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Low Back Pain: What Can I Do for It?

2 Aug

Low back pain (LBP) is the second most common reason for doctor visits in the United States and it is a condition that most of us will at some point in our lives. Last month, we reviewed the wide acceptance of spinal manipulation as the treatment of choice for both acute and chronic LBP.  This month, let’s take a look at what you can do outside the doctor’s office to self-manage acute and chronic low back pain.

One of the best self-management protocols for LBP is exercise that targets the lower back. It appears that the optimal time to engage in exercises for the lower back is during the work day since doing so may help alleviate some of the overuse and repetitive strain contributing to one’s LBP. Let’s focus on exercises you can perform from either a sitting or standing position during short work breaks…

RULES: Perform slowly to a full/firm stretch without pain; take three slow deep breaths for each; only do exercises that “fit” your job and time limits—this might be only one every fifteen minutes; make it work!

SITTING EXERCISES: 1) Sitting Forward Bends – bend forward and reach for the floor (as far as reasonably tolerated). 2) Sitting trunk rotations – twist slowly left, then right. 3) Cross Leg Stretch – cross one leg over the other; grasp and pull the crossed leg knee to the opposite shoulder while arching the back to its maximum until a firm stretch is felt in the buttocks.

STANDING EXERCISES: 1) Hamstring Stretch – place one foot on an elevated surface (like a chair seat, foot stool, or guard rail); perform an anterior pelvic tilt by arching your low back until you feel a firm stretch in the hamstrings. Switch sides and repeat. 2) Groin Stretch – do exactly the same steps as the hamstring stretch but this time, rotate your trunk to the side of the standing leg (away from the stretched leg) until you feel the stretch in the inner thigh or groin muscles. 3) Backward Bends – place your fists behind your low back and slowly bend backwards to a maximum tolerated point.

These “portable” exercises can be performed frequently throughout the work day, whenever you can spare 30-60 seconds. The most important point is to do these exercises on a regular basis. It may help keep your LBP from worsening during your workday.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Smoking – Is It Really That Bad?

30 Jul

Smoking tobacco causes more than 480,000 deaths annually, which makes it the leading cause of preventable death in the United States (US)—that is nearly one in every five deaths in the country! Smoking causes more deaths than HIV, illegal drug use, alcohol abuse, car accidents, and firearm-related deaths COMBINED. More than ten times as many US citizens have prematurely died from cigarette smoking than American soldiers have died in ALL the wars fought by the US over its 240+ year history.

Tobacco use increases the risk of death from all causes in men and women. Smoking causes approximately 90% of all lung cancer deaths and 80% of all COPD (chronic obstructive pulmonary disease)-related deaths. Smoking also elevates the risk for coronary heart disease (2-4x), stroke (2-4x), and lung cancer (25x). Cigarette use diminishes overall health, increases absenteeism for employment, and increases healthcare utilization and cost.

Regarding the lungs, smoking damages the airways starting with the small air sacs (alveoli), leading to COPD, emphysema, and chronic bronchitis. Most cases of lung cancer are caused from smoking cigarettes. Tobacco smoke can trigger an asthma attack and/or make an attack worse.

In a reproductive capacity, smoking can increase the risk for preterm delivery, stillbirth, low birth weight, sudden infant death syndrome (SIDS), ectopic pregnancy, orofacial cleft in infants, and miscarriage.

Smoking harms virtually EVERY organ of the body. Hence, it’s the cause of many diseases. Smokers have an increased risk for osteoporosis, gum and tooth decay, and cataracts. This does not take into consideration the harmful effects that second-hand smoke inflicts to the innocent bystanders.

Cigarette smoking can cause cancer almost ANYWHERE in your body: bladder, blood (acute myeloid leukemia), cervix, colon and rectum (colorectal), esophagus, kidney and ureter, larynx, liver, oropharynx, pancreas, stomach, trachea, bronchus, and lung. Smoking also increases the risk of dying from cancer and other diseases among those who have or have had cancer.

If this article scares you, GOOD! Take home message: Don’t Smoke, and if you are already a smoker, QUIT!

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

How Does Chiropractic Help Whiplash Patients?

23 Jul

Whiplash associated disorder (WAD) injuries usually result from rear-end, low-impact crashes with about 90% occurring at speeds less than 14 mph. Approximately 40% of all WAD patients develop long-term, chronic problems. Let’s look at how chiropractic care can help crash-injured patients recover and return to their normal lives…

REDUCE INFLAMMATION: Inflammation occurs when ligaments and muscles are injured. However, the pain associated with inflammation may be delayed and not show up right away. Rather, you may wake up the next morning with acute neck and/or back pain, as WAD injuries are NOT limited to only the neck. Several studies have shown that chiropractic spinal manipulation results in the release of anti-inflammatory Interleukin 6 (IL-6), which helps reduce inflammation.

RESTORE MOVEMENT: Injured joints quickly become stiff from pain and swelling. Muscles often “splint” in response to pain as a way to protect a deeper ligament or joint-related injury. Both factors can lead a patient to unnecessarily restrict their movement, weakening that area of the body, and increasing the risk of further injury down the road.         

REDUCE SCAR TISSUE: As injured tissue heals, the body’s “Band-Aid” is actually scar tissue that is made up of similar cells as the surrounding tissue but is laid down quickly and in an unorganized way. Scar tissue reduces the ability for the injured tissue to stretch and can lead to tissue shortening. If it is performed early enough, Chiropractic adjustments help to stretch out and—in a sense—break up the scar tissue.

RELIEVE LOCALIZED PAIN: Many studies report spinal manipulation (SM) to be a safe, fast, and effective way to reduce pain. As a result, SM is now strongly recommended in treatment guidelines published throughout the world.          

REDUCE WIDESPREAD PAIN: Some WAD-injured patients develop pain not just in the neck or back but more widespread throughout their body. This is thought to be caused by “sensitization” of parts of our nervous system. Spinal adjustments have been shown to stimulate the nervous system in such a way as to reduce this hypersensitized effect.       

REDUCE STRESS & CHRONIC PAIN: Due to initial high pain intensity, stress and anxiety levels often soar following a WAD injury. Chiropractic care includes patient education, exercise, nutrition, and more to help patients cope with ongoing problems. The importance of EARLY INTERVENTION cannot be overemphasized in quest of preventing chronic, long-term pain and disability.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

What Exercises Are Best for Neck Pain?

16 Jul

Past research has demonstrated that combining spinal manipulative therapy (SMT) with exercise yields the best long-term results for individuals with neck pain. So what exercises should we consider when neck pain rears its ugly head?

In the acute phase of an injury, rest and ice may be appropriate, but patients will often benefit from lightly applied isometric exercises. Place your hand against the side of your head and lightly push your head into your hand for a count of five seconds. If tolerated, tip your head sideways five to ten degrees and repeat the process. This can be repeated multiple times at progressively greater angles until you’ve accessed your full range of motion (ROM).

The above isometric exercise can be repeated in the opposite direction as well as forwards, backwards, and into left and right rotation directions. The KEY is to always stay within reasonable pain boundaries—no sharp/”bad” pain allowed!

You can then move on to isotonic neck exercises. Using the same amount of light pressure, gently push your head into your hand as you did before, but this time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backwards, and into left and right rotation.

Using only one or two fingers rather than the whole hand helps to prevent you from pushing too hard with your hand or head when performing isometrics or isotonic exercises. Also, the same movements of the head can be done without any hand/finger resistance, but faster results seem to occur when pressure is applied.

Studies also show that weakness of the deep neck flexor muscles is very common in people with chronic (more than three months) neck pain. These are deep, involuntary muscles, so to properly strengthen them, look straight ahead, tuck in your chin as far as you can, hold for five to ten seconds, and repeat five to ten times.

Beyond treatment options for neck pain such as spinal manipulation, mobilization, and exercise, your doctor of chiropractic may utilize soft tissue therapies such as myofascial release, active release technique, as well as various physical therapy modalities, ergonomic modifications, and more in the effort to help you get out of pain and return to your normal activities.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Can Chiropractic Help Prevent a Hamstring Injury?

12 Jul

Sports that require rapid acceleration and deceleration, cutting left and right, agility, jumping, and bending pose a unique risk for injury to the lower limbs. Hamstring injuries are the most prevalent injury in Australian rules football, afflicting 16% of players, causing an average of 3.4 missed matches per injury, accounting for the most time lost due to injury, and having the highest recurrence rate once players return to the active roster. Moreover, a player’s performance can be highly diminished by hamstring injuries.

In a 2010 study, researchers randomly assigned 57 male Australian football players to either a control group that received the current best practice medical and sports science management or an intervention group that received the same care with the addition of a sports chiropractic manual therapy injury prevention program that included manipulation/mobilization and/or soft tissue therapies to the spine and lower extremities. Both groups received a minimum of one treatment per week for six weeks, one treatment every two weeks for three months, and one treatment per month for the remainder of the season (three months).

At the close of the season, the researchers found that the group receiving the chiropractic injury intervention program reported significantly fewer primary lower-limb muscle strains and weeks missed due to no-contact knee injury than the other group. Though lower-limb injury prevention was the primary focus of this study, the players in the chiropractic group also experienced fewer episodes of back pain.

Because dysfunction in one area of the body can place added stress elsewhere, it’s important to examine the whole patient in order to identify other issues that may either be the cause or contribute to the patient’s chief complaint. Likewise, preventative care focused on maintaining proper motion in the joints throughout the body can lead to a reduced risk for injury, as was demonstrated by this study.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

The Most Important Principles for Staying Young: Don’t Hold It In!

9 Jul

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

When it comes to Alzheimer’s disease and other forms of dementia, the reality is that scientists have conducted over 1,000 clinical trials and none of the drugs tested seem to have any major positive effects on changing the course of the disease. However, researchers have found that lifestyle choices that you can make now—such as eating a healthier diet, making sure you get enough sleep, managing stress, getting regular exercise, maintaining social connections, avoiding toxins, and keeping your mind stimulated—can keep your brain healthy, delaying or even preventing cognitive decline.

Here is a weird one that you may not have thought can affect your brain: don’t pass a bathroom up. Yes, Manny did it behind the Green Monster while playing left field for the Boston Red Sox. LeBron has taken himself out of the game for it. Michael Phelps did it in the pool. “Every single athlete has to deal with this,” reports U.S. women’s national hockey team forward, Jocelyne Lamoureux-Davidson, “No one ever talks about it.”

It? Coping with the need to pee.

Uber-hydrated athletes often have to confront the urgent feeling, but on a long drive or in an intense meeting, chances are you’ve had to decide, should I excuse myself or just hold it in?

Medically speaking, urologists say it’s always better to respect nature’s calling. But the truth is, before the age of 50, you have the ability to hold urine in for about eight hours and that’s okay to do as long as you don’t do it all the time.

However, some professions, such as a nurse, teacher, surgeon, or truck driver seem to demand that you hold it in frequently. In those cases, you’re risking infections, long-term damage to your bladder, and even possible damage to your kidneys.

Dr. Peter Snyder, a neurologist from Brown University, notes that there is another drawback to holding it in: it impairs higher-order cognitive functions on a level similar to drunken driving. Snyder found that the longer study participants avoided the bathroom, the higher their self-reported pain levels increased, which led to worse performance on cognitive assessments. We do not know if this has long-term effects, but I imagine that bouts of pain can cause destruction of neuronal connections in your brain.

So when nature calls, it’s okay to hold it in for a little while but avoid making it a habit or one day you may lose the ability to hold it in at all.  And when you find that urge to pee relieved, vow to and develop a plan to immediately implement some lifestyle choices that preserve and increase brain function. Because when it comes to your brain, an ounce of prevention is really worth a ton of non-effective cures.

 

Next month, we’ll talk about another choice that keeps you young.

Thanks for reading. Feel free to send questions to: AgeProoflife@gmail.com

Dr. Mike Roizen

PS: Please continue to order the new book by Jean Chatzky and myself, AgeProof: Living Longer Without Running Out of Money or Breaking a Hip

 

NOTE: You should NOT take this as medical advice.
This article is of the opinion of its author.
Before you do anything, please consult with your doctor.
You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have two newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz.  These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.  
Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.
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