Pain Relief Chiropractic

Low back pain (LBP) is one of the most common ailments that chiropractors treat. That’s probably because MOST of us will suffer from low back pain that requires outside help at some point in our lives! Posture has long been studied as a potential cause of low back pain, and this month’s topic will take a closer look at some recent research discussing this issue.

A December 2014 study looked at low back posture in two groups of LBP patients and its relationship with problems associated with intervertebral disk diseases. Looking at a person from the side, have you noticed that the low back area has an arched or inward curve? This is called the “lumbar lordosis” (or, the “sway back” area), and this can be highly variable in terms of the angle or amount of arch. It normally differs between males and females. Degenerative disk disease (DDD) is a common condition affecting virtually all of us at some point in time. DDD results in narrowing of the disk spaces, which there are five total in the lumbar spine (twelve in the thoracic spine/mid-back, and six in the cervical spine/neck). One particular study evaluated a group of 50 patients with long-term intractable (chronic) low back pain with intervertebral disk disease and a group of 50 chronic LBP patients without DDD that served as a “control group.” Researchers measured the degrees of lordosis, or amount of curve (lumbar lordosis), by looking at the person from the side using two different methods in the two patient groups and compared the data. The group with degenerative disk disease had an overall reduction in the lumbar lordosis curve (less arched) using both methods of measuring. The authors concluded that the patients with intervertebral disk lesions had a straighter, or more flat curve (less sway back), when compared to those without disk degeneration. What they were unable to determine was which came first, the disk degeneration or the reduction in the lumbar lordosis?

This study points out several important points. When treating patients with low back pain, some patients feel better when placed in a bent forwards position, or they favor a flat low back curve. Others have the opposite response, or their position of preference favors a more curved (arched) lower spine. The reason for this difference is that LBP is generated from different tissues in the low back, and some tissues favor or feel better in one position and typically feels worse in the opposite direction when injured. The intervertebral disks in the spine lie between the vertebral bodies and serve as “shock absorbers” for the spine and trunk. The center, or “nucleus,” of the disk is liquid-like and is usually well contained inside the disk, held by a tough, outer fibrocartilage material (the “annulus”). The disk is approximately 80% water, and as we age, the water content gradually reduces and the disk spaces narrow, thus limiting the mobility of that part of the spine. More importantly, DDD usually narrows the size of the canals through which the spinal cord and nerve roots travel. When we bend forward, these canals open up wider placing less pressure on the nerves and/or spinal cord. This is why we often see elderly people leaning on grocery carts when shopping, as it hurts less and they can walk longer / farther. Those with herniated disks tend to be the opposite, as they favor bending backwards as this position shifts the nucleus or liquid center forwards and away from the nerve root thus reducing the pinched nerve resulting in less or complete elimination of radiating leg pain.

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.

Low back pain (LBP) affects most of us at some point in life, and usually its cause is mechanical. We typically do not think about low back pain resulting from a virus or bacteria, though we might be quick to recall times when LBP occurred suspiciously close to an infection such as a flu or a cold. Today’s topic looks at a less common but dangerous cause of low back pain: Lyme disease.

Lyme disease (LD) was originally recognized in 1975 when an unusual number of children were diagnosed with juvenile rheumatoid arthritis in the city of Lyme, Connecticut and a neighboring town. The investigators at that time thought it was suspicious that these affected children lived near woods and that their symptoms would recur during the summertime, the height of the tick season. Unique findings included a peculiar rash on the skin that developed just prior to the onset of arthritic-like symptoms, and many recalled being bitten by a tick near the rash site. Further investigation led to the discovery that tiny DEER ticks infected with a spiral shaped bacterium or spirochete, later named Borrelia burgdorferi, were indeed the responsible culprit of the LD associated arthritis. Ordinarily, wood ticks or dog ticks do not carry the infection.

Investigators found that the Borrelia burgdorferi bacterium usually feed and mate on deer during part of their life cycle. With the expansion of suburban developments in rural regions alongside a growing deer population, more and more people have been infected by this bacterium. Geographically specific regions include the coastal Northeast, mid-Atlantic states, Wisconsin, Minnesota, and Northern California. Lyme disease has also been found in large areas of Asia and Europe and more recently, in South America.

Lyme disease can affect the heart, brain, nervous system, and other parts of the body in varying degrees as it progresses. The bacteria enters the body where the tick bite occurs and days to weeks later, as the bacteria spread in the skin, an expanding reddish rash often with flu-like symptoms occurs. Later, it can produce abnormalities in the joints, heart, and nervous system. Three phases of LD include: 1) Early localized disease with skin inflammation; 2) Early spread of the disease with heart (arrhythmias and more) and nervous system involvement (e.g. Bell’s palsy and meningitis); 3) Late disease includes motor and sensory nerve damage and brain inflammation, as well as arthritis. More than 25% do not develop a rash and many cannot recall a tick bite. A rash can develop within days to weeks of the bite, may or may not itch, is often accompanied with fatigue, muscle and joint stiffness, painful and swollen lymph nodes, headache, and less often, fever. The rash usually resolves without treatment in approximately one month, and from weeks to months later, the effects of the bacteria can spread through the body, potentially affecting the joints (especially the knees), heart, and nervous system.

The “ideal” treatment is antibiotics within the first four to six weeks because of the potential harm Lyme Disease can cause. Kids 5-14 and adults 40-50 are the populations that are most often affected. Lyme disease is NOT contagious. As chiropractors, we recognize the importance of an accurate diagnosis and will promptly refer you for conditions such as this!

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.

Low back pain (LBP) can strike at any time or place, often when we least expect it. There are “self-help” approaches that can be of great benefit, but many of these approaches can fail, or worse, irritate the condition. Here are some “do’s and don’ts” when self-managing low back pain!

Ice vs. Heat? Typically, people are almost always confused about which is better, ice or heat? This decision can be significantly helpful or hurtful, depending on the case. Generally, “ice is nice,” as it vasoconstricts and pushes out inflammation or swelling, which usually feels relieving and helpful even though the initial “shock” of ice may not be too appealing to most of us! This is probably why MOST people will wrongly choose heat as their initial course of self-care. This is usually wrong because heat vasodilates, which draws blood into the injured area that is already inflamed and swollen, thus adding more fluid to the injured area — sort of like throwing gas on a fire! Heat may feel good initially, but often soon after, increased pain intensity and frequency may occur. When LBP is chronic or NOT new / acute, heat can be very helpful, as it relaxes muscles and improves movement by reducing stiffness (but never use heat more than 20 minutes per hour). The biggest mistake about the use of heat is leaving it on too long – some people even burn themselves with a heating pad they’ve left on for hours of continuous use – sometimes overnight (PLEASE DON’T DO THAT!). When using ice, there are MANY ways one can apply it. If you only have 5-10 minutes, that is better than nothing! However, an ideal approach is to apply the ice pack or bag as follows:  On 15 min. / off 15 min. / on 15 min. / off 15 min. / on 15 minutes (total time: 1:15 hr). The “off 15 minutes” helps the area to warm up by allowing the blood to come back into the low back area, which avoids frost bite and sets up a pump-like action. Even better is an approach called “CONTRAST THERAPY” where we start and end with ice and use heat in between as follows: ICE 10 minutes / HEAT 5 min. / ICE 10 min. / HEAT 5 min. / ICE 10 min. (total time: 40 minutes). This approach creates a stronger pump-like or “push-pull” action that pushes out fluids/inflammation (with ice) followed by pulling in fluids (with heat). Both approaches are effective! If you ever feel worse after icing, PLEASE STOP AND CONTACT US, as you may have a unique case or situation.

How active should I be? Here too, most people usually try to do too much even after they feel “warning signs”. It’s human nature to want to “…get things done,” so sometimes we push ourselves beyond the limits of our tissue’s capacity, resulting in an injury. Once we’ve hurt our back, we STILL try to stay with our daily routine, ignoring our LBP the best we can. Generally, it’s BETTER to be a little active than it is to be too sedentary, but there is also a limit, as too much activity is like “…picking at a cut,” only prolonging healing and recovery. If every time you bend over results in a sharp, dagger-like pain in your low back, PLEASE STOP and assess the situation! Position preference is the KEY to determining what type of stretches or other exercises may be best for you. So, if bending over REDUCES LBP, pull your knees to your chest (we’ll show you how)! If bending backwards feels better, we’ll show you several extension exercises that can be done multiple times a day. Remember, too much sitting or lying down will weaken your low back muscles. Emphasize positions that feel good and avoid sharp, lancinating pain!

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.

Last month, we addressed low back pain (LBP) in the younger patient (age 30-60), so it only seems appropriate to continue the discussion for those over the age of 60. As previously mentioned, back pain does NOT discriminate when it comes to age. In fact, chiropractors see many children and teenagers with LBP as well as 90+ year-olds! Let’s take a look at the “usual” differences…

In the younger adult, facet syndrome and disk derangement are common conditions, and though this can still occur in the older adult, it becomes less common after age 60. The primary reason is because our disks become dehydrated or “dry up” as we age, making them less likely to herniate compared to a young, well-hydrated disk. During this “dehydration” process, the disks gradually narrow and bulge outwards. Therefore, in the 60+ year-old adult, disk-related pain is typically NOT from the soft liquid center herniating through the tough outer “annular” layer as it does in the younger patient. Rather, it’s from a combination of conditions. These conditions combine together and result in narrowing of the openings through which the nerve root exits the spine (called the neuroforamen).

The multiple conditions that contribute to this process include (but are not limited to): narrowing and bulging of the disk, osteoarthritis, or spurring extending off the vertebral endplates where the disk attaches, facet joint arthritis resulting in “hypertrophy” or enlargement, calcification of ligaments, and more. WHEN the neuroforamen narrows to the point of pinching the nerve root, symptoms occur. This condition is called “spinal stenosis” (SS), which literally means, “narrowed spinal canals” with entrapment of the spinal cord and/or nerves. Classic symptoms associated with SS include low back pain and stiffness. Most importantly, SS causes a gradual reduction in the amount of time that people with this condition can tolerate walking. Restricted mobility is initially subtle, but after months and years, walking may become more and more limited. That is, every time a certain time frame is reached (like 5 or 10 minutes of walking), the symptoms become significant to the point they force the SS patient to stop and sit or bend over often for one to two minutes, after which time they are able to resume walking for a similar amount of time.

Another common feature is that bending forwards HELPS (because it opens up the neuroforamen), and many SS patients walk bent over as their “norm.” When walking in a grocery store, they may lean forwards on the grocery cart because it allows for a longer, less painful walk. Other symptoms common with osteoarthritis (which always precedes SS), include morning stiffness, stiffness and pain when rising from sitting, decreased range of spinal motion or flexibility, localized painful joints, and others. As mentioned previously, degenerative joint disease or osteoarthritis is a slow, smoldering process that can often be traced back over the past 5, 10, and even 20 years.

As chiropractors, we can improve spinal joint flexibility and slow this process down. Give chiropractic a try as back pain in our elderly years DOES NOT have to be disabling!

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.

Low back pain (LBP), as previously stated, will affect most (if not all) of us at some point in time. Knowing what to do when the warning signs occur is essential to avoiding a disabling level of LBP. Last month, we started the discussion about offering ways to manage the LBP using exercises with the objective of stopping and reversing a potentially serious level of LBP. We offered ways of stretching from a sitting position that can be done in public. Here are some standing exercise options.

1. EXERCISE C: THE HAMSTRING & GROIN STRETCH: From standing 1) Place your foot up onto a seat, bench, chair, pipe of a railing, or anything about knee level (it doesn’t have to be very high). If your balance isn’t very good, make sure to hold onto a wall or counter to keep your balance. 2) Keep your knee bent 20-30 degrees and arch your lower back by sticking out the buttocks until you feel the pull or stretch in the hamstrings (back of the leg). 3) Slowly straighten your knee (keep the buttocks poked out and the low back arched) and you will feel the hamstrings gradually get tighter. 4) Change the angle of the knee and/or the amount of l ow back arch/pelvic tilt to modify the pulling intensity in the hamstrings. Continue this stretch for 15-30 seconds or until you feel the muscles loosening up. 5) Stay in that EXACT SAME POSITION and rotate your torso inwards (towards the leg you’re standing on) until you will feel the pull change from the hamstrings to the groin (inside thigh) muscles. You can also go back and forth between the hamstrings and the groin (adductor) muscles and continue the exercise until the back of the leg and groin feel adequately stretched (usually 5 to 15 seconds/leg).

2. EXERCISE D: THE HIP FLEXOR STRETCH: From standing: 1) Step forwards with one leg and stand in a semi-long, stride position (one foot ahead of the other). 2) On the back leg side, rotate the pelvis forwards until the hip lines up with the forward leg hip (or, the pelvis is square). 3) Add a posterior pelvic tilt (tuck in your buttock/pelvis or, flatten your low back). 4) Lean backwards (extend the low back) holding the above position. As you extend back, feel for the pull deep inside the upper front part of the thigh/groin area. You can alter between the third and fourth steps to release and re-stretch the hip flexor. Continue the stretch for 5-15 seconds or until you feel it’s stretched out and repeat on the opposite side. This one takes a little work but once you feel it, you will see why it’s so good!

3. EXERCISE E: THE ADDUCTOR STRETCH: As an alternative to the second part of EXERCISE C (step 5 of the standing hamstring stretch), stand with your legs spread apart fairly wide. Shift your pelvis from side to side (left then right) and feel for the stretch on the inner thigh/groin region. You can increase the stretch by adding a lean to the side you’re shifting the pelvis. Try holding the stretch for 5-15 seconds, alternating between sides 5-10 times.

These exercises are meant to be done in public WHEN you need to stretch. Stop the vicious cycle from getting out of control by STOPPING, STRETCHING, and then resuming your activity if you can!

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.