A patient recently asked me if I believe the spine is the key to one’s health. What followed was a lengthy discussion about treatment options for her chronic low back pain and her desire to utilize a chiropractor as an alternative treatment measure.

This patient encounter prompted me to reflect on the countless number of patients who present with uncontrolled low back pain, and the desperation they experience seeking symptom improvement.

A survey sponsored by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, Chapel Hill, showed that from 1992 to 2006, chronic low back pain doubled in the state of North Carolina alone. Estimated healthcare-associated costs for this diagnosis in the United States reach about $100 billion dollars a year.

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Treating chronic low back pain is challenging for both the patient and provider. It requires logical approach. The provider must determine a treatment plan based on the pathophysiology of the disease process, and the patient must have realistic expectations for how well the plan will improve their symptoms.

There are risk factors that can be easily identified to prevent the development of chronic low back pain and subsequent need for treatment. Avoiding the use of tobacco, engaging in lifestyle modification to prevent obesity, using proper body mechanics or other mechanisms to assist in physically strenuous work environments, and adequately managing stress in physiologically demanding work or home environments, will aid in preventing low back pain.

Discussing these modifiable risk factors with patients and aiding in the modification of their lifestyle to prevent chronic low back pain are challenging but necessary if we expect to decrease the incidence of low back pain nationwide.

Maintaining the spine’s well being will undoubtedly improve an individual’s health. Preventing the development of chronic pain will improve an individual’s ability to complete daily living activities and maintain an adequate quality of life.

Although the spine is an importance aspect of health, identifying and modifying risk factors through engaging in preventative health activities is the key to achieving good health from head to toe, and is the backbone of primary care.

Leigh Montejo, MSN, FNP-BC, provides health care to underserved populations at the Metropolitan Community Health Service’s Agape Clinic in Washington, North Carolina.