Tag Archives: back pain

Two Things You Should Do If You Don’t Want Back Pain.

12 Mar

It’s funny how the more we learn about ourselves and the world around us, the more established “facts” turn out to be completely wrong and the opposite of what is “true.” For example, new research concludes that people with low back pain will achieve greater benefits by exercising more, not less.

In a study done by the University of Alberta on 240 men and women with chronic lower back pain showed, those who exercised 4 days a week had a better quality of life, 28 percent less pain, and 36 percent less disability. Those who hit the gym only 2 or 3 days a week did not show the same level of change.

“While it could be assumed that someone with back pain should not be exercising frequently, our findings show that working with weights 4 days a week provides the greatest amount of pain relief and quality of life,” said Robert Kell, lead author of the study and an Assistant Professor of Exercise and Physiology at the University of Alberta, Augustana Campus.

Here is something really important from the study… The participants were split into four groups of 60. One group exercised with weights 2 days a week, another 3 days a week, and a third group 4 days a week. The fourth group did not exercise with weights.

All groups were tracked for 16 weeks. At the end of the 16 weeks, the level of pain reportedly decreased by 28% in the 4-day a week group, by 18% in the 3- day a week group, and by 14% in the 2-day a week group.

So What Does This Mean To You?

It depends. Every case of back pain is individual and you should not just run out today and start lifting weights. That could be a disaster.

If you have back pain, your first move should be to get a complete examination by a qualified doctor who treats back pain every day.

Chiropractors are specially trained to diagnose and treat low back pain and can tell you what the probable cause of your back pain is and the best treatment methods for your individual case.

But clearly, for many low back sufferers, exercise is a very good thing.

Now for something else that can possibly help your back pain…

As If Lung Cancer Wasn’t Bad Enough…

For quite some time, researchers have known that smoking is a risk factor for chronic pain disorders. More specifically, smoking has been linked to increased risk for low back pain, spinal disk problems, and poor outcome after surgery.

Now, a new study published in the December 2012 issue of The Journal of Bone and Joint Surgery found that smokers suffering from spinal disorders and related back pain reported greater discomfort than spinal disorder patients who stopped smoking during an eight-month treatment period.

The study analyzed the pain reported by more than 5,300 patients with back pain and related conditions.

The results as reported in Science Daily: “At the time of entry into care, patients who had never smoked and prior smokers reported significantly less back pain than current smokers and those who had quit smoking during the study period. Current smokers reported significantly greater pain in all visual analog scale (VAS) pain ratings — worst, current and average weekly pain — when compared with patients who had never smoked.”

It was also noted that patients who quit smoking reported greater improvement than those who continued to smoke and the group that continued to smoke had no reported improvement in pain.

The leading author of the study said that nicotine increases pain. According to the study, if you quit smoking, your condition should improve. If you continue to smoke, you may see no improvement, regardless of what treatment you receive. If you smoke, you are dramatically decreasing your chances of getting better from any treatment, including surgery.

Here is the conclusion of the study: “Given a strong association between improved patient-reported pain and smoking cessation, this study supports the need for smoking cessation programs for patients with a painful spinal disorder.”

Low Back Pain and Balance Specific Exercises.

24 Dec

Low back pain (LBP) and its relationship to balance has been the topic for the past two Health Updates, and an initial discussion regarding specific balance exercises was introduced last month. This month’s Health Update will complete the discussion about what you can do to preserve your current balance skills, or better yet, improve them! Remember, wear your foot orthotics and don’t forget to move them between your different shoes. Similarly, if you have leg length imbalance, move your heel lift to other shoes or simply purchase additional lifts and keep the heel lift in several pairs of shoes. Also, test your balance skills now before starting a balance exercise program and re-test every 2-4 weeks to measure improvement (see the January 2013 Health Update for the testing protocol).

The initial exercise we discussed was standing with your feet together and holding that position for progressively longer times (eyes open and closed). Once you can hold this position with your eyes closed for ≥ 30 seconds, start increasing the balance challenge by:

Move your heel of the left foot next to the big toe of the right foot and repeat the exercise with the eyes open and closed. Repeat on the other side! When successful for ≥30 sec., do it with eyes closed…..

Place your left foot in front of the right foot/toes (like standing on a balance beam) and repeat the exercise with the eyes open and closed. Repeat on the other side! When successful for ≥30 sec., do it with eyes closed…..

Repeat #1 and #2 standing on a thin pillow and/or a wobble cushion or rocker board, making sure you are “safe” by standing in the corner of a room or in an entrance to a room where you can grab the door frame when needed. DO NOT RISK falling!

Rocker board exercise options:

Rock forwards/backwards (FW/BW) looking straight ahead (don’t look down at your feet). Make sure the board you are using is “safe” (where you can safely step off forwards and backwards). Don’t use a board that is too high off the ground (about 3” is maximum). Repeat the FW/BW rocking slowly for 10 minutes periodically opening and closing your eyes.

Repeat “A” but stand at a 45° angle to the front/back direction so you are rocking at an angle using the same methods and time frame.

Repeat “A” but stand at a 90° angle to the front/back direction so you are rocking at an angle using a similar method and time frame.

You can then “make up” exercises standing on the rocker board or cushion like simulating a golf swing, tennis stroke, or other favorite sport, yoga move, etc. Be creative and make it fun!!!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

Can Chiropractic Help the Post-Surgical Patient?

16 Dec

Low back pain (LBP) accounts for over 3 million emergency department visits per year in the United States alone. Worldwide, LBP affects approximately 84% of the general population, so eventually almost EVERYONE will have lower back pain that requires treatment! There is evidence dating back to the early Roman and Greek era that indicates back pain was also very prevalent, and that really hasn’t changed. Some feel it’s because we are bipedal (walk on two legs) rather than quadrupedal (walk on four limbs). When comparing the two, degenerative disk disease and spinal osteoarthritis are postponed in the four-legged species by approximately two (equivalent) decades. But regardless of the reason, back pain is “the rule,” NOT the exception when it comes to patient visits to chiropractors and medical doctors. Previously, we looked at the surgical rate of low back pain by comparing patients who initially went to spinal surgeons vs. to chiropractors, and we were amazed! Remember? Approximately 43% of workers who first saw a surgeon had surgery compared to ONLY 1.5% of those who first saw a chiropractor!  So, the questions this month are, how successful IS spinal surgery, and what about all those patients who have had surgery but still have problems – can chiropractic still help them?

A review of the literature published in the Journal of the American Academy of Orthopaedic Surgeons showed that in most cases of degenerative disk disease (DDD), non-surgical approaches are the most effective treatment choice (that includes chiropractic!). They report the success rate of spinal fusions for DDD has been only 50-60%. The advent of artificial disks, which originally proposed to be a “cure” for symptomatic disk disease, has fared no better with possible worse long-term problems that are not yet fully understood. They state, “Surgery should be the last option, but too often patients think of surgery as a cure-all and are eager to embark on it.” They go on to write, “Also, surgeons should pay close attention to the list of contraindications, and recommend surgery only for those patients who are truly likely to benefit from it.” Another study reported that, when followed for 10 years after artificial disk surgery, a similar 40% of the patients treated failed and had a second surgery within three years after the first! Similar findings are reported for post-surgical spinal stenosis as well as other spinal conditions.

So what about the success rate of chiropractic management for patients who have had low back surgery? In a 2012 article, three patients who had prior lumbar spinal fusions at least two years previous were treated with spinal manipulation (three treatments over three consecutive days) followed by rehabilitation for eight weeks. At the completion of care, all three (100%) had clinical improvement that were still maintained a year later. Another study reported 32 cases of post-surgical low back pain patients undergoing chiropractic care resulted in an average drop in pain from 6.4/10 to 2.3/10 (that means pain was reduced by 4.1 points out of 10 or, 64%). An even larger drop was reported when dividing up those who had a combination of spinal surgeries (diskectomy, fusion, and/or laminectomy) with a pain drop of 5.7 out of 10 points!

Typically, spinal surgery SHOULD be the last resort, but we now know that is not always practiced. IF a patient has had more than one surgery and still has pain, the term “failed back syndrome” is applied and carries many symptoms and disability. Again, to NOT utilize chiropractic post-surgically seems almost as foolish as not utilizing it pre-surgically! GIVE US A CALL!!!

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 and Travel Tips.

16 Dec

Low back pain (LBP) is a common complaint when it comes to traveling, whether it’s in a car, bus, train or airplane. Traveling is hard on our joints, muscles and nerves for many reasons. Traveling requires us to do something our bodies are not used to, such as prolonged sitting in a cramped area. Remember the last time you had the middle seat on a plane? Also, unless you have a very unique exercise routine, injuries commonly occur from hoisting carry-ons into overhead bins or yanking them off the baggage claim belt. This month’s article will offer tips about traveling and things you can do to minimize risk of irritating or creating LBP. Bon voyage! 

Luggage Wisdom 

Lifting (in preferential order of lowering the risk of LBP injury): 

Ask for help if you know your carry-on is too heavy for you to place into the overhead bin safely. There are many kind co-travelers who will jump at the chance to facilitate (especially if you ask them nicely). If that fails, most flight attendants will be happy to help if they know you are struggling with LBP (be honest with yourself; now is NOT the time to be in denial of your back issue!) 

When it is possible, try to ship your heavy items ahead of time. It’s not only good for your back, but it’s often cheaper than the cost many airlines charge per bag! If you do this, all you need is a small carry-on that can easily fit under the seat in front of you. 

Why NOT simply check a bag, especially heavy items? You still have to be careful removing it from the luggage carousel, but again, ASK FOR HELP!

Try a backpack. It sure beats slinging a heavy briefcase over only one shoulder, which should be reserved for a light hand bag only. 

If no one comes to help, and you end up having to complete this often unpleasant task yourself, think before you lift. Break the lift into small movements or actions. For example, when placing your carry-on into an overhead bin, keep the luggage close to your body since the farther away from your body you hold the bag, the heavier it becomes to your lower back (up to 10x the load!). Try this method: 1st lift the bag to the arm of the seat that lies below the overhead bin; next lift it to the top of the seat back top; and then (the hard part), squat down, arch your low back, grip the bag, and in a smooth continuous movement, raise the bag up and onto the edge of the overhead bin. At that point, wiggle it in the rest of the way. Another important point about lifting is to try to avoid twisting, ESPECIALLY if combined with bending. A bend / twist combination is often the cause of a low back injury. Try to pivot your feet to move your body to avoid your back from twisting. 

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

Low Back Pain and Common Mistakes (Part 2).

14 Dec

Last time, we started a great discussion on “what NOT to do” for low back pain (LBP). Let’s continue that focus!

5. STAY STILL: You’ve heard, “…don’t do that – you’ll get a bad back!” There is something to be said about being careful, but one can be too cautious as well. In order to determine how much activity vs. rest is appropriate, you have to gradually increase your activities by keeping track of how you feel both during and after an activity. If you do notice pain, it may be “safe” to continue depending on the type and intensity of the pain. In general, a sharp, knife-like pain is a warning sign that you should STOP what you’re doing, while an ache is not. Until you’re comfortable about which type of pain is “safe,” start out with the premise, “…if in doubt, stop.” If the recovery time is short (within minutes to hours), then no “harm” was done. If it takes days to recover, you overdid it. Think of a cut on your skin – if you pick at it too soon, it will re-bleed, but if you are careful, you can do a lot of things safely without “re-bleeding.” Talk to us about the proper way to bend, lift, pull, push, and perform any activity that you frequently have to do that often presents problems. There is usually a way to do that activity more safely!

6.  SURGERY IS A “QUICK FIX”: Though in some cases this may inevitably be the end result for your back condition, most of the time, it is not needed. As a rule, don’t jump to a surgical option too soon. It’s tempting to view surgery as a “quick fix,” but non-surgical care at least for 4-6 weeks and maybe several months is usually the best approach. As the old saying goes, you can’t “un-do” a surgery, so wait. UNLESS there are certain warning signs such as: a) bowel or bladder weakness &/or, b) progressive neurological losses (worsening weakness in the leg). If there are no “surgical indicators” meaning, no instability, no radiating leg pain, and only low back pain that is non-specific and hard to isolate what is generating the pain, DO NOT have surgery as the chances of improvement following surgery drops off dramatically in this group. There are guidelines that we all should follow and they all support non-surgical care initially for 4-6 weeks. Chiropractic is one of the best options cited in these guidelines because it’s less costly, involves less time lost from work, and chiropractic carries the highest patient satisfaction.

7. DON’T STRETCH – IT’S HARMFUL: You may have heard or read that stretching can actually increase or worsen your time if you’re a runner, reduce your ability to lift heavy weight (if you’re a weight lifter), or cycle as fast.  Though this seems obviously silly, there IS a growing body of evidence that has found this TO BE TRUE! HOWEVER, it appears (at least at present), that is applies primarily to static, long hold stretching and NOT to dynamic exercising like jumping jacks, toy-soldier like high kicks, or core stabilization. Moreover, no study YET has found a negative effect for non-athletic competitive activities or for low back pain specifically. A good general rule is, if you feel better after exercising, or in this case stretching, it’s probably better for you than not. Also, as stated last month, there is a “right vs. wrong” time to exercise and WAY to exercise. For example, when LBP occurs in flexion but reduces in extension, there is plenty of evidence published that performing exercises INTO the direction of pain relief is VERY helpful. So until you hear differently, KEEP ON STRETCHING, but follow our advice!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

Low Back Pain and Common Mistakes.

14 Dec

We often read about what to do for low back pain (LBP), but do we look at LBP from the perspective of “what NOT to do!”

ICE vs. HEAT: If you ask your doctor, “what’s better for my back, ice or heat?” the answer is either one or the other or, “…whichever you like better.” This leaves the LBP patient at a loss of who or what to believe. So, let’s settle this once and for all. Ice should be tried first because it will rarely make the LBP worse, whereas heat can. Ice is an “anti-inflammatory” agent, meaning it reduces swelling. Ice reduces congestion or pushes painful chemicals and fluids that accumulate out of the injured area when there is inflammation and usually feels good (once it’s numb), maybe not initially because it’s cold. Heat does the opposite of ice. It’s a vasodilator meaning it pulls fluids INTO the area. Sure, it feels “good” initially, but often people will say it makes them worse later. That’s because the additional fluid build up in an already inflamed area is kind of like throwing gasoline on a fire. When LBP is chronic (it’s been there >3 months), heat MAY be preferred. Contrast therapy or, alternating between the two can work as an effective “pump” pushing out fluids (with ice) and pulling in fluids (with heat). Here, start and end with ice so the first and last things done are “anti-inflammatory.”

IGNORE YOUR LBP: The comment, “I was just hoping it would go away,” has been used by all of us at some point. Though LBP can get better over time, it’s simply impossible to know when or if it will. If you have suffered from back pain previously, then you already know that getting in quickly for a chiropractic adjustment BEFORE the reflex muscle spasm sets up can stop the progression, often before it reaches a disabling level. If you want to reduce the chances of missing work or a golf game due to LBP, come in immediately when the “warning signs” occur – you know, that ‘little twinge’ in your back that’s telling you, “…be careful!”

BED REST: There is a time for rest and a time for exercise, but knowing what to do when is tricky. Another “true-ism” is the best exercise when done too soon may harm you, but when done at the right time will really help. So, here are some general guidelines: a) no more than 24-48 hours of mostly bed rest; b) walking is usually a great, safe starting activity after or even during the first 48 hours; c) avoid activities that create sharp pain (like bend, lift, twist combinations); d) use ice or contrast therapies a lot during that initial 48 hours; e) follow our exercise instructions and treatment plan – we’ll guide you through this process.

FOCUS ON X-RAY OR MRI FINDINGS: Did you know that about 50% of us have bulging disks, and 20% of us have herniated disks in our low back and yet have NO pain? That’s right! Many of us have “disk derangement” but no symptoms whatsoever. Similarly, the presence of arthritis on x-rays may have no relationship to an episode of LBP. It’s easy to blame an obvious finding on an image for our current trouble, but it may be misleading. In fact, it can even make a person fearful of doing future activities that may be just fine or even good for us. The WORST thing for some types of arthritis is to do nothing. That will just lead to more stiffness and pain! More later!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.