20 Jul Back Pain & Acupuncture
Treating back pain can be tricky. We feel that deep pull that locks us up, then we feel pain in certain positions, doing daily activities, or even when we breathe. It freezes us, and we stretch and it feels better for a little bit but then returns. We get adjusted by our chiropractor or get a massage and we feel great again for a couple of days, but our muscles still want to protect us, so they return to the pattern they had before treatment. We are right back where we started. What is causing this?
In the vast majority of cases of back pain, the culprit is the tiny muscles called Multifidi. The muscles are deep under layers of larger muscle groups and attach to the spinous processes of each vertebra. The origins of the muscle differ depending on whether cervical, thoracic or lumbar, but generally speaking they insert on the lateral aspect and tips of the spinous processes of vertebrae 2-5 levels above the origin. The Multifidi extend the spine, rotate the spine and stabilize the vertebrae during flexion. When they are tight, they impede the dorsal rami of the spinal nerve roots emerging from the spinal cord causing deep, often shooting pain. These muscles are difficult to massage because they are deep, small, and in between the many bony prominences of each vertebral body. This makes manual treatment or adjustment difficult. Is there a treatment modality uniquely suited to reaching the tiny bellies of these muscles, resetting them, and allowing for manual treatments to stick more easily?
The answer is yes. Acupuncture is able to easily reach the multifidi, threading through the thick layers of muscle that protect the spine, and the bony aspects of the vertebrae to reach those tiny bellies. Once the belly is contacted the gnarled and knotted tissue of the Multifidi tend to release, putting them back into neutral so that they can rest, recover, and take in new blood and fluid for proper physiological function. Inserting a sterile metal implement into muscles ruled by nerve conductivity, which is electrical in nature, will reset the proprioceptors in the muscle spindles. These proprioceptors maintain proper position of the fibers and allow them to fire properly and create a contraction, lengthening or stabilization depending on which action is required. Additionally, the immune response to a foreign invader, in this case an accurately placed needle, calls for natural anti-inflammatories (white blood cells) to be sent to the site aiding in reducing inflammation and boosting recovery times. While the effect on symptomology will vary due to their nature and severity, the effect on the tissue is immediate and will typically continue to work for 2 to 3 days after a single acupuncture treatment. A consistent course of weekly acupuncture will increase the effect and repattern the muscles so that they not only stop the pain, but establish a new physiological pattern that will allow for free movement again. While the length of treatment protocols vary due to the severity of the injury, whether it is acute or chronic in nature, or the existence of other injuries, in most cases the prognosis is good. Acupuncture alone can treat the issue but why rely only on acupuncture when there are other modalities that can work together symbiotically to increase the efficacy of treatment?
Combining it with other modalities can speed the process and allow for deeper, more substantive healing. Chiropractic adjustments can reset the vertebral bodies into more alignment, and healthy, relaxed multifidi will accept the adjustment more readily. Deep fascial release as in Active Release Therapy (ART) will create more space for the dorsal rami of the nerve roots to deliver messages to the rest of the body without being impinged. Corrective exercise and postural adjustments can strengthen and stretch these muscles and their surrounding muscle groups to allow for a more balanced, efficient use of the spine to keep the stress off of the multifidi to prevent reoccurring injury. All of therapies together with Acupuncture will keep your back in good health and prevent these bouts of pain and injury before they flare up.
– TJ Morton, Licensed Acupuncturist at Kinetik Performance, Inc.