Who can assist you with back pain in the car?
There are a number of professionals who can assist and advise you. Listed below are some of these experts with a brief description describing exactly what each of them does.
Chiropractor
Someone who practices chiropractic. Chiropractic defined as a system of diagnosis and treatment that is based upon the concept that the nervous system coordinates all of the body's functions and holds that disease results from a lack of normal nerve function and employs manipulation and specific adjustment of body structures such as the spinal column so that pressure on nerves coming from the spinal cord due to displacement (subluxation) of a vertebral body may, it is believed, cause problems not only in the back but some distance from it as in the leg. Chiropractors therefore work to manipulate the spine with their hands to realign the vertebrae and relieve the pressure on the nerves. Chiropractic treatment is believed effective for muscle spasms of the back and neck, tension headaches, and some sorts of leg pain.
Modern chiropractic was founded by Daniel David Palmer, a grocer, who performed his first chiropractic adjustment in 1895. The term "chiropractic" derived from the Greek "chir-" referring to the hand + "prassein", to do = to do with the hands (to manipulate) dates to 1898, the year Palmer founded the Palmer College of Chiropractic in Davenport, Iowa.
Not all chiropractors are alike in their practice. The International Chiropractors Association believes that patients should be treated by spinal manipulation alone while the American Chiropractors Association advocate a multidisciplinary approach that combines spinal adjustment with other modalities such as physical therapy, psychological counseling, and dietary measures. For some years the American Medical Association (AMA) opposed chiropractic because of what it termed a "rigid adherence to an irrational, unscientific approach to disease." However, Congress amended the Medicare Act in 1972 to include benefits for chiropractic services and in 1978 the AMA modified its position on chiropractic. To become a doctor of chiropractic (D.C.) requires minimally 2 years of college and 4 years in a school of chiropractic.
Osteopath
Osteopathy is a system and philosophy of health care that separated from traditional (allopathic) medical practice about a century ago. It places emphasis on the musculoskeletal system, hence the name—osteo refers to bone and path refers to disease. Osteopaths also believe strongly in the healing power of the body and do their best to facilitate that strength. During this century, the disciplines of osteopathy and allopathic medicine have been converging.
Osteopathy was founded in the 1890s by Dr. Andrew Taylor, who believed that the musculoskeletal system was central to health. The primacy of the musculoskeletal system is also fundamental to chiropractic, a related health discipline. The original theory behind both approaches presumed that energy flowing through the nervous system is influenced by the supporting structure that encase and protect it—the skull and vertebral column. A defect in the musculoskeletal system was believed to alter the flow of this energy and cause disease. Correcting the defect cured the disease. Defects were thought to be misalignments—parts out of place by tiny distances. Treating misalignments became a matter of restoring the parts to their natural arrangement by adjusting them.
As medical science advanced, defining causes of disease and discovering cures, schools of osteopathy adopted modern science, incorporated it into their curriculum, and redefined their original theory of disease in light of these discoveries. Near the middle of the 20th century the equivalance of medical education between osteopathy and allopathic medicine was recognized, and the D.O. degree (Doctor of Osteopathy) was granted official parity with the M.D. (Doctor of Medicine) degree. Physicians could adopt either set of initials.
However, osteopaths have continued their emphasis on the musculoskeletal system and their traditional focus on "whole person" medicine. As of 1998, osteopaths constitute 5.5% of American physicians, approximately 45,000. They provide 100 million patient visits a year. From its origins in the United States, osteopathy has spread to countries all over the world.
Osteopaths, chiropractors, and physical therapists are the experts in manipulations (adjustments). The place of manipulation in medical care is far from settled, but millions of patients find relief from it. Particularly backs, but also necks, command most of the attention of the musculoskeletal community. This community includes orthopedic surgeons, osteopaths, general and family physicians, orthopedic physicians, chiropractors, physical therapists, massage therapists, specialists in orthotics and prosthetics, and even some dentists and podiatrists. Many types of headaches also originate in the musculoskeletal system. Studies comparing different methods of treating musculoskeletal back, head, and neck pain have not reached a consensus, in spite of the huge numbers of people that suffer from it.
The theory behind manipulation focuses on joints, mostly those of the vertebrae and ribs. Some believe there is a very slight offset of the joint members—a subluxation. Others believe there is a vacuum lock of the joint surfaces, similar to two suction cups stuck together. Such a condition would squeeze joint lubricant out and produce abrasion of the joint surfaces with movement. Another theory focuses on weakness of the ligaments that support the joint, allowing it freedom to get into trouble. Everyone agrees that the result produces pain, that pain produces muscle spasms and cramps, which further aggravates the pain.
Some, but not all, practitioners in this field believe that the skull bones can also be manipulated. The skull is, in fact, several bones that are all moveable in infants. Whether they can be moved in adults is controversial. Other practitioners manipulate peripheral joints to relieve arthritis and similar afflictions.
Manipulation returns the joint to its normal configuration. There are several approaches. Techniques vary among practitioners more than between disciplines. Muscle relaxation of some degree is often required for the manipulation to be successful. This can be done with heat or medication. Muscles can also be induced to relax by gentle but persistent stretching. The manipulation is most often done by a short, fast motion called a thrust, precisely in the right direction. A satisfying "pop" is evidence of success. Others prefer steady force until relaxation permits movement.
Return of the joint to its normal status may be only the first step in treating these disorders. There is a reason for the initial event. It may be a fall, a stumble, or a mild impact, in which case the manipulation is a cure. On the other hand, there may be a postural misalignment (such as a short leg), a limp, or a stretched ligament that permits the joint to slip back into dysfunction. Tension, as well as pain, for emotional reasons causes muscles to tighten. If the pain has been present for any length of time, there will also be muscle deterioration. The osteopathic approach to the whole person takes all these factors into account in returning the patient to a state of health.
Other repairs may be needed. A short leg is thought by some to be a subluxation in the pelvis that may be manipulated back into position. Other short legs may require a lift in one shoe. Long-standing pain requires additional methods of physical therapy to rehabilitate muscles, correct posture, and extinguish habits that arose to compensate for the pain. Medications that relieve muscle spasm and pain are usually part of the treatment. Psychological problems may need attention and medication
Physiotherapist
Physiotherapy is a health care profession concerned with human function and movement and maximising potential:
* it uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status
* it is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery
* the exercise of clinical judgement and informed interpretation is at its core.”
The above definition is taken from the Chartered Society of Physiotherapy Curriculum Framework (January 2002). See the Chartered Society of Physiotherapy website for details
Physiotherapists work in a great variety of settings such as orthopaedics, intensive care, paediatrics, mental illness, stroke recovery, occupational health, ergonomics, musculoskeletal treatment in hospitals and private practice, and care of the elderly.
Physiotherapy science and skills
Physiotherapy is a science-based healthcare profession which views movement as central to health and well being. Physiotherapists aim to identify and make the most of movement ability by health promotion, preventive advice, treatment and rehabilitation.
Core skills used by chartered physiotherapists include manual therapy, therapeutic exercise and the application of electrophysical modalities.
Physiotherapists believe it is of vital importance to take note of psychological, cultural and social factors which influence their clients. They try and bring the patients into an active role to help make the best of independence and function.
Physiotherapy is an autonomous profession (practitioners make their own clinical judgements and treatment choices) and practice reflection (reviewing their own behaviour and success in their work and taking action as appropriate to solve problems they identify in themselves).
Systematic clinical reasoning is used in a problem-solving approach to patient-centred care.
What do physiotherapists do?
Chartered physiotherapists work with a broad variety of physical problems, especially those associated with the neuromuscular, musculoskeletal, cardiovascular and respiratory systems. They may work alone, with physiotherapy colleagues or teams and with other healthcare professionals in multi-professional teams.
These are examples of the areas physiotherapists work in:
* Outpatients - treating spinal and joint problems, accidents and sports injuries.
* Intensive Care Units - keeping limbs mobile and chests clear.
* Women’s Health - ante- and post-natal care advice, exercise and posture, managing continence and post-gynaecological operations.
* Care of Elderly - maintaining mobility and independence, rehabilitation after falls, treatment of arthritis, Parkinson’s disease, chest conditions.
* Neurology - helping people restore normal movement and function in stroke, multiple sclerosis and other conditions.
* Orthopaedics and Trauma - restoring mobility after hip and knee replacements and spinal operations, treating patients after accidents.
* Mental Illness - taking classes in relaxation and body awareness, improving confidence and self-esteem through exercise.
* People with Learning Difficulties - using sport and recreation to develop people, assessing and providing specialist footwear, seating and equipment.
* Occupational Health - treating employees in small to large organisations and companies, looking at work habits to prevent physical problems such as repetitive strain injury.
* Terminally Ill (Palliative Care) - working in the community or in hospices, treating patients with cancer and AIDS.
* Paediatrics - treating sick and injured children, those with severe mental and physical handicaps, and conditions like cerebral palsy and spina bifida
* Community - treating a wide variety of patients at home and giving advice to carers.
* Private Sector - working independently in private practice, clinics, hospitals, and GP surgeries, treating a wide range of conditions.
* Education and Health Promotion - teaching people about many conditions and lifestyle choices. This may include back care, ergonomics, taking exercise classes and cardiac rehabilitation groups.
* Sports clinics - treating injuries in sportsmen and women, advising on recovering fitness and avoiding repeated injury.
* Voluntary Organisations - advising and consulting for organisations supporting and caring for people with multiple sclerosis and Parkinson’s disease.
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