When Back Pain Is Serious: Red Flags Chiropractors Watch For

Back pain is common — and most of the time, it’s not dangerous.
The real problem is knowing when back pain can be safely managed and when it should not be ignored.

In this episode of Ask the Chiropractor, Dr. Brant Hulsebus explains the red flags chiropractors watch for when evaluating back pain. Learn which symptoms may signal something more serious, when waiting it out is a mistake, and how chiropractors determine whether conservative care is appropriate or further evaluation is needed.

This episode is designed to bring clarity, not fear. If you’re unsure whether your back pain is serious or just mechanical, this discussion will help you make confident, informed decisions about your health.

www.rockforddc.com

Transcript

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Hello, Dr. Brant Hulsebus here and welcome to another edition of Ask the Chiropractor. Ask The Chiropractor is my little podcast that I do when someone has a question about chiropractic or chiropractic care, I try to answer. I'm a chiropractor here in Rockford, Illinois. I'm a proud graduate of Palmer College of Chiropractic, and I'm happy to be the team chiropractor of the Rockford IceHogs. Let's dive into it. hello and thanks for tuning in to another podcast here. So I wanted to talk. Somebody asked me online , when is it maybe not a chiropractic case? You make it sound like it's always chiropractic case. And there are red flags that chiropractors watch for. So when is back pain serious? What are the red flags we look for? How do we know that you're at the right place? What do we do if we feel like maybe your back pain's too much for a chiropractor? because , that's could be a thing, right? Could be a something else. So as a chiropractor, I want to discuss with you what we do when we have somebody comes in that maybe we need to work another healthcare provider on maybe their situation's too big. because believe it or not, we will do that., We will. Work with other healthcare providers. If we feel like what you have going on maybe isn't, , a hundred percent chiropractic, maybe we do need some other help to help you get better. So I wanted to discuss those things too. And I'm going to discuss this as a chiropractor here in my town of Rockford, Illinois. And I'm going to give you examples of what we do with patients in my community. So I don't know where your chiropractor might be or where you're watching or listening to this, but I'm sure your chiropractor, wherever you are, would have a similar. Arrangements like we have here in town. So let's go ahead. So most back pain is not dangerous, right? Most back pain is in the, we can just handle most of it's muscular, skeletal or neurological involvement, but there are some other ones that we just can't ignore. So we want people to know that as chiropractors, we are trained when to act like when to refer you out, when to get you other help, maybe get you more imaging. Maybe it's not even referring you to another healthcare provider. Maybe it's referring you to imaging here in Rockford, Illinois down the road from us as a place. That we use called Forest City Imaging that does all kinds of MRIs, CAT scans and stuff like that. And your chiropractor can order those tests. If we feel like, hey, you're not getting better, you should have responded to carby now. Something here is being weird or misbehaving, we'll send you out for a scan and get a deeper dive looking to that. And if you find out it's a bigger problem, we will get you to where you need to be. Don't be confused that going to the chiropractor, they might miss something that's bigger than chiropractic. because we have the ability to get you where you need to be. This is often a, area that we deal with. Insurance companies, they, they often say maybe you need to refer the patient somewhere and get more. A deeper look at this patient. And to me it's ironic because these are the same people. They think we maybe over x-ray take too many x-rays, but yet they get mad if we were to miss something. But the x-rays help us not miss something. So to me it's comical. So let's dive into that. The people need to overreact or underreact, some people panic every time they have an ache pain. You know, oh my gosh, this, I feel a little pinch here. And I,, if I lean forward, look to the left arch, my back. Reach up high, twist my left ankle and cough three times. I feel a little catch. Should I go to the er? Should I run to the emergency room? No. Those are not, serious things. But other people, they come in, they tell me I have lower back pain, and when I go to lift my foot, I had a little bit of lower back pain yesterday. Today I got up, I slept, I fell. I went to walk and I went to lift my foot and my, my, I can't lift my toes up anymore. My foot's just flapping. Yeah. I'm going to refer you out right away for an MRI and see what's going on. You might have actually blown a disc in that injury, if you're in that much pain. So we do have to look at it. What are some of these flags? We, like I just talked about, if you come in, your foot's totally flapping,. I had one patient come in one time and he had really bad neck pain. I gave him a good adjustment. He called me later, said, I don't feel any better. The ice and the heat doesn't work. I don't feel like, the chiropractic adjustment did anything and I feel like I'm getting worse. And I have a little bit of a fever now. And I said, get to the emergency room. And I called the emergency room and I told 'em they were coming. And turns out this person had a staph infection in their neck. He had been in the emergency room twice before and they had sent him home. But when I called him, demanded an MRI of him, they'd been able to figure that out and they were able to do emergency surgery and that day in order to save his neck. because we were able to catch that and they didn't. So as a chiropractor, we're not afraid to call the ER and argue on your behalf. So we know these things that are red flags. We know it, you know what we're an expert of more than anything else. We know when things are adjusting and behaving the way they should be. because that's what we do all day. So if you came in every day and saw me and I adjusted you, I would know that this is not adjusting normally, that you're not responding the way you're supposed to. Something bigger is happening here. It's time to get a deeper dive and see what's happening. So as chiropractic profession, we're not afraid to do that. So we were refer appropriately and in Illinois and I practice here in Rockford, Illinois. We're primary healthcare providers, so we have the ability to refer you out for more imaging and to other doctors into more advanced without having to wait two weeks to see your primary and then get another referral. Another referral. We can directly connect you. And the unique thing about my practice is that being the team chiropractor for the Rockford Ice Hogs is so many other teams. I actually know these doctors I'm referring you to. We actually have a personal relationship and when I tend to call their office on your behalf, they know there's something really wrong. We tend to go pretty fast. So if you actually had something in your lower back and you're like, I don't know if it's a chiropractic to see me, if there's something bigger going to the chiropractor, you might actually save yourself a couple weeks in my community. To getting referred in. We tend to do it pretty fast here. What are the things that we look for? Just, let's just break this down. Progressive or worsening pain. You come in to see me, we take your x-rays, you adjust, things are moving good, but your pain's getting worse. That's not, shouldn't be happening. Or you're having zero response to care. You're getting adjusted. Now. I'm not talking about one adjustment. I'm talking about you've come in three, four times and you're not getting well. Then we have situations. Now the first adjustment. After that, you could have some discomfort and pain, but after you've received three or four and you may notice that you are holding your adjustment, you're not giving me as much to adjust, but your pain is getting worse than something bigger is going on. Nerve pain that travels right, and now you couldn't see me. Tell me your hand's a little numb. You have some sciatica. We adjust you. That should start getting better after we take care of you. But if it's not getting better and your range of motion's improving and you're holding your adjustment, then something else is irritating that nerve. It's not coming. From your spine and that's worth more imaging. We talked about a loss of control or a weakness. We talked about the foot drop. That's our red flag., We, people have a hard time walking their gate's changing., Their balance is getting worsening or they're having in,, problems with bowels and bladder control. These are things that we want to get a deeper dive into. It may just be you need a few adjustments. It may be something else is bigger going on, so we're not afraid to refer you out for more imaging, blood worker testing there. Here again in Rockford, Illinois, I can order blood work for you. I can't promise your insurance. They'll cover it, but we're legally allowed to order it so I can usually order it and send it to your primary, and your primary can reorder it and get it taken care of., Is the pain bother you when you're resting? Hey, I'm not even moving and my pain's getting more intense, or the pain that wakes me up in the middle of the night. These are certain things that we want to ask bigger questions for. And again, I can't even stand up. I can't sit down. I can't move. I have to use a walker. I have to use a cane. My pain just is rapidly deteriorating now. Sometimes it's just because you haven't taken care of yourself for a long time. Other reasons, there's bigger things going on. So we're able to look at this and analyze it and say, you know what? It's time to get more help. And not to say you don't have a chiropractic issue still, but there's sometimes when we need to just go ahead and get you more help. So I want to let you know as chiropractors, if you're scared about coming to see us because you think we might miss something, we see these things, we have a lengthy education and licensure process, so we don't miss things like kidney stones. We don't miss things like. A space occupying lesion. What do I mean by that? Maybe if you're a male and you have an extra large prostate, something's going on. We recognize stuff like that and we're able to get you where you need to be. So we don't ignore things. We don't just keep adjusting you through them. Now, not, this isn't. That's what we do and that's what everyone does. We do modify your care. We will order new imaging when appropriate and we'll refer you out to work with other healthcare providers that we work with, that we have communications with. So it's not like I'm just packing you up and shipping you out. We're actually continue our dialogue back and forth and work as a team to help. We have that unique relationship here in Rockford where we can send you to er even, because we work with er doctors at the hockey team with the Rockford Ice Hawks. We work with the orthopedic doctors at the different sports teams we've gone to. And again, we have friendships and relationships with, movement fitness down the street from us. Let's say, . Places are going to teach you how to exercise properly, and we also have relationships with the physical therapy outfit here in town. So we're not saying goodbye to you, we're just giving you the extra help you need while we take care of you with them, and we're able to help manage that or be your director of all that as a primary healthcare provider here in Rockford. So, but what's not a reason to come see a chiropractor? I'm stiff, I'm sore. I have pain after I work. Those are things that we see all the time. So those are definitely reasons that come see us. But if you're concerned that, maybe there's more going on, maybe the chiropractor's not checking that. It's definitely not the case. We definitely know to do that. Who am I talking to here? I'm talking to that person that's really nervous about seeing a chiropractor because they're afraid they might have a bigger underlying issue. We're going to discover that. We'll find that out. We'll dive into it. So we're afraid where we need to be. We don't, we won't like. We won't ask the medical doctor to tell you about chiropractic. We're not going to tell you what to do about what we find. We're going to refer you to the right doctor to answer the right questions. because remember, if you have question about chiropractic, only a chiropractor can answer. And if you have questions about a different procedure that non chiropractic, we want you to see the expert in that field as well. So again, if you nurse about seeing a chiropractor, remember that we're non-surgical. We're not, we don't give out medicine. We're natural holistic kinda healthcare providers, but we are uniquely trained to refer you where you need to be. And again, in my community, Rockford, Illinois, we know everyone that refer you to and who to get you the best help as fast as we can. So you know, if you've got sciatic pain, go see a chiropractor. How do I know it's sciatica and not something else? We have all that training. We have a bunch of testing that we do to see whether or not that's the case for you. And if it's not the case for you, we'll get you where you need to be. Coming in next time, we're going to talk a little bit about why sitting all day is quietly destroying your back, or as one of my favorite professors always said, sitting to your spine is the same as sugar to your teeth. All right. Thanks for tuning in.