Tag Archives: LBP

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.

 

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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.

 

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Low Back Pain: Surgery vs. Chiropractic?

12 Dec

Low back pain (LBP) is the second most common cause of disability in the United States (US) and a very common reason for lost days at work with an estimated 149 million days of work lost per year. The total cost associated with this is astronomical at between $100-200 billion/yr, of which 2/3rds are due to decreased wages and productivity. More than 80% of the population will have an episode of LBP at some point in their lifetime. The good news is that 95% recover within two to three months of onset. However, some never recover which leads to chronic LBP (LBP > 3 months), and 20-44% will have a recurrence of LBP within one year with lifetime recurrences of up to 85%! What this means is that most of us have, have had, or will have LBP, and we’ll get it again! So the question is, what are we going to do about it?

Surgery has traditionally been considered a “last resort” with less invasive approaches recommended first. Chiropractic adjustments and management strategies have traditionally faired very well when compared to other non-surgical methods like physical therapy, acupuncture, and massage therapy. But, is there evidence that by receiving chiropractic treatment, low back surgery can be avoided? Let’s take a look!

A recent study was designed to determine whether or not we could predict those who would require low back surgery within three years of a job-related back injury. This is a very important study as back injuries are the most common occupational injury in the US, and few studies have investigated what, if any, early predictors of future spine surgery after work-related injury exist. The study reviewed cases of 1,885 Washington state workers, of which 174 or 9.2% had low back surgery within three years. The initial predictors of surgery included high disability scores on questionnaires, greater injury severity, and seeing a surgeon as the first provider after the injury. Reduced odds of having surgery included: 1) <35 years old; 2) Females; 3) Hispanics; and 4) those who FIRST saw a chiropractor. Approximately 43% of workers who first saw a surgeon had surgery compared to ONLY 1.5% of those who first saw a chiropractor! WOW!!! This study supports the FACT that IF a low back injured worker first sees a chiropractor vs. a surgeon, the likelihood of needing surgery in the three years after the injury would be DRAMATICALLY reduced! In fact, the strongest predictor of whether an injured worker would undergo surgery was found to be related to who they saw first after the injury: a surgeon or a chiropractor.

If this isn’t enough evidence, another recent study (University of British Columbia) looked at the safety of spine surgery and reported that (taken from a group of 942 LBP surgical patients): 1) 87% had at least one documented complication; 2) 39% of the 87% had to stay longer in the hospital as a result; 3) 10.5% had a complication during the surgery; 4) 73.5% had a post-surgical complication (which included: 8% delirium, 7% pneumonia, 5% nerve pain, 4.5% had difficulty swallowing, 3% nerve deterioration, 13.5% wound complication); 5) 14 people died as a surgical complication. Another study showed lower annual healthcare costs for those receiving chiropractic vs. those who did not. The “take-home” message is clear: TRY CHIROPRACTIC FIRST!!!

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 both presently and in the future.

 

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Low Back Pain and Obesity.

10 Dec

Low back pain (LBP) is a VERY COMMON PROBLEM! Here are some facts about LBP: 1) At ANY given time, 31 million Americans experience LBP; 2) LBP is the single leading cause of disability worldwide; 3) 50% of ALL working Americans admit to having LBP symptoms each year; 4) LBP is the #1 reason for missed work and, the 2nd most common reason for doctor office visits (outnumbered ONLY by upper respiratory infections); 5) Most cases of LBP are “mechanical” and NOT caused by serious conditions like inflammatory arthritis (like rheumatoid), infection, cancer, or fracture; 6) At least $50 BILLION is spent annually by Americans on back pain (and that’s JUST the more easily identifiable costs); 7) At some point in life, experts estimate 80% of the population will experience LBP.

In prior Health Updates, we’ve discussed ways to prevent LBP like exercise, eating right, staying active (avoid prolonged inactivity or bed rest), not smoking, maintaining proper posture, wearing low heeled comfortable shoes (and possibly foot orthotics and/or heel lifts), sleeping on a medium-firm mattress, using proper bending and lifting methods, fixing work station problems (computer key board and monitor placement is important!), and more.

This month’s topic concerns obesity and LBP. How are these related, and does it really matter? Let’s look at some adult obesity facts: 1) Obesity is common, serious, and costly: 35.6% of US adults are obese; 2) Obesity related conditions include: heart disease, stroke, type 2 diabetes, certain types of cancer, and is the LEADING CAUSE of preventable death! 3) An estimated $147 BILLION was spent on obesity related medical costs and the average medical cost for an obese person was $1429 higher than for those of normal weight (Body Mass Index or BMI of 18.5-24.9). 4) Ethnic variations: Non-Hispanic blacks have the highest obesity rate at 49.5% vs. Mexican Americans (40.4%), all Hispanics (39.1%) and non-Hispanic whites (34.3%) [ref. JAMA, 2012; 307(5):491-97]. 5) There was a dramatic increase in obesity in the US from 1990 through 2010. No state in the U.S. met the nation’s “Healthy People 2010” goal to lower obesity prevalence to 15%. Instead, in 2010, there were 12 states with obesity prevalence >30% vs. in 2000, NO state had an obesity prevalence >30%! 6) More than 2 in 3 adults are overweight (BMI 25-29.9) and, 1 in 3 adults are obese (BMI >30). 7) In children 6-19 years old, about 33% are overweight or obese and 17% are obese.

Intuitively, common sense tells us that if we are overweight, it has to affect our low back in a negative way. Well, you are right! In the 1/15/13 journal Spine, an 11 year study from Norway, gathered data between 1995-1997 and again in 2006-2008 of an entire county in Norway which included 8733 men and 10,149 women, aged between 30-69 years old who DID NOT have chronic LBP (>3mo. within the past year) vs. 2669 men and 3899 women who DID have LBP. After 11 years, a significant increase in risk was reported between those with a BMI >30 (obese) vs. those <25 (BMI 18.5-24.9 = normal). They also found that the recurrence rate of LBP was also higher in those who were obese.

Weight management is a goal of LBP care, and we have many strategies that can help you fight this problem.

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