Pain Relief Chiropractic

Did you know that 50-72% of women have low back pain (LBP) and/or pelvic pain during their pregnancy but only 32% do something about it? Let’s look closer!

Pregnancy-related low back pain (PLBP) can be a highly debilitating syndrome that accounts for the most common cause of sick leave for pregnant women. In 2004, Americans spent $26.1 billion dollars in an effort to find relief from back pain during pregnancy. Statistics show one out of ten women will experience daily DISABLING LBP for at least two years following delivery.

Because of the limited number of treatment options available for the pregnant woman due to mother and fetus safety, and given the high propensity of potentially disabling PLBP that can significantly limit function and quality of life, chiropractic care seems to be a natural choice for this patient population! Obviously, pharmaceuticals and surgery are NOT appropriate options for the expectant mother, even during the post-partum breast-feeding time period. Chiropractic offers a non-invasive and safe approach to managing lumbopelvic pain that uses many different approaches.

In a 2009 research paper, 78 women participated in a study that investigated disability, pain intensity, and percent improvement after receiving chiropractic care to treat pregnancy-related PLBP. Here, 73% reported their improvement as either “excellent” or “good.” For disability and pain, 51% and 67% (respectively) experienced clinically significant improvement! Researchers followed up with them eleven months later and found 85.5% reported their improvement as either “excellent” or “good!” For disability and pain, 73% and 82% (respectively) experienced clinically significant improvement!

So, what’s causing LBP in pregnant women? Because of the biomechanical changes that occur in the low back and pelvis over a relatively short amount of time during pregnancy, especially in the second and third trimesters, common pain generators include (but are not limited to): the sacroiliac joint, facet joints, shock-absorbing disks, and the many connecting muscles (strains) and ligaments (sprains). During the later stages of pregnancy, the hormone Relaxin prepares the pelvis for delivery by widening the pelvic girdle, which can also be problematic.

Treatment options within chiropractic often include spinal manipulation, lumbopelvic exercises, patient education, posture correction, massage, an SI belt, soft tissue mobilization, and more. Exercises that target the transverse abdominus, multifidus, and pelvic floor muscles help to stabilize the lumbopelvic region. The American College of Obstetricians & Gynecologists recommends exercise at least three times a week during pregnancy, and studies report NO obstetric complications (pre-term labor, premature ruptured membranes, or changes to maternal or neonatal weight) with exercise.

So, the answer is clear! When PLBP strikes, seek chiropractic care to safely and effectively manage the pain and disability and so you can ENJOY YOUR PREGNANCY!!!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Low back pain is a very common complaint. In fact, it’s the #1 reason for doctor visits in the United States! The economic burden of LBP on the working class is astronomical. Most people can’t afford to be off work for one day, much less a week, month, or more! Because of the popularity of hospital-based TV dramas over the past two decades, many people think getting an MRI of their back can help their doctor fix their lower back problem. Is this a good idea? Let’s take a look!

Patients will often bring in a CD that has an MRI of their lower back to a doctor of chiropractic and ask the ultimate question, “….can you fix me?” Or, worse, “…I think I need surgery.” Sure, it’s quite amazing how an MRI can “slice” through the spine and show bone, soft tissues, disks, muscles, nerves, the spinal cord, and more! Since the low back bears approximately 2/3 of our body’s weight, you can frequently find MANY ABNORMALITIES in a person over 40-50 years old. In fact, it would be quite odd NOT to see things like disk degeneration, disk bulges, joint arthritis, spur formation, etc.!

Hence, the “downside” of having ALL this information is the struggle to determine which finding on the MRI has clinical significance. In other words, where is the LBP coming from? Is it that degenerative disk, bulged disk, herniated disk, or the narrowed canal where the nerve travels? Interestingly, in a recent review of more than 3,200 cases of acute low back pain, those who had an MRI scan performed earlier in their care had a WORSE outcome, more surgery, and higher costs compared with those who didn’t succumb to the temptation of requesting an MRI!

This is not to say MRI, CT scans, and x-rays are not important, as they effectively show conditions like subtle fractures and dangerous conditions like cancer. But for LBP, MRI is often misleading. This is because the primary cause of LBP is “functional” NOT “structural,” so it’s EASY to get railroaded into thinking whatever shows up on that MRI has to be the problem.

Here is how we know this, when we take 1,000 people WITHOUT low back pain between ages 30 and 60 (male or female) and perform an MRI on their lower back, we will find up to 53% will have PAINLESS disk bulges in one or more lumbar disks. Moreover, we will find up to 30% will have partial disk herniations, and up to 18% will have an extruded disk (one that has herniated ALL the way out). Yet, these people are PAIN FREE and never knew they had disk “derangement” (since they have no LBP). When combining all of these possible disk problems together, several studies report that between 57% and 64% of the general population has some type of disk problem without ANY BACK PAIN!

Hence, when a patient with a simple sprain/strain and localized LBP presents with an MRI showing a disk problem, it usually ONLY CONFUSES the patient (and frequently the doctor), as that disk problem is usually not the problem causing the pain! So DON’T have an MRI UNLESS a surgical treatment decision depends on its findings. That is weakness, numbness, and non-resolving LBP in spite of 4-6 weeks of non-surgical care or unless there is weakness in bowel or bladder control. Remember, the majority of back pain sufferers DO NOT need surgery!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Last month, we discussed common causes of back pain including mattresses, shoes, diet, exercise, and posture. Here are some additional considerations…

6. OFFICE CHAIR: Because of vast differences between people’s height, weight, body type, and preference, it’s difficult — if not impossible — to find a one-size-fits-all solution when it comes to office chairs! In the ideal world, the option to sit, stand, walk, and stretch as needed would be perfect but this simply is not reality! Low back pain (LBP) from sitting is common due to the excess pressure it places on the joints and disks (the “shock-absorbers” of the spine). Here are some remedies: 1) Find a chair that FITS YOU. 2) Get up and move at least once every hour (set the timer on your smartphone as a reminder). 3) Place the computer monitor directly in front of you and keyboard/mouse so the elbows bend only 90°. 4) Keep your feet on the floor at your desk (use an upside down box if you have short legs). 5) Perform “in the chair” stretches when your timer goes off!

7. BODY TYPE: We’ve discussed obesity as an obvious cause of back pain, but other factors are important as well. A very common cause of back pain for women is breast size. Here, the topic of a supportive bra is important, as carrying more weight in front of you adds additional stress on the back and shoulders.

8. SHOULDER BAGS: Back pain can be caused and/or perpetuated by a heavy purse, bag, briefcase, and even a thick wallet in the back pocket! To keep your eyes level, your body has to compensate and assume a less-than-ideal posture that may place unnecessary stress on your back! So before leaving the house today, CLEAN OUT that bag and/or put your wallet in a front pocket and lessen the load on your spine!

9. SMOKING: Smoking can reduce the amount of oxygen that reaches your cells, which can cause them to function at a less than optimal state. You’ve perhaps heard that a conscientious back surgeon will NEVER operate on a smokers’ back due to both the prolonged healing time and subsequent bad outcomes. So in addition to giving your heart, lungs, and those around you a break, if you want your lower back to heal, STOP SMOKING! Studies also show smokers are TWICE as likely to develop LBP compared with non-smokers, so quit. Better yet, DON’T START in the first place!

10. STRESS & DEPRESSION: Remember, “health” is a balance between structure, chemistry, and mental factors. Stress increases muscle tightness and alters posture in a way that can lead to or exacerbate existing LBP. Exercise, meditate, eat smart, and resolve your differences with family members and friends to minimize this problem! When needed, your doctor of chiropractic can refer you for counseling!

11. ERGONOMICS: How we “fit” into our job, lifting properly, workstation set up, work pace, and work stressors ALL play into LBP management. Have an assessment to see what can be fixed!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

It’s been said that if you haven’t had back pain, just wait, because (statistically) some day you will! The following list is a list of “causes” that can be easily “fixed” to reduce your risk for a back pain episode.

1. MATTRESS: Which type of mattress is best? The “short answer”: there is no single mattress (style or type) for all people, primarily due to body type, size, gender, and what “feels good.” TRY laying on a variety of mattresses (for several minutes on your back and sides) and check out the difference between coiled, inner springs, foam (of different densities), air, waterbeds, etc. The thickness of a mattress can vary from 7 to 18 inches (~17-45 cm) deep. Avoid mattresses that feel like you’re sleeping in a hammock! A “good” mattress should maintain your natural spinal curves when lying on your sides or back (avoid stomach sleeping in most cases). Try placing a pillow between the knees and “hug” a pillow when side sleeping, as it can act like a “kick stand” and prevent you from rolling onto your stomach. If your budget is tight, you can “cheat” by placing a piece of plywood between the mattress and box spring as a short-term fix.

2. SHOES: Look at the bottom of your favorite pair of shoes and check out the “wear pattern.” If you have worn out soles or heels, you are way overdue for a new pair or a “re-sole” by your local shoe cobbler! If you work on your feet, then it’s even more important for both managing and preventing LBP!

3. DIET: A poor diet leads to obesity, which is a MAJOR cause of LBP. Consider the Paleo or Mediterranean Diet and STAY AWAY from fast food! Identify the two or three “food abuses” you have embraced and eliminate them – things with empty calories like soda, ice cream, chips… you get the picture! Keeping your BMI (Body Mass Index) between 20 and 25 is the goal! Positive “side-effects” include increased longevity, better overall health, and an improved quality of life!

4. EXERCISE: The most effective self-help approach to LBP management is exercise. Studies show those who exercise regularly hurt less, see doctors less, have a higher quality of life, and just feel better! This dovetails with diet in keeping your weight in check as well. Think of hamstring stretches and core strengthening as important LBP managers – USE PROPER TECHNIQUE AND FORM; YOUR DOCTOR OF CHIROPRACTIC CAN GUIDE YOU IN THIS PROCESS!

5. POSTURE: Another important “self-help” trick of the trade is to avoid sitting slumped over with an extreme forward head carriage positions. Remember that every inch your head pokes forwards places an additional ten pounds (~4.5 kg) of load on your upper back muscles to keep your head upright, and sitting slumped increases the load on your entire back!

We have only scratched the surface of some COMMON causes and/or contributors of back pain. Stay tuned next month as we continue this important conversation!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

A major manufacturer of workstations reports that 86% of work computer users have to sit all day, and when they do rise from sitting, more than half (56%) use food as the excuse to get up and move. In addition to sitting at work, for meals, and commuting to/from work, 36% sit another one to two hours watching TV, 10% sit one to two hours for gaming, 25% sit one to two hours for reading/lounging, and 29% use their home computer for one to two hours. In summary, the average American sits for thirteen hours a day and sleep for eight hours. That’s a total of 21 hours a day off their feet!

The manufacturer’s survey also notes 93% of work computer users don’t know what “Sitting Disease” is but 74% believe that sitting too much can lead to an early death. “Sitting Disease” represents the ill-effects of an overly sedentary lifestyle and includes conditions like “metabolic syndrome” (obesity and diabetes), which is rapidly becoming more prevalent, especially in the young – even in adolescence and teenagers! Recently, the American Medical Association (AMA) adopted a policy encouraging employers, employees, and others to sit less citing the many risks associated with sitting including (but not limited to): diabetes, cancer, obesity, and cardiovascular disease. Standing is SO MUCH BETTER as it burns more calories than sitting, tones muscles, improves posture, increases blood flow, reduces blood sugar, and improves metabolism. Standing is frequently overlooked as “an exercise” and it’s both simple and easy to do!

So, what about the low back and sitting? You guessed it – sitting is hard on the back! The pressure inside of our disks, those “shock absorbers” that lie between each vertebra in our spine (22 disks in total) is higher when we sit compared with simply standing or lying down. It’s estimated that when we lay down, the pressure on our disks is the lowest at 25mm. When lying on one side, it increases to 75mm, standing increases disk pressure to 100mm, and bending over from standing pushes disk pressure to 220mm. When we sit with good posture, our disk pressure may reach 140mm but that can increase to 190mm with poor posture. To help relieve the pressure on our disks, experts recommend: 1) Getting up periodically and standing; 2) Sitting back in your chair and avoiding slouched positions; 3) Placing a lumbar roll (about the size of your forearm) behind the low back and chair/car seat; and 4) Changing your position frequently when sitting.

Because certain low back conditions “favor” one position over another, these “rules” may need modification. For example, most herniated disk patients prefer low back extension while bending over or slouching hurts. In those with lumbar sprain/strains, bending forwards usually feels good and extension hurts. Modifying your position to the one that is most comfortable is perhaps the best advice.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services

When you think of low back pain, you may visualize a person half-bent over with their hand on the sore spot of their back. Since many of us have experienced low back pain during our lifetime, we can usually relate to a personal experience and recall how limited we were during the acute phase of our last LBP episode. However, when the symptoms associated with LBP are different, such as tingling or a shooting pain down one leg, it can be both confusing and worrisome – hence the content of this month’s article!

Let’s look at the anatomy of the low back to better understand where these symptoms originate. In the front of the spine (or the part more inside of the body), we have the big vertebral bodies and shock absorbing disks that support about 80% of our weight. At the back of each vertebrae you’ll find the spinous and transverse processes that connect to the muscles and ligaments in the back to the spine. Between the vertebral body and these processes are the tiny boney pieces called the pedicles. The length of the pedicle partially determines the size of the holes where the nerves exit the spine.

When the pedicles are short (commonly a genetic cause), the exiting nerves can be compressed due to the narrowed opening. This is called foraminal spinal stenosis. This compression usually occurs later in life when osteoarthritis and/or degenerative disk disease further crowds these “foramen” where the nerves exit the spine. Similarly, short pedicles can narrow the “central canal” where the spinal cord travels up and down the spine from the brain. Later in life, the combined effects of the narrow canal plus disk bulging, osteoarthritic spurs, and/or thickening or calcification of ligaments can add up to “central spinal stenosis.” The symptoms associated with spinal stenosis (whether it’s foraminal or central) include difficulty walking due to a gradual increase in tingling, heavy, crampy, achy and/or sore feeling in one or both legs.  The tingling in the legs associated with spinal stenosis is called “neurogenic claudication” and must be differentiated from “vascular claudication”, which feels similar but is

caused from lack of blood flow to the leg(s) as opposed to nerve flow.

At a younger age, tingling in the legs can be caused by either a bulging or herniated lumbar disk or it can be referred pain from a joint – usually a facet or sacroiliac joint. The main difference in symptoms between nerve vs. joint leg tingling symptoms is that nerve pinching from a deranged disk is located in a specific area in the leg such as the inside or outside of the foot. In other words, the tingling can be traced fairly specifically in the leg. Tingling from a joint is often described as a deep, “inside the leg,” generalized achy-tingling that can affect the whole leg and/or foot or it may stop at the knee, but it’s more difficult to describe by the patient as it’s less geographic or specific in its location. Chiropractic management of all these conditions offers a non-invasive, effective form of non-surgical, non-drug care and is the recommended in LBP guidelines as an option when treating these conditions.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.