Tag Archives: low back pain

Risk Factors for Postpartum Low Back Pain

1 Dec

It’s estimated that as many as 50–70% of new mothers experience low back pain and
related disability, which can hinder their ability to carry out daily activities such as household
chores, self-care, and meeting the physical demands of infant care—including feeding, lifting,
and carrying. When severe enough, these physical limitations can contribute to stress, anxiety,
and postpartum depression, further interfering with the mother’s ability to bond with her
newborn and diminishing her overall quality of life. What are the underlying causes of
postpartum low back pain?
Interestingly, some risk factors may be present even before conception. Research
suggests that being overweight or obese, physically inactive, or exposed to occupational risk
factors such as whole-body vibration, poor ergonomics, and frequent lifting can set the stage for
low back pain both during pregnancy and after delivery. Women with a prior history of low back
pain are also at elevated risk for symptoms during and following pregnancy.
As the baby grows, the center of mass shifts forward in the body. To compensate, the
pelvis tilts anteriorly and the lumbar spine increases in lordosis, placing added stress on the
lumbar intervertebral disks and facet joints. The stretching of the abdominal muscles can reduce
spinal stability, while hormonal changes that prepare the pelvis for childbirth can increase joint
laxity, further affecting stability in the lower spine and pelvic region. To compound these effects,
expectant mothers may experience fluid retention, deconditioning from reduced activity, sleep
positions that strain the lower back, and psychosocial factors such as stress and anxiety that
heighten pain perception.
Childbirth itself can also contribute to postpartum low back pain. The physical effort of
pushing during delivery can strain the lower back, and the hormonal changes that allow for
ligamentous laxity during pregnancy may persist afterward, leaving the spine more susceptible to
mechanical stress. In cases of cesarean delivery, factors such as spinal anesthesia, post-surgical
immobilization, and prolonged bedrest can further delay recovery and exacerbate pain.
Unfortunately, it’s a common misconception that postpartum low back pain will simply
resolve on its own. In reality, studies suggest that up to 1 in 5 new mothers with low back pain
will develop chronic symptoms lasting a year or longer. While some risk factors for postpartum
low back pain are beyond a woman’s control, others—such as maintaining an active lifestyle,
avoiding prolonged inactivity, and seeking chiropractic care to help restore proper joint motion
and function in the lumbar spine during and after pregnancy—can play a key role in prevention
and recovery.
Brent Binder, D.C.

4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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Low Back Pain and The Importance of Sleep

27 Feb

Monthly Health Update: Whole Body

Low back pain is the leading cause of disability worldwide, and it’s estimated 619 million people suffer an episode each year. By 2050, it’s expected this total will jump to 843 million! In addition to the direct and indirect effects low back pain can have on the individual patient, the overall healthcare costs and productivity losses associated with this musculoskeletal disorder add up to more than $230 billion dollars each year in just the United States! This in mind, identifying and mitigating risk factors for low back pain by even a small amount can result in large societal gains. One risk factor for low back pain that isn’t typically imagined is sleep.

Sleep is considered essential for survival. Many vital functions occur during slumber including tissue growth and repair, cytokines production to bolster the immune system, heart rate and blood pressure regulation, memory consolidation, and brain detoxification, just to name a few. If an individual suffers from insomnia, obstructive sleep apnea, circadian rhythm sleep-wake disorders, or sleep bruxism, these critical processes are impeded, which can make the body more susceptible to developing musculoskeletal pain, including low back pain.

In one study, researchers looked at health data concerning 6,285 older adults and found that an individual’s risk for low back pain increases by 13.6% for each hour less than seven hours of sleep he or she averages a night. However, any additional sleep beyond seven hours does not confer additional low back pain reduction benefits. Interestingly, this finding held true even after adjusting for age, gender, income level, education level, and occupation.

Not only can poor sleep increase the risk for low back pain, but it can stimulate changes in how pain is perceived, leading to greater pain sensitivity, which in turn results in increased disability and avoidance behaviors. One study, published in December 2020, found that older adults with moderate-to-severe sleep disturbances will likely accumulate chronic neuropsychiatric and musculoskeletal conditions at a faster rate than seniors with good sleep hygiene. To complicate matters, the American Academy of Sleep Medicine reports that 80% of American adults experience daytime sleepiness, meaning they either aren’t sleeping enough each night or the quality of their sleep is poor. So what can be done to improve sleep hygiene?

The Centers for Disease Control and Prevention (CDC) offers the following tips for better sleep: be consistent with bed times; make sure your bedroom is quiet, dark, relaxing, and kept at a comfortable temperature; remove electronic devices from the bedroom; avoid large meals, caffeine, and alcohol before going to bed; and get some exercise during the day. If low back pain is keeping you up at night, be sure to let your doctor of chiropractic know. They may be able to recommend additional strategies to improve your sleep and if necessary, co-manage your case with an allied healthcare provider.

If you are struggling with sleep, come on in for a visit!

Watching your back,

Dr. B

Pain Relief Chiropractic

4909 Louise Drive, Suite 102

Mechanicsburg, PA 17055

 717-697-1888

Painreliefcare.net

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.

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Low Back Pain and The Importance of Sleep

6 Feb

Low back pain is the leading cause of disability worldwide, and it’s estimated 619 million
people suffer an episode each year. By 2050, it’s expected this total will jump to 843 million! In
addition to the direct and indirect effects low back pain can have on the individual patient, the overall
healthcare costs and productivity losses associated with this musculoskeletal disorder add up to more
than $230 billion dollars each year in just the United States! This in mind, identifying and mitigating
risk factors for low back pain by even a small amount can result in large societal gains. One risk
factor for low back pain that isn’t typically imagined is sleep.

Sleep is considered essential for survival. Many vital functions occur during slumber
including tissue growth and repair, cytokines production to bolster the immune system, heart rate and
blood pressure regulation, memory consolidation, and brain detoxification, just to name a few. If an
individual suffers from insomnia, obstructive sleep apnea, circadian rhythm sleep-wake disorders, or
sleep bruxism, these critical processes are impeded, which can make the body more susceptible to
developing musculoskeletal pain, including low back pain.

In one study, researchers looked at health data concerning 6,285 older adults and found that
an individual’s risk for low back pain increases by 13.6% for each hour less than seven hours of sleep
he or she averages a night. However, any additional sleep beyond seven hours does not confer
additional low back pain reduction benefits. Interestingly, this finding held true even after adjusting
for age, gender, income level, education level, and occupation.

Not only can poor sleep increase the risk for low back pain, but it can stimulate changes in
how pain is perceived, leading to greater pain sensitivity, which in turn results in increased disability
and avoidance behaviors. One study, published in December 2020, found that older adults with
moderate-to-severe sleep disturbances will likely accumulate chronic neuropsychiatric and
musculoskeletal conditions at a faster rate than seniors with good sleep hygiene. To complicate
matters, the American Academy of Sleep Medicine reports that 80% of American adults experience
daytime sleepiness, meaning they either aren’t sleeping enough each night or the quality of their
sleep is poor. So what can be done to improve sleep hygiene?

The Centers for Disease Control and Prevention (CDC) offers the following tips for better
sleep: be consistent with bed times; make sure your bedroom is quiet, dark, relaxing, and kept at a
comfortable temperature; remove electronic devices from the bedroom; avoid large meals, caffeine,
and alcohol before going to bed; and get some exercise during the day. If low back pain is keeping
you up at night, be sure to let your doctor of chiropractic know. They may be able to recommend
additional strategies to improve your sleep and if necessary, co-manage your case with an allied
healthcare provider.

Watching your back,

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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Glute Weakness & Low Back Pain

30 Jan

Glute Weakness and Low Back Pain

While we traditionally view low back pain as the result of a problem localized to the low back itself, several studies have found that issues in adjacent parts of the body can play a role in the development of low back pain.  For example, chronically tight hamstrings can affect pelvic tilt, which in turn can alter the posture of the lumbar spine, potentially leading to low back pain. Another potential contributor to low back pain that’s often overlooked is glute muscle weakness.

In September 2024, the New York Times ran an article focused on a condition called gluteal amnesia, though it’s more colloquial name is dead butt syndrome. Gluteal amnesia is the result of prolonged inactivity of the three glute muscles (maximus, medius, and minimus). Prolonged inactivity can occur from things such as sitting at a desk or in a car for more than two to three hours at a time without getting up to move around and stretch. The gluteals help stabilize the hip, lift the leg, and rotate the thigh. This muscle group also serves an important role in the kinetic chain, and when not working properly, the risk for problems like hamstring tears, sciatica, shin splints, and knee arthritis increases.

Gluteal amnesia is NOT like the temporary numbness/tingling noticed when we sleep on an arm and it “falls asleep” or goes numb and recovers quickly when we change positions. Some people may feel a dull ache or pain after a long walk or after a jog or hike. Because muscle strength and activation are affected, the body may recruit nearby muscles to help perform regular movements, which can lead to pain in the lower back, for example.

            Though it’s best to be examined by a qualified healthcare provider, like a doctor of chiropractic, you can perform the following test to check if you may have dead butt syndrome: stand on one leg letting the other leg dangle (standing sideways on a step holding onto a railing works well) press into your buttocks region on the dangling leg, it should feel soft (not firing); do the same on the other side; now stand on both feet and squeeze your “cheeks” hard; you should feel the muscle contract or get firm; if it takes a few squeezes before you feel it get firm, then you may have gluteal amnesia.

            The key to overcoming this condition is to restore normal activation to the gluteal muscles. You can start by setting an alarm on your phone to stand up every 30-50 minutes and gently tap on your glut/butt cheeks with your fingertips. This reminds the brain that these muscles need to fire. Better yet, march in place, do some hip circles and squats and consciously tighten your gluts with each rep. Other exercises for this include clamshells, hip thrusts, side planks, split squats, and single-leg glut bridges. Just remember to consciously engage the glutes.

            If the condition persists, schedule an appointment with your doctor of chiropractic so they can determine if there are additional problems present that can be addressed with treatments provided in the office, such as manipulative or mobilization therapy, with the goal of helping restore normal function.

Pain Relief Chiropractic

4909 Louise Drive, Suite 102

Mechanicsburg, PA 17055

Painreliefcare.net

717-697-1888

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.

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The Thoracolumbar Fascia and Chronic Low Back Pain 

5 Oct

The thoracolumbar fascia is a structure in the lower back that is comprised of layers of densely packed collagen and elastic fibers separated by loose connective tissue that allow the deep stabilizing muscles in the lower back to move independently of the superficial muscles used for twisting and bending forward and backward. When adhesions form in the fascia, movement can become restricted, which can lead to pain and disability in the lower back and nearby parts of the body. A January 2023 study that included 131 adults—68 with low back pain—revealed a 25-30% reduction in thoracolumbar fascia elasticity among those with low back pain. This suggests that improving the function of the thoracolumbar fascia is essential in the management of low back pain. So, what can your doctor of chiropractor do to improve the elasticity of these important tissues?

The most common technique used to address adhesions in the thoracolumbar fascia is a manual therapy technique called myofascial therapy or myofascial release. Myofascial release is a hands-on treatment in which a doctor of chiropractic applies pressure with their hands, elbow, or a tool to stretch the muscles to knead out trigger points or adhesions that may inhibit the ability of the muscles to slide against one another during normal movements. In the last thirty years, various forms of myofascial therapy have been developed and disseminated to healthcare professionals who apply hands-on care, which includes doctors of chiropractic. In addition to care provided in the office, patients may also be instructed on self-myofascial release, which may include the use of a foam roller, for example.

In 2021, two systematic reviews—studies that pool data from previously published studies—concluded that myofascial therapy is effective for reducing disability and pain in patients with low back pain. More recently, a 2023 study that included 48 patients with low back pain found that those treated with a single session of myofascial therapy experienced a significant decrease in pain and thickness of the thoracolumbar fascia, in addition to a reduction in stiffness in the erector spinae muscles and thoracolumbar fascia. Follow-up examinations after the treatment showed the benefits persisted two and seven days later. 

In many cases, there are many contributing factors to a patient’s low back pain that must all be addressed to achieve a satisfactory result. This starts with a thorough examination to understand the patient’s unique situation and extends to a multimodal approach that incorporates several treatment methods to reduce pain and improve mobility in the lower back, which can include myofascial treatment to break down adhesions in the thoracolumbar fascia to allow for proper movement. In fact, an October 2022 study found that a multimodal chiropractic treatment plan that included spinal manipulation, education, exercise, self-management advice, and myofascial therapies led to improvements in pain, disability, and thoracolumbar fascia mobility in women with chronic low back pain. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

Member of Chiro-Trust.org 

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Spinal Manipulative Therapy for Seniors with Low Back Pain

5 Sep

While low back pain can affect people of all ages, it’s particularly problematic for older adults and is one of the top three reasons they see a doctor. Despite this, low back pain among seniors often persists for longer than three months, and in the presence of multiple comorbidities (which is often the case with advancing age), low back pain may be under treated or mismanaged. While guidelines for the management of low back pain often emphasize conservative approaches first and foremost, older patients tend to be underrepresented in the studies used to formulate such recommendations. Let’s take a look at the current research on the utilization of spinal manipulative therapy—the primary form of treatment provided by doctors of chiropractic—for the management of low back pain in older adults.

A 2022 study scoured electronic databases for randomized controlled trials conducted during the previous two decades that examined the effects of spinal manipulative therapy in older adults with chronic low back pain. The research identified ten studies consisting of a total of 786 individuals over 55 years of age, of which 261 were between 65 and 91 years old. The types of spinal manipulation included in this study are high-velocity low-amplitude (HVLA) techniques and mobilization or low-velocity low-amplitude (LVLA) techniques.  In particular, the research team looked at how these manual therapies fared with respect to improvements in pain and function against other approaches, including standard medical care and exercise therapy, in the short-, medium-, and long-term. 

In their final analysis, the authors concluded there is moderate-quality evidence that spinal manipulative therapy results in similar outcomes (compared to usual medical care and exercise therapy) for pain and functional improvement, and it should be considered a non-pharmacological treatment option for this patient population. This is important as up to 80% of older adults already take multiple prescription medications, with nearly a third taking five drugs, to manage their current health concerns. The addition of one or more prescriptions to manage low back pain increases the risk for adverse events and harmful drug interactions.

The researchers add that while their analysis was unable to establish a safety profile as the studies used had heterogenous data on adverse events, spinal manipulation appears to be safe for older patients. They further note that their findings are consistent with other systematic reviews on the effectiveness of spinal manipulative therapy for all age groups. 

The findings from this analysis confirm that spinal manipulative therapy has a place in the management of low back pain affecting older patients. If you suffer from chronic low back pain, don’t put it off or assume you need to live with it. Schedule an appointment with your local doctor of chiropractic to see if a course of conservative chiropractic care can help reduce your pain and improve your mobility.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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