Expert: Dr. Victor Dolan, DC, DACBSP - 8/26/2008

Question
I'm 15 years old and I've been having severe back pains ever since I was 13. I was at the doctor when I was in the 7th grade so that I could play basketball and the doctor checked my back and said that I had a "rib hump". There was a pretty long word for it, I don't remember it though. Ever since then, I've noticed my back pain getting worse very quickly, especially when I sit down. I've been to the doctor a few times over my back since then and my doctor told me that I had rheumatoid arthritis, but I just can't take his word for it this time. It hurts way too much to be that, it seems to me. I have this dent like place in my lower back when I try to stand up straight. And when i lay on my stomach, and use more my lower back to get up, it's like something catches in my back. Could this be scoliosis? or is my doctor right?

Answer
rib hump, scoliosis, rheumatoid arthritis, spondylitis, spondylosis, spondylolisthesis, back pain, severe back pains,

Hello Kristan,

Sorry to hear of your pain.  

First things first;  First we need a proper workup.  This will take time and effort on your part.  You have to get to your local doctor of chiropractic for a complete evaluation.  Your question to me shows a multitude of possibilities as to the cause of your pain and problems.

Get to the local DC.  The DC will take a history and perform a physical examination.  This may lead to Xrays and blood tests.

"Back Pain" can come from many many different causes.  Luckily, usually (most commonly) back pain is not from big BAD things, usually not from metabolic or organic causes; usually back pain is from neuro-musculo-skeletal causes such as strain/ sprain/ muscle spasm/ vertebral subluxation/ or at worst- a disc herniation.

In my Staten Island Chiropractic office I utilize informational handouts-  along the lines of a neuro-musculo-skeletal cause for your problems, this infomation may be helpful for you:

+++++++++++++++++++++++++++++++++++++++++++++

Lower  Back  Pain  (LBP):          Low  Back  Pain  can be caused by many different things.  Big, BAD, catastrophic things like a tumor or a cancer can cause low back pain (only a proper exam by a licensed doctor, like your Doctor of Chiropractic, or your family Doctor of Medicine, can evaluate your signs and symptoms, and perhaps refer for testing).  Big, bad things like a Herniated Disc, sciatica, possible fracture or dislocation can cause LBP (again, best evaluated by your DC or MD, and perhaps referral).  Bad things, like  - Sprains, Strains, contusion, or Vertebral Subluxation Complex (all very efficiently diagnosed and treated by your Doctor Of Chiropractic.  LBP can come from a motor vehicle accident, sport injury, slip, trip, fall, arthritis, lifting improperly, or even bad posture in standing, sitting or sleeping.  All of these things often have a Lumbar (Low Back) Vertebral Subluxation involved.

              Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)

The vertebral subluxation complex is the underlying cause of many healthcare problems. A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

This is a serious condition identified by its five parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical-  problem requires a mechanical   correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN), FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
+++++++++++++++++++++++++++++++++++++++++++++++

Rheumatoid  Arthritis
Rheumatoid arthritis (RA) is a degenerative joint disease that primarily affects the synovial tissue (the membranes around the joints that secrete lubricating fluid to allow bones to move easily against each other).  Rheumatoid arthritis is an autoimmune disease in which the body attacks its own tissue and causes the joints to become swollen, tender and possibly deformed.  Women are most often affected (3:1 ratio) and the disease usually begins between 20 and 50 years of age.  Rheumatoid arthritis can affect any part of the body, including the heart, lungs and eyes and can be a very debilitating disease.  It is a chronic disease, but it can have flare-ups where symptoms are more intense, and then can be followed with periods of remission.  The course of the disease is variable.  As an exact cause is not known, - therefore  BUILDING health is an approach to help minimize progression of the disease.  One approach to ‘building health’ is to remove STRESS from the patient.  Chiropractic REMOVES STRESS by assuring more proper alignment of the joints by removing Vertebral  Subluxation Complex (VSC).  VSC is a misalignment which hastens deterioration of the joints involved, and irritates nerves that supply far-reaching parts of the body.

         Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of joints, and can cause  JOINT  degeneration,  Degenerative Disk Disease,  degenerative joint disease, etc.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.  VSC disrupts BALANCE in the body
Subluxation  is  a  serious  condition  identified  by  its  five  parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve  system  dysfunction  can  cause  symptoms  elsewhere  in  the  body.  STRESS- that may be manifested as dysfunction/ symptoms anywhere in the body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The  resulting  scar  tissue  changes  muscle  tone,  requiring  repeated  spinal  adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation.   Inflammed  Discs can easily bulge,  herniate,  tear,  or  degenerate.   Other  soft tissues  may  also  suffer  permanent  damage.
    Pathophysiology:
         The VSC contributes to  vertebral joint  degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term  nerve  dysfunction  can  cause  other  systems  of  the  body  to  malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, Disk Degeneration,  or aggravate such conditions.   
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

+++++++++++++++++++++++++++++++++++++++++++++++++

Disk   Herniation
Herniated  disk  is  actually  a  quite  common  condition.   However,  the course of the condition is highly variable.   Some patients with a herniated disk literally cannot walk, yet other patients with similar MRI findings may be able to run marathons or lift heavy weights.   Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow:  Ice the area when painful-  10/ 15minutes on, 30/ 45 minutes off;  avoid certain postures and movements;  bend the knees when coughing or sneezing;  bend the knees when lifting anything;  do not extend legs straight out when sitting, laying down, lifting, or driving.   Avoiding certain movements and postures will prevent aggravation of the condition.   Practicing good postures and movement patterns will help the condition heal and be less painful.
Disk  Herniation  is often caused by, or often  concurrent with the Vertebral Subluxation Complex.
         Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
    Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.   
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians;  Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine

++++++++++++++++++++++++++++++++++++++++++++++++++++

          Before we assume it is a musculo-skeletal problem as explained in the above handouts,  history,  Xrays,  and Blood Tests must be made.

Evaluating for Rheumatoid Arthritis or other metabolic/ organic causes of your problems mean evaluation through the blood should be part of your workup:

Blood test consisting of CBC with Differential,
Erythrocyte Sedimentation Rate (ESR or Sedrate)
Rheumatoid Factor (RF)
HLA B27 Typing
Antinuclear Antibody (ANA)
C-Reactive Protein (CRP)
Lupus Erythematosus (LE) Test
Anti-CCP

These tests will let your Doctor of Chiropactic have a look into your metabolic condition.

Xrays will find any boney anomalies.

Could this be Scoliosis?, maybe;  Could this be Rheumatoid Arthritis?, maybe; Could this be spondylolisthesis?, maybe.

Proper evaluation should be performed before proper diagnosis can be made, before an appropriate treatment regimen initiated.

Visit your local Doctor of Chiropractic, Orthopedist, Physiatrist, or Rheumatologist MD.  Get a proper workup.  Begin appropriate care.

Good Luck, and Good Health Naturally,  your Staten Island Chiropractor signing off,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com      (email newsletter)
http://www.DocDolan.net
http://www.GoodHealthNaturally.info