Low Back Pain: Who Will Respond Best To Care?

Low Back Pain:  Who Will Respond Best To Care?

Is it possible to identify which low back pain patients might experience the
most benefit from spinal manipulation combined with exercise? In a 2011 study,
researchers identified which patients might respond best to this combination of
care and which patients might need a more aggressive approach.

Directional preference (DP) describes a situation in which it feels better for
the patient to move in one direction versus another. For example, if a patient
feels worse bending forwards (which is quite common) and feels better bending
backwards, then “extension-biased exercises” are preferred.

If leg pain is present, the DP that reduces or eliminates the leg pain (called
centralization, or CEN) is the exercise-biased direction, and it’s important to
avoid any exercise that increases leg pain (peripheralization).

In the study, which involved 584 patients with low back pain, the researchers
found that 60% of the participants had a DP and of those patients, 60% had CEN.
The researchers found that the patients with a DP that reduced CEN responded the
best to care (in this case, spinal manipulation combined with exercise) in
regards to improved pain and function. On the other hand, the patients who had
no DP experienced the least overall improvement.

The value of using a classification system like this allows a doctor of
chiropractic to determine which exercises will help each individual LBP patient
the most.  It also provides them with the ability to identify those most likely
to respond favorably and those patients who may need a more comprehensive
treatment.

So, if you feel best bending backwards and/or leg pain lessens, the preferred
exercises include bending backwards (extension) from standing, prone press-ups
(“saggy” push-ups) or hugging a gym ball, and/or extending your back over a gym
ball or a stack of large pillows. Of course, there are many additional exercises
but ANY position that reduces LBP and/or leg pain will help.

 We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services. Visit http://www.olsonchiropracticcenter.com for more information.

Why Does My Back Hurt? Part 2

Last month, we discussed common causes of back pain including mattresses, shoes, diet, exercise, and posture. Here are some additional considerations…

6. OFFICE CHAIR: Because of vast differences between people’s height, weight, body type, and preference, it’s difficult—if not impossible—to find a one-size-fits-all solution when it comes to office chairs! In the ideal world, the option to sit, stand, walk, and stretch as needed would be perfect but this simply is not reality! Low back pain (LBP) from sitting is common due to the excess pressure it places on the joints and disks (the “shock-absorbers” of the spine). Here are some remedies: 1) Find a chair that FITS YOU. 2) Get up and move at least once every hour (set the timer on your smartphone as a reminder). 3) Place the computer monitor directly in front of you and keyboard/mouse so the elbows bend only 90°. 4) Keep your feet on the floor at your desk (use an upside down box if you have short legs). 5) Perform “in the chair” stretches when your timer goes off!

7. BODY TYPE: We’ve discussed obesity as an obvious cause of back pain, but other factors are important as well. A very common cause of back pain for women is breast size. Here, the topic of a supportive bra is important, as carrying more weight in front of you adds additional stress on the back and shoulders.

8. SHOULDER BAGS: Back pain can be caused and/or perpetuated by a heavy purse, bag, briefcase, and even a thick wallet in the back pocket! To keep your eyes level, your body has to compensate and assume a less-than-ideal posture that may place unnecessary stress on your back! So before leaving the house today, CLEAN OUT that bag and/or put your wallet in a front pocket and lessen the load on your spine!

9. SMOKING: Smoking can reduce the amount of oxygen that reaches your cells, which can cause them to function at a less than optimal state. You’ve perhaps heard that a conscientious back surgeon will NEVER operate on a smokers’ back due to both the prolonged healing time and subsequent bad outcomes. So in addition to giving your heart, lungs, and those around you a break, if you want your lower back to heal, STOP SMOKING! Studies also show smokers are TWICE as likely to develop LBP compared with non-smokers, so quit. Better yet, DON’T START in the first place!

10. STRESS & DEPRESSION: Remember, “health” is a balance between structure, chemistry, and mental factors. Stress increases muscle tightness and alters posture in a way that can lead to or exacerbate existing LBP. Exercise, meditate, eat smart, and resolve your differences with family members and friends to minimize this problem! When needed, your doctor of chiropractic can refer you for counseling!

11. ERGONOMICS: How we “fit” into our job, lifting properly, workstation set up, work pace, and work stressors ALL play into LBP management. Have an assessment to see what can be fixed!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services. Visit http://www.olsonchiropracticcenter.com for more information.

Why Does My Back Hurt? | Yankton Chiropractor

It’s been said that if you haven’t had back pain, just wait, because (statistically) some day you will! The following list is a list of “causes” that can be easily “fixed” to reduce your risk for a back pain episode.

1. MATTRESS: Which type of mattress is best? The “short answer”: there is no single mattress (style or type) for all people, primarily due to body type, size, gender, and what “feels good.” TRY laying on a variety of mattresses (for several minutes on your back and sides) and check out the difference between coiled, inner springs, foam (of different densities), air, waterbeds, etc. The thickness of a mattress can vary from 7 to 18 inches (~17-45 cm) deep. Avoid mattresses that feel like you’re sleeping in a hammock! A “good” mattress should maintain your natural spinal curves when lying on your sides or back (avoid stomach sleeping in most cases). Try placing a pillow between the knees and “hug” a pillow when side sleeping, as it can act like a “kick stand” and prevent you from rolling onto your stomach. If your budget is tight, you can “cheat” by placing a piece of plywood between the mattress and box spring as a short-term fix.

2. SHOES: Look at the bottom of your favorite pair of shoes and check out the “wear pattern.” If you have worn out soles or heels, you are way overdue for a new pair or a “re-sole” by your local shoe cobbler! If you work on your feet, then it’s even more important for both managing and preventing LBP!

3. DIET: A poor diet leads to obesity, which is a MAJOR cause of LBP. Consider the Paleo or Mediterranean Diet and STAY AWAY from fast food! Identify the two or three “food abuses” you have embraced and eliminate them – things with empty calories like soda, ice cream, chips… you get the picture! Keeping your BMI (Body Mass Index) between 20 and 25 is the goal! Positive “side-effects” include increased longevity, better overall health, and an improved quality of life!

4. EXERCISE: The most effective self-help approach to LBP management is exercise. Studies show those who exercise regularly hurt less, see doctors less, have a higher quality of life, and just feel better! This dovetails with diet in keeping your weight in check as well. Think of hamstring stretches and core strengthening as important LBP managers – USE PROPER TECHNIQUE AND FORM; YOUR DOCTOR OF CHIROPRACTIC CAN GUIDE YOU IN THIS PROCESS!

5. POSTURE: Another important “self-help” trick of the trade is to avoid sitting slumped over with an extreme forward head carriage positions. Remember that every inch your head pokes forwards places an additional ten pounds (~4.5 kg) of load on your upper back muscles to keep your head upright, and sitting slumped increases the load on your entire back!

We have only scratched the surface of some COMMON causes and/or contributors of back pain. Stay tuned next month as we continue this important conversation!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.  For more information visit www.olsonchiropracticcenter.com

Is Sitting Bad For My Back?

Is Sitting Bad For My Back?

A major manufacturer of workstations reports that 86% of work computer users have to sit all day, and when they do rise from sitting, more than half (56%) use food as the excuse to get up and move. In addition to sitting at work, for meals, and commuting to/from work, 36% sit another one to two hours watching TV, 10% sit one to two hours for gaming, 25% sit one to two hours for reading/lounging, and 29% use their home computer for one to two hours. In summary, the average American sits for thirteen hours a day and sleep for eight hours. That’s a total of 21 hours a day off their feet!

The manufacturer’s survey also notes 93% of work computer users don’t know what “Sitting Disease” is but 74% believe that sitting too much can lead to an early death. “Sitting Disease” represents the ill-effects of an overly sedentary lifestyle and includes conditions like “metabolic syndrome” (obesity and diabetes), which is rapidly becoming more prevalent, especially in the young – even in adolescence and teenagers! Recently, the American Medical Association (AMA) adopted a policy encouraging employers, employees, and others to sit less citing the many risks associated with sitting including (but not limited to): diabetes, cancer, obesity, and cardiovascular disease. Standing is SO MUCH BETTER as it burns more calories than sitting, tones muscles, improves posture, increases blood flow, reduces blood sugar, and improves metabolism. Standing is frequently overlooked as “an exercise” and it’s both simple and easy to do!

So, what about the low back and sitting? You guessed it – sitting is hard on the back! The pressure inside of our disks, those “shock absorbers” that lie between each vertebra in our spine (22 disks in total) is higher when we sit compared with simply standing or lying down. It’s estimated that when we lay down, the pressure on our disks is the lowest at 25mm. When lying on one side, it increases to 75mm, standing increases disk pressure to 100mm, and bending over from standing pushes disk pressure to 220mm. When we sit with good posture, our disk pressure may reach 140mm but that can increase to 190mm with poor posture. To help relieve the pressure on our disks, experts recommend: 1) Getting up periodically and standing; 2) Sitting back in your chair and avoiding slouched positions; 3) Placing a lumbar roll (about the size of your forearm) behind the low back and chair/car seat; and 4) Changing your position frequently when sitting.

Because certain low back conditions “favor” one position over another, these “rules” may need modification. For example, most herniated disk patients prefer low back extension while bending over or slouching hurts. In those with lumbar sprain/strains, bending forwards usually feels good and extension hurts. Modifying your position to the one that is most comfortable is perhaps the best advice.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.  Visit www.olsonchiropracticcenter.com or call 605-665-2434 for more information.

Low Back Pain (...or is it?)

Have you ever had leg pain and immediately blamed your low back? Me too! Many patients (and unfortunately, many doctors) conclude this to be “sciatica” or a “pinched nerve.” When this diagnosis is wrong, it can lead to an inappropriate type of treatment, delaying appropriate care, or worse, it may result in death due to a missed diagnosis of a blood clot. There is currently a government campaign seeking to warn the public about this hard-to-diagnose ‘silent killer.’ Here’s the news flash that was recently released (updated 8:28 a.m. CT, Mon., Sept. 15, 2008): “WASHINGTON - Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time.” “It’s a silent killer. It’s hard to diagnose,” said acting Surgeon General Dr. Steven Galson, who announced the new campaign Monday. “I don’t think most people understand that this is a serious medical problem or what can be done to prevent it.” Blood clots make headlines when seemingly healthy people collapse after prolonged sitting, such as long airplane flights or being in similarly cramped quarters. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the Iraq invasion. According to the Surgeon General’s new campaign, there are about 100,000 deaths associated with blood clots each year. Risk factors include increasing age (especially over 65), recent surgery or fracture, falls, car crashes, prolonged bed rest, smokers, obesity, pregnancy, and hormone replacement drugs including birth control pills. Other less controllable causes can include genetic conditions so it is important to tell your doctor if a relative has ever suffered a blood clot. People with these factors should have “a very low threshold” for calling a doctor or even going to the emergency room if they have symptoms of a clot, said Galson, who issued a “call to action” for better education of both consumers and doctors, plus more research. Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply. Unfortunately, studies suggest only a third of patients who need protective blood thinners for major surgery get them. And patients can even be turned away despite telltale symptoms, like what happened to Le Keisha Ruffin just weeks after the birth of her daughter, Caitlyn. In her case, after being turned down by several visits to the doctor and ER, only after a very hot bath did her leg swell to 3-4 times its normal size, tipping off the doctors to make the right diagnosis. Don’t wait for your medical doctor or our office to make the diagnosis if you’re suspicious of a blood clot. Ask us if it’s a possibility. Rest assured that we have been properly trained to diagnose this condition and we work with other health care providers when needed. Visit www.olsonchiropracticcenter.com for more information.