If you suffer with chronic neck pain, back pain, headaches, sciatica or any other chronic pain condition I know how frustrated you can be and how limiting your pain can be on your ability to fully participate in and enjoy life. 

Before we look at a different way to approach chronic pain let’s take a look at the standard medical approach to treating chronic pain.

Let’s look at how effective this approach is and what if any downsides there are to the standard medical treatment. 

The Standard Medical Approach to Chronic Pain

Conventional treatment approaches for chronic neck pain, back pain, and headaches typically involve a combination of medications, physical therapy, and interventional procedures. The effectiveness of these treatments varies, and they may have potential complications.

Conventional Treatment Approaches Medications

1. Nonsteroidal anti-inflammatory drugs (NSAIDs): Effective for acute bone and muscle pain and some forms of chronic pain conditions2.
2. Acetaminophen: Useful for pain relief, but can have liver effects if taken in excess2.
3. Antidepressants: Particularly tricyclic antidepressants, which can help control pain at lower doses than those used for treating depression2.
4. Muscle relaxants: Used to alleviate muscle tension associated with pain2.

Physical Therapy

Physical therapy is often considered the standard treatment for chronic lower and upper back pain2. It typically involves:

• Standard exercise routines
• Electrical Stimulation and Ultrasound 
• Education on proper body mechanics

Interventional Procedures

1. Epidural steroid injections: Used to relieve pain in the neck, shoulders, and arms caused by compressed nerves12.
2. Facet joint injections: Help reduce inflammation and control pain in the spine’s facet joints1.
3. Cervical radiofrequency ablation: Uses heat from radio waves to disrupt pain-related nerve signals1.
4. Spinal cord stimulation: Blocks painful nerve signals with controlled electrical currents1.

Other Treatments

• Botox injections: FDA-approved for chronic migraines in adults with at least 15 headache days per month3.
• Trigger point injections: Target muscles to address co-occurring myofascial and chronic neck and shoulder pain3.

Effectiveness

The effectiveness of conventional treatments varies:

1. Exercise therapy has shown low-quality evidence for effectiveness compared to usual care in treating chronic low back pain5. 

Almost everyone who comes to Life Chiropractic in Grass Valley, CA when asked what they have been doing to deal with their pain tells me they have tried stretching. Rarely do they tell me that it has been effective. We’ll discuss why in a little bit. 

1. Behavioral therapy has low evidence for effectiveness compared to no treatment5. Here again the standard approach has little evidence of being effective. So much for what they so often call evidence based medicine. 
2. Multidisciplinary treatment has moderate evidence for effectiveness compared to no treatment and other active treatments in reducing short-term pain for chronic low back pain5. This really isn’t a solution when you are providing expensive short term relief for a chronic problem. 
3. OnabotulinumtoxinA (Botox) has substantial data demonstrating its effectiveness in reducing the number and frequency of headaches among adults with chronic migraines6. Botox can cause weakness in the muscles injected as well as other problems. 

Complications

Any time you inject or consume medication there is a possibility of problems. The potential issues can include:

1. Medication side effects: NSAIDs and acetaminophen can cause gastrointestinal or liver problems if overused2.
2. Injection-related complications: Infections, bleeding, or nerve damage (though rare).
3. Dependency: Some pain medications may lead to dependency if used long-term.

Impact on Underlying Conditions

The search results do not directly address whether conventional treatments often result in a worsening of underlying conditions. However, it’s worth noting that:

1. Overuse of acute headache treatments (more than 10 days per month) can lead to medication overuse headaches, potentially worsening the original condition3.
2. Long-term use of onabotulinumtoxinA for chronic migraines has not shown new safety concerns, suggesting it doesn’t typically worsen the underlying condition6.

In conclusion, while conventional treatments can provide relief for many patients, their effectiveness can vary, and they may not always address the root cause of the pain. A comprehensive, multidisciplinary approach tailored to the individual patient’s needs is often recommended for managing chronic pain conditions.

A Different Approach to Chronic Pain

Sometimes the standard treatments offering short term reduction in pain or short term relief is the best that can be done. In these situations the focus should be on minimizing the potential for problems caused by the treatment. 

Let’s look at a different way of approaching chronic pain. 

The common denominator in every single approach above is that the treatment is directed at the pain. That seems reasonable on the surface. But, it clearly isn’t working.

What is missing?

What’s missing is looking a little deeper at what are the imbalances that are causing the pain to persist or are responsible for the intensity of the pain. 

Restoring Balance 

A different approach that I have used for decades is to look deeper than the location of pain, deeper than joint damage like arthritis. 

The human body is amazing in its capacity to heal. A key component of that is restoring balance. The body is working hard 24/7 to maintain balance. On a chemical basis that balance is called homeostasis. 

Sometimes the body is unable to restore balance and needs some help. Let’s look at a few examples to understand this. 

Example #1: A woman came to my office a little more than a year ago complaining of hip pain. She is in her 50’s and had experienced this pain for years. Her primary care MD told her she had hip arthritis and referred her to an orthopedic surgeon. He told her she wasn’t a candidate for hip replacement and offered to give her an injection in her hip. That’s when she decided to consult me.

Neither her MD or the Orthopedic Surgeon bothered to look past her hip. My exam told me something else was going on. There was evidence of nerve irritation from her low back. X-rays of her lumbar spine and pelvis showed disc degeneration and misalignment in her low back. 

I told her I felt that some of her pain was due to imbalance in the pelvis and low back and we would treat her lumbar spine, her pelvis, and of course her hip. She was out of balance and every step she took was putting excess stress on her hip.

What happened?

Over the course of a month or so she experienced a progressive reduction in her pain and was able to resume a lot of activities that she had been unable to participate in due to pain. 

Example #2: Just recently a woman came in with neck pain and headaches. Her neck was in spasm and she had limited movement in her neck. There was so much muscle spasm that I really was unable to get past the muscle spasm. 

What I did find was a lot of imbalance in her upper and mid back. I adjusted those areas and when we returned to her neck about 80% of the muscle spasm was gone and her motion was almost normal. I did make one small adjustment in her neck. 

This underscores the fact that her problem wasn’t primarily in her neck even though that was where she was experiencing pain. 

The Life Chiropractic Corrective Rebalancing Approach

When I evaluate someone experiencing pain not only do I evaluate the area of pain I also look at the entire structure of the pelvis and spine. I look for imbalances:

• Is the pelvis unlevel?
• Are the Sacroiliac Joints of the pelvis moving properly?
• Are the joints of the lumbar, thoracic and cervical spine moving?
• Are the shoulders level?
• Is the head level?

The Pain Isn’t THE Problem

The vast majority of the time I find the cause of the problem or the imbalance is not in the same location of the pain. It is almost always above, below, to the right, or to the left of where the pain is.

Why is that?

Remember that the body is always striving for balance? 

When there is imbalance the body will compensate for the imbalance by shifting something else. It is almost always these areas of compensation that cause the most pain. But, the problem is the original imbalance. 

When we restore balance to the original area(s) the pain starts to diminish, sometimes immediately. 

If you suffer from chronic pain become your own strongest advocate by asking your providers the difficult questions like: 

• What is causing the pain?
• How is this treatment going to correct the cause of the pain?
• Are there any risks or side effects to the treatment?
• Will the treatment make the problem worse over time?

About Dr. Berkowitz  

Dr. Bill Berkowitz is a dedicated chiropractor who brings reliability and depth to his practice at Life Chiropractic in western Nevada County. Focused on addressing chronic issues like low back pain, headaches, and anxiety, Dr. Berkowitz delivers patient-centered care rooted in proven methods without unnecessary extras.

Life Chiropractic, founded by Dr. Bill Berkowitz, offers reliable and results-driven chiropractic care for residents of western Nevada County. With a focus on foundational health solutions, the practice prioritizes quality and effectiveness to help clients achieve relief from chronic issues without unnecessary add-ons.

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