Category Archives: Low Back Pain

Investing in Your Future Self

“The greatest wealth is health.” – Virgil


So, what’s your long-term game plan? Where are you going to be in 10 years? 20? 40? Are you investing now for a future of high returns, or are you over-drawn? And, yes, we’re talking about your health.

I’d argue that many people think more about their money than they do their general wellness, but at the end of the road, which would you really prefer?  What is good is all the money in the world if you’re too sick or in too much pain to really enjoy it?  In the end, your health is really your true wealth. Without it, disease becomes an unfortunate distraction that makes it much harder to provide for yourself and your family, harder to become prosperous, harder to achieve your dreams, and harder to enjoy retirement.

Investing in your health is like putting money in a bank. You’re saving for the future, and every choice you make is either a deposit or a withdrawal. That exercise you did – it’s a deposit. The donut you ate – a withdrawal. Unfortunately, too many people think of their health as out of their control, a byproduct of bad luck or bad genes. “It runs in my family,” some would say. But you have more power than you know.

Healthy aging isn’t just a matter of family history. The vast majority of the chronic health issues people suffer from really stem from the choices, deposits or withdrawals, they make in their life. And, essentially, disease occurs when you become overdrawn. The good news is, even with a health bankruptcy, your body has an amazing ability to heal, and climbing back out of that hole is often possible with the right decisions. It just requires a little savings, investing again in the promise of better health.
Of course, the best time to think about contributing to your health is when things are good. Start the funding for your future health with small deposits of good choices every day while you can. Sadly, when the good times are good is usually when people think about their health the least, and they crash when their balance is depleted.

It only takes a little time each day, though. Some vitamins. A thirty minute walk. Salad instead of a burger. Water instead of soda. Fasting if you’re not really in the mood to eat. An adjustment once every few weeks. Set aside those little amounts of attention and you’ll reap the rewards of better health as you age.

Be Well.

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Kinesiotaping: Managing Your Pain Like A Pro

One of the latest trends in healthcare over recent years has been the use of kinesiotape for managing pain and injuries. Professional and amateur athletes alike are turning to the tape in increasing numbers to help manage soreness in muscles and joints as well as accelerate healing.

Not familiar with kinesiotape? You should be. It’s an excellent alternative to potentially risky medications for the management of acute and chronic pain. It can be used on just about any part of the body and risks of any side effects are fairly low.   It doesn’t contain any medication and can be effective for a broad range of conditions, from sprains and strains to arthritic pain.

Kinesiotape is, basically, just a cloth tape with a skin adhesive. Unlike a traditional athletic tape, kinesiotape does not restrict movement but, instead, moves with your body. Full range of motion is still possible with application of the tape. The skin over the affected area now works with the kinesiotape to help improve function in an affected area and decrease pain. How does it work? Well there are several theories:

  1. Improved proprioception – Now, this is one of those fancy health terms but, basically, the tape improves your body’s ability to sense and respond to the environment. Applying the tape to the skin acts as a minor stimulus to heighten the sensitivity of the soft tissues to movement (improved proprioception).   Increased soft tissue sensation allows the body to respond and adapt to stress better, including additional stresses to the joints and tissues. It will also decrease the likelihood of additional injury.
  2. Lifting the skin off the affected area – In many instances, the inflammatory processes that produce pain lie below the skin. When taped properly, contraction of the kinesiotape will help to lift skin off the affected area and decrease pressure of more superficial tissues on the affected area, leading to decrease deep tissue irritation.
  3. Improved circulation – As you move the tape expands and contracts with the skin according to your movement. This will help pump new blood supply into the area and encourage a decrease in swelling. The tape improve oxygenated blood supply to the area but also increase vein activity to draw fluid, including swelling, away from the affected area. Improved circulation will also decrease muscle spasming and will bring in immune cells to help repair the damaged tissues.
  4. Improved lymphatic flow – Your lymphatic system is you “other circulatory system.” Consisting of a series of vessels and lymph nodes distributed around the body, your lymphatic system helps to remove cellular waste from the tissues, including lactic acid which can cause pain. Like your veins, the lymphatic system requires movement to accomplish lymphatic flow. Kinesiotaping helps to improve lymphatic flow, drawing inflammatory products away from the injured area. Additionally, because the lymphatic system is a critical component of the immune system, improved lymphatic flow will improve the body’s ability to heal.
  5. Gate theory – Most patients with chronic pain are familiar with a TENS (Transcutaneous Electrical Nerve Stimulation) unit. A tens unit works by electrically stimulating mechanical nerve receptors for the tissues and joints. By stimulating those receptors, you can trick nervous system into paying less attention to pain sensitive nerves (nociceptors). In a similar fashion, kinesiotepe stimulates these receptors mechanically, desensitizing the pain sensitive portion of the nervous system.
  6. Shifted load – Because kinesiotape is an elastic tape, taping over the area will shift some of the physical stress load off the soft tissues and onto the tape. While it is not generally intended to restrict movement, the tape does have some bracing effect by supplementing your soft tissues.
  7. Mobility reatraining – The Tape can be applied in such a way as to retrain a joint to move and function differently according to how the tape is a applied.   Accomplishing this may require additional training by the person applying the kinesiotape.

While taping is not generally indicated for joint restriction, there are some instances where you can accomplish stability with kinesiotape, including taping the shoulder blade into position or taping an extremity joint to minimize motion, such as an ankle or wrist.

Will kinesiotape replace physical therapy or chiropractic care? No. The tape is simply a tool used to improve a soft tissue’s ability to function while managing pain. In many cases, rehabilitative care is still necessary and taping will not substitute for spinal adjusting, exercise therapy or practical prevention. Kinesiotaping is a low tech simple approach to managing pain without harmful chemical side effects of medications.

There are some contraindications to taping. This includes taping over a rash or skin irritation, application over a sun burn, open wounds, specific contraindications to bracing, and in patients who have sensitivities to adhesive bandages. Out of the hundreds of patients to whom I’ve applied tape, I’ve only seen a few patients with any negative reaction to the tape at all, generally a mild skin irritation. That being said, kinesiotape is an excellent choice for the following applications:

  1. Neck and back injuries
  2. Shoulder injuries
  3. Knee injuries
  4. Sprained ankles
  5. Joint swelling
  6. Muscle tightness
  7. Joint stiffness
  8. Point tenderness
  9. Trigger points
  10. Scoliosis

The tape can be left in place for up to 10 days. You can shower and swim with it. Just be sure not to rub it dry as it may rub off the tape. Occasionally, some residual adhesive may remain on the skin when the tape is removed. Baby oil is a simple solution to remove any residual. You may experience some itching with the tape but my experience has been it is more due to improved circulation than any allergic reaction. Again, negative reactions to the tape are extremely rare.

Before kinesiotaping, I would recommend a thorough evaluation by a healthcare provider who works extensively with musculoskeletal conditions and injuries, to rule out serious issues that may require more intensive intervention. This is especially important in conditions that don’t improve or are worsening, pain that does not respond to kinesiotaping or medication, pain at night, or excruciating pain. Kinesiotaping is not intended to substitute for evaluation or adequate rehabilitative care for a serious injury.

Kinesiotaping is safe for most adults and children, including the elderly.   In my office, I’ve used it effectively on kids with sprained ankles and seniors with knee swelling. It’s also excellent for tightness in the shoulders and low back pain. To be most effective, it does take some training to apply properly. There is a bit of an art-form to the taping procedure. I would recommend working with a healthcare provider who has the expertise and training to properly apply the tape for therapeutic benefit.

If you are an athlete, have a regular workout, suffer from chronic pain, or have recently had a sprain type injury, kinesiotaping may be an excellent way to help manage your condition and accelerate your recovery. Talk to your healthcare provider today about getting taped!

Pregnancy Related Back Pain: Real Solutions

This is the most amazing thing to happen to you!  Congratulations!  Few things will change your life more than having a child.  It’s a joyful time for you, filled with anxious excitement and planning.   While you relish this 9 months and the anticipation of your baby, there was one thing you weren’t planing on: pregnancy back pain!  Ugh!

Pregnancy related back pain is an extremely common complication of pregnancy. Some estimates place as many as 61% of women as experiencing low back pain while carrying their child.  That being said, there are many practical conservative solutions to the stress on the low back that occurs while pregnant.

So, why does a woman develop low back pain? Well there is the obvious answer that with added weight, comes added pressure on the joints. True, the average woman, in a healthy pregnancy, gains 25-35 pounds on average. However, there is more the back pain it than a simply weight gain.

Many women describe pregnancy related low back pain as back pressure, pain across the back, or pain in the hips. Additionally, they may report achiness, stabbing, burning, or instability in the low back.   Regardless of the description, the causes of pregnancy related low back pain are many and include:

  1. Increased weight gain – as your body increases in weight, increased stress is applied to the joints. Gaining the typical 25-35 pounds in a period of 9 months is a relative rapid weight gain, and change your body may have difficulty adapting to. Generally, the impact of weight gain will be affected by general health going into the pregnancy and other factors such as core strength and exercise levels. While healthy weight gain should not generally be discouraged, there are ways to get the body to adapt better to the increased weight, minimizing stress to the joints and maintaining full function of the back through the duration of your pregnancy.
  2. Changes in weight bearing – Generally, most of the weight gain during pregnancy is in the stomach causing the center of gravity to shift forward. While non-pregnant individuals will generally have a center of gravity that is somewhere over the mid-pelvis, pregnancy causes trunk weight to shift forward. This forward weight bearing can cause an increase in the curvature of the low back leading to cramping as the back muscles struggle to support the weight of the abdomen. Additionally, forward weight bearing stress the sacroiliac joints, those tailbone joints that work with the pelvis, to cause sacroiliitis.
  3. Changes in hormones – As your body approaches its due date, your body will start to produce hormones which will increase flexibility. While the hormones do allow for increased motion in the pelvis to allow for birthing, they also make it more difficult for the pelvis and low back to stay in proper alignment, leading to increased instability and pain. Pain may come and go as the pelvis and low back shift and move more easily, resulting in low back irritation and pain.

So, you have low back pain from your pregnancy, what can you do? There are a lot of conservative interventions available to help your deal with your back pain. Some can be accomplished on your own, others require the help and intervention of others. Here are a few suggestions:

  1. Weight bearing exercise – A moderate amount of walking will help keep postural muscles strong and improve circulation to affected tissues. Additionally, walking will help improve motion in the pelvis which should, in turn, decrease the likelihood of joint instability, asymmetry, and misalignment of the pelvis.
  2. Stretching – Later in pregnancy, your body does produce hormones that increase joint flexibility and make birthing possible. However the degree to which flexibility improves often depends on pre-pregnancy range of motion. It’s been my experience that many women have developed such muscle tightness before pregnancy that the relaxing hormones can’t even get those individuals to normal ranges of motion. Your body is designed to have a certain level of flexibility that we lose due to life circumstances. Maintaining and improving that flexibility will help decrease the stress on your low back and pelvis. Often, stretching areas you would not associate with your back can even help, such as hamstrings, upper back, and hips. Sitting on an exercise ball and rolling the hips or laying on your back and using the ball to roll the hips back and forth are great exercises for improving your back pain. There are also yoga programs for pregnancy that are available. True, you may not be able to do every pose, but working on your range of motion is generally a good idea.
  3. Improved diet – Of, course, it should go without saying that you should be eating well during your pregnancy, and I’m not talking about volume but quality. After all, you are eating for two now. You should be eating whole foods free of artificial ingredients. Not only will you be healthier for it but your baby will thank you. Improved nutrition will increase nutrient supply for the muscles, ligaments, and tendons of the back. Good food will decrease the likelihood of muscle spasms due to nutritional deficiency.   Avoid excessive carbs/sugars because they can be pro-inflammatory and contribute to inflammation in the joints. Also, watch your water intake. Dehydration can also lead to muscle spasming and soreness in the soft tissues. Finally, a whole food pre-natal vitamin should be part of any regimen to help fill the holes in your diet, not to mention prevent possible birth defects.
  4. Stress management – Mental stress causes physical distress. True, your low back pain is most likely due to the physiologic changes you’re experiencing with your pregnancy but mental stress can take a physical problem and make it that much worse. Pregnancy in and of itself can be a trying time mentally, especially for single or first time mothers. Finding an outlet or your stress, such as exercise or even counseling will help your body adapt better.
  5. Improve your body positioning – Being conscious of your posture and taking active steps to alleviate the stresses on your back may improve your pain symptoms. This may include everything from sleeping on your side with a pillow between your legs to using pillows to support the back and legs while you’re sitting. Back supports may also help.   Avoid standing or sitting in one position for too long and try to get moving as much as possible.
  6. Massage Therapy – Because much of the pain experienced during pregnancy is due to tension and stress on the muscles, soft tissue mobilization may help alleviate a portion of the pain. Massage therapy will help relax tightened muscles, improve circulation to the tissues, and promote a general sense of well-being.
  7. Heat or ice – While many sources will include hot baths for relieving pain, I will generally discourage that for my patients. In fact, many physiotherapy resources discourage the application of heat over the abdomen as a contraindication during pregnancy. I generally tell patients to use a regional warm pack over the back for no more than 15-20 minutes. It can be repeated but allow about an hour or so for re-application. I want the patient to avoid increasing their resting metabolize temperature and the goal isn’t to cook the tissues. A warm pack can often provide just as much effect as a hot pack, with less risk. A microwaveable heat pack or hot water bottle will generally suffice to ease tension in the low back without the danger of overheating the area. As a general rule, avoid placing heat or ice over the abdomen while you’re pregnant.
  8. Kinesiotaping – This is an athletic taping technique that has been gaining popularity in recent years. Kinesiotape is being increasingly used by professional and amateur athletes to help alleviate pain and improve tissue healing. It’s safe to use during pregnancy because it does not use any drugs and is strictly a cloth tape with a skin adhesive.  In fact, there are specific taping regimens for pregnancy, to not only alleviate low back pain, but possible abdominal pain associated with carrying your baby. To be effective, though, the tape should be applied by an individual with training and experience in kinesiotaping. There is a certain art form to its application. It can, however, offer notable decrease in pain and improved stability in the back, hips, and abdomen.
  9. Proper spinal alignment – Arguably one of the most important aspects of decreasing pain in your back, I saved this for last. Proper alignment of the low back will decrease pressure on pain sensitive nerves, improve motion of the joints of the low back, decrease stress on the soft tissues, and improve overall function of the low back. Chiropractic care has been routinely shown to be safe and effective for relieving the back pain associated with pregnancy. Spinal adjusting has also been linked to improved labor and delivery. There are certain medical conditions that may be a contraindication to chiropractic care but, for most women, chiropractic care can be very effectively incorporated into a pain management regimen. In my office, I will frequently see pregnant patients on a weekly or biweekly basis for their pain and most women will see decreased pain immediately following their adjustment. They also will report improved ability to sleep, decrease generalized soreness, and an improved ability to function. In my opinion, chiropractic adjusting should be incorporated for most women with pregnancy related low back pain.

If you are struggling with pregnancy related low back pain, there are solutions out there for you. Perhaps the best place to consult about your back pain is with someone who sees a lot of back pain patients, like a chiropractor. Besides adjusting your spine, they can provide you with additional tips and tricks to alleviate your pain.

Has your doctor suggested pain medication to you? Always ask better questions. The decision to take pain medication while pregnant should be a thoughtful one made with your medical doctor.  You need to know what research has been done on that medication and its effect on a developing fetus. Certain conditions like asthma and autism have risen to alarming rates, with little research done on the effects of oral medications on an undeveloped fetus. While there is little overt evidence to explain the remarkable rise in childhood illness, that is mostly the result of a lack of research. Just because there is not an established 1 to 1 relationship between a specific cause and disease does not discount an overall trend toward increasing illness due to an accumulation of exposures. I don’t think it’s an accident that autism rates have risen to 1 in 88 kids. Too much of the research focuses on, and debunks, a single specific cause like vaccination and I fear conditions like autism are not due to a solitary cause but a series of toxic exposures over time. Unfortunately, there is very little research on the effects of pre-pregnancy, intra-pregnancy, and post-pregnancy toxic exposure on the developing child. However, it reasons that the rises in childhood illness rates may be linked to the fact that our environment is as toxic as it’s ever been. Anything you put in your body that is not food is a potential toxin. That toxin can affect you and your baby. Pain medication is not food. Anything you feed your body while pregnant, your baby will respond to, either for good or bad. Try to remove as many toxins as possible from your diet and lifestyle. Turning to natural means for alleviation of your pain may make you and your baby a whole lot healthier and happier for a lifetime of wellness.

Sources:

http://en.wikipedia.org/wiki/Symptoms_and_discomforts_of_pregnancy

www.webmd.com/baby/guide/back-pain-in-pregnancy

http://icpa4kids.org/Chiropractic-Research/Pregnancy-and-Adjustments/