How common is low back pain?
Low back pain is a very common complaint in many clinics in Hong Kong (HK), with between 60 and 80% of the general population being affected at some stage of their lives. Although most individuals recover within 6 weeks, 5 to 15% are unresponsive to treatment and have continued disability, severely affecting their quality of life.
Back Pain Prevalence in Hong Kong
While back pain is common around the world, research by specialists has found an estimated 57.1% of the Hong Kong population has experienced lower back pain at least once in their lifetime. Across the 3 million people comprising the working population in HK, approximately 900,000 days of sick leave were granted for back pain and HK$513 million were paid for clinical consultations because of work-related low back pain.
Compared to other nations such as Great Britain, back pain sufferers in Hong Kong are less likely to seek professional clinical treatment for their symptoms. This can be attributed to various factors, however it is always advisable to ensure treatment is pursued if your back pain is affecting your life.
What are the causes of low back pain?
The majority of low back pain is mechanical in nature. Acute low back pain are initiated by an acute injury or trauma which cause immediate damage to tissues in the low back area. Accidents such as a fall, sports injury, or performing certain movements in the wrong way may precipitate an acute low back pain. Chronic low back pain is usually associated with a gradual increase in or recurrent symptoms over a period of months or years. Sometimes it may be related to an acute onset with a prolonged recovery. Repeated minor injuries resulting from poor postures or faulty techniques in sports may also cause chronic low back pain.
Clinically, the exact cause of many incidents of low back pain is often difficult to determine due to the vast number of structures in the lower back that could be the source of pain. It is important to obtain a correct diagnosis before proceeding with treatment. Sometimes radiographic or other studies are required to confirm the diagnosis. The most common conditions seen by a chiropractor in Hong Kong are:
- Lumbar (low back) sprain and strain
- Discogenic pain
- Facet syndrome
- Sacroiliac sprain
What signs of low back pain require immediate attention?
If you develop the following signs and symptoms, you should see your doctor immediately. It could indicate a serious condition that may need immediate medical attention:
- Back pain persisting beyond a few days
- Back pain that awakens you at night
- Difficulty controlling bowel or bladder function
- Back pain that is accompanied by fever, chills, sweats or other unusual symptoms
What is the chiropractic treatment approach for low back pain?
- Reduce Pain - For both acute and chronic pain, the goal of treatment initially would be to reduce the pain, or to “break the pain cycle”. As the pain level is reduced, the muscles will relax, reversing the pain cycle. Certain modalities may be employed to provide pain relief and reduce inflammation at this stage, such as interferential current therapy, ultrasound therapy, dry-needling, ice/heat cycle, etc.
- Restore normal joint mechanics - Depending on the examination findings, your chiropractor will adjust (manipulate) the vertebral joints that are misaligned (subluxated). A chiropractic spinal adjustment is a high-velocity, low-amplitude force directed to specific joint segment(s). Sometimes other techniques are also employed to effect the correction, including flexion-distraction, drop table, etc.
- Improve flexibility and strength – To prevent future injuries, it is important to improve the flexibility of the joints and the strength of the core muscles. Your chiropractor will advise you on appropriate stretching and strengthening exercises according to your physical needs and fitness level.
- Lifestyle adjustments – Exercises, diet, working posture, sleep etc. play a vital role in the development and otherwise prevention of low back pain. Your specialist in chiropractic will work with you to identify lifestyle adjustments that will help you maximize the quality of your health.
What are some of the Recommended Treatments for Mechanical Low Back Pain?*
- Spinal manipulation - for restoration of joint movements
- Dry-needling - for pain relief and relax muscles
- Ultrasound Therapy - for reducing inflammation
- Interferential Current Therapy - for relaxing muscles and enhance circulation
- Shockwave Therapy - to speed up tissue healing
- Exercise Therapy - to restore normal function and flexibility
Effective relief from low back pain starts from a proper examination and diagnosis. In Hong Kong, chiropractors are licensed primary healthcare practitioners who can help identify the causes of your back pain and formulate a treatment plan suitable to your needs. Please don’t hesitate to ask any questions and you’ll receive professional advice based on the most up-to-date scientific evidence.
How effective is chiropractic treatment for low back pain?
Chiropractic adjustment or spinal manipulative therapy (SMT) is an effective treatment for both acute and chronic low back pain. A 2018 study1 shows that after 6 weeks, those who received usual care (including medications, self care and physical therapy) plus up to 12 sessions of chiropractic treatments reported the following:
- less pain intensity
- experienced less disability and more improvement in function
- higher satisfaction with their treatment
- needed less pain medicine
Other studies2 also show that in conjunction with standard medical care, chiropractic spinal manipulative therapy offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute low back pain.
1. Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain - A Comparative Effectiveness Clinical Trial ~ JAMA Netw Open. 2018;1(1):e180105. doi:10.1001/jamanetworkopen.2018.0105
2. Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study ~ Spine 2013 Apr 15:38(8):627-34
Author: Dr Claudia Ng, BSc, DC
* A proper diagnosis has to be obtained for all of the above conditions before an appropriate combination of treatments will be provided. This is just a list of possible treatments for the individual condition but not all of them may be necessary, nor is it limited to those listed only.