Inflammatory bowel disease, or IBD, causes inflammation of the digestive tract lining, which often involves the deeper layers. Gastrointestinal or GI problems of the stomach and intestines often include diarrhea, weight loss, rectal bleeding, fatigue, and back pain. The inflammation can reach the spine’s joints, causing stiffness, discomfort, and pain symptoms. Injury Medical Chiropractic and Functional Medicine Clinic can help manage symptoms and guide individuals on treatment options.

IBD Back Pain

IBD is a set of conditions associated with chronic or intermittent inflammation of the gastrointestinal tract. It includes Crohn’s disease – CD and ulcerative colitis – UC. Although there are genetic components that predispose individuals to IBD, environmental factors appear to contribute the most. Research shows that IBD is likely related to disturbances in the gut’s flora, which include:

• Bacteria
• Fungi
• Viruses

These set up a systemic inflammatory response.

Symptoms

Other environmental factors associated with IBD include the long-term use of birth control pills and nonsteroidal anti-inflammatory drugs/NSAIDs. Research theorizes that as the gut becomes inflamed, its normal integrity and structure become compromised and begin to leak out, causing an immune system overreaction response. This can cause non-gastrointestinal symptoms that include:

• Fever
• Anemia
• Joint swelling
• Varying pain sensations
• Inflammation of blood vessels
• Breathing problems
• Vision issues

Other symptoms can include:

• Anorexia
• Nausea
• Vomiting
• Chest pain
• Heartburn
• Liver issues – For example, gallstones

Spine

IBD can cause low back pain as the IBD can inflame the spine’s joints, especially the sacrum, as well as cause abdominal cramps and rectal sensations that radiate to the low back area. However, irritation, inflammation, or infection of any central, abdominal, or pelvic organs can cause low back pain.

Diagnosis

• Diagnosis requires a physical examination of the colon – a sigmoidoscopy or a colonoscopy is used.
• Both procedures take a biopsy of the intestinal tissues, which is studied to determine the extent and degree of inflammation.
• Depending on the circumstances, an X-ray could be used to show the depth or extent of the condition.

Chiropractic Management

A chiropractor can help individuals decrease or completely alleviate musculoskeletal symptoms by realigning the spine and pelvis and massaging, releasing, and relaxing the muscles, which increases circulation and soothes inflammation. The reason why chiropractic care can effectively treat IBD is its ability to stabilize the internal systems. When the central nervous system and immune system communicate and function properly, this prevents the immune system from attacking the body’s tissue cells, preventing inflammation. The chiropractic whole-body approach can also help with recommendations regarding lifestyle changes and nutritional anti-inflammatory modifications.

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Ulcerative Colitis

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References

Centers for Disease Control and Prevention. “What Is Inflammatory Bowel Disease (IBD)?” 2022, www.cdc.gov/ibd/what-is-IBD.htm

Danese S, Fiocchi C. Etiopathogenesis of inflammatory bowel diseases. World J Gastroenterol. 2006;12(30):4807-4812. doi:10.3748/wjg.v12.i30.4807

Limsrivilai, Julajak et al. “Systemic Inflammatory Responses in Ulcerative Colitis Patients and Clostridium difficile Infection.” Digestive diseases and sciences vol. 63,7 (2018): 1801-1810. doi:10.1007/s10620-018-5044-1

van Erp, S J et al. “classifying Back Pain and Peripheral Joint Complaints in Inflammatory Bowel Disease Patients: A Prospective Longitudinal Follow-up Study.” Journal of Crohn’s & colitis vol. 10,2 (2016): 166-75. doi:10.1093/ecco-jcc/jjv195

Zeitz, Jonas, et al. “Pain in IBD Patients: Very Frequent and Frequently Insufficiently Taken into Account.” PloS one vol. 11,6 e0156666. 22 Jun. 2016, doi:10.1371/journal.pone.0156666