Back pain can be caused by medical conditions, some of them life threatening (1). Incapacitating back pain can occur without an underlying medical condition, providing one with a diagnosis of sciatica, disc prolapse or bulge, facet imbrication and muscular strain.
In 2010, a study looked at people with sciatica and a confirmed (by MRI) disc issue. The trial split people between surgery and chiropractic adjustments. 60% of patients with a disc issue benefitted from chiropractic adjustments and did not need surgery. Of the 40% unsatisfied, there was an excellent response to surgery (2). Chiropractic care is effective, can fit with existing medical options whilst reducing surgical load. Chiropractic works because the pain you experience may come from spinal joints (3) even when disc disease is present on MRI (2). What the study didn’t do was to differentiate between lateral and medial disc concerns.
Chiropractic adjustments are not available within the NHS in England, so it is up to you to find and pay for a Chiropractor to help you.
Non-urgent care waiting times should be 18 weeks or less, 92% of the time (4) within the NHS. In 2021 the operating level of the NHS, in England, was 68% (5), not 92%.
A back pain visit to a GP will likely consist of categorisation of your concerns as emergency, urgent or non-urgent. You’ll likely be asked to try paracetamol and/or NSAIDs and then ‘safety netted’ for a further week or two. A second visit might include a referral to a Physiotherapist who will get to you at about 6-12 weeks later. A physio will likely give you advice and exercises. Hands on treatment could take 3-4 months. A time point predictive of chronicity. At 5 years you are likely to have the same pain as at 3 months (6).
- Diagnosis | Low Back pain (without radiculopathy) Accessed 21.10.21
- McMorland G et al (2010) Manipulation or Microdiskectomy for Sciatica? JMPT 33 (8) 576
- Differential Diagnosis | Sciatica | Accessed 21.10.21
- Statistics » Consultant-led Referral to Treatment Waiting Times Data 2021-22 (england.nhs.uk) Accessed 21.10.21
- ‘Latest waiting times by Hospital Trust’. A download from Ref 2.
- Back Pain in Most Older Adults Remains Unchanged After 5 Years. (2020) Talk Back Magasine, Spring Issue, Back Care (The Charity).