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Have You Tried This for Your Back Pain?

1 May

It’s not uncommon for low back pain patients to reduce their activities in an effort to avoid their pain. Unfortunately, it’s likely their core muscles—the muscles that help support their midsection—will become deconditioned over time due to inactivity, which may only increase the risk of further injury. Therefore, to effectively improve one’s low back pain status, he or she must first strengthen and keep their core muscles strong! Think in terms of one to three sets of ten reps for ease of application and ALWAYS release the exercise SLOWLY—don’t just drop back from the end-range of the exercise.

The ABDOMINAL muscles include four groups: the rectus abdominis (they attach our rib cage to our pelvic area, and the fibers run straight up and down), overlapping on the sides are the internal obliques (fibers run down and inward), the external obliques (fibers run down and out), and lastly, the transverse abdominis (the fibers run horizontal and attach to the fascia in the low back).

If we think of three levels of exercise difficulty, an easy (or Level 1) sit-up can include a “crunch” or simply lifting the head and shoulders off the floor. A more difficult (Level 2) ab exercise would be to bend the knees and hips at 90 degree angles while performing a sit-up, while a more difficult (level 3) ab exercise could be a double straight leg raise during the sit-up. The rectus is stimulated by coming straight up and down while the overlapping obliques require a trunk twist. You can employ an “abdominal brace”, or holding the stomach muscles firmly as if someone is going to punch you in the stomach, in any position or activity during the day.

You can strengthen the LOW BACK extensor muscles using a number of effective exercises including (but not limited to) the “bird-dog” (kneeling on “all-fours”) straightening the opposite arm and leg separately (Level 1) and then simultaneously and switching back and forth (Level 2). Level 3 could be longer hold times, drawing a square with the hand and foot, or increasing the repetitions.

Another low back strengthener is called the “Superman”, which requires laying on the stomach (prone) initially lifting one arm and then the opposite leg separately (Level I); then opposite limbs at the same time (Level 2); and finally raising both arms and legs simultaneously (Level 3). Placing a roll under the pelvis/abdomen can make it more comfortable.

You can strengthen the SIDES OF THE CORE, or lateral trunk stabilizers, using a side-bridge or plank (laying on the side propped up between the elbow and feet, with the hips up and off the floor). Level 1 could be a six-second hold from the knees, Level 2 a six-second hold from the feet, and Level 3 could be a twelve-second hold between the elbow/forearm and feet. A modification could include slow repetitions of lowering the pelvis to the floor and back up. Mix it up!

There are MANY more exercises, but these should keep you going for a while! Remember, stay within “reasonable pain boundaries” that you define, release each exercise SLOWLY, and most importantly, have fun!

 

 

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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 Many Back Pain Sufferers Can Do at Home

3 Apr

Low back pain (LBP) is a very common problem that affects most of us at some point in life and for some, it’s a daily issue. Through education and research, researchers have found low back-specific exercises can not only help get rid of LBP but can also prevent future exacerbations or episodes. Like brushing our teeth, low back exercises are equally important in order to maintain, preserve, and optimize function. But because there are SO MANY exercise options available, it’s hard to know which ones are best, especially for each specific person.

There are different methods for determining the right low back exercises for the patient. One of the most common is to try different exercises to determine individual tolerance, but this is not very specific, as it only determines whether or not the patient is comfortable with an exercise. Another is using physical performance tests (PPTs) that measure the strength and endurance of specific muscle groups, muscle shortness, balance, aerobic capacity, and spinal range of motion.

Physical performance tests are much more specific because they address each patient’s differences. Also, many PPTs include normative data to compare against the patient’s own performance, so repeat use of the abnormal PPTs on a monthly interval can gauge their progress (or the lack thereof), which is motivating to the patient and serves as a great outcome measure!

PPTs are typically done two to four weeks after an initial presentation or at a time when the condition is stable so as not to irritate the condition. Initially, the decision as to which exercise is best is often made by something called “directional preference” or positional bias. This simply means if a patient feels best by bending over, we initially give “flexion-biased” exercises.

Flexion-biased exercises include (partial list): pulling the knees to the chest (single then double), posterior pelvic tilts (flattening the low back into the floor), sitting and/or standing bend overs, hamstring stretches, and more. If a person’s low back feels best bending backwards, their doctor of chiropractic may give extension-biased exercises, which include (partial list): standing back bends, saggy push-ups (prone press-ups), and/or laying on pillows or a gym ball on their back, arching over the ball.

Chiropractors generally add exercises gradually once they’ve determined tolerance and will recheck to make sure the patient is doing them correctly. Studies show that spinal manipulation achieves great short-term results, but when exercise is added to the treatment plan, the patient can achieve a more satisfying long-term result. Unfortunately, other studies have shown that ONLY 4% of patients continue their exercises after pain is satisfactorily managed and they fall back into old habits of not exercising.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

Do YOU Want to Avoid Back-Related Disability?

2 Mar

In 2008, a study published in the journal Spine sought to identify EARLY PREDICTORS in an effort to reduce the number of low back pain (LBP) patients who go on to experience long-term disability. Researchers followed 1,885 low back injury claimants for a year and then later reviewed data collected during the first three weeks following their injury to identify anything that might predict a greater risk of work-related disability one year later.

According to their findings, the factors that increase the risk of work-related disability include: injury severity, the type of healthcare provider from which they initially sought treatment; worker-reported physical disability, the number of pain locations, work-related stress; no available option for job accommodation (such as light duty); and a prior injury involving a month or more off work.

Of note, one VERY important factor mentioned in the study was the type of healthcare practitioner (HCP) the injured worker first consulted with for treatment. Those who sought chiropractic care initially were far less likely to become disabled (only 5%) than those who first visited doctors who specialize in primary care (12%), occupational medicine (26%), or “other” disciplines (23%).

Studies have also noted additional benefits by seeking chiropractic care for work-related musculoskeletal injuries versus other forms of healthcare delivery, as chiropractic care reduces the likelihood for extended time off work, results in less total healthcare costs, higher quality of life, fewer medications, fewer emergency department visits, and higher levels of patient satisfaction.

In addition, LBP Guidelines published in the United States and around the world consistently recommend spinal manipulation as a FIRST form of care for most types of low back pain based on these findings. We all have the option of seeking the type of care that we believe will best solve our problem. But with the findings reported in this and many other studies, evidence STRONGLY supports that seeking chiropractic IS the logical FIRST choice!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Can Damaged Nerves Regenerate?

2 Feb

Previously, we discussed how herniated disks can resorb all by themselves, especially large herniated disks. But what about a damaged nerve—can it self-repair too?

First, it’s important to realize that damage can occur when enough pressure is applied to any living tissue. The anatomy of our nerves includes many micro-structures such as the blood vessels that bring needed oxygen to the several layers of the nerve. If the nerve is deprived of oxygen long enough, there can be damage to its infrastructure, similar to a heart attack damaging the heart muscle.

A pinched nerve results in symptoms that include numbness, tingling, weakness, and in some cases, burning sensations. There are three stages of nerve damage that can be simplified into mild, moderate, and severe, and the ability for nerves to regenerate depends largely on the amount of damage and the length of time that has passed before treatment is sought out.

Generally speaking, it has been well reported that the nerves that make up the peripheral nervous system (the nerves outside of the brain and spinal cord) have the ability to regenerate, while those within the central nervous system (CNS) generally do not. However, there is hope. Researchers have begun to identify the molecular mechanisms that can promote axon regeneration in CNS injuries. Much of the knowledge and insight derived from these studies comes from the experimental use of fruit flies, as is referred to as “Drosophila models of axonal regrowth.”

The activation of an important receptor (called “insulin-like growth factor 1 receptor or IGF-1R) appears to be an essential step for axonal regeneration to occur in adult CNS neurons. Studies utilizing Insulin-like Growth Factor-1 (IGF-1) as a form of treatment in animal models after a brain injury found IGF-1 to be “neuroprotective” in the early stages of brain injury, and blood levels are often elevated soon after an injury.

In a study of 45 patients who suffered traumatic spinal cord injuries, researchers detected higher levels of IGF-1 blood serum levels in those who had clinically documented neurological resolution as compared to lower levels that were found in those who did not have neurological remission.

Unfortunately, researchers need to identify some of the missing pieces of the CNS-injury recovery puzzle before a consistent and predictable outcome can be expected for people who have sustained a serious spinal cord injury.

Doctors of chiropractic are trained to identify injuries to peripheral nerves as well as to the spinal cord and they can also work closely with other experts who manage the more significant neurological injuries, all in the quest of getting you back on the road to as much recovery as possible!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Can Bad Backs Heal Themselves?

2 Jan

Low back pain (LBP) from a herniated disk often leads to surgical intervention. However, there are patients with this painful malady who can successfully “ride it out” and repeat MRI imaging six to twelve months later often fails to show little, if any, evidence of the original herniated disk that was initially very obvious. How is this possible?

The proposed theory is that there must be some unique interplay between molecular signals that might explain why some herniated disks heal themselves while others do not. Researchers at Vanderbilt University Medical Center are investigating this and published a report on their progress in the January 2016 issue of the Journal of Clinical Investigation.

LBP affects 60-80% of Americans during their lifetime, and there are upwards of 300,000 surgeries for herniated disks annually in the United States alone. A disk can herniate when its outer fibers tear or give way, allowing the semi-fluid center to leak out. If the herniated disk material hits the nerve root exiting the spine, the classic sciatica, or pain down the leg, can result.

Dr. Dan Spengler states that about 50% of patients with disk herniation will improve within six weeks, and the actual herniated material may completely resorb over time. What troubles Dr. Spengler and other researchers is why this doesn’t occur with everyone.

Looking specifically at the molecules that are frequently present when disks herniate, researchers have identified a group of proteins called matrix metalloproteinases (MMPs). Certain MMPs have the ability to act like “Pac-Man” and literally chew through other proteins making it highly suspect that MMPs may be at the forefront of why some disks resorb while others do not! Additionally, when a disk herniates, bleeding occurs and white blood cells—specifically macrophages, which are immune system cells in our blood that ingest foreign materials and bacteria—also flood into the area.

What most surprised the authors was the interplay between the macrophages and the MMPs. They found that when the blood/macrophages and one of two specific MMPs interacted in a very specific manner, disk resorption occurred and they were even able to replicate this process in a lab. They concluded the following, “These enzymes are more complicated and interesting than we originally thought. Rather than being big bulldozers, they’re a fine pair of scissors that cut certain things.”

The TAKE-HOME MESSAGE here is unless you are having progressive neurological loss (meaning muscle weakness or sensory pain that is progressing, and/or especially bowel or bladder weakness), there is NO RUSH to run and have surgery! Doctors of chiropractic can offer natural, non-invasive treatments to manage pain while you let your body manage the herniation!

 

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder 856 Century Drive, Suite C Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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.

Circadian Clocks and Low Back Pain?

1 Dec

According to the National Institutes of Health, circadian rhythms include physical, mental, and behavioral changes that roughly follow a 24-hour cycle, responding largely to environmental light and darkness. Most living things possess this trait including animals, plants, and many microbes.

So how does this relate to low back pain? Recent studies reveal that the intervertebral disk (IVD)—the “shock-absorbers” located between our vertebrae in our spine—contain intrinsic circadian clocks that are regulated by age and cytokines and are linked to degeneration. This means we have a 24-hour rhythm producing various changes in an organized way throughout the day in each of the disks in our spine!

Researchers have found at least 600 genes with 24-hour patterns of expression representing several essential pathways associated with disk pathology. In experiments on mice, scientists have observed that when the normal expression of these genes is disrupted, disk degeneration may occur. The study concludes, “These results support the concept that disruptions to circadian rhythms may be a risk factor for degenerative IVD disease and low back pain.”

So what can we do about this? These findings support an important concept that improves overall health, quality of life and longevity: our sleep habits! We know our circadian rhythms influence sleep-wake cycles, hormone release, body temperature, and many other important bodily functions and are linked to various sleep disorders.

Researchers have linked abnormal rhythms with obesity, diabetes, depression, bipolar disorder, and seasonal affective disorder (SAD), to name a few. We also know how we feel when we fly from California to New York and the alarm rings at 7am in NYC but our biological clock says 4am!

The importance of sleep cannot be overstated. Longevity is shortened when sleep duration is altered (either too little OR too much sleep) and we know quality of life is negatively affected in swing-shift workers. Now, we’ve learned that the cells in our disks also have a circadian rhythm, and alteration of that rhythm can lead to disk degeneration resulting in low back pain!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org