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  • Q&A with Australian Health Practitioners

    Back pain - physiotherapist and chiropractor disagree - what now?

    I have had lower back pain, on and off, for about 2 years. Recently it became unbearable - my physiotherapist diagnosed a prolapsed disc in the lumbar region and gave me strict instructions to stop training (powerlifting). I have since seen a chiropractor (due to the pain, I was willing to try everything in case it helped) and she strongly disagrees with my physiotherapist - she advised that my pelvis is misaligned and this would be the cause of the pain. Meanwhile, the pain continues and at times it is unbearable. Both practitioners are giving conflicting advice - who should I listen to? Or who should I go to for a second opinion? I get nerve pain in my calves but believed this was due to surgery (bilateral fasciotomies for chronic compartment syndrome). I have recently experienced nerve pain down my left arm for the first time. Should I have an MRI or should I not worry about the diagnosis, provided the pain goes away?
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    James is passionate about osteopathy, it’s philosophy and works with facilitating the bodies innate drive for health and balance. He enjoys teaching patients about how … View Profile


    Sounds confusing right? I think the difficulty in seeing different practitoners is that the language they use is also different. We have a couple of things to consider here. Firstly, what is the tissue causing the issue? This is perhaps the disc, perhaps the facet joint or perhaps something entirely different. Secondly what is the cause? Now although I don't like the language of a pelvis being mis-aligned, there may be functional restriction through this area which has caused (or be a result of) the injury. Thirdly there is nothing stopping you getting some imaging on this area and you may very well find a bulging disc. However consider more then half the people walking around outside will also have bulging discs without any back pain! Any scans you do get need to be put together with presenting symptoms and a thorough clinical examination.

    Finally to put it simply.... See an Osteopath ;)

  • Dr Greg Sher


    I am the Clinic Director of the Sydney Spine and Sports Clinic.At our clinic, we see an equal mix of city office workers and elite … View Profile

    Hi there.


    Firstly, I am sorry to read that you have been having such difficulty with your back.


     I agree with most of the things James has said in his answer.  


    I'd just like to add that all chiropractors, physiotherapists and osteopaths have some variation from one another in terms of their assessment and treatment techniques.


    I think with a good examination and the MRI to confirm or rule out significant findings, and a multiple practitioner treatment approach, you can have a good outcome. 


    I work closely with physiotherapists, and we often co-manage our patients together. We have found that this approach tends to have a very successful outcome (from a conservative point of view) as we have slight variations in our beliefs, which means the patient wins with more rounded and complete care, as the problem is attacked from multiple directions.


    My advice is for you to keep on looking out there for someone to help you, and don’t give up.


    Good luck.

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