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Low Back Pain

As an adult, you probably have experienced low back pain, in fact the AANS (American Association of Neurological Surgeons) states that 75-85% of adults will experience some form of back pain in their lifetime.  As you may know, low back pain can greatly affect your life and make daily activities very difficult. Before we dive into how to treat low back pain, let’s take a look at why you may be dealing with low back pain in the first place.

Causes

Because the low back is a main area of stabilization, support and rotation, many different factors can contribute to pain felt there. Some of the causes include strained muscles, sprained ligaments, nerve irritation, degeneration, overuse, intervertebral disc injury, spinal stenosis, scoliosis as well as an acute injury.

Overuse/acute injury is a very common cause of low back pain. A low back injury can occur by doing a lot of activity that our body isn’t prepared to do. This could be anything from repetitive lifting to being a weekend warrior.  Acute injuries can happen from activities you perform on a regular basis or an activity you have never done before.

As we age, our bodies slow down. The low back experiences a lot of wear and tear over the years which may result in damage.  One form of damage that can occur is in the form of disc degeneration (the wear and tear, shrinking, and collapse of intervertebral disc).  Another is spinal stenosis (narrowing of the space around the spinal cord).

When an intervertebral disc (the shock absorbers of the spine) is damaged the result can be a stretching known as an intervertebral disc bulge or a rupturing known as an intervertebral disc herniation.

Scoliosis may also be a cause of low back pain.  Scoliosis is an abnormal curvature of the spine.  A scoliosis can cause your back to be off balance and become strained, thereby causing pain and stiffness.

Symptoms

Low back pain symptoms can vary greatly from person to person in nature, frequency and intensity and are often different depending upon the cause. Your pain may be dull or sharp. It may constant or intermittent.  It may get worse with standing, sitting, bending, or walking. Pain may even extend into your buttock or down your leg.

Symptoms can vary a lot from person to person. Getting an examination with Dr. Boroditsky is the best way to assess what treatment plan is best for you.

Treatment

Prior to starting any type of treatment, it is always advisable to first see an appropriately trained spine specialist to develop an appropriate treatment program for your specific condition and medical history.

The main goals for managing back pain in the lumbar spine (lower back) usually include:

  • Providing enough pain relief to be able to actively participate with physical therapy and rehabilitation
  • Preventing further injury or stress to the spine through improved ergonomics and posture
  • Maintaining an ability to function enough at home and at work

Non-Surgical Back Pain Treatments

There are a wide variety of non-surgical options for back pain treatment of the lumbar spine. The more common treatment approaches include:

Pain medication. Typical pain medications used to treat the lower back pain include acetaminophen, NSAIDs, oral steroids, narcotic drugs, muscle relaxants, and anti-depressants. Each type of medication has strengths, limitations, and risks, and the patient’s particular problem in the lower back and overall health will determine which pain reliever, if any, is indicated.

Heat or ice. Application of a cold pack or heating pad can help relieve low back pain. Some people find that alternating between the two works best.
Manual manipulation. This treatment maybe applied by a Dr. Boroditsky! He can improve your pain by manually and gently  manipulating the vertebrae away from the nerve, reducing pressure. This will greatly improve your pain.  Manipulations also increase flexibility, improving blood flow and reducing muscle tension.
Therapeutic massage. Massage therapy is thought to improve blood flow, reducing muscle stiffness, and decrease stiffness.
Exercise. A program of back exercises and physical therapy will usually include a combination of strengthening, stretching, and low-impact aerobic exercise.
Call 763.390.1323 today to schedule an appointment, we can help with your low back pain!

What is Pronation?

When a foot is severely “pronated,” it means its arches have fallen and the foot is flat. Flat feet are less shock-absorbent, and make for a less stable “base” for everything above—the bones, muscles, ligaments and tendons of the entire body. They can also:

  • Shift the entire body out of alignment
  • Cause aches and pains in the feet, knees, hips, neck and/or spine
  • Lead to injury and problems like shin splints, Achilles tendinitis and plantar fasciitis
  • Women with flat feet are 50% more likely than those without to have low back pain
  • Up to 1/3 of people suffer from flat feet

 

Causes of Pronation

The connective tissue, called the plantar fascia, on the underside of the foot is critical to maintaining the foot’s healthy arched shape. Injury and certain health conditions can cause the fascia to stretch out and flatten, but so can everyday, ongoing stressors like walking and standing. Once the fascia stretches out, it is unable to “spring back.” With the foot structure flattened, the body’s very foundation is in trouble.

Treatment

  • Extremity adjusting to ensure proper positioning of bones and joints
  • Functional orthotics in every pair of shoes for pronation control, support and comfort
  • Rolling feet on a tennis ball to help soften foot musculature and connective tissue

Stretching

Stretching may take a back seat to your exercise routine. You may think that stretching your hamstrings and calves is just something to be done if you have a few extra minutes before or after pounding out some miles on the treadmill. The main concern is exercising, not stretching, right?Not so fast. Although studies about the benefits of stretching are mixed, stretching may help you improve your joint range of motion, which in turn may help improve your athletic performance and decrease your risk of injury. Understand why stretching can help and how to stretch correctly.Stretching can help improve flexibility, and, consequently, range of motion in your joints. Better flexibility may improve your performance in physical activities or decrease your risk of injuries by helping your joints move through their full range of motion and enabling your muscles to work most effectively.

Stretching also increases blood flow to the muscle. And you may come to enjoy the ritual of stretching before or after hitting the trail, ballet floor or soccer field.

Stretching essentials

Before you plunge into stretching, make sure you do it safely and effectively. While you can stretch anytime, anywhere — in your home, at work, in a hotel room or at the park — you want to be sure to use proper technique. Stretching incorrectly can actually do more harm than good.

Use these tips to keep stretching safe:

  • Don’t consider stretching a warm-up. You may hurt yourself if you stretch cold muscles. So before stretching, warm up with light walking, jogging or biking at low intensity for five to 10 minutes. Or better yet, stretch after you exercise when your muscles are warmed up.Also, consider holding off on stretching before an intense activity, such as sprinting or track and field activities. Some research suggests that pre-event stretching before these types of events may actually decrease performance.Strive for symmetry. Everyone’s genetics for flexibility are a bit different, so rather than striving for that gymnast or ballet dancer degree of motion, focus on having equal flexibility side to side (especially if you have a history of a previous injury).
  • Focus on major muscle groups. When you’re stretching, focus on major muscle groups such as your calves, thighs, hips, lower back, neck and shoulders.Also stretch muscles and joints that you routinely use at work or play. Make sure that you stretch both sides. For instance, if you stretch your left hamstring, be sure to stretch your right hamstring, too.
  • Don’t bounce. Stretch in a smooth movement, without bouncing. Bouncing as you stretch can cause injury to your muscle.
  • Hold your stretch. Hold each stretch for about 30 seconds; in problem areas, you may need to hold for around 60 seconds. Breathe normally as you stretch.
  • Don’t aim for pain. Expect to feel tension while you’re stretching, not pain. If it hurts, you’ve pushed too far. Back off to the point where you don’t feel any pain, then hold the stretch.
  • Make stretches sport specific. Some evidence suggests that it’s helpful to do stretches tailored for your sport or activity. If you play soccer, for instance, you’re more vulnerable to hamstring strains. So opt for stretches that help your hamstrings.
  • Keep up with your stretching. Stretching can be time-consuming. But you can achieve the most benefits by stretching regularly, at least two to three times a week.If you don’t stretch regularly, you risk losing any benefits that stretching offered. For instance, if stretching helped you increase your range of motion, and you stop stretching, your range of motion may decrease again.
  • Bring movement into your stretching. Gentle movement can help you be more flexible in specific movements. The gentle movements of tai chi or yoga, for instance, may be a good way to stretch.And if you’re going to perform a specific activity, such as a kick in martial arts or kicking a soccer ball, do the move slowly and at low intensity at first to get your muscles used to it. Then speed up gradually as your muscles become accustomed to the motion.

“Do I have to stretch?” is a very common question, especially when discussing exercise. It’s a good idea, says the American College of Sports Medicine. The ACSM recommends stretching each of the major muscle groups at least two times a week for 60 seconds per stretch. Staying flexible as you age is a priority to help keep your mobility high as discussed in this weeks previous blogs.

If you have problems with posture or activities, make it a habit to stretch those muscles regularly. If you have back pain from sitting at a desk all day, stretches that reverse that posture can help.

Simple Back Stretchstretching2

Exercise physiologist Mike Bracko recommends doing the “Standing Cat-Camel” as a work-related back stretch. Here’s how:

  • Stand with your feet shoulder-width apart and knees bent slightly
  • Lean forward, placing your hands just above your knees.
  • Round your back so that your chest is closed and your shoulders are curved forward.
  • Then arch your back so that your chest opens and your shoulders roll back.
  • Repeat several times.

If your job keeps you in the same position all day, Bracko suggests doing 2-minute stretch breaks to reverse that posture at least every hour.

Strength Training

Whatever your age, strength training is an activity that provides many health benefits for both men and women. Strength training can be done by people who are in good health, as well as by those who have health concerns — such as arthritis or chronic pain.

Combined with regular aerobic exercise, doing an activity like lifting weights two or more times a week can improve your mental, emotional and physical health.

Strength training is known to reduce the symptoms of several health problems and chronic diseases, such as:

  • Arthritis, including osteoarthritis
  • Back pain and other types of pain
  • Depression
  • Diabetes
  • Obesity
  • Osteoporosis

While some of the benefits of strength training are for older men and women, it is never too early to start. The major benefits of strength training include:

  • Increased muscle strength. Without use, our muscles waste away as we age. Regular strength training can keep your muscles strong well into the post-retirement years. This can have a profound impact on your ability to function in your daily life.
  • Improved balance and reduced falls. Simple strength and balance training can improve your balance. This can reduce the risk of falling, which is a common problem for older people. Bone fractures from falls can lead to permanent disability and may even lead to death.
  • Stronger bones. Lifting weights or doing other types of resistance exercises puts stress on the bones. In response, the bones grow stronger (denser). This reduces the risk of bone fractures. Post-menopausal women, in particular, can benefit, because they lose 1 to 2 percent of their bone mass each year.
  • Weight control. Building muscle also increases how many calories you burn, because muscle tissue is very active. For this reason, strength training can boost your metabolism, which can help you lose weight or maintain a healthy weight.
  • Improved glucose control. Millions of Americans have type-2 diabetes, a condition that involves elevated levels of glucose in the blood. Left untreated, this condition can lead to heart or kidney problems, and even blindness. Strength training reduces the risk of these conditions by improving the glucose levels in the blood.
  • Better moods and sleep. Like aerobic exercise, strength training can improve your mood, self-confidence and self-esteem. In addition, regular exercise can help you sleep better. Together, these add up to a better overall quality of life.
  • Stronger heart muscle. The muscles of your arms and legs are not the only ones that benefit from strength training. Your heart will also grow stronger with exercise, which shows up as improved aerobic capacity. Even cardiac patients can benefit from doing this type of physical activity three times a week.

It is never too early or too late to start a strength training program. Adults should aim for doing this as least two days a week. The exercises should work all the major muscle groups of the body.

Strength training often involves lifting weights. But other types of resistance exercises also work well — such as using exercise bands or doing bodyweight exercises, such as push-ups or crunches.

If you are physically inactive, have an existing health condition or have concerns about your health, check with your doctor before starting any exercise program.

Movement & Exercise

Maintaining mobility is critical in order to live free from pain and disability. Maintaining good mobility is not difficult, but it does not happen on its own.

Imagine waking up one morning with a frozen shoulder where you couldn’t move your upper arm more than a few inches in any direction. How much would that impact your ability to do your job? How much would that affect your ability to drive your car or even to dress yourself? How much would that affect your ability to concentrate on anything other than your shoulder? Obviously, if your shoulder did not move correctly, it would have a dramatic impact on your life. Well, the same is true with movement in every part of your body. If things aren’t moving the way they are supposed to move, it will have a negative impact on your ability to function at work, take care of the demands of everyday life, and even your ability to concentrate.

Many patients with severe low back pain report that their pain came on suddenly when they did something as simple as bend down to pet their cat, put on their socks, or pick up the newspaper. Just about everyone would agree that a person’s body should be able to handle such simple movements. So what has happened?

In every one of these cases, the joints of the patient’s body were “all locked up” — they were barely moving at all. When the joints in one area of the body do not move the way they should, other areas of the body are forced to move more in order to compensate. This creates a significant stress on those areas that have to pick up the slack, and it soon leads to pain and inflammation. At the same time, the areas that don’t have normal movement will slowly worsen as the muscles continue to tighten, the joints stick together, and the ligaments and tendons shorten. This leaves the body in a very unstable condition; if left unchecked, this process will continue until the body can hardly move at all. That is how a person comes to suffer flare-ups of pain at the slightest provocation.

Most of us have seen people who have lost most of their normal mobility: they look like bodies have been starched stiff whenever they try to move around. This is especially prevalent among the elderly. Contrary to popular belief, however, this is not an inevitable effect of aging; rather it is the inevitable effect of not maintaining the body’s mobility through exercise, healthy alignment, and body mechanics. There are people in their 60s, 70s, or even older, who are stronger and more flexible than the average person in their 30s, simply because they keep themselves exercising.

Maintaining mobility is critical in order to live free from pain and disability. Maintaining good mobility is not difficult, but it does not happen on its own. Just as in developing a good posture, it is necessary that you perform specific exercises and stretches to keep your muscles, ligaments, and tendons flexible and healthy. In addition, it is necessary that all of the joints in your body are kept moving correctly as well. Although this can be achieved to a great degree through stretching, most people also find routine chiropractic adjustments to be very beneficial.

If you are dealing with long-term chronic pain, it is likely that the last thing you want to think about is exercising. However, staying physically active is important for your overall health and in preventing the onset of other conditions like heart disease and obesity.

An appropriate exercise program can also relieve symptoms associated with chronic pain by boosting your body’s pain-fighting chemicals. It may also reduce your risk of sustaining certain injuries and of developing chronic pain after an injury.

In addition to helping you maintain a healthy weight and strengthening your muscles and heart, exercise provides other benefits for people with chronic pain, including:

  • Reduction in muscle spasms
  • Decrease in inflammation in the joints
  • Improved spinal alignment
  • Strengthened muscles around your joints
  • Prevention of atrophy of your muscles
  • Increased ability to carry out everyday activities
  • Boost in your mood
  • Improved quality of life

Exercise may help alleviate pain associated with many types of conditions, including:

  • Arthritis
  • Certain back problems
  • Fibromyalgia
  • Certain neck problems
  • Osteoarthritis

To gain the benefits of exercise, you should aim for at least 150 minutes per week of moderate-intensity physical activity. This includes walking, swimming, bicycling or water aerobics.

In addition to this aerobic exercise, you should do two or more days per week of muscle strengthening exercise. This should work all the major muscle groups of the body, including the arms, shoulders, abdomen, chest, hips and legs.

It is also beneficial to stay physically active throughout the day. This can be done by walking or biking to work, parking farther from the shopping center entrance, taking periodic walks, gardening or taking the stairs instead of the elevator.

If you have had a recent injury or suffer from chronic pain, the first step is to visit your primary care doctor for an exam. He or she can suggest an appropriate medical plan to treat your injury or alleviate your chronic pain. Your treatment plan might include visiting your chiropractor and starting an exercise program to help relieve your symptoms. Your chiropractor and primary care physician can work together to develop an exercise program that is suitable for your individual needs.