How Does “Cracking” My Back Help to Relieve My Back Pain?

Spinal manipulation is the primary treatment utilized by chiropractors. The “cracking” sound is most often associated with spinal manipulation. Joints and muscles are supposed to move through their full range of motion. When they do not this can cause pain and muscle spasm, and eventually lead to the breakdown of the joint. This breakdown of the joint is arthritis. Manipulation restores the normal movement to the joint. After the motion is restored to the joint you can strengthen the muscles around the joint.

A common misnomer is “your back is out of alignment.” The only way for your back to be out of alignment is to fracture (break) your spine. A chiropractor would not be able to help you.

A simple analogy to understand the concept of spinal manipulation is a door hinge and a door. If the door hinge is lubricated and moving properly, then the door open and closes normally. The door hinge can be thought of as a spinal joint and the door as spinal muscles attaching to that joint. Manipulation is like lubricating the door hinge, and exercise is like opening and closing the door. Manipulation and exercise are complimentary.

Some of the benefits of spinal manipulation to your back condition are reduced muscle spasm, decreased pain, and increased range of motion. In my opinion most spinal conditions can be rehabilitated through manipulation and exercise in four to eight weeks.
Spinal manipulation and exercise has been shown in clinical studies to be a very effective treatment for back pain.

~Dr. Dave

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What is Sciatica?

Sciatica is defined as leg pain. If you complain of pain in your leg and ask your doctor what is causing your pain, he may answer, “you have sciatica.” With this answer, all he did was tell you in another language that you have pain in your leg. Sciatica is a symptom, like chest pain. There are many different causes of sciatica.

The sciatic nerve is a large nerve that is made up of 4 smaller nerves that leave your spine in the lower back. The sciatic nerve runs deep in the buttocks and goes to the muscles in the back of the thigh and most of the muscles below the knee.

If you have pain in the front of your thigh, you do not have “true sciatica” because the sciatic nerve does not go there. The most common cause of sciatica is disc problems, but there are many other causes of sciatica. Some of these are tumors, misplaced injections in the buttocks, and trauma.

If your doctor tells you that you have sciatica, ask him what is causing your leg pain.

~Dr. Dave


What is Brain Plasticity?

Your brain has plasticity. What does that mean? Your brain can “rewire.” If you learn new things or have new experiences, your brain will take that new information in and make new pathways. If you suffered a brain insult, it has been shown that your brain can “rewire” and compensate for the damage.

People that have had strokes, for example, have regained use of their “bad” arm by strapping down their “good” arm and thus using or “retraining” their “bad” arm. Researchers looked at their functional mri’s, which showed their brain had actually “rewired!” Some cases were after 10 years! If these people can “rewire” their brain after a traumatic insult, is it possible for you, too, to “rewire” your brain? To “rewire” your brain you have to first decide you want to. Some of the best things for your brain are learning a new language or instrument, exercise, and eating a healthy diet.

Too often in middle age we get stuck in bad habits. We do not learn new things or have new experiences. This is horrible for your brain and body. This can lead to depression, anxiety, and chronic pain. To create a healthy brain and body, you have to learn new things and have new experiences.

~Dr. Dave

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Will Chiropractic Adjustments Hurt?

Chiropractic adjustments, also known as spinal manipulations, are a procedure in which a joint is moved past its usual range of motion in daily life. The purpose of chiropractic adjustment is to improve your body’s functioning and alleviate pain.

Adjustments are most commonly made to joints in your back, but also to joints of the neck or other parts of the body, such as the shoulders. You may be treated by a chiropractor in order to correct such conditions as:

• Neck, back, shoulder, arm, hand, chest, leg, or foot pain and stiffness
• Headaches
• Sciatica
• Arthritis
• Trauma, such as whiplash
• Scoliosis
• Sports injuries
• Repetitive strain disorders such as carpal tunnel syndrome
• Fibromyalgia

Moving the joint beyond its range of motion sounds painful, doesn’t it? However, the joint is not moved beyond the range of motion it is naturally designed to move in the body. You may feel pressure or mild discomfort, and the discomfort may be greater if there is significant inflammation or tension around the joint being treated. However, chiropractic adjustments should not be painful.

If you are new to chiropractic medicine, you may have a harder time relaxing during the procedure than more experienced patients. If you stiffen or resist the adjustment, you may feel some discomfort. However as you get used to the procedures you should find not only that the discomfort decreases, but that you may feel relief and a sense of well-being after the adjustment I completed.

During the procedure, you will be placed in a certain position to treat the affected areas. Usually you will be lying face down on a padded table. There may be popping or cracking noises during the adjustment, as the joint is moved. These noises are the result of the release of tiny pockets of gas during the procedure, which is completely normal. In fact, it’s the same thing that occurs when someone cracks their knuckles.

After the procedure, you may feel some soreness or aching in the muscles or spinal joints. If it occurs, this kind of discomfort usually happens within the first few hours of treatment. It should not last longer than 24 hours (and if it does, be sure to contact your chiropractor for assistance). If you like, you can place an ice pack on the affected area which should help reduce the symptoms and help you recover more quickly.

In order to be sure you have as pain-free a treatment as possible, be sure you choose a board-certified chiropractor with good patient references. An experienced, competent practitioner will be able to give you the most effective treatment possible with the least amount of discomfort.

References
Chiropractic Adjustment: What you can Expect. http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107
Reactions Following a Chiropractic Adjustment. http://www.spine-health.com/treatment/chiropractic/reactions-following-a-chiropractic-adjustment

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Do I Really Need to Stretch?

Stretching is the part of our workout regimen many of us tend to skip. We might say it is because of lack of time, impatience or a feeling that stretching is “pointless.” However it is important that our joints are able to move in various directions with a certain degree of freedom. As our bodies age, we become stiffer and lose the flexibility we had when we were young. Chances are unless you’re a dancer or a gymnast, you’ll have lost that fluid flexibility you had as a child even in your twenties. However, it is never too late to regain enough flexibility to remain youthful and limber by training through stretching. Proper stretching allows us to continue doing our daily tasks into old age, such as reaching that high shelf, bending to pick up a dropped object, or accessing that hidden switch behind an awkward kitchen cabinet.

One reason it’s really important to stretch before working out is that we are likely to use muscles and tendons that are normally inactive. Without flexibility to those muscles, the risk of injury or of tearing those muscles and tendons when used, is higher. If stretching is done correctly before working out, it’s a good prevention against injury, and can also be used to treat injuries as well. Finally, when done properly, stretching simply feels good. It can be a great way to gently start the day or to wind down after work.

Preparing the body for exercise by warming up the muscles by stretching is easy and need not take up much of your time. This will increase the blood flow to your muscles and loosen them up allowing you to exercise without having to worry about injury or being overly sore the next day. Simply warm up the various muscle groups with slow stretches of the joints towards the end of their range of motion; this should cause the feeling of a gentle “pull” being felt in the muscles. Hold the position for up to half a minute and then alternate side or muscle groups. Not only does stretching prevent injury, but it also improves the mechanical efficiency of your body. Stretching prior to exercise means the muscles are stretched and warmed up, allowing them to undergo the full range of motion with less effort when exercising – this means the body’s overall performance is improved.

Other added benefits to stretching include improved circulation to the muscles and joints, alleviating the pains felt post-workout, and stretching can also help to improve your posture. If you find at the end of the day stiff and achy from sitting at a desk all day – try stretching. You might find that you’ll feel instantly better. Regular stretching in your shoulders and neck may help you to maintain a better posture. As a result, this may help to prevent the onset of lower back pain.

References Used:
[1] http://www.spineuniverse.com/wellness/exercise/incorporating-stretching-your-exercise-routine Accessed October 2011
[2] http://www.healthnewengland.com/newsletters/LivingWell/LW/Livewell13.pdf Accessed October 2011

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How to Avoid Injuring Your Back During Fall Yard Work

With summer at an end, the leaves are turning brown and falling, cluttering up your yard and garden – so it’s only natural you’ll want to get the rake out. However, as with all physical tasks about the house and garden, it is very important you take the necessary precautions against accident and injury.

Fall yard work, leaf raking and other outdoor maintenance activities carry numerous risks such as: upper and lower back strain, neck strain and shoulder pain. Just like with sports, if your body isn’t prepared for physical activity this can increase your chances of injury. You can avoid straining yourself by taking simple precautions, such as: doing warm ups, stretches and maintaining good posture.

Athletes are able to reduce the risk of strain and injury by doing warm ups. The American Chiropractic Association (ACA) recommends 10-15 minutes of stretching exercises: from trunk rotations, side-bends and knee-to-chest pulls. When these are also combined with a short walk, which helps to stimulate circulation, and with additional stretches at the end, this prepares the body for manual labor associated with raking and yard work.

While raking your garden or yard, good posture can also prevent back problems – make sure you keep your back straight and your head up. Use common sense while working: lift with your legs and bend with your knees, taking care you don’t strain your back while picking up bundles of leaves and grass. If you’re likely to carry heavy items, hold them close to your body to help prevent back strain. In order to take the pressure off your back, rake using the “scissors” stance: put your right foot forward and the left one back, then reverse after a few minutes. When using a lawn mower, try to use your body weight to move it as opposed to your arms and back.

It is vitally important to take breaks. Pace yourself, and whenever your body feels tired take a respite – this is particularly important if the weather is hot, so drink lots of water and wear sun-protection such as a hat, sun block and protective glasses. Investing in extra protective gear, such as gloves to prevent blisters, a mask if you’re prone to allergies and protective eyewear, can make life easier while taking on outdoor chores.

Ergonomic tools with extra padding, larger or curved handles are less strenuous to use over a long-time period. Changing tasks regularly helps to prevent repetitive strain injury of certain muscle groups – change positions, or simply move onto another task for a short period of time before returning to the previous one. Make plans for your gardening tasks; make sure they’re realistic and unlikely to cause strain or exhaust you too much.

If you’re unaccustomed to physical labor, chances are you will feel sore and stiff the next day – in this case, use ice to soothe the discomfort, but if there is no improvement in your aches and pains, then see your chiropractor.


Surgery or Chiropractic for Chronic Sciatica Sufferers?

Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica – which can include pain, tingling, numbness and muscle weakness – is really a symptom indicating an underlying problem, not a diagnosis in and of itself.

This article will explore in detail the findings of a recent controlled study comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches.

The study discussed here was conducted by the National Spine Center in Alberta Canada and published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics[1]. The 40 study participants all had sciatica lasting over 3 months which had not responded to treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or acupuncture. They had all been referred by their primary care physicians to spinal surgeons who had deemed them appropriate surgery candidates.

Instead of having all the patient proceed with surgery, they were split into two groups – one group to undergo a surgical microdiscectomy and the other group to be treated with standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the results they obtained from their assigned method, the patients were allowed to switch to the other treatment plan after 3 months.)

So what happened? Both groups made significant improvements over baseline scores – meaning that they saw noticeable improvements whereas previous approaches had failed. A full 60% of the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if they underwent surgery. And, after 1 year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their primary care physicians and accepted as surgical candidates by the neurosurgeon could actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting, anesthesia and ER time.

There is one paragraph in the results section of this study that is easy to overlook, but incredibly important. There were originally 120 candidates of which 60 met the study criteria and were asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal manipulation as an alternative to surgery! They didn’t want to participate in the study and be randomly placed in the surgery group without first trying the spinal manipulation! This is incredibly telling. Not only does it demonstrate that there is still a lot of education about chiropractic that needs to happen among the public and among primary care providers, it also demonstrates that people understand the risks and costs of surgery and want to exhaust other possibilities first.

This was the first study to ever look at people who had failed traditional medical management of sciatica. Currently most patients that fail ‘conservative care’ are referred for a surgical evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term outcomes with chiropractic.

Please share this article with anyone considering surgery for sciatica.

[1] McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ., Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010; Oct;33(8):576-84.

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Stress on the Job

Stress has been called the spice of life, the common cold of the psyche, and even a socially acceptable form of mental illness. No doubt, stress can be beneficial—for example, a deadline can help us focus and become more alert and efficient. Persistent or excessive stress, however, can undermine performance and make us vulnerable to health problems, from cancer and heart disease to substance abuse and obesity.

Stress is a physical and mental response to the difference between our expectations and our personal experience, real or imaginary. While reacting to stress, the body goes through alarm, resistance, and exhaustion. Released hormone epinephrine, or adrenaline, prepares the body for physical action (“fight or flight”) by increasing heart rate, blood pressure, and blood glucose levels. Then, the body releases glucocorticoid cortisol, or hydrocortisone, producing anti-inflammatory and immunosuppressing effects.

Consequences of Chronic Stress
Although occasional stress can be of benefit, too much stress is taxing on the body. Excessive levels of glucocorticoids can hinder growth, delay wound healing, and increase risk of infection. Chronic stressors—or their constant anticipation—can make us believe that we must always be on guard, leading to anxiety. Feelings of hopelessness or avoiding solving our problems can spark depression.

Past or present psychological distress can also lead to pain, particularly low-back pain, which often comes with leg pain, headaches, sleep problems, anxiety, and depression. Stress may even be a more powerful pain generator than strenuous physical activity or repetitive motion. Research shows, for example, that pain in adolescents is associated with depression and stress, but not with computer use or physical activity.

Stress is highly individual and depends on our circumstances. For example, we react to stress better if we can vent our frustrations, feel in control, hope that things will change for the better, and get social support.

Gender also determines how we handle stress. Women are easily stressed by household problems, conflicts with people, or illness in people they know. Men get more significantly affected by job loss, legal problems, and work-related issues. Men are also more likely to get depressed over divorce or separation and work problems. Depression in women, however, is more likely to spring from interpersonal conflicts or low social support, particularly from family.

Stress on the Job
The workplace has become a major stressor, contributing to the risk of hypertension and heart disease. Recent studies have shown, however, that what stresses us out is not so much the job demands, but our attitude toward them. For example, people who react with anger to their high job strain or who are worried about their chronic work overload have much higher morning corsisol levels. Lack of a sense of control over a job is also associated with higher blood pressure, especially in women and in people with higher socioeconomic status.

Stress Relief Is Important

No matter what stresses you out, consider taking active steps to change your attitude toward stress and to reduce stress in your life.

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Spinal Manipulation Proves Equally Beneficial As Surgery In Sciatica Treatment

In a recent study, “Manipulation or Microdisketomy for Sciatica? A Prospective Randomized Clinical Study,” (Journal of Manipulative and Physiological Therapeutics, October 2010, Vol. 33 Iss. 8, p: 576-584), researchers concluded that spinal manipulation was just as effective as microdiskectomy for patients struggling with sciatica secondary to lumbar disk herniation (LDH).

The patient population studied included people experiencing chronic sciatica (symptoms greater than six months) that had failed traditional, medical management. Overall, 60 percent of patients who received spinal manipulation benefited to the same degree as those who underwent surgery.

“Sciatica is a serious spinal condition that causes pain, numbness, or weakness in one or both legs. Many times when symptoms become debilitating and without further help, surgery is prescribed to alleviate discomfort. But surgery is not without financial and physical drawbacks.”

“To our knowledge, this is the first, randomized trial that directly compared spinal manipulation, which in this study was delivered by a doctor of chiropractic, and back surgery, two popular treatment choices for this prevalent health condition,” says Dr. Gordon McMorland, who co-authored the paper with neurosurgeons Steve Casha, MD, PhD, FRCSC, Stephan J. du Plessis, MD, and R. John Hubert, MD, PhD, FRCSC, FACS.

“Sciatica is a serious spinal condition that causes pain, numbness, or weakness in one or both legs. Many times when symptoms become debilitating and without further help, surgery is prescribed to alleviate discomfort. But surgery is not without financial and physical drawbacks.”

According to the study, “Outpatient Lumbar Microdiscectomy: A Prospective Study in 122 Patients”, more than 200,000 microdiskectomies are performed annually in the United States, at a direct cost of $5 billion, or $25,000 per procedure. In this year-long study, consenting participants were chosen randomly to receive either an average of 21 chiropractic sessions over a year or a single microdiskectomy, both with the additional integration of six supervised active rehabilitation sessions and a patient education program. If cost is assumed at $100 per chiropractic visit, there is a direct, total savings of $22,900 per manipulation patient. System-wide, this could save $2.75 billion dollars annually.

“After a year, no significant complications were seen in either treatment group, and the 60 percent patients who benefitted from spinal manipulation improved to the same degree as their surgical counterparts,” says Dr. McMorland, who also points out that, “The 40 percent of patients who were not helped by manipulation did receive subsequent surgical intervention. These patients benefitted to the same degree as those that underwent surgery initially, suggesting there was no detrimental effect caused by delaying their surgical treatment.”

“Our research supports spinal manipulation performed by a doctor of chiropractic is a valuable and safe treatment option for those experiencing symptomatic LDH, failing traditional medical management. These individuals should consider spinal manipulation as a primary treatment, followed by surgery if unsuccessful.”

Source: Foundation for Chiropractic Progress

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11 Tips for Living With Chronic Pain

1. Learn deep breathing or meditation to help with chronic pain.

Deep breathing and meditation are techniques that help your body relax, which eases pain. Tension and tightness seep from muscles as they receive a quiet message to relax.

Although there are many to meditate, the soothing power of repetition is at the heart of some forms of meditation. Focusing on the breath, ignoring thoughts, and repeating a word or phrase — a mantra — causes the body to relax. While you can learn meditation on your own, it helps to take a class.

Deep breathing is also a relaxation technique. Find a quiet location, a comfortable body position, and block out distracting thoughts. Then, imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.

2. Reduce stress in your life. Stress intensifies chronic pain.

Negative feelings like depression, anxiety, stress, and anger can increase the body’s sensitivity to pain. By learning to take control of stress, you may find some relief from chronic pain.

Several techniques can help reduce stress and promote relaxation. Listening to soothing, calming music can lift your mood — and make living with chronic pain more bearable. There are even specially designed relaxation tapes or CDs for this. Mental imagery relaxation (also called guided imagery) is a form of mental escape that can help you feel peaceful. It involves creating calming, peaceful images in your mind. Progressive muscle relaxation is another technique that promotes relaxation.

3. Boost chronic pain relief with the natural endorphins from exercise.

Endorphins are brain chemicals that help improve your mood while also blocking pain signals. Exercise has another pain-reducing effect — it strengthens muscles, helping prevent re-injury and further pain. Plus, exercise can help keep your weight down, reduce heart disease risk, and control blood sugar levels — especially important if you have diabetes. Ask your doctor for an exercise routine that is right for you. If you have certain health conditions, like diabetic neuropathy, you will need to be careful about the types of activities you engage in; your doctor can advise you on the best physical activities for you.

4. Cut back on alcohol, which can worsen sleep problems.

Pain makes sleep difficult, and alcohol can make sleep problems worse. If you’re living with chronic pain, drinking less or no alcohol can improve your quality of life.

5. Join a support group. Meet others living with chronic pain.

When you’re with people who have chronic pain and understand what you’re going through, you feel less alone. You also benefit from their wisdom in coping with the pain.
Also, consider meeting with a mental health professional. Anyone can develop depression if they’re living with chronic pain. Getting counseling can help you learn to cope better and help you avoid negative thoughts that make pain worse — so you have a healthier attitude. Asking for help is a sign of strength, not weakness.

6. Don’t smoke. It can worsen chronic pain.

Smoking can worsen painful circulation problems and increase risk of heart disease and cancer.

7. Track your pain level and activities every day.

To effectively treat your pain, your doctor needs to know how you’ve been feeling between visits. Keeping a log or journal of your daily “pain score” will help you track your pain. At the end of each day, note your pain level on the 1 to 10 pain scale. Also, note what activities you did that day. Take this log book to every doctor visit — to give your doctor a good understanding of how you’re living with chronic pain and your physical functioning level.

8. Learn biofeedback to decrease pain severity.

Through biofeedback, it’s possible to consciously control various body functions. It may sound like science fiction, but there is good evidence that biofeedback works — and that it’s not hard to master.

Here’s how it works: You wear sensors that let you “hear” or “see” certain bodily functions like pulse, digestion, body temperature, and muscle tension. The squiggly lines and/or beeps on the attached monitors reflect what’s going on inside your body. Then you learn to control those squiggles and beeps. After a few sessions, your mind has trained your biological system to learn the skills.

9. Get a massage for chronic pain relief.

Massage can help reduce stress and relieve tension — and is being used by people living with all sorts of chronic pain, including back and neck pain.

10. Eat a healthy diet if you’re living with chronic pain.

A well-balanced diet is important in many ways — aiding your digestive process, reducing heart disease risk, keeping weight under control, and improving blood sugar levels. To eat a low-fat, low-sodium diet, choose from these: fresh fruits and vegetables; cooked dried beans and peas; whole-grain breads and cereals; low-fat cheese, milk, and yogurt; and lean meats.

11. Find ways to distract yourself from pain so you enjoy life more.

When you focus on pain, it makes it worse rather than better. Instead, find something you like doing — an activity that keeps you busy and thinking about things besides your pain. You might not be able to avoid pain, but you can take control of your life.

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