Does Weather Increase Back Pain?

Did you ever know someone who could predict the weather based on their aching joints?  They might be pretty accurate according to a recent scientific paper.

A study that appeared in the journal Spine on June 15, 2004 stated that there was a link between weather conditions and spinal pain.

26,862 patients were evaluated at 23 different centers across the US.  Patients were evaluated with an assessment tool called an SF-36, which is a survey that measures general health status. They found a positive correlation between barometric pressure and negative health status.

The article noted “The most commonly implicated climatic variables are high humidity, cold temperature, and low barometric pressure, interesting all indicative of impending storms.”

The research suggests that “abnormal impulses generated at injured areas could contribute to increased pain and paresthesias and that these impulses are sensitive to and aggravated by cold temperature.”

The weather doesn’t cause pain, but it does aggravate pain that is already there.  The best course of action is to get the underlying causes of the pain addressed so you don’t feel so bad when the weather shifts.

For more information on non-drug, non-surgical relief for chronic pain, log on to:  http://www.newbackpainreliefinfo.com.

Low Back Pain: Where Does The Pain Come From?

“Were does the pain come from?” is probably the most common question chiropractors hear, and frequently, the patient is not told the answer to this simple question.  The problem is, the question is not so simple.  This is because there are many structures in the low back that share a common nerve supply and hence, the pain arising from those structures is located in the same area of the back.  For example, the back portion of the disk, the facet capsule and some of the deep muscles in the spine are all innervated by the same nerve and therefore hurt is a similar location. In all honesty, the only way to try to isolate the pain generator is to inject a local anesthetic to block the pain for a short while.  This is like when you go to the dentist and they “numb” your tooth so you don’t feel the pain when they work on it.  After a few hours, you start to feel some “life” coming back to your mouth and soon it regains its full feeling. Of course, no one would consider “numbing” the back just to figure out exactly where the pain is arising as really, it’s not that important.  This is because the chiropractic treatment approach is similar regardless of the exact tissue that is involved.  However, it DOES matter in cases where a nerve root is shooting pain down the leg caused by a herniated disk vs. a localized pain in the back that doesn’t radiate.  Hence, doctors of chiropractic work hard to differentiate these two distinct types of conditions as the treatment is definitely different.

In 1995, the Quebec Task Force recognized the importance of this distinction and recommended all health care providers concentrate on differentiating the nerve root / herniated disk case from what is called “mechanical low back pain.” As noted in the model below, the arrow and pen point to the two most common structures that cause nerve root pain (the herniated disk) and mechanical low back pain (the facet joint).

The facet joint, when sprained / injured, hurts worse when bending backwards and feels good bending forwards.  This is exactly the opposite for the herniated disk where bending backwards helps reduce pain and often reduces the shooting leg pain as well, while bending over even a little can create a sharp stabling pain in the back that may shoot down the leg. Of course, there are variations of this and, to make matters more complicated, BOTH the disk and the facet can generate pain at the same time, so it’s not always this cut and dry.

YOU MAY BE A CANDIDATE FOR NON-DRUG NON-SURGICAL CARE FOR LOW BACK PAIN!  FOR MORE INFORMATION LOG ON TO: www.newbackpainreliefinfo.com

Low Back Pain and Spinal Fusions

You may think it’s odd to discuss low back pain (LBP) from the perspective of spinal fusion because as chiropractors, we do not perform surgery. So, why discuss it?  It is important that we discuss research like this so you can make informed treatment decisions after you’ve considered all the facts.  Now, there are certainly times when a surgical procedure for back and leg pain is necessary and appropriate for some patients. But the problem is, there are also some patients who have been told they need spinal surgery when, in fact, they may be better off NOT proceeding with surgery. So, the question is, what happens to those patients who elect not, vs. those who do choose to proceed with surgery?

That question was addressed in a study where a total of 1450 patients injured at work were followed over a 2-year time frame. There were a total of 725 patients who proceeded with the fusion surgery and the other 750 elected NOT to have the surgery. A fusion surgery can be described as when two or more vertebra are fused together, usually because there are neurological problems such as shooting leg pain, weakness and/or numbness in one or both legs.  The conditions treated in this study included herniated disks, degeneration of the disk, and radiating leg pain. There were primarily 3 factors that were compared between the two groups, namely, 1) ability to return to work; 2) disability (the inability to work), and 3) opiate (narcotic) drug use. Other factors compared included the need for re-operations, complications, and death.

The results showed, in general, those who proceeded with surgery had significantly more problems compared to those who did not have surgery.  For example, only 26% returned to work, compared to 67% returned to work.  The total number of days off work were 1140 vs. 316 days, respectively.  There were 17 vs. 11 deaths, respectively and, 27% of the surgical group required re-operations with a 36% complication rate. Also, there was a 41% increase in the use of narcotic medication with 76% continuing the use after surgery.

Again, there are times when surgery is absolutely the right choice.  Those times include when there is a loss of bladder or bowel control, progressively worsening neurological symptoms in spite of non-surgical care, and of course, unstable fractures, cancer/tumor and infections. But that’s about it!

In other words, if you don’t have one of the before mentioned conditions which do require surgery, don’t be too quick to jump at the chance of “getting it fixed” with surgery. As the study suggests, the post-surgical results favor those who elected NOT to have surgery.  Also, when in doubt, don’t trust the opinion of only one surgeon – always get a 2nd or even 3rd opinion.  It is also very important to consider your current level of function.  This includes your ability to do your desired tasks. Unless there is a significant loss in that ability, consider additional time with non-surgical treatment.  The non-surgical treatment you can expect to receive from chiropractic includes (but may not be limited to) spinal manipulation, exercise training, dietary counseling, and job modification information.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR MORE INFORMATION LOG ON TO: www.newbackpainreliefinfo.com

Should I Use Ice Or Heat For My Sciatica?

Ice, Ice, Ice.  I can’t say that enough.  You should use ice for any acute injury.  This includes an acute flare-up of a chronic problem, like sciatica.

For a long time medical doctors have debated whether someone should use ice or heat.  Both can relieve pain.  In fact, in my clinical experience, pain is probably better relieved with heat.  But pain relief isn’t the most important factor in the decision of which to use.

You see, ice decreases circulation to an area.  If the area is injured, it will decrease swelling.  Heat increases circulation.  If you use it on an injured area, it will increase swelling.  Swelling causes further damage to the injured area and more pain.

Although heat does have a temporary soothing effect following an injury, it actually increases pain 30 minutes following the application. (1)

When people put heat on an injured area, in this case their back, the pain gets relieved somewhat.  After say a half hour, the injured person takes the heat off.  Then 30 minutes later the pain comes back worse than before.  So… they put the heat back on… the area gets more swollen, but the pain is somewhat relieved.  The person takes the heat off again and in 30 minutes or less, the pain comes back worse than ever.  Usually, the person will then decide to keep a heating pad on constantly, in order to not feel the pain.  This creates so much swelling that within 24 hours the person is incapacitated.  They can’t stand up, sleep, walk or drive.

When a person ices an injury, the pain may not be relieved as much, but the swelling is reduced.  It may not relieve the problem completely, but it will make the injured area much easier to treat.  In fact, patients who use ice instead of heat were found to heal in less than half the amount of time.  (2)

Why do medical doctors and nurses continue to tell patients to use heating pads ?  I have no clue. The research on this is clear. And, the research is coming from the medical profession not chiropractic.

I had a sciatica patient recently who used a heating pad on her back 24/7 at the advice of her medical doctor.  After a month of this, she couldn’t walk without assistance.  She had called her medical doctor’s office to get an appointment, but they said she would need to go to pain management.  Why pain management ? To get a shot to REDUCE THE SWELLING.

Anyway, my advice is to use ice and if the problem isn’t going away, see doctor who understands musculoskeletal problems like sciatica.

Should you never use heat ?  I respond to this question with a hesitant no.  There are some indications for heat, but in my opinion, you should be examined by someone prior to using it.  And, the application of heat, like ice, should be staggered.  20 minutes on, an hour or two off.  You should never use the constant heat of a heating pad.  And, if you notice that when you take the heat off, the pain is worse a short time later, stop using it.  The heat is making the area more swollen.

In fifteen years of practice, I have seen only one person get in trouble using ice.  He put an icepack directly on his skin and he got frostbite.  (so always have a towel or clothing between skin and an icepack)  In those same years, I average seeing two patients a month, that have over used a heating pad to the point they can’t stand up.

For more information on how I treat back pain, log on to: www.newbackpainreliefinfo.com.

(1)   McDonald, Lundgren, Thieme, A Practical Guide to Therapeutic Modalities, p.40
(2)   Hocutt, Jaffe, Rylander, Beebe, Am Journal Med 10:316-319, 1982

How Much Does Back Surgery Cost?

According to the Virginia Healthcare and Hospital Association, the average spinal surgery without complications costs $77,107.  If the surgery has complications, it ranges from $117,901 to $260,584.  This does not include doctors fees.

Of course, this does not include human costs like pain, suffering, time spent in rehabilitation, time spent away from family, lost activities like sports and hobbies, continued pain after surgery, doctors visits and on and on.

As a contrast, according to Chiropractic Lifecare of America, an insurance organization,  the average course of chiropractic treatment, for the same conditions, is $3,799.

Quite a difference.

If you consider the success rates of surgery when compared to chiropractic, it’s a wonder anyone has spinal surgery at all.

For more information on low back pain, degenerative disc disease, spinal stenosis and sciatica, log on to www.newbackpainreliefinfo.com

I Hurt My Back After Shoveling Snow- Ice or Heat ?

I am asked this question all the time.  Should I use ice or heat if my back is hurting. ? The answer is “ICE”.

Ice reduces swelling.  When muscle or ligament tissues are injured, blood vessels get injured as well.  The injured blood vessels let blood leak out and it causes swelling.  The swelling gets bigger and bigger until the amount of pressure outside the injured blood vessel equals the pressure inside.  The swollen tissue gets stretched, it can be damaged further and the amount of pain increases.

Ice causes the muscles surrounding larger blood vessels to contract.  This allows less blood to get to the cold area.  Less blood means lower blood pressure at the site where there is an injury.  This means that less blood will leak out of the injured vessels and therefore less swelling.

Heat increases circulation and can cause swelling in injured tissues.  Heat makes larger blood vessels expand.  This increases the pressure in the injured area and causes more blood to leak out of injured vessels.  More swelling, more pain, no fun for the patient.

Whenever someone sprains an ankle, injures a shoulder, breaks a bone, etc. they always put ice on it to control swelling.  If you didn’t use ice, or worse if you used heat, a sprained ankle could swell to the size of a softball in no time.  But, for some reason, people like to treat the back differently.  Patients are often told to use heat; probably because it feels better when it is applied; especially during cold winter months.  This is bad advice.  Heat makes the back swell and it can take weeks for the swelling to go down.  People who use heat, often end up having to go to the emergency room because the pain gets so bad they can’t walk.

So, even if it doesn’t feel good after you have been shoveling snow, use ice.

For more information on back pain log on to: www.newbackpainreliefinfo.com

The Little Known Secrets to Treating Degenerative Discs

Degenerative disc disease is rampant in America.  It affects almost everyone to a certain extent, but roughly 65 million American get pain from it every year.  But, what is it ? and, what can be done about it ?

Degenerative disc disease (DDD) is really another term for arthritis of the spine.  The discs of the spine are located between the spinal bones (vertebra).  They are made of a tough outer layer (the annulus) and a soft inner layer (the nucleus).  The discs allow the spine to bend and give your body flexibility.  They also act like shock absorbers, which take the pressure off your bones when you jump run or walk.

Unfortunately, just like the shock absorbers in your car, discs wear out.  The process is called DDD.  It starts when bones of the spine get out of position and cause more pressure on weaker parts of the discs.  These parts will tear a little bit and swell.  This will cause some pain.  After a while, if left untreated, the swollen area will attract calcium and you will get arthritis in the area.  That leaves the area stiffer and more prone to injury.  The arthritis will progress throughout your life if left untreated.

The disc is just like a shock-absorber in your car that wears out faster, the harder you are on it.  Wear and tear on your spine, speeds up arthritis.  If you injure yourself often, have bad posture, lift heavy things, run with bad shoes, etc., you will wear out your discs faster.

You can wear out a disc at age 20 or age 90, it all depends on how badly it has been injured or mis-treated.  The pain from DDD is usually at its worst between ages 30 and 60.  After 60 elements of the disc that feel pain die off, as the bones fuse together.  The pain may lessen, but the stiffness remains.

A common comment I hear from patients is “ I went to see Dr. So and So, and he told me I have the spine of a 80 year old”.  I usually am polite when I hear this and nod my head.  But in the back of my mind I am thinking “Dr. So and So, doesn’t know much about DDD.”  I’ve seen 80 year olds with no DDD whatsoever and I’ve seen 25 year olds with discs that are completely destroyed.  DDD gets worse over time, but wear and tear is the biggest reason discs wear out.

What can be done if you have a degenerative disc ?  You will need to address the problem from multiple angles.  First,  the bones around the disc need to be in proper alignment.  If they are left mis-aligned the disc tissue will continue to be swollen and wear out.  So spinal and posture re-alignment is the key to helping the disc heal.

From there, dietary and lifestyle changes will need to be made to keep the disc healthy.  Adding anti-oxidants and omega-3 fatty acids to the diet help decrease inflammation.  Lifestyle changes like quitting smoking and heavy drinking definitely help.  Also, sleeping on the correct mattress, wearing good shoes and sitting in better chairs will help take pressure off the spine and help the area to heal.

For more information on degenerative disc disease, log on to: www.newbackpainreliefinfo.com

What is Spinal Stenosis?

Spinal Stenosis means narrowing of the spinal canal.  Narrowing of the spinal canal can cause many different symptoms.  These symptoms include, low back pain, neck pain, pain in the arms and legs, numbness in the arms and legs, muscle cramping and weakness.  These symptoms come from a common cause, so it is helpful to understand why they happen.

The spine contains the spinal cord.  The spinal cord is made of soft nerve tissue.  The nerve tissue sends messages from the brain out to the body and from the body to the brain.  When the spinal canal narrows, it can compress the spinal cord.  When the cord is compressed, the messages going back and forth from the brain and body get altered.  This causes pain, weakness and numbness in the affected area.

The next logical question is, “what can be done about it ?”  From a medical standpoint, surgery is recommended to open up the spinal canal.  Usually a piece of a spinal bone or spinal disc is removed in order to create more space for the spinal cord and nerve tissue.  It sounds easy, but these procedures do have serious risks and have a low success rate.

The latest research on spinal surgery is saying that it should only be attempted after six months of conservative (non-surgical) treatment is done.  If the conservative treatment doesn’t help, then surgery can be attempted.

Chiropractic care can be very helpful for spinal stenosis cases.  You see, part of the problem in spinal stenosis patients is that their spinal alignment causes the spinal cord to be stretched. In areas where the canal is narrowed, this creates more pressure on the cord.  Re-aligning the spine takes the stretch off the cord and allows it to move freely in narrowed areas of the spine.  Removing the stretch relieves a lot of the symptoms and can allow the patient to avoid surgery.

For more information on non-surgical, non-grug solutions for spinal stenosis, log on to: www.newbackpainreliefinfo.com

What Stretches Can I Do For My Sciatica?

I am asked this question quite often, and the correct answer is a little complicated.

Stretching does not alleviate sciatica.  It only makes it worse.

The sciatic nerve is the largest nerve in the body.  It starts in the lower back and goes all the way down the legs to the toes.  It commonly gets irritated from poor posture, degenerative discs, narrowing of the spinal canal (spinal stenosis), swollen joints in the spine, or problems with the pelvic joints (sacro-iliac joints).

When the sciatic nerve gets irritated or pinched, it is very painful.  As a response, the muscles in the buttocks and the back of the legs spasm up.  Because the muscles are cramped and spastic, people with sciatica want to stretch.  Typically, they bend forward and stretch the hamstrings or they lay on the back and pull their legs up.

These stretches loosen up the spasms and give slight relief of the pain.  However, the stretching also elongates the sciatic nerve and causes more irritation.  The nerve irritation causes more pain and spasm.  So, the patient stretches more.  They get temporary relief from relaxing the spasms, but the nerve gets more irritated.  This leads to more pain and spasm…so the patient stretches more…and on and on it goes.

The stretching only gives temporary relief, but in the end, it makes the patient worse.

The best thing to do if you suffer from sciatica, is to get the cause of the problem solved.  You should find out if the cause is poor posture, degenerative discs, swollen spinal joints or a sacro-iliac joint problem.  All these conditions are treatable.  If the condition is properly treated, the sciatic pain and spasms go away.

For more information on sciatica treatment log on to: www.newbackpainreliefinfo.com

Low Back Pain and Balance

What do low back pain and balance have to do with each other?  Well, a lot!  First (and most obvious), poor balance can lead to falling, which is the number one cause of injuries after the age of 70 (which includes low back pain). Unfortunately, as we age, we lose both balance AND bone density – a double whammy when it comes to falling, as this combination can result in fractures of low back vertebra. Below is a chart that shows what the “normal” length of time we should be able to stand on one foot (eyes open and eyes closed):

As this chart illustrates, over time, we rapidly lose our ability to balance, especially when we close our eyes.  In fact, many of us cannot stand on one leg with our eyes closed for more than a few seconds well before the age of 59! Try it!  Stand up in a corner of a room or in a doorway where you can grab onto the wall or door jams if you lose your balance. (We certainly do not want you to fall during this test!)  Look at your watch or a clock with a second hand and count out loud in time with each second on the clock, “one thousand one, one thousand two, one thousand three, …..”– you get the idea.  Once you have the rhythm down, try counting first with your eyes open for 30 seconds and then try it again with the eyes closed.  Quite different, isn’t it? Now switch legs and try it again – eyes open first and then eye closed counting in time with the passing of each second. If you’re not pleased with you performance, try it over again a few times.  If you’re like most of us, you may feel a little inadequate right now.  Most of us need to start including some “balance exercises” into our daily routine.

So, why is it that we lose our balance so easily as we age?  This is mostly because we become less active or, more sedentary as we advance in age, partially because we’re not interested in doing activities that require balance.  Also, we get afraid of falling down. Remember, when we were young(er), we romped around and bounce off walls and fell all the time.  It was “routine” to come home from school with grass stains on our knees and backyard sports always resulted in falling, sometimes pretty hard! Rolling down a hill to purposely getting dizzy was quite attractive to us as kids – but certainly not now!  In fact, getting on the floor to play with the kids usually leaves us sore for at least a few days. Now, I’m not suggesting we all run out and start rolling down hills, jump up and down or purposely fall down.  But, including active “balance” exercises into our daily routine should be THE LEAST we should do.  So, go for a brisk walk or a slow jog, ride a bike, walk in the park on uneven ground.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR MORE INFORMATION< LOG ON TO: www.newbackpainreliefinfo.com