Don’t Blame The Desk: Tips to Stay Healthy at Work

Your desk is not to blame for poor health. There are many ways that one can remain healthy at a desk job. Incorporate these healthy tips into your day to stay healthy at work.

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Chronic Refractory Myofascial Pain and Denervation Supersensitivity As Global Public Health Disease

CASE HISTORY

A 63 year old successful entrepreneur / mountaineer treated disabling chronic LBP and left buttock pain after an 8 feet (2.4 meters) fall in 2011 with pain aggravation 5 months later from a physically-challenging expedition. He had laminotomy with lumbar disc removal when contrast MRI in 2013 shown L4-L5 broad-based left paracentral disc extrusion with central canal narrowing and mass effect on bilateral L5 roots. Other MRI results included L4-L5 retrolisthesis, C5-C7 degenerative disc changes, lower thoracic Schmorl's nodes, L1-S1 small broad-based disc bulges, moderate sacro-iliac joint arthritis bilaterally, left hip labral tear and old right total hip arthroplasty. Spine X-Rays shown 24 ° lumbar levoscoliosis.

Post-spinal surgery, pain worsened, not alleviated with physical therapy, manual stretching, inversion spinal traction, epidural injectionsx3, chiropractic / osteopathic manipulations, anti-inflammatory treatments, short and long-acting opioides, acupuncture and alternative methods. Pain severely compromised going up inclines / steps and ambulation to 500-1000 feet (150-300 meters) necessitating back and hip muscle stretches every 5-10 minutes. Pain-scale was 6/10 on presentation on August 7, 2014. Examination showed moderate range of motion limitation of neck, back, shoulders and hips with core muscle weakness, especially on the left. There were no sensory deficits or upper motor neuron signs.

Pain-scale reduced from 6/10 to 2/10 with first DTPS session stimulating the MTRPs confirming predominant myofascial involvement. He continued with DTPS. Nine months into treatment, he successfully completed traveling in an expedition, his first since 2011 during which he walked 4-6 miles (6.4-9.6 km) on most days. During the 60 day vacation hiatus beginning June 1, 2015 to July 30, 2015, he performed self DTPS but due to frequent, strenuous activities, pain-scale increased to 6/10. In the 45 day period prior to and after the expedition his treatment sessions lasted 115 + 12.9 minutes and 120 + 6.6 minutes respectively indicating more difficulty in eliciting large force twitches due to tightness of muscles. Electrical supersensitivity related twitching at remote sites typically returned but he lost ability to mechanically provoke autonomous twitch-trains.

For further improvement and / or maintenance of QOL, it requires and still receives ongoing, self-applied and professionally-applied DTPS.

GLOBAL HEALTH PROBLEM ANALYSIS

Discussion:

Scope of chronic pain

Chronic pain (CP) is a world-wide public health problem affecting physiological, psychological and social well-being. There are 1.5 billion CP sufferers worldwide (American Academy of Pain Medicine web-site), including 100 million American adults. In the United States, annual CP care is estimated at $ 635 billion, which is more than cost / year for cancer, heart disease and diabetes, costing $ 243, $ 309 and $ 188 billion respectively. Total incremental cost of pain health-care is $ 261- $ 300 billion, private insurers paid the largest share ($ 112- $ 129 billion), government programs (Medicare and Medicaid) 25% ($ 66- $ 76 billion and 8%) $ 20- $ 23 billion) respectively with individuals paying an additional $ 44- $ 51 billion in out-of-pocket health-care expense. CP negatively impacts annual number of work-days, work-hours and wages resulting in lost productivity of $ 299- $ 334 billion.

With global child survival improvement and increasing aging populations, the number of people experiencing LBP and NP will escalate since CP increases with age. CP dominate patients' lives, causing disabilities in family / home responsibilities, occupational, social, recreational, sleep and sexual activities. Pain-related investigations and treatments often make CP worse affecting patients' interactions with coworkers, doctors, family and social network creating alienation and isolation.

Constant pain interfereses with ability to concentrate, impairs cognition with mood / memory alterations from effects of medicines. World Health Organization data obtained in primary care centers worldwide show that 22% of all primary care patients suffer from CP. They are four times more likely to have co-morbid anxiety / depression than pain-free patients.

LBP causes more global disability than any other condition. NP and LBP have no associated mortality but morbidity rate for CP is higher than the general population. YLD and disability adjusted life years (DALY) is high. In 2010, DALY for NP rose to 33.6 million and 83.0 million for LBP. Systematic reviews of LBP treatments utilized in developed countries and treatments available in developing countries, heat / ice / ultrasound / traction, are discussed later.

Spine XRays and imaging studies for establishing presence of intervertebral disc pathology or spinal degenerative diseases for diagnosis of NP and LBP are not available / feasible in resource poor settings. Despite significant multilevel spinal imaging abnormalities, our patient had objective improvements in pain and QOL with DTPS indicating that XRays / imaging studies correlate poorly with clinical symptoms.

It is essential to authenticate CRMP, the most common type of CP, as a ubiquitous neuromusculoskeletal disease resulting from spondylotic radiculopathies induced partial denervation with denervation supersensitivity (DS). Public health prioritities necessitate urgent need for a safe, efficient, practical and objective cost-effective system with potential for prevention (pre-rehabilitation) with simultaneous real-time ability to clinically diagnose, treat (rehabilitation) and provide prognosis in of acute and CRMP management.

MTrPs / Motor Point Identification

MTRPs are pathognomonic of MP, clinically identifiable when pressure at this point causes referred pain and snapping palpation of the myofascial band produces local twitch response. Meta-analysis does not recommend physical examination as a reliable test for diagnosis of MTrPs.

Electrophysiologically, motor point is where single muscle contractions can occur with minimum intensity and short duration electrical pulses. Anatomically it is the area where motor endplates, previously terminal area of ​​motor nerve fibers are dense. Electricly-evoked single muscle twitch contractions precisely locate MTrPs.

Twitches in Denunciation Supersensitivity (DS)

Within 6-8 days of denervation, DS develop due to acetylcholine (Ach) receptor increase and decrease in acetylcholinesterase activity. DS can also occur in prolonged construction block.

Twitches exercise and stretch individual muscles promoting local blood flow specifically to that muscle. Rat skeletal muscle experiments show that twitch contracts from 1Hz stimulation increase muscle blood flow by 240%.

DEEP TRIGGER POINT STIMULATION (DTPS) also known as ELECTRICAL TWITCH OBTAINING INTRAMUSCULAR STIMULATION

Twitches in DS

Force, firing pattern, ease / difficulty of twitch elicitation of deep MTrPs objectively aids clinical differentiation of normal condition from partial denervation of spondylotic radiculopathy. Grade1 twitches result from focalized, partial contraction of stimulated muscle (s) at MTRP. Stronger twitch force on the electrode overlying MTrP with DS gives an asymmetrical, bouncy feedback on the bipolar probe with 6 inches (15 cm) separation between two water-wetted surface electrodes. Grade 2 twitches additionally showing rocking / shaking limb and / or trunk movements from stimulation of MTrPs of deep muscles apposed to bone and joint. Grade 3 twitches produce anti-gravity limb movements due to whole muscle (s) contraction. This indicates proximal stimulus spread to many and / or larger nerves from antidromic / ephaptic / direct stimulation, and / or distal spread of the current front due to DS. Grade 4 twitches produce antigravity limb movements with firing rate slower than applied pulses due to erratic stimulation of MTRPs with DS from filter effect of tight and stiff overlying tissues. Ability to elicit Grade 4 twitches is recognized when joint movements suddenly become stronger. On halting DTPS, joint movements continue automatically repeating from a few seconds to> 10 minutes before fatiguing. Grade 5 twitches produce anti-gravity movements with firing rate faster than applied pulse-frequency and rapidly fatigue within a few seconds indicating full, instantaneous depolarization of MTRPs with DS in non-tight muscle.

A pre-fatigue phenomenon heralds onset of Grade 5 twitches as multiple twitches / pulse instead of normal single-twitch / pulse. On continuing stimulation, sudden increase in twitch-rate, rhythm and force occurs before erupting into automous fatigable twitches. When the twitch-cascade ends, DTPS can be re-applied repeatedly for 1-5 minutes at this motor end plate zone until the entire muscle becomes refractory at which time another patient position is used for stimuli to reach other MTrPs with DS within same muscle .

Pathophysiology of autonomic twitches is similar to cardiac dysrhythmias.

Deep MTrPs are difficult to seek in CRMP due to muscle stiffness, tightness, tenderness and poor tolerance to electrical stimulation. In normal muscles, finding MTrPs is immediate, pleasant and painless. There is non-forceful symmetrical feedback on both electrodes and Grades 3-5 twitches do not occur.

To facilitate twitching, relaxed muscle (s) is positioned at slight stretch advantageous for contracting, stimulating along less electrically-resistive intermuscular / intramuscular grooves. If elicited twitches are Grade 1 force, patient re-positioning in supine / prone / side-lying, sitting, standing, etc., and / or clinician repositioning is necessary to obtain the correct angle to locate / effectively stimulate the MTrP with DS. To obtain pain relief, minimum Grade 2 force is essential. Grade 3-5 forces in CRMP will not occur until many professional hours of consecutive treatments. Such twitches are elicitable at acute MTRPs with DS within non-tight muscles.

Stimulus parameters used for evoking twitches are similar to those used in electrodiagnostic medicine for peripheral nerve lending studies. Repetitive stimulation at 2-3 Hz tests stability of neuromuscular transmission by temporarily depleting Ach at diseased or immature endplates causing fatigue in neuropathic conditions. Similarly, using 2-3 Hz, fatigable autonomic twitches elicited with DTPS signify neurogenic involvement with unstable neuromuscular transmission in CRMP.

MP Theories

Muscle trauma, overload, or strain causes endplate damage, resulting in excessive Ach release. This provokes local, partial muscle fiber contraction benefit the endplate and muscle fiber contracture leads to ischemia and pain. The neuromuscular junction is the site most susceptible to acute ischemia. Dysfunctional end plate exhibiting increased ACh release may be the starting point for abnormal regional contractions, which may be essential for the formation of MTrPs.

Spondylotic radiculopathies causes MP from intramuscular entrapment of nerves and blood vessels. Partial denervation induced shortened / tight muscle fibers produce tension on pain sensitive regions, eg annulus fibrosus, bones and joints. Others have also found MTRPs in radiculopathies. Intervertebral disc degeneration, with nerve root compression / angulation from reduced intervertebral space, causing neuropathy which leads to distal muscle spasm in radicular distribution. Pain results from shortened / tight muscle fibers compressing small / large blood vessels leading to ischemia. Bradykinin and other neurochemical release sensitizes and / or excites nociceptors.

Systematic Reviews of Treatments for CRMP

Many methods are available to directly treat MTrPs to inactivate, disrupt or suppress MTRP activity. Systematic reviews have not shown MTRPs treatments with Botox, steroids, acupuncture or dry needling to be effective. In order to improve dry needling results in CRMP, the corresponding author first developed Automated Twitch-Obtaining Intramuscular Stimulation, which employs mechanical stimulation with a monopolar needle oscillated 3 times in 2 seconds. To facilitate twitching, she then created / engineered needle DTPS device that could deliver electrical pulses through a single automatic insertion and retraction of the monopolar needle. These methods were discontinued when she implemented the safe, efficacious, non-traumatic and non-invasive DTPS. Needling methods cause pain, bleeding, bruising and tissue trauma and thus not indicated for repetitive / frequent applications throughout the body in CRMP patients requiring life-long regular treatments.

Systematic Reviews of LBP Treatments

Therapies for chronic LBP not showing high quality evidence for improving pain intensity, functional status, global improvement and return to work include lumbar supports, traction, superficial heat and cold, ultrasound, transcutaneous electrical nerve stimulation, low level laser therapy, muscle energy techniques, spinal manipulation techniques and chiropractic treatments.

In acute and chronic LBP, massage improves pain and function only short-term. Direct manual / mechanical stimulation mobilizes wonderful muscles but deep massage can produce pain as an adverse event. DTPS accurately focalizes stimulation to MTRPs with DS and has minimal tenderness to cause post-treatment pain which can be resolved with longer / more treatment sessions.

In neuropathic conditions, in hypertensive patients, and the elderly with significant tightness and stiffness, it is necessary that DTPS be applied essentially pain-free using only stimulation parameters that the patient can tolerate and settle for Grade1-2 twitches. The probe must be lifted off the skin every 2-4 twitches so that the stimulus on the non-twitching / poor twitching muscle does not undergo repetitive sub-threshold stimulation leading to spasm and pain during and after treatment. Patients may tolerate pain during treatment thinking erroneously that enduring strong stimulation will obtain larger twitches. Contrarily, pain-induced involuntary tightening of muscles during DTPS will inhibit deep penetration of electricity into the tissues causing pain during and after treatment. The clinician must watch patients' facial expressions and listen for sighs / moans or objective physical distress signs related to increased sympathetic tone such as pilomotor, vasomotor and sudomotor reflexes and reduce stimulation strength accordingly.

Blood pressure and pulse rate reduction have been noted after pain relieving massage attributable to increased parasympathetic tone and sympathetic tone inhibition. Regular exercise in older active individuals lowers both SBP and PP compared to sedentary counterparts. Similarly regular DTPS sessions are useful aerobic exercises that reduce blood pressure and pulse proportional to twitch force.

There is insufficient evidence to support use of epidural injection to facet joints and nerve blocks in LBP. US Food and Drug Administration reports paraplegia, quadriplegia, spinal cord infarction, and stroke from technique-related problems such as intrathecal injection, epidural hematoma, direct spinal cord injury, and embolic infarction after inadvertent intra-arterial injection.

Systematic reviews on medicines do not show clear evidence that anti-depressants, are more effective than placebo in chronic LBP. Non-steroidal anti-inflammatory drugs (NSAIDs) are effective for short-term symptomatic relief in patients with acute and chronic LBP without sciatica. Muscle relaxants are effective in management of non-specific LBP, but adverse effects require careful use. Opioids compared to NSAIDs or antidepressants did not show differences regarding pain and function. There are no placebo-randomized controlled trials (RCTs) supporting effectiveness and safety of long-term opioid therapy for treatment of chronic LBP.

Gabapentin at doses of 1200 mg or more is effective for some people with some painful neuropathic pain conditions. Gabapentin (1200 mg) use on this patient an hour before DTPS reduced pain which facilitated twitch elicitation.

Conflicting evidence exists on short-term effect of radiofrequency lesioning in chronic LBP and disability of zygapophyseal origin. Intraditional radiofrequency thermocoagulation is not effective for chronic discipulative LBP.

Evidence for minimally invasive discectomy (MID) although associated with shorter hospital stay has been found inferior in terms of relief of leg pain, LBP and re-hospitalization and our patient fits this profile. More research is needed to define appropriate indications for MID as alternative to standard open discectomy.

Systematic review of RCTs on stretching suggests that before, after, or before-after exercise stretching, does not produce clinically important reductions in delayed-muscle muscle soreness in healthy adults. Chronic MP patients who did stretching for three weeks did not demonstrate effectiveness in improving muscle extensibility, despite stretching increased tolerance to stretch-associated discomfort. When stiff hamstrings are subjected to eccentric exercise, strength loss, pain, muscle tendness, and increased creatine kinase activity occurs. This is consistent with the sarcomere strain theory of muscle damage showing experimental evidence of association between flexibility and tension to muscle injury.

Mechanical stretch forces delivered from the surface occurs to many muscles simultaneously and are not effective in stretching shortened fibers fibers at deep MrTPs. The solution to make stretching consistently more effective lies in finding new methods including DTPS. Effective summation of twitch-induced stretch forces focused to MTrPs are best with repetitive 1-3 Hz stimulation.

Not commonly recognized is thixotropy of muscle which is a ubiquitous and functionally important phenomenon since it results from tension of actin and myosin filaments to stick together when inactive for a period of time. Passive properties of thixotropy can be reduced with previous movements as evident with preventive warm-up activities of athletes before strenuous sports. Overcoming thixotropy may be the basis by which DTPS is able to clinically improve function in muscle tightness without pain, fibromyalgia, stroke or Parkinsonism. Reduced muscle thixotropy / stiffness persists as long as motion persisted but will return to its previous state. Stiffness reduction afforded by twitch exercise allows more mobility and the increased mobility and increased blood flow perpetuates to improve muscle function and QOL.

Improving Denervation Supersensitivity Related CRMP

Partial denervation and / or construction block in the presence of DS leads to onging MTRPs formation in many myotomes at various times daily with ADL. Morphologic and electromyographic studies have demonstrated atrophy and delayed activation of deep muscles of the spinal in patients with chronic NP and chronic LBP. Decrease in maximum force of deep back muscles improve resultant joint moments and reduce the stabilization function provided by these muscles to the lumbar spine. Exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic LBP. There is conflicting evidence for effectiveness of exercise in reducing the number of recurrences or the recurrence rate.

DTPS is aerobic exercise therapy to individual muscles. If there is no pain relief with the first DTPS session, the primary diagnosis of CP is not CRMP and other causes need consideration, eg neuropathic, inflammatory, psychiatric or nociceptive. Further DTPS sessions are advised even in such patients to treat co-morbid CRMP and / or muscle tightness to facilitate management of the primary pain.

For best functional results optimal treatment in CRMP includes these 5 muscle areas: trapezius, latissimus dorsi, gluteus maximus, adductor magnus, and paraspinal muscles from neck to sacral areas. This is needed even if patient presents only with NP / upper limb pain or LBP / lower limb pain as in this patient. Additionally, other muscles connected to the thoracolumbar fascia and along the kinetic chain must be treated proximo-distally starting with the largest muscles that cross multiple joints to small muscles of hands and feet as needed. Treatments begin with weakened muscles exposed to injurious eccentric contracts before directed treatments to strong muscles used primarily for concentric contracts. In the presence of weak symptomatic-side muscles, asymptomatic-side muscles are stronger by default and from overuse developing MTRPs that need treatment. This balances chronic strong pull of muscles toward asymptomatic side that more weakens symptomatic side. Treatments begin on the symptomatic-side starting with upper trapezius MTrPs with DS which can be easily located. Through its myofascial connections, other muscles on the symptomatic side become easier to treat. Provided MTrPs with DS are stimulated, Grades 3-5 twitch elicitation is facilitated by aged neuromuscular junctions exhibiting enhanced pre-synaptic nerve terminal branching, post-synaptic distribution of neurotransmitter receptor sites, increased Achilles quantal content and more rapid decline of endplate potential strength during continuous pre-synaptic neuron stimulation.

Additionally, central sensitization amplifies the DS. Noxious stimuli and / or misinterpretation of non-noxious stimuli (secondary hyperalgesia and allodynia) can induce chronic pain. Injury induced functional and adaptive changes include ineffective synapses unmasking, receptive field shifts and reorganization or altered effectiveness of surviving neural networks at the brain cortex level as well at peripheral nerves and receptors.

DTPS Role in CRMP

With DTPS we have issued an algorithm with consistent pain / discomfort relief and reproducible results without concurrent use of multiple medications or other therapies. Presence of DS in CRMP requires that treatments be safe and effective for regular life-long use on the entire body. We studied our case with statistical process control (SPC). Studying one case in detail sequentially over time can produce statistical results superior to that of a RCT. In these circumstances SPC has greater statistical power to exclude chance as an explanation.

DTPS is suitable for use in developing countries since it is cost effective.

LEARNING POINTS / TAKE HOME MESSAGES

1. CRMP is a neuromusculoskeletal disease caused by spondylotic radiculopathies following acute or chronic cumulative trauma with DS induced peripheral and central, mechanical and electrical hyper-excitability.

2. The mediate cause of CRMP is neuromuscular ischemia at deep MTRPs in tightened / shortened / stiffened muscles from spondylotic radiculopathy related partial denervation that meets / aggravates CRMP.

3. Systematic reviews show lack of effective treatments for CRMP. As CRMP is a global public health problem with huge economic toll on society, governments of developed and developing nations should invest in safe, efficient, cost effective novel systems such as DTPS for its prevention and management.

4. DTPS is a safe and efficient innovation for repetitive, life-long whole body treatments for CRMP management as a real-time preventive, diagnostic, therapeutic and prognostic armamentarium. It empowers patients in their own health-care since it can also be self-performed.

5. Commonly available sphygmomanometer is useful as an inexpensive, practical, objective, real-time pain monitor for clinical follow-up of DTPS treatments.

PATIENT'S PERSPECTIVE

I, Crawford Hill, had a spinal surgery two years ago in July 2013. The hypothesis was that my accessibility to walk uphill was actually severely compromised by a herniated disc at L4-L5. I had had several injuries and trauma which probably contributed to the problem, whether it was a herniated disc or some other cause of compromising function- especially walking uphill. One of these was an expedition trip to Ecuador during which I was on a boat which slammed up and down for four hours. I had to tighten my buttock intensely and hold on for the entire boat-ride. The next day I was on a horse which trotted causing me more bouncing effects on my spine for four hours. This was an extreme challenge as I had to tighten my buttock again to end the bouncing up-and down. These two back to back followers followed about five months after I fell from a rock climb gym wall. After that fall, I laid on the padded mat for several minutes thinking I had severely hurt myself. However I was able to get up and I appeared to be okay. I thought that these injuries did not apparently compromise my function. However on hindsight it probably did – especially in conjunction with the traumatic accidents in Ecuador which I mentioned. Going further back in time about 10 years ago I attempted to water ski and ended up in a very compromised position and felt some tremendous strain on my hamstrings. I let go of the rope and thought that I had damaged my hamstrings severely. However again I was able to function and forgot about the injury.

Going further back in time I did “pull my groin” as they say, in high school football. There was no good treatment available. Lots of heat and inappropriate exercise probably contributed to the injury. However once again I moved on because I was generally very fit and probably have a high tolerance for pain and compromised function. I have tried just about every treatment possible including many versions of physical therapy, gravity-assisted traction, yoga, Feldenkrais exercises, spinal manipulations, acupuncture with four different practicers, chiropractic release, medications, epidural injections, many anti-inflammatory medications including opioids and even spinal surgery. In addition I have a stretching and myofascial release program which does give me relief. Pain is on my mind 23 hours / day and I thought relief with eToims. After treatment with DTPS within six months, I can feel my affected musculature previously the gluteal and hamstrings muscles returning to function. The deep twitching has released most of the spasms and the muscles feel more functional and I'm ready to start light exercise. In June of 2015, I went on my first expedition since 2011. I went to Crete and I was able to walk on level and inclines for 3-6 miles daily for two weeks. This has been a dramatic development after years of frustration with all the other modalities I tried.

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Why More People Are Choosing Chiropractic Over Drugs and Surgery for Back Pain?

Conventional medicine is built on treating illnesses with two tools and only two tools: drugs and surgery. You can visualize a conventional doctor as a workman who carries only a hammer and a screw driver. To be fair, they're the absolute best hammer and screw driver that science can build, and the workman is very, very good with those particular tools; if you need a nail or screw driven, this is the guy you want to hire.

But back pain is not all just nails to be hammered and screws to be driven. Back pain can be caused by multiple factors, and each cause can require a different kind of treatment.Would it make sense to fix everything with only two tools even though the problem may require other tools? Would it be better to patch the road or fix it at its root?

For example, if drugs are used to treat a spinal misalignment, will that correct that misalignment that is causing the pain? Or will that just temporary inhibit the pain without treating the cause? Ultimately, medications are there to just block the pain, and although this eases the anguish associated with back pain, it does not restore the functional biomechanics. Even worse, while prescription drugs can be effective at treating pain, in most cases they can not do anything to fix the underlying problem causing that pain. This means that if you want that pain to stay away, you have to keep taking those medicines until the cause of the pain somehow fixes itself. That's a life sentence of sky-high medical bills and side effects!

Pain is a sign that something is seriously wrong with the body, and blocking that mechanism will only cause more damage in the long run. Would not it be better to treat the underlying problem and restore its proper function?

And surgery, while generally more effective at treating the root cause of a problem, can be even more dangerous. Iatrogenic disease-that is, illnesses caused by doctors-is currently the number three cause of death for Americans, behind only cancer and heart disease. Every time a patient goes under the knife, no matter how necessary, they are taking their life in their hands. Again, there are certainly conditions where surgery is the best option, but why put up with the risks of surgery when there are alternative treatments that can deal with a problem before it gets bad enough for surgery to be the only option?

In short, when it comes to back pain, conventional medicine comes at the problem with nothing but that hammer and screw driver, and whatever the cause of the pain may be, those are the tools you get. Given the alternative, would not you rather be treated by someone with a complete toolbox, a medical practitioner who approaches each problem by its own standards instead of using the same approach to every malady?

Considering how adhere to the drugs-and-surgery method is at effectively treating back pain, is it any surprise that millions of Americans are seeing Doctors of Chiropractic? Chiropractic medicine, unlike conventional medicine, is not about treating symptoms, but about treating people. Doctors of Chiropractic make use of a wide range of methods and equipment to treat a variety of problems. After all, chronic disorders such as back pain result in almost 80% of health care expenditures in the United States, and chronic disease can not generally be fixed with drugs or surgery. Chiropractor helps patients look at their lifestyle and medical history as a whole so they can treat the root cause of chronic pain-and “treat” does not mean “make it go away by taking a pill.”

Let's examine why more and more people are looking to chiropractor to treat their back pain:

Chiropractic is Safe and All Natural

Compared to the dangers of surgery as described above, chiropractic is incredibly safe, with injury to patients during spinal manipulation reported in fewer than one in three million adjustments. Doctors of chiropractic make use of all natural remedies instead of relying on prescription drugs, which lead to millions of hospitals annually. The safety of chiropractic explains why malpractice insurance is one of the lowest of any medical practiceer.

Chiropractic is Effective for Back Pain

The effectiveness of chiropractic in treating back pain has been proven countless times. In fact, chiropractic is so effective that the Ontario Ministry of Health recommended that chiropractic should be the preferred treatment for lower back pain, with traditional medicine not even in the running. Chiropractic patients have reported being happier with chiropractic treatment than traditional medicine in starting numbers, citing the communicativeness of chiropractor, the low cost of treatment compared to traditional medicine, and most importantly, the effectiveness at reducing pain compared to drugs and surgery.

Chiropractic Has Shown to Reduce Hospital Admissions and Healthcare Costs

Doctors of Chiropractic do not just keep their patients safe when treating back pain; they actually reduce hospital admissions as a result of their treatment. According to the Journal of Manipulative and Physiological Therapeutics, patients who saw chiropractor as their primary care physician experienced 43% fewer hospitals and had more than 50% reduction of their pharmaceutical costs. Considering how many hospital visits result in iatrogenic disease, it's not only better financially to avoid hospitalization, it's a lot safer, too!

Chiropractic is the not answer to every health ailment. However, for musculoskeletal issues such as back and neck pain, headaches, and other related disorders, it is a safer and more effective treatment than drugs and surgery.

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Permanent Cure For Back Pain

Nowadays, lower back pain is on the list of common disorders. Back pain, especially the lower back ache is a chronic condition where the patient sufferers from a persistent mild or severe pain in their back. Beside, the pain may accompany stiffness, burning, tingling and numbness. If you are looking for the best cure for this pain, Ayurveda is the answer. Let's take a look at the causes and treatment methods of the lower back pain in Ayurveda.

Causes

Mostly, backache is the result of the poor posture. With balanced posture, you can reduce strain on your back, as the right posture will keep the bones, muscles and other parts of the body in the natural position.

When you maintain an abnormal sitting position for several hours, your spinal curve may get hurt or you may end up with dropped muscles. This can cause muscle contracting that can cause pain.

Other disorders that can trigger back pain include spinal stenosis, scoliosis, and osteoporosis. Beside, training or spraining of the ligaments or muscles in your back can also cause the pain.

If the tissues around your spine suffer from a prolonged stress, or the tissues get damaged due to a hard blow, you may get pain in your back. A sedentary lifestyle is another most common cause.

Treatment methods

The traditional treatment for the lower back pain involves the use of drugs and surgical operations. These treatments do not work in all cases because most people do not have backache due to an injury. Instead, the pain is the response of the mind and body to an underlining condition.

According to Ayurveda, lower back pain occurs because of the vitiation of any of the 3 main doshas. The backache is an indicator of the weakness of bones / muscles and Vata aggravation.

Ayurvedic Treatments

In Ayurveda, the treatment of most diseases and conditions is to balance the three doshas. In Ayurveda hospitals, both internal and external treatments are used to help patients get rid of the backache. Herbal stuff, such as Asthavargam is given to the patients. Apart from this, daily purgation is also used to “fix” the vitiated doshas.

Abhyanga, which is an Ayurvedic Panchakarma way of treatment requires you to get an oil massage. Beside, Basti is really helpful for relief from the pain and fix abnormalities. If you want to use Ayurvedic herbal medicine, you can go for Mahanarayana tailam, Triphala Guggul, Lakshadiguggul and Yogarajagugul, just to name a few.

Yogasana for the Lower back pain

At times, the pain in the back occurs when you push yourself beyond your emotional or physical capacity. Your spine should be stable. For the stability of the spine, your mind should be steady.

You first step is to train your mind to relax, and then focus on the areas of the back that hurt. With a little bit of practice on a daily basis, you can easily redirect the energy of your mind to get relief from the pain.

As far as Yogasanas are concerned, you can try easy back-bends like Sunbird, Cat and Locust. You can also try Hero Pose to realign your spell.

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The Link Between Mental Health and Back Pain

Some medical professionals suggest depression could have the most common emotion associated with chronic pain. Medicically known as major depression or clinical depression , the mental symptoms that patients experience go beyond the normal emotions of sadness that everyone feels at some point or another. Clinical or major depression is more likely to be diagnosed in patients suffering from chronic back pain than those who experience acute or short term problems with their backs. This article explains how being aware of the host of symptoms associated with chronic back conditions goes a long way to understanding why depression sometimes develops.

For many patients living with long-term back discomfort, being able to get a good night's sleep is close to impossible. This can lead to fatigue and irritability during the day which can contribute to continuous feelings of negativity and low mood. On top of that, there is the possibility of not being able to take part in activities with the family, which again, can leave the patient feeling low, disconnected and isolated.

The points below highlight some of the main reasons why back pain can often lead to depression:

  • Chronic back conditions can make it difficult to sleep which can lead to extreme tiredness, irritability and frustration during the day.
  • Back pain can cause some people to become inactive movement which results in spending a lot of time at home. This can lead to the patient feeling socially isolated and able to enjoy regular activities with friends and family.
  • If a patient is unable to work due to their back problems, financial stress and strain may have an impact on the entire family.
  • Gastrointestinal problems may arise as a result of taking anti-inflammatory medication. Some patients suffering from back issues also report “brain fog” or feeling mentally “dull” as a result of pain medications.
  • Many back pain sufferers lose interest in a physical relationship with their partners, which can put more stress and strain on relationships.

Contact your GP or medical professional if you are experiencing long-term back problems and any of the following symptoms:

  • Regularly feeling depressed, sad, irritable or hopeless
  • Crying for no obvious reason or crying more than usual
  • A reduced appetite or abnormal weight loss
  • An increased appetite or unusual weight gain
  • Sleeping difficulties – either sleeping too much or too little
  • Low energy and fatigue
  • Agitation
  • Reduction or loss of interest in usual hobbies / activities
  • Reduced / diminished sex drive
  • Feeling worthless or guilty
  • Lack of concentration or memory problems
  • Suicidal thoughts (contact 999 immediately)

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Back Pain As A Result Of Breast Augmentation

Women with large breasts often complain about the back pain that they experience as a result. Such back pain ranges from mild to severe, with some even developing poor posture as a result. Large breasts also put women at a risk of developing spinal deformity. The weight of the breasts may cause strain on your shoulder and chest muscles.

These are important considerations you should keep in mind if you want to increase your breast size significantly through augmentation surgery.

Why Do Large Breasts Cause Back and Spinal Problems?

Larger breasts tend to cause a shift in the center of gravity which leads to a whole host of other problems in the body. Large breasts are additional weights which extend far beyond your normal center of gravity, leading to up to 10 times the amount of pressure being placed on the spinal column.

This is a problem that slowly develops which leads to other complications in the long run. The resulting change in posture may lead to disc hernia or a pinched nerve.

How Large Breasts Affect Posture

It's a subconscious effort that women make to change their posture in order to compensate for the additional weight from particularly large breast implants. The upper back tends to pull back, pushing the chest out and causing an arc to form in the lower back. Doing this will give you temporary relief, but over time, it will become harder for you to maintain that kind of posture. Occasionally, it leads to back pain and spinal injuries.

Complications from Larger Breasts

The change in your spinal curve may lead to numerous problems that will affect nerves, back skin, bones and muscles.

As a result of the increase in breast size, the right kind of support bra is needed. Because of the extra weight, bra straps may dig into your skin, causing permanent bruising. The bruising can lead to skin chaffing which in turn causes breast fungus.

Lordosis is another complication that may develop as a result of having large breasts. It is characterized by increased curvature of the spine as a result of increased weight. Lordosis causes frequent pain in the back. It sometimes leads to muscle cramps as well as pinched nerves.

Also, women with large breasts tend to develop a duck walk, which is characterized by the jutting out of the lower back as a result of the body accommodating the additional weight.

If you choose to have breast augmentation, you may want to keep these facts in mind. Ensure your doctor knows about your concerns by voicing them. He / she should have an understanding of the kind of effect increased breasts will have on your body.

Before you undergo surgery, it's important for you to determine whether your body weight can handle the additional weight of the boobs. A lot of women make the mistake of choosing the biggest size they come across when it comes to choosing breast implants. A shady surgeon will happily increase your breast size with little regard to the implications it may have on your health.

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Using Inversion Tables for Low Back Pain

Is using inversion tables for low back pain a good idea? Is it safe? Who should not use one?

These are all very important questions for anyone considering inverting. Although simply hanging upside down may seem benign, it can aggravate certain types of health conditions. In this article I'll discuss what I've learned in my experience with inversion tables and what my chiropractor has told me about using them.

Over the years my back has taken a beating from martial arts, running, scoliosis, sciatica and a bad car wreck. However, the last thing I wanted to do was give up being physically active. I did not want to completely stop my martial arts training, my weight lifting and my running. – But, I definitely wanted to completely stop my low back pain and other issues like sciatica.

For many years I had tried medication, stretching, physical therapy, massage therapy and chiropractic care in order to treat my back issues. Yes, all of these methods helped to some degree. However, I did not want to have to depend on expensive prescription medications forever. Medication that would make me drowsy and worthless. I also did not like the expensive bills that came with physical therapy.

In the end, the best options for me seemed to be chiropractic care and massage therapy together. These two seemed to be a great natural way of easing my back pain, but again, these things cost money.

After realizing the amount of money I was spending on my chiropractor and massage therapy, I was looking to look at other options. My friend had been using inversion tables for low back pain for the past few years and said I should really give it a shot. So, I did.

My first time on one of these tables, I did not completely invert, but the experience was still amazing. As soon as I was partly inverted, I felt relief from the weight of my body being lifted off of my spell. It was pretty amazing.

So the next time I saw my chiropractor, I decided to ask for her thoughts on using inversion tables for low back pain.

She said that using inversion tables could actually be good for the back because they decompress the spine. Decompressing the spinal is healthy because as people get older the disks in the spinal column get discharged out and decompression of the spine helps to re-lube the spinal which is very healthy.

She did say however that people with high blood pressure, glaucoma and people with certain heart problems should probably not use inversion tables. Also people who have had surgery and neck problems should not use inversion tables. In short she said, just check with your doctor.

Anyways, I was pleased to find out that she approved. Because for me, I had already tried one of the best inversion tables around and could majorly feel the difference.

So yes, using inversion tables for low back pain can definitely work. – But always remember to check with your doctor first. Especially if you have any health conditions or are taking any medications.

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Is Back Pain Hereditary?

There are many characteristics that follow down from generation to generation but could back pain be one of them? Could it be that just like hair and eye color, the chances of developing certain forms of back pain may be inherited?

Quite possibly.

Many medical professionals have long had doubts that genetics play a role in the development of back pain and various studies have shown that persistent back pain often runs in families.

When evaluating the cause of possible inherited back pain, it's important to take into account that we get many of our emotional and physical hits from our parents. Many of these dispositions, physical forms and personality traits are trickled down through the genes and enhanced by the lifestyle choices we make. In other words, being aware of our family's medical history may be significant in discovering any increased risks of developing back pain. Early diagnoses and accurate treatment play a major role in the successful cure of many spine conditions. It is therefore important to know of any major back problems experienced by our immediate relatives so that we can be aware of any potential risk to ourselves.

Those of us with a family history of back pain can lower our risk by properly looking after our spines, maintaining a healthy weight and undertaking regular exercise.

One puzzling aspect of low back pain is the perception of pain between patients. For example, some people suffering from a herniated disc may report severe or even unbearable pain while others may experience no discomfort at all. With the growing number of studies suggesting that pain susceptibility or pain tolerance is inherited, it may be that some families have a higher awareness of pain than others.

Similar lifestyle choices between family members also must be taken account. Obesity within a family or how a family tend to “carry” their weight is one example. An overweight or obese person who carries their weight around their abdomen will experience additional stress on the lower back. As the extra weight is not even distributed, the weight at the front of the body can result in an abnormal curve in the lower spine.

It must also be considered that people who are overweight or obese may may not undertake regular exercise. A reduced amount of physical activity can contribute to poor muscle tone and muscles weakness. Untrained or reconditioned muscles do not have the optimum level of strain resistance to combat the risk of back pain.

Poor lifestyle choices such as being overweight can also aggravate almost all types of existing back pain.

Here are some simple tips to reduce your risk of developing back pain

1. Implement regular exercise into your lifestyle. Swimming and walking are great ways to strengthen the muscles in your back.

2. Make an effort to maintain a good posture. Avoid slouching and hunching and take breaks from sitting every 30 minutes.

3. Quit smoking. It has been suggested that smoking hinders the blood supply to the disks in your spine which could lead to disc degeneration.

4: Maintain a healthy weight and a varied diet.

5: Invest in a mattress that is correct for you. A good bed specialist will be able to provide you with bespoke advice.

It's important to remember that the spine is an extremely complex structure that plays a major role in the functionality of many processes within the body. It is therefore critical to look after our spine health, wherever we may be at risk of genetic conditions or not.

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Does Back Pain Ever Go Away?

Sometimes it looks that your back pain will never go away. You have tried all the treatments from rest to physical therapy, even surgery, but the pain lingers. Sure some days are better than others. There are days when there is no pain and then days when the pain just makes you want to lie in bed. Is there any sure fire way to back pain go away and never return?

Well the short answer is no! I say this based on my own experience and research. The back is a complex system of vertebra, disc, nerves, spinal column, muscles and ligaments. Keep all this properly aligned relations on many factors. Below are four of the largest factors.

  1. Weight : Even an extra five pounds of weight can put awful strain on your back, especially if it's around the middle an area where most men gain weight.
  2. Lack of Exercise : Keeping the weight off goes hand in hand with exercise. We are a sedentary people. Humans were not meant to sit all day. Are bodies were designed to be on the move.
  3. Improper lifting : We all know or should know the proper way to lift. Heck many boxes have illustrations and instructions on how to lift, but do we pay attention?
  4. Weekends : Who does not love the weekends? It is a chance to relax and maybe get outside and do some yard work or play golf. But wait a minute, you have been sitting on your duff all week and now you put a strain on your body. A body that is out of shape and you get a backache. What did you expect?

So if you are suffering from back pain how can you expect it to go away if you fall into one or more of the above factors? Popping a few pain pills or even having therapy and / or surgery may reduce or eliminate the pain for the time being. But unless you seriously look at the reasons for the pain happening in the first place and address the source of your back problem the pain and discomfort will return.

The only real solution is to aggressively deal with the issues that are causing the problem. If it is being overweight than a diet and exercise program is in order. Some people have the discipline to go on a diet by themselves, but others need a more structured approach. Remember unless the change in diet is one that you can maintain after losing a few pounds, chances are you will just get back those pounds.

If I have learned anything from my own journey it is this: Knowing what works for me and adapting a life style that helps me maintain my ideal weight and muscle tone takes time and dedication. Also knowing what triggers my pain things such as shoveling snow and raking leaves means I approach these tasks aware of the proper technique and my own limitations.

Yes I still get some back pain from time to time. Usually when I overdo it and or lay off my exercises. But based on my experience with my back and the knowledge I have gained over the years I also know what I have to do to eliminate the pain. Wanting to live an active life, I accept the fact that my back will act up once in a while, but I now know how to ease the pain and go on with my life.

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Back Surgery: The Cold, Hard Truth

Suffering from back pain and wondering if surgery is the way to go? Well here is the cold hard truth. Back surgery is should not be your first or only option. First there are many types of surgery for the back. Here are a few: Spinal Fusion, Laminectomy, Foraminotomy, Discectomy, Disc Replacement and Interlaminar. The type of surgery obviously depends on your specific symptoms. Along with these types of operations advances in surgical techniques has made operations less invasive resulting in less risk, speedier recovery and shorter hospital stays. Also all this means a better chance of a successful operation and elimination of your back / spinal problems.

This is all great news and certainly surgery is a very viable option. But there are also risks involved in any surgical procedure, blood clots, infections, reactions to medications and anesthesia and nerve damage. Many times the surgery is successful, but the pain continues. There is even a term to describe this. It is called “Failed Back Surgery Syndrome”. Some statistics claim that the failure rate is as high as seventy-four percent!

The biggest reason is the fact that back pain is very hard to identify. The back and spine is a very complex system of nerves, muscles, bones and ligaments. Even with the best diagnostic tools is very hard to pin point the problem. Also many times the muscles and nerves have been blamed for so long that recover is very slow if at all.

I also think that too many patient and for that matter doctors see surgery as the only solution. Back pain sufferers believe that all they have to do is have an operation and presto the pain is gone. While that is true for some, for many the pain is still there.

As a person who had back pain and surgery here are my suggestions. Now I am no expert so take these ideas as based on one person's experience and research. However many studies have concluded that anyone suffering from back pain should consider the following suggestions before resulting to surgery.

  1. Rest: Many times simply resting for a few day and taking over the counter pain killers will alleviate the problem.
  2. Loss weight: The amount of stress a few extra pounds of weight places on the back is awful and although this is a long term solution and results will not be felt for some time it is definitely a good course of action.
  3. Exercise: Again like losing weight this will take time, but again the results are worth it. Walking is probably the best single thing you can do for a bad back. There are also specific exercises for your particular back problem.
  4. Avoidance: Learn what types of activities cause the back pain and avoid them. Sounds easy I know, but hard to do in practice. For me shoveling snow sets off my back. So if I have to shovel I use an ergonomic shovel, take smaller scoops and rest frequently. Of course moving further South would solve this problem.

So the cold hard truth is surgery is a viable option. But in my opinion taking an alternative approach and exploring these non-surgical options first is the way to go.

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Before Orthopedic Surgery: Tests For Disk Injuries

Doctors are keenly aware that surgery is the last resort in treating any spinal condition, and to ensure that an operation upon a spinal disk or nerve injury is necessary, there is a range of tests that look for the precise cause of a patient's pain or limitations . Muscle spasm, tingling, weakness, or lack of range of motion in the arms or legs-all of which may be caused by a disk injury-are not enough, and there should be proof that these arise from an identifiable, specific lesion that matches the complaints.

For instance, for pain radiating from the neck to the little finger, a doctor might suspect an injury at the level of the eighth cervical nerve (C8) -the lowest in the neck-but would want to be able to see that injury on a scan and verify it with an EMG / NCS (Electromyogram / Nerve Conduction Study), since it may call for nonsurgical treatment or be caused by a condition not related to the disks, such as thoracic outlet syndrome. Plain X-rays are one step in diagnosing an injury but are not as informative as CT scans (Computed Tomography), or an MRI (Magnetic Resonance Imaging), which provide extremely detailed information about the examined area. These may be accompanied by the EMG / NCS, which sends electrical impulses through the patient's affected nerves and muscles. Ideally, the data from the tests should conform with what a doctor observes on physical examination, the outcome of conservative treatment, and the patient's reported history in order for there to be a need for orthopedic surgery.

In a CT scan, one lies down on a table, which is then slid into a donut-shaped scanner, which then rotates around and takes a series of x-rays, creating a stack of images to show the three-dimensional structure of the part being scanned. This takes only a brief time – most of the appointment is spent in preparation time rather than inside the machine. Sometimes, it may be necessary for dye to be injected in the affected level (s) of the spine for the resulting image to provide better contrast.

An MRI is a similar experience in that person, again, lies inside a machine that surrounds him or her, although an open machine may be available for those who are uncomfortable in small spaces. Since it uses strong magnetic fields, this scan shows different information from x-rays and adds to the total knowledge available about an injury.

If your doctor has ordered an EMG / NCS, he or she will wish you to prepare by ceasing to take medicines that might interfere with the results: blood thinners, for instance. To prevent any possibility of infection, your physician or a technologist will clean the skin over areas being tested, then insert a sterile needle electrode into your muscle. Recording machines typically include a video monitor that shows the results as wavy or spiky lines and audio devices that make popping, firecracker-like noises to help your doctor reach a diagnosis.

To see if orthopedic surgery is necessary, the electromyogram determines whether a patient's nerves are functioning abnormally. So, first, resting muscular electrical activity is recorded, before one contracts and relaxes that part of the body. The electrode may be relocated several times to gather information from different regions. This typically lasts for 30 to 60 minutes. As with any needle, you may experience a minor, sharp pain when the electrode is applied. Afterwards, you should expect some swelling and tingling for a couple of days.

For a nerve conduction study, several metal disks will be attached over the affected nerves' pathways using paste or tape and a short series of quick (nearly instantaneous) electric shocks of a very low voltage will be sent through them. This enables the instruments to measure how quickly a muscle contracts- its contract velocity. Often, the other side of the body will be tested for comparison. A difference between the two sides' results is one of the indicators for orthopedic surgery. The NCS typically goes for about between 15 minutes and an hour, depending on how many different nerves and muscles are studied. It does tend to make some people angry, but the strength of electricity involved is too low to cause injury.

The combination of all information from a person's experience with conservative treatment (exercise and therapy), reports of symptoms, those physically observable such as muscle spasm, and the result of radiographic, magnetic, and electrical tests combine to inform a doctor about the nature of one's injury, whether it lies within the spinal disks, and whether orthopedic surgery should be both necessary and helpful.

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Curing Your Back Pain Is Up

Is it possible to cure back pain without surgery? While I'm no doctor, I am someone who has lived with back pain, had surgery and for the last eight years have been reliably pain free. I can tell you that surgery alone is not the answer. Surgery can fix the problem of a ruptured disc. But only by changing your life style can you really cure back pain.

Think of it this way. You have back pain and after an MRI and discussion with your doctor you decide on surgery. After the operation the surgeon tells you he “fixed” the problem and mechanically you're fine. But are you? Have you changed your lifestyle and addressed the undering causes of your pain? Or did you rely on doctors, surgeons and drugs to ease your agony?

Let me make an important point. Modern medicine and the advance in surgical procedures or absolutely wonderful. But they can only go so far. We all know stories of a person who smoked, had lung cancer and beat it only to start smoking again. Or an overweight person who spent a fortune on weight lost programs, lost the weight only to gain it back!

It's hard to change habits and lifestyle. However in my opinion the only way to cure back pain is to get to the root cause. Think of it this way. I bring my car into the shop and have the brakes replace. But I continue to slam on the brakes and or constantly ride the brakes and have to replace them much sooner than would otherwise expected if I drive the car properly. Who is to blame? My mechanic for doing a bad job? The brakes pads for being faulty? No, the problem is not the brakes or the mechanic, the fault rest with me? I failed to change my driving habits and the results were predictable.

Relying solely on doctors and drugs to cure my back pain and not addressing the underlying problems will more than likely put you right back in the doctor's office. Too many people expect the surgery to cure their back pain and then they can go back living their normal lives. Not taking action to address the real causes of their back pain only leads to more problems.

The real way to cure back pain whether you have surgery or not is to make positive changes in your life. Two of the most critical are:

1. Lose weight! I know a person who had back surgery about the same time I had mine and who has lived with back pain ever since. It's gotten so bad that he can barely walk. He went to all kinds of specialists, endured all kinds of test and procedures and still the pain persists.

However the one thing he could do which in my opinion would make all the difference is lose the spare tire around his gut! This extra 20 or 30 pounds puts severe strain on his back. But whenever I mention the fact he gets mad and tells me to mine my own business! I should add this person has diabetes and high blood pressure. Again losing the weight would make a huge difference in his health.

2. Exercise: There are exercises that will straighten your back from simple walking to specific movements designed to address your particular problem. I follow follow to live an active pain-free life.

None of this is rocket science. Rely on surgery to cure your pain and ignoring the reasons that caused the pain is foolish. Why live in pain if the cure is readily available? Curing your back pain really is up to you!

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Can MRIs Reveal Back Pain?

The prospect of undergoing an MRI scan can be extremely daunting. In addition to the fact that a scan could mean that there may actually be something amiss in your body, the thought of lying alone in a noisy, confined space is a frightening looking for many. Like many medical contraptions, an MRI is something most of us will end for the sake of achieving a correct diagnosis. But are they really useful in diagnosing the majority of lower back conditions?

What's interesting in using MRI scanners as a diagnostic tool for lower back pain is what they reveal can be misleading to the patient. For example, MRIs typically show abnormalities in the spine that have no link to the patients' symptoms whatsoever. Wear and tear, disc degeneration and arthritis often come with the increasing age of the hardworking spine, but that information is particularly helpful to a patient who back pain has nothing to do with these factors? For many angry patients, these common 'abnormalities' may only cause additional and unnecessary worry; a 'false alarm' in the search to discover the true cause of their symptoms.

Many leading chiropractors claim that about a third of middle aged people with no back problems would have abnormal MRI results. On the flip side, many back pain patients who suffer with extreme pain have normal MRIs. Pain is not black and white; we can not take a picture of true pain, even with medical advances as impressive as they are today.

There is no disputing that MRI is an incredible technology. The ability of achieving clear pictures of soft tissues within the depths of the body is extremely valuable for diagnosing many medical complaints and MRI scans have saved and continue to save lives every day across the world. But diagnosing the cause of most types of lower back pain is not best placed with MRI scanning, so it sees. Of course, there are always exceptions and sometimes MRI scans do discover underlining reasons for lower back pain. However, looking towards MRI machines for a general answer of why a patient sufferers from back pain should not always be the primary route of investigation.

This argument was recently put to the test in a study where researchers attempted to diagnose back pain using only MRI results, with no prior medical information about the patient. The study involved patients with stenosis (narrowing of the spinal canal) based on the thinking that stenosis always presents with pain. Interestingly, the study revealed that few patients with the associated kind of pain had narrowed spinal canals! Similarly, those who did have narrowed canals did not report that they were experiencing any pain. In this study, the researchers could not accurately diagnose lower back pain using MRI alone. *

For the majority of people with any kind of medical condition, the word “scan” strongly implies that there is a possibility that something could be seriously wrong – which is a common fear in those suffering from chronic back pain. Taking into account the many unrelated spinal abnormalities that MRI scans reveal, is it worth adding to this fear with a scan that may not help with diagnosis and may just identify unrelated abnormalities?

The lack of clarification that many results give also brings an element of confusion to the patient. Many people who present without pain have all sorts of “abnormalities” with their backs and many people with pain have normal scan results. This potentially creates a risk of diagnoses and treatment running in all sorts of directions.

MRI scanners are useful for detecting the cause of certain types of lower back pain, but the requirement should be evaluated by each patient's individual case.

* Haig AJ, Tong HC, Yamakawa KS, et al . Spinal stenosis, back pain, or no symptoms at all? A masked study comparing radiologic and electrodiagnostic diagnoses to the clinical impression.

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What Is Text Neck?

Is your smart phone literally a pain in the neck?

Text neck is being described as a modern ailment that is due to spending long periods of time starting down at your mobile phone, tablet or other device.

Recent research shows that smart phone users are spending an average of 4 hours each day staring at their device (that's 1,400 hours each year!), So it is no wonder that the incidence of 'text neck' is on the rise! And it sees that this relatively new phenomenon is becoming alarmingly common with the increasingvalence of mobile technology, particularly among younger generations.

The posture we adopt as we stare at our phones increases the stress on the neck and can cause excess wear and tear that could lead to permanent damage.

The problem with this is that in order to look at your screen, you need to bend your head forwards into a flexed or dropped forwards position. This unnatural position actually reverses the normal back curve of the cervical spine (your neck). This change can actually be observed on X-Rays, where we have seen a straightening, or even a reverse of the normal curve of the cervical spine.

The average head weights around 5 to 6 kilograms. The cervical spine (your neck) is designed so that it will balance the weight of the head effortlessly. It even has a slight backwards curve to absorb the shocks and impacts of moving around. However, as we bend our heads forward, the amount of stress and strain on the neck increases. At a 15-degree angle, this weight is about 12 kg / 27 pounds, at 30 degrees it's 18 kg / 40 pounds, and at 60 degrees it's 27 kg / 60 pounds. That is the same as having an 8 year old child hanging unsupported off your neck for several hours every day!

Over time this can lead to muscle strain, pinched nerves and herniated discs. But the most obvious immediate effect is on our posture. Just have a look around, everyone has their head down! Poor posture can cause other problems as well. Experts say it can reduce lung capacity by as much as 30 percent. It has also been linked to headaches and neurological issues, depression and heart disease.

What are the symptoms associated with text neck?

Text neck most commonly causes neck pain and soreness. In addition, looking down at your cell phone too much each day can lead to:

Upper back pain ranging from a chronic, nagging pain to sharp, severe upper back muscle spasms.

Shoulder pain and tightness, possibly resulting in painful shoulder muscle spasm.

If a cervical nerve becomes pinched, pain and possibly neurological symptoms can radiate down your arm and into your hand.

While it is nearly impossible to avoid the technologies that cause these issues, individuals should make an effort to look at their phones with a neutral spine and to avoid spending hours each day hunched over.

These 2 simple tips can help to minimize the risk of developing text neck.

Look down at your device with your eyes. No need to bend your neck.

Exercise: Move your head from left to right several times. Use your hands to provide resistance and push your head against them, first forward and then backward. Stand in a doorway with your arms extended and push your chest forward to strengthen the muscles of good posture.

But probably the key point is to try and reduce the amount of time we spend watching at our phones. You can not live a life through your phone, and there is a beautiful world right in front of your eyes. Just look up from time to time!

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