Chiropractic to relieve back pain

Quèsaco? New name for chiropractic, this therapy aims to treat by "adjustments" of the spine, with very precise and very gentle gestures, done with the fingertips. Only 200 g of pressure is enough to realign a vertebra in the rest of the column and "unblock" the situation.
"By acting on the small imbalances of the spine, via the nervous system, it affects immunity, endocrine systems, scarring, etc., says Caroline Lambert, chiropractor. By reducing the interference of emotional, physical or chemical stress, we have an action on the nervous system. "

To do what ? Chiropractic treats pain: neck pain, back pain, acute or chronic low back pain, sciatica. But also posture problems: arched back, S-shaped column, tendonitis, synovitis and sprains. As well as tinnitus, migraines, tension headaches, facial neuralgia, vertigo, fatigue, depression, gynecological problems. The therapist diagnoses, treats, stabilizes and prevents, thanks to individualized ergonomics or breathing advice. This approach is adopted in some pain centers.
At what price ? Count between 40 euros and 65 euros of fees per consultation. Two or three sessions should suffice for a simple backache in acute crisis, followed by one or two annual sessions to stabilize the results and prevent recurrence.
To achieve a lasting cure, treatment must be considered in the long term. In the case of a more complex and chronic pathology (osteoarthritis, for example), there are about twenty sessions. No refund by Social Security. To find out if your complementary health care service supports this care, consult the French Chiropractic Association: www.chiropratique.org , 08 20 88 83 77 (0,118 euros / min).

For or against? In its January 2006 report on osteopaths and chiropractors, the Academy of Medicine warns: "Some schools issue degrees after six years of training (...), others are content with a few weeks of ends. On the risks of chiropractic, the authors believe that they are very rare, "but they are not all published," and conclude that it is, however, more reasonable to entrust a doctor with his fate before embarking on these "adjustments".

However, the numbers speak for themselves: chiropractic is the third health profession in the world. The second in the United States, where "chiropractors" outnumber dentists. This discipline is refunded and recognized. The World Chiropractic Federation is a partner of the World Health Organization. According to her, the risks resulting from the adjustments are exceptional. "We pay the lowest liability insurance premium in the medical profession," says Caroline Lambert. We ask all our patients to bring X-rays. We do not treat serious pathologies (infections, cancers). We ask our diagnosis, but if the breach is not our responsibility, we pass the hand. "

Know that the French Association of Chiropractic cleans the profession. The diploma it issues requires six thousand hours of course over six years. By addressing its members, charlatans are avoided.

Relieving Back Pain: Osteopathy

Quèsaco? A global manual medicine that relies on the self-healing abilities of the body. This is considered as a balanced whole. Any disturbance has repercussions on the whole, which is why the osteopath sometimes intervenes at a distance from the painful area. "With his hands, with a fine and precise touch, he seeks to identify the physical origin of the disorder (bone, muscle) and restore the body to function properly," says Dr. Gilles Mondoloni in his book "Healing by osteopathy "(Odile Jacob). "Depending on the disorder, he continues, he uses different techniques: mobilization, stretching, manipulation ..."
Whatever the reason for the consultation, the osteopath always proceeds in the same way. He looks for the physical origin of the dysfunction, then uses manual techniques according to the system on which he must act: parietal (articulations, muscles, ligaments); visceral (internal organs of the abdomen and thorax) or bones of the skull and membranes attached thereto.

To do what ? If the indications are almost the same as those of chiropractic, osteopaths consider that they are not limited to the spine and that they treat more the individual as a whole. This is obviously criticized by chiropractors, who also believe that they do a global treatment, playing, moreover, in the long term.

At what price ? 50 euros of fees on average, with great disparities. The number of sessions is variable. For sciatica or osteoarthritis, count three or four, spaced a week, with an annual maintenance. Osteopathic acts are, in principle, not reimbursed by Social Security, but some doctors can issue care sheets. Information on www.osteos.net (Association of Osteopathic Physicians of France) or on https://osteopathie.org (Register of Osteopaths of France).

For or against? It was not until the 1950s that this specialty gained a bit of support in our country, under the impulse of a renowned rheumatologist, Dr. Robert Maigne. Since then, she has been taught at the faculty, where interuniversity degrees in manual medicine have been awarded, recognized by the Council of the Order of Doctors since 1996. Osteopathy is practiced in some pain centers. Today, there are about 10,000 non-medical osteopaths in France and 2,000 doctors, most of them general practitioners, rheumatologists, physical medicine and rehabilitation doctors. The training lasts six years and requires 5,000 hours of courses when the candidate is not a doctor, 2,500 hours if he is a physiotherapist and 1,500 if he is a doctor.

That can reassure ... Attention, because, parallel to these recognized formations, there are less serious, warns the Academy of Medicine. Some question the effectiveness of this practice. They describe it as "manual psychotherapy", with sedative effects, certainly, but intended for patients who would, in any case, have healed spontaneously. Professor Charles-Joel Menkes, former head of rheumatology at the Cochin hospital (Paris 14th), does not mince his words: "To do medicine, it is better to be a doctor. The manipulations that cure everything is frankly comical. "

Relieving back pain: Etiopathy

Founded in 1960 by osteopath Christian Trédaniel, this therapy resembles osteopathy and is, like it, a part of the old legacy of bailing practices. The practitioner sees himself as a "body mechanic" who manipulates the joints and the viscera to treat the disorders. The diploma is not recognized by the State, despite five thousand hours of teaching provided by four private schools. There is a National Register of Etiopaths at the Ministry of Health. Information on www.etiopathie.com (International Institute of Etiopathy). 50 euros the session on average, but the rates are variable.

Rheumatologist's advice for relieving back pain

Véronique Rouillon, Gonesse Hospital (Val-d'Oise).

"It all depends on your lifestyle. The sports doctor is suitable for athletes, young people, victims of accidents during their activity. On the other hand, if you are 50 years old and have knee or back pain, it is better to consult - on the recommendations of your doctor - a rheumatologist who will make an accurate diagnosis, with the necessary examinations. In case of acute pain, he will prescribe analgesics and anti-inflammatories for rapid relief. Then he passes the relay to the physiotherapist who gives ergonomic advice and teaches the appropriate movements during the sport. Physical activity is essential to avoid recurrence. Swimming, for example, is just as effective as physiotherapy for certain indications.

"Manual techniques, such as osteopathy or chiropractic, are adapted in a specific context. The important thing is to make the right diagnosis in the face of pain. If we do not know where it comes from, we can not apply the right treatment. Is it articular, muscular, ligamentous, tendinous, bony? If you manipulate a bone metastasis, you risk paralysis, so be careful! A rheumatologist conducts seven years of study, plus four specialization. If this medical training does not make him infallible, she helps him to make a diagnosis. One should only be manipulated after this one, which nonphysical manual therapists do not know how to do. "

Relieving back pain: What does the law say?

Until 2002, when a person went to see an osteopath or a chiropractor in France, patient and therapist acted out of the law. Since then, it recognizes and legalizes these two professions. But the decrees of application, expected for four years now, should specify who has the title of chiropractor or osteopath, and which formations are recognized. In the meantime, it leads to a paradoxical situation that leaves patients at the mercy of any self-appointed manipulator who can affix his plate freely after a few weekends of rough studies. This is why the Register of Osteopaths of France has filed an appeal before the Council of State to speed up the procedure.