At our office, we specialize in Gonstead, a well rounded technique created by Clarence S. Gonstead that is a diagnostic tool and an adjusting technique. Since there are many different causes and types of low back pain, it is our job to figure out the cause and the best way to help with low back pain. At our office there are specific things we look for when a patient comes in with low back pain such as:
Sometimes the spine can have areas with redness, swelling, heat, and inflammation which point to a ‘stuck’ segment. The hand held instrument Delta-T or a Nervoscope is designed to detect temperature changes on the surface of the skin and provide objective proof of heat and inflammation.
We use the Delta T/Nervoscope along the low back and hips to find areas of higher temperature which means there is inflammation. We commonly find these ‘hot spots’ are also painful and have less motion when touched.
2)Areas of the spine that are ‘stuck’
- An important part of the analysis for treating low back pain is looking for those ‘stuck spots’ that are fixated, aren’t moving well, or cause pain when moving. We spend time palpating the joints of the low back and hips, comparing the movement between each segment of the spine to see which spots aren’t moving well.
- Did you know that there are different types of pain? Dull, achy, sharp, stabbing, tingling, and burning are all variations of pain and have a different meaning when doing a diagnosis. Part of our analysis is to determine what kind of pain it is and where the pain is.
With chronic low back pain, we often feel a heavy buildup of fibrous scar tissue along the muscles of the spine near the low back. This can feel like rope or knots when palpating the muscles. The body uses scar tissue fibers as ‘glue’ to help stabilize parts of the body that are weakened such as with a whiplash injury, or due to repetitive injury and microtraumas with improper healing like poor posture.
5)Tight muscles or ligaments
There are many muscles and ligaments around the low back that provide support as well as allow motion. We look for tight muscles and ligaments that can create tension in the low back causing pain. We use gentle pressure with palpation and specific stretches of certain muscles and ligaments to determine which areas are tight.
6)Positive Signs with Orthopedic Testing
We use selected orthopedic testing to help determine the cause of low back pain. We are looking for an increase of pain, tingling, numbness, or weakness when performing the orthopedic tests to help diagnose conditions such as sacroiliac joint dysfunction, nerve compression, sciatica, disc bulges/herniations, etc.
7)X-Ray Imaging or MRI
An advantage for some patients that come in with x-ray or MRI’s from previous doctors is the benefit of being able to ‘peek under the hood’. We use imaging of the spine for valuable information such as the ability to see details of the bones, any abnormalities, and the overall structure of the spine.
Gonstead X-Ray analysis is used to determine the misalignments of the low back, hips, and for scoliosis.
- It is important to consider the posture of how a person sits or stands because most people are performing those actions roughly 40-60% of the day. When looking at a person’s natural posture, we are able to see what parts are under more stress such as the feet, knees, low back, or hips. We use strengthening exercises to build stability in the lower body to reduce and prevent low back pain.
9)Wear and tear of Shoes
- Did you know that the way the soles of the shoe wear out can tell a lot about how a person walks, runs, and even if they drag their feet? We look at shoes for signs of even wear, angle, and severity (how much of the rubber has worn out) between the left and right shoe.
- It is normal for people to have discrepancies between body parts such as hands, arm length, and legs. For most people, these minor differences are so small that there is no effect on the body. In cases where one leg is significantly different in length than the other like >3-5mm, it can increase stress and cause low back pain.