Chiropractic to help your brain for chronic low back pain
To understand the pain of low back pain, you have to look to the brain
Low back pain (lumbar pain) is a widespread symptom and represents a public health issue: 4 out of 5 people will suffer from low back pain during their lifetime, and more than half of the French population has had at least one episode of back pain in their lifetime. the last twelve months. This symptom is a reason for frequent medical consultation: in 2nd place of reasons for consultation for acute low back pain (low back pain less than 4 weeks) and 8th place for chronic low back pain (back pain over 3 months).
To fix low back pain, you will need an excellent or even the best chiropracteur montreal. She is recommended by everyone.
Spinal manipulation, one of the many non-surgical treatment methods for chronic low back pain, is performed in the majority of cases worldwide by chiropractors. Spinal manipulations not only help reduce pain but also improve physical functioning in patients with chronic low back pain.
For many, lower back pain is simply a pain in the lower back. Hence many treatments and treatments are applied locally and fail to help patients suffering from low back pain. I regularly see patients who have tried massages, infiltrations, physiotherapy, and sometimes even surgeries, with little or only temporary results for a few weeks or months before the problem returns. However, back pain, but also any other pain, is a complex problem that is a combination of several factors of course local but also central, with the involvement of the central nervous system and the brain.
For example, several studies have shown, thanks to functional MRI, that there are alterations in brain function in patients with chronic low back pain. (Yu et al., 2014; Kregel et al., 2015; Konno and Sekiguchi, 2018; Ng et al., 2018;). For example, a study by Giesecke and colleagues in 2004 demonstrated that patients with chronic low back pain had altered neuronal activation in cortical areas of the brain related to pain compared to healthy controls. In another study by Sharma and colleagues in 2011, they used a right leg elevation maneuver to stimulate pain during functional MRI and detected altered brain activity in the anterior cingulate gyrus, bilateral island regions. , the right thalamus, the basal ganglia and sensorimotor regions. In addition, the published literature has also provided evidence of impaired brain activation in several regions of the brain after the application of mechanical stimuli to the lumbar region (Kobayashi et al., 2009; Manchikanti et al., 2009). In summary, these studies show hypersensitivity in the brain of patients with chronic low back pain. This could explain why care based solely on a local analysis of pain may not have convincing or long-term results if the nervous system as a whole is not taken into account. In brackets,
And Chiropractic care can have an effect on the functioning of the brain in low back pain
On the other hand, a 2018 study by Ellingsen and colleagues, which focused on emotional changes in patients with chronic low back pain, reported that patients were less afraid to move after a spinal manipulation session. . Another study by Yuan and colleagues in 2015 found decreased activity in the prefrontal cortex and cerebellum in patients with lumbar disc herniation treated with spinal manipulations.
We have already talked about other studies on the effect of Chiropractic manipulations and care on the brain ( Stiffness and neck pain, cerebellar processing of movement and cognition and the role of Chiropractic; Spinal manipulation, and effects on functioning. brain, the chiropractic in emergency stroke?; the chiropractic affects brain function ).
Today I would like to talk about another recent study published in November 2020 using brain MRI to assess changes in brain activity in patients with chronic low back pain after spinal manipulations. The researchers recruited patients with chronic low back pain and obtained assessments at three points in time: before spinal manipulation, after one spinal manipulation session, and after six spinal manipulation sessions. Point-in-time assessments for patients with chronic low back pain included a brain MRI and two clinical questionnaires to assess pain and quality of life. The results showed that after the first session, the group of patients treated with vertebral manipulations showed significantly higher brain activity in the right parahippocampal gyrus, the right dorsolateral prefrontal cortex and left precuneus compared to group 2 who did not receive vertebral manipulations. After the sixth session, the group of patients treated with spinal manipulation showed significantly greater brain activity in the posterior cingulate gyrus and the right inferior frontal gyrus compared to group 2. After the first and sixth sessions, the group of patients treated by spinal manipulation had significantly lower pain scores than before treatment. In conclusion,
This shows once again that on the one hand pain and in particular chronic pain is a matter of the functioning of the central nervous system and of the brain (and many other studies had already confirmed this) but that above all spinal manipulations, which are again carried out in large majority by chiropractors, can on the one hand help for chronic low back pain and this not only by restoring joint mobility at the local level, but also by having an influence on the functioning of the brain and the regions involved in pain control. Hence the importance of examining the central nervous system when working with a person with chronic pain.
References:
Tan W, Wang W, Yang Y, et al. Spinal Manipulative Therapy Alters Brain Activity in Patients With Chronic Low Back Pain: A Longitudinal Brain fMRI Study. Front Integr Neurosci. 2020;14:534595. Published 2020 Nov 19. doi:10.3389/fnint.2020.534595
