Q: I had an MRI and have a bulged disc. Can chiropractic help?

A: Chiropractic can help most disc problems. The real question here is the 'bulged disc' causing the pain. When MRI first can into use researchers had a surprise. They did MRIs on normal painfree individuals to see what their spines looked like. Most had bulging discs! So the presence of a disc bulge is not particularly significant. It may be related to pain or just an incidental finding. MRI findings need to match the clinical findings. Low back pain can come from many sources other then the discs. For example, back pain can be related to poor alignment or spinal posture. Since MRIs are nearly always taken lying down these postural problems cannot be seen.

Q: I have had back surgery. Can chiropractic help and is it safe?

A: A recent study published is the Journal of Manipulative and Physiological Therapeutics reported on the outcome of 32 patients who had back surgery and were having low back pain. Discectomy, laminectomy, fusion or a combination of these procedures had been done. Chiropractic care consisted of Cox flexion distraction technique. This is a gentle stretching technique that decompresses joints and discs and stretches tight muscles and ligaments. The average pain score decreased 4.1 on a scale of 10 or 41%. Improvement in pain was most remarkable in patients who had undergone a surgery that combined lumbar discectomy, fusion, and/or laminectomy, with an average pain reduction of 5.7 or 57%. What is also remarkable is that no patient got worse.

Many doctors and patients falsely assume that once surgery has been done all spinal manipulation is contraindicated. I have been using this Cox flexion distraction technique for over 25 years. Patients like it because it is both gentle and effective. Unlike other forms of decompression that are considered 'investigational' and not paid for by insurance companies, I have never encountered reimbursement problems.

Q: Can my shoes affect my low back?

A: The short answer is yes. High heels increase the amount of forward curve (lordosis) in the lower back(see study). Increased lordosis places more compression of the facet joints in the lower back and posterior discs. If you already have too much curve in your lower back, high heels would not be a good idea. If you do a lot of standing on high heels you increase the risk of irritating nerves in the facet joints.

Q: Can my feet affect my low back?

A: If the arches in your feet are too flat or in some cases too high, this will cause your foot and ankle to roll inward or outward. Since the ankle is bone is connected to the thigh bone and the thigh bone to the hip bone and the hip bone to the back bone, this kinetic chain can affect the back. Orthotics can provides proper support for the arches of the feet and reduce this kinetic chain of events. If you have a combination of foot, knee, hip or back pain, this is a stronger indication that orthotics can be a part of the solution. We use custom flexible orthotics that support all three arches in the foot not just two that most rigid orthotics support. Patients also have an easier time getting used to flexible orthotics.