Conditions
Lower back pain
Four out of five people who come to see me arrive with a back that has been sore for a while. Here is how I go about it.
What it usually feels like
For most people it is a band of ache across the low back that is worst getting out of a chair or out of the car, and easier once they are moving. Sitting is often worse than walking. Mornings can be stiff for the first twenty minutes.
Some people describe one side that catches — bending to put socks on, or lifting something out of the boot — and then a few days of guarding it. Others have no single moment they can point to; it simply became normal over a couple of years and now it interrupts sleep.
Pain that travels below the knee, or numbness in the leg or foot, behaves differently and matters. Mention it when you book.
What I'd look at first
The low back is often where it hurts rather than where the problem is. I look at how you bend and rotate, how your hips move, whether one side takes more weight standing, and what your feet are doing — then I examine the low back itself, joint by joint.
I also check the things that make a difference to what I'd choose: how you sleep, how long you sit, what you lift and how often, and what has already been tried.
What treatment usually involves
Most often adjusting the joints that aren't moving well, together with soft tissue work through the hips and low back. Where things are irritable I'll start with acupuncture or lighter hands-on work instead and adjust later, once it has settled.
You'll leave with two or three things to do at home — usually few enough that you'll actually do them. If your feet are part of the picture, orthotics may come up, but not at the first visit.
When it isn't chiropractic
Not everything is a chiropractic problem. Back pain with fever, unexplained weight loss, a change in bladder or bowel control, progressive weakness in a leg, or pain that is unrelenting at night belongs with your family doctor first, and I will tell you so at the first visit and help you work out where to go. I'd rather send you to the right place than keep you here.
Realistic expectations
Most people notice a change within a few visits. A back that has been like this for ten years usually takes longer than one that went two weeks ago, and some of it depends on what you do all day. I'll tell you if it isn't working, and I won't keep going out of politeness.