Lower back pain - chiropractor, osteopath or physio?

[NotNob]

I went to see my GP yesterday about ongoing lower back pain as its getting progressively worse. She didn't examine me but had referred me and it is my choice who I see ; a chiropractor, osteopath or a physiotherapist. I'm not medical and wondered if anyone has experience and could advise me please?

Background: 38 years old, loads of exercise (running, HIIT, spinning, weights). I suspect it is the exercise which had caused it, indeed it's been noted by a personal trainer that my core is significantly weaker than the rest of my body, probably because of a traumatic c section and separated stomach muscles.

Could anyone help with the decision I must make please?

I have back and hip problems and I go to an osteopath as it's nice to be straightened out, but I think in your situation I'd choose a physio as I think they are more likely to give you exercises to help yourself between sessions. Having said that I think so much is down to the individual you get rather than the profession.

Thank you for your reply, waiting, I suspected physio might be better for me but I wanted others' experiences too.

Watching with interest as have lower back, hip , leg pain atm.

Physio has never worked for me. Osteopath all the way. And pilates.

Could you find a specialist sports rehab physio or therapist? I have a great one who is way better than any General physio I have seen ( many). Pilates style exercises which are tailored to your back pain may help.

I don't wish to sound doomy but I was a very fit individual when my back pain started and it turned out to be a disc prolapse.

physio

I would say physio too, especially for your core.

Chiros focus on the nervous and musculoskeletal system. Osteos are about the musculoskeletal system/joints and ligatures etc. Physio is - if you get a good practitioner - holistic, so would look at why your core is weak and how your whole body works together. (Though there are of course good and bad practitioners, for all these).

In my (limited) experience as well, osteos/chiros are more about them manipulating your body; physios are more about you doing the work and possibly some treatment on top of that, so you have more "ownership" and learn more about how your body works.

I wouldn't trust a chiropractor, they're less qualified than an osteo or physio. Agree an osteo should give you a quicker fix, but temporary, whereas a physio will help you longer term.

I can highly recommend post-natal specific Pilates classes if you can find one. I've kept serious back issues at bay by doing a class each week and practicing in between.

Going forward, look for a regular Pilates class that's run by a physiotherapist. I can recommend two people, if you are anywhere near Durham.

I've had ongoing lower back, hip and leg pain/sciatica. Have just been referred for an MRI scan. I'm a nurse and suspect disc problems myself

Have used a chiro for back problems, it may well help initially, but when you stop having treatment the pain returns ...

Thanks everyone, I'll look for a sports physio.

I'd just like to ask those who have had disk prolapse, what were your symptoms? My pain is full most of the time but I sometimes get a shooting pain which is v painful, especially upon standing. Stretches seem to help and I am hyper mobile, I've just realised.

Dull, not full!

Where is the shooting pain? I have that from my lower lumbar spine and I have a possible diagnosis of osteoarthritis. I'm similar to you, lots of exercise and problems with ITB, quads, piriformis, psoas tightness plus old hamstring strain that all probably contribute. I swim a lot, and religiously do a programme of core exercises every day, which had helped. Anything weight bearing or even walking too far causes me problems.

My shooting or more like stabbing pain is like a hot needle in my lower back. I also have a bit of pain in my left hip/buttock.
I'm clearly going to have to knock high impact on the head. I'm gutted about this as am currently re-training to go into fitness but I guess I'll have to stick with spinning, give Pilates a try and start swimming (which I hate!) Apologies for the self-pity, I've just found exercise in my thirties and am a junkie for the endorphins!

Sorry to hear of your possible diagnosis, waiting, rudely thinking of myself only!

Yeah, it's crap, I used to run 15-20 miles a week and I really miss it. And kettlebells. Luckily I quite like swimming too (though not the annoying people in the pool...) - I even thought the other day about aqua aerobics but fortunately it's not come to that yet....

Lots of back pain does get resolved though. I struggled with Pilates as too slow, although some of the basics were really useful about pelvic position and what you should be doing with your abs when you exercise, but it sounds like some sort of core work is needed, perhaps in conjunction with some leg stretches and twists, but a good physio should be able to help you with that and sounds like you should already have some knowledge anyway. The other thing is pacing and not getting into a cycle of overdoing it one day then having to rest, but evening out activity. I'm working on that...!

Hmm. Don't know why that double posted, sorry!

Physio then consider Pilates-I've totally sorted quite bad lower back pain with Pilates

Physio and pilates. Definitely the way to go. Pain in your left hip, might that be a tight IB band?

Can I jump on this thread and ask you ladies that are recommending physio for lower back pain. Is this something you have managed to get on the NHS or something you have had to pay privately for? I am a fit 47 year old who dances and am struggling with lower back pain this week. I want it fixed asap so am suspecting that I need to fork out and pay, I don't have any private health cover.

Would always, always say physio as they are the only one out of the three that has to do an approved NHS degree course for their training. Chiropractice and osteopathy are both mostly based on very weak evidence, considered "alternative medicine" and for that reason very rarely offered on the NHS.

You can get physio on the NHS but you do need to be prepared to take responsibility for your recovery and really follow the treatment plan, i.e. doing all the exercises requested of you etc. You sound very proactive though so I'm sure you will have no problem with that. I have had physio twice, once for pain from a misaligned knee cap and once for pain from a whiplash injury, both times did me lots of good and both were very well educated professionals carrying out evidenced-based treatment on the NHS.

"Would always, always say physio as they are the only one out of the three that has to do an approved NHS degree course for their training. Chiropractice and osteopathy are both mostly based on very weak evidence, considered "alternative medicine" and for that reason very rarely offered on the NHS."

Hmm, there are more things in life than NHS approved courses. Sadly, the NHS isn't that great at musculo-skeletal stuff it seems...

My osteo says that:

Osteos are better at manipulation and palpation of inflammed tissue to improve its quality
Physios are better at rehabilitation (knowing what to exercise first during the recovery process and how to develop that process)

A physio finds it very obvious to become a pilates instructor because they can use their training. An osteopath would not find it so easy because it doesn't use their training. But an osteopath would be a better massage therapist than a physio.

So, for instance, my physio initially just made me worse (because the tissue was too inflamed) until I'd had enough osteopathic treatment to calm it down and change my posture slightly. At that point osteo said I'd plateaued but would now tolerate lots and lots of physio/pilates.

it was, by the way, an extremely eminent neurologist who told me I needed osteopathy, not physiotherapy.

Depending on what's wrong...

A physio first. Any suggestion of a structural issue such a disc prolapse and you may have to see a medical specialist. But physio can be great.

Pilates is fantastic

Avoid chiropractors like the plague. There is very little clinical evidence for all the 'subluxation' stuff (it's woo, basically) and a reasonable amount of evidence it can be actively harmful. People have had carotid arteries dissected by neck movements.

Very annoying it's offered on the NHS!

I've also found massage very good for musculoskeletal injuries (if your physio oks it.) it can help to release tension which reduces pain, which reduces tension, hence a virtuous circle.