Friday, June 22, 2018

Low Back Pain: Who Will Respond Best To Care?

Low Back Pain:  Who Will Respond Best To Care?

Is it possible to identify which low back pain patients might experience the
most benefit from spinal manipulation combined with exercise? In a 2011 study,
researchers identified which patients might respond best to this combination of
care and which patients might need a more aggressive approach.

Directional preference (DP) describes a situation in which it feels better for
the patient to move in one direction versus another. For example, if a patient
feels worse bending forwards (which is quite common) and feels better bending
backwards, then “extension-biased exercises” are preferred.

If leg pain is present, the DP that reduces or eliminates the leg pain (called
centralization, or CEN) is the exercise-biased direction, and it’s important to
avoid any exercise that increases leg pain (peripheralization).

In the study, which involved 584 patients with low back pain, the researchers
found that 60% of the participants had a DP and of those patients, 60% had CEN.
The researchers found that the patients with a DP that reduced CEN responded the
best to care (in this case, spinal manipulation combined with exercise) in
regards to improved pain and function. On the other hand, the patients who had
no DP experienced the least overall improvement.

The value of using a classification system like this allows a doctor of
chiropractic to determine which exercises will help each individual LBP patient
the most.  It also provides them with the ability to identify those most likely
to respond favorably and those patients who may need a more comprehensive

So, if you feel best bending backwards and/or leg pain lessens, the preferred
exercises include bending backwards (extension) from standing, prone press-ups
(“saggy” push-ups) or hugging a gym ball, and/or extending your back over a gym
ball or a stack of large pillows. Of course, there are many additional exercises
but ANY position that reduces LBP and/or leg pain will help.

 We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services. Visit for more information.

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