short order, Matthew was back on his feet and defending his team’s goal. He even received a scholarship to play soccer in college and travel with a road team.

During my classes I often hear doctors tell me that a patient presented with lower back pain and they -– general practitioners, orthopedists, neurologists, chiropractors, naturopaths, physical therapists, etc. –- always treat the area of the patient’s pain. Or the doctors send their patient to physical therapy and the physical therapist treats and exercises the patient’s low back. Worse yet, the doctors have their patient undergo exploratory surgery to find out what is wrong, and they find nothing of significance. As a matter of fact, had Matthew had his exploratory surgery the findings would probably have been negative and the effects of the surgery would have left him unable to play soccer at that level again.

When I travel around the world and teach doctors of all kinds, one of the most important issues I can tell them is that the neck controls what the lower back does. If a person has lower back pain, be sure to examine their neck closely because chances are that is where one will find the source of the problem.

If you or someone you know has a lower back problem that has continued for longer than either of you would like, please give me a call. I understand this idea is new to most doctors, but I also understand the issues that bind the neck and lower back together. Let me see if I can help before ever submitting to the knife.

For more information, watch the HealthBuilderS® videos that describe some of Dr. Allen’s examination procedures. Go to: http://bit.ly/1JRbSfe.

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