Threw out back, what’s next?

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I recently threw out my back (sciatica or herniated disc) and have to see a chiropractor and physical therapy. I’m always in pain at work and am looking at my non-floor options. I am considering a Masters program in nursing informatics or biomedical informatics. Which one should I study and what programs do you recommend? And what job can I do while I go to school with five years of bedside that’s easier on my back? I’ve been told endoscopy, psych NP, insurance, and quality assurance.

Thank you so much!

Specializes in SRNA.

It cracks me up seeing all these people dissing chiropractors. I've been to them many times and have had great experiences. Most physicians don't know what to do with back pain except medicate it. I think physical therapy is good too. Find a good chiropractor and PT and actually do the prescribed exercises. Myself and many nurses I know benefit from chiros. My view on body mechanical problems is chiro/therapy first, pills second, surgery last by far.

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Specializes in Former NP now Internal medicine PGY-3.
On 2/23/2020 at 4:39 PM, Defibn' said:

It cracks me up seeing all these people dissing chiropractors. I've been to them many times and have had great experiences. Most physicians don't know what to do with back pain except medicate it. I think physical therapy is good too. Find a good chiropractor and PT and actually do the prescribed exercises. Myself and many nurses I know benefit from chiros. My view on body mechanical problems is chiro/therapy first, pills second, surgery last by far.

some chiro are OK. Until they start imaging your back and giving diagnoses. PT and physicians are better. A lot of chiros are quacks

Docs give pills because most back pain is just muscle strains tx by you know nsaids or muscle relaxers and some light exercise.

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Specializes in SRNA.
2 hours ago, Tegridy said:

some chiro are OK. Until they start imaging your back and giving diagnoses. PT and physicians are better. A lot of chiros are quacks

Docs give pills because most back pain is just muscle strains tx by you know nsaids or muscle relaxers and some light exercise.

Sure, there are plenty of bad apples. But you never see the same blanket statements for other providers. Plenty of physicians, NPs, PAs, Pods, dentists, whatever.. suck hard and actually harm patients a lot. The truth is, chiropractic is safe. Yes there are some bad outcomes. Yes some are just doing it for the money and therefore get out of the realm of reality. Find a good one and they can drastically improve your quality of life.

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Specializes in Former NP now Internal medicine PGY-3.
48 minutes ago, Defibn' said:

Sure, there are plenty of bad apples. But you never see the same blanket statements for other providers. Plenty of physicians, NPs, PAs, Pods, dentists, whatever.. suck hard and actually harm patients a lot. The truth is, chiropractic is safe. Yes there are some bad outcomes. Yes some are just doing it for the money and therefore get out of the realm of reality. Find a good one and they can drastically improve your quality of life.

IDK I learned plenty of OMM in DO school. Some had data behind it some does not. Actually much of it does not. Same goes for chiros. Subluxation is a myth that if real would show up on MRI. That’s the back bone of chiro science. sure popping our own neck and back feels fine but most of it is just meh

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On 2/23/2020 at 4:39 PM, Defibn' said:

It cracks me up seeing all these people dissing chiropractors. I've been to them many times and have had great experiences. Most physicians don't know what to do with back pain except medicate it. I think physical therapy is good too. Find a good chiropractor and PT and actually do the prescribed exercises. Myself and many nurses I know benefit from chiros. My view on body mechanical problems is chiro/therapy first, pills second, surgery last by far.

Chiropractors make their money by having you come back over and over and over with phony diagnosis. And there is the vertebral dissections that they cause.

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.
On 2/23/2020 at 9:22 AM, DeeAngel said:

Stay away from chiropractors, they can ruin you. Stick with modern physiotherapy instead.

A good chiropractor can help you . Mine, for instance. I ruined my back years ago at the beside and a chiropractor helped me walk after that incident. My current chiro I see whenever I need to. He uses an instrument that is not painful and doesn’t do the same thing hands on does and for me works much better. Between him and exercise I walk without pain, for which I am thankful.

I was anti-chiro once upon a time until I needed one. Consumers need to research chiropractors and choose wisely, but they can be beneficial.

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Specializes in Intensive Care.

As a reformed chiropractor, I agree with some of the above statements and find others ignorant.

Traditional chiropractic focused on spinal alignment and the term for the misalignment is subluxation (not to be confused with medical subluxation). The standard was to take xrays, point out minor misalignments, correlate with objective and subjective findings, and manipulate. Like most passive musculoskeletal treatments, this has a fairly poor outcomes record in studies, but charm and persuasion and the body’s natural regression to non-pain create the appearance of effectiveness. This goes for PT, chiro, massage and acupuncture as well as many others.

I see a current trend of young chiropractors dismissing the old school and learning very sound diagnostic skills and employing more rehab therapy and patient education, with a goal of empowering patients to participate in recovery and minimize dependence in the chiro.

You may ask how this differs from PT. In practice, not a lot. The chiropractic license provides some latitude in scope and they are primary care, so no referrals are needed. There are many chiros that would jump on a short DC to PT degree program just to work at outpatient PT clinics and leave the billing, coding and practice operations to someone else. The DOD, VA, Kaiser, and other systems are hiring evidence-based chiropractors with increased frequency because enough honest, ethical, intelligent DCs are moving away from the pseudoscience.

As far as vertebral artery dissection, the risk is minuscule. There are legion chiropractors twisting and cracking necks every day (along with massage therapists, PTs, frat brothers, etc.) and VAD is extremely rare. Look up the studies. Cervical manipulation does offer at least temporary relief to a portion of those who receive it, so the VAD risk doesn’t come near the modest benefit.

Long story short- if you’re in pain and haven’t found non-opioid and non-surgical relief, consider a chiropractor. Pre-screen by asking a) do they treat subluxations? If yes, move on. b) how long are the first and subsequent visits? First should be at least an hour. Follow-ups, at least 30 minutes. This leads to c) does the chiro prescribe and supervise exercises at every visit? The answer needs to be “yes”. d) are xrays required for all or most patients? Most xrays are useless and only serve as marketing tools for “scare care”.

Finally- a good chiro will not be cheap. They won’t likely charge the hundreds per visit that MDs and PTs do, but chiros are physicians, chiro school is very thorough (as are the 5-part national board exams), and chiros tend to carry the entire overhead of a private practice on their shoulders.

In the end, most back pain resolved on its own. Getting and staying active seems to help. Cognitive behavioral therapy seems to help. Core and balance (but not necessarily yoga) integrity seems to help. Stress reduction, hydration, inflammation control seem to help.

Drugs and therapies may often do more to create dependence and catastrophizing the pain/diagnosis.

Excellent resources:
Back Mechanic by Stuart McGill, PhD.

fixyourownback.com

mckenzie institute international

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Specializes in Community Health, Med/Surg, ICU Stepdown.

I agree that chiropractors can be wonderful but do your research. I injured my back many years ago as a CNA and didn't want to take opioids. A good chiropractor helped me, as well as acupuncture, gentle exercise (mostly walking and certain stretches), and ice/heat/ibuprofen. At the time I didn't have good enough insurance for PT, but I'm sure that would have helped. But as said above there are many types of back injuries affecting bones, discs, muscles, nerves, etc. and they all have different treatments, diagnoses and prognosis. I hope yours is a short term issue! If not I agree clinic work can still involve in person patient care without the heavy lifting. Wishing you the best!

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