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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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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A Vacation from Back Pain | Tips for the Pain-free Summer Traveler

For many of us, summer is the season to burn some vacation time and hit the road. The longer days and warmer weather may make it easier to get away, but summer travel often includes cramped flights and seemingly-endless road trips. And that can take a real toll on your back—even if you don’t have a history of pain.To fully enjoy your summer destination, you need to know how to protect your back during the journey.Below are some simple ways you can take care of your back on the road—and in the air.

Car Trips

Car travel is back on the rise—the economy has forced many summer vacationers to accessible, domestic locales. But sitting in a car for hours on end can put a lot of pressure on your back. Fortunately, there are ways to alleviate the strain long car rides can place on your low back:

If your car seat doesn’t offer enough support for your low back, there are a variety of seat cushions, pillows, and other car aids on the market that are designed to make your car trip much more comfortable. If you don’t want to spend the money, simply roll up a towel and create a makeshift cushion between your back and the seat.
Take time to stop at rest stops and towns along the way to stretch and move around. Staying in the same position for hours at a time will only exacerbate your back pain. Even spending just a few minutes doing some back stretches may make a big difference in preventing pain.

Make sure you’re not sitting on anything (such as a wallet, money clip, or cell phone). If you are, it can aggravate back pain. Bring a cooler packed with ice packs to relieve pain on the road. If you need to ice your back, do so for no longer than 15 minutes at a time. Also, make sure there is a barrier, such as a towel, between the ice and your skin.

Air Travel

With the struggling economy, the comfy, roomy first-class airline seats are an unattainable luxury for most of us. Unfortunately, coach seats are often cramped, restrictive, and offer little support for your back. In fact, a 2008 SpineUniverse survey found that 88% of people who had flown in North America in the last year reported that they had back or neck pain—or both—after their flight.If you want to arrive at your gate pain free, you should follow the guidelines below:

Request an aisle seat—it will allow you easy access to get up and move around. On a similar note, take advantage if your airline offers special deals on seats with extra legroom. Focusing on your posture is essential if you want your flight to be a bearable experience. Keep both feet on the floor and sit upright. Most airlines also offer pillows to passengers, and you can place one behind your lower back for extra support. However, firmer pillows are the best option, especially for long-haul flights.

Use rolling luggage and pack light. At the luggage carousel, don’t be afraid to ask for help in picking up your bags. If you are confident handling your own bags, take your time and don’t bend your spine as you lift. If you need more tips on how lifting and reaching to avoid back pain, read this article.

When it comes to pain-free traveling, the journey is just as important as the destination. Summer vacation should be something to look forward to, but it can be anything but enjoyable if you have back pain. Taking these precautions will help prevent pain, letting you truly enjoy your time away.

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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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Conservative Pain Management: A First-Line Defense Against Prescription Drug Abuse Crisis

May 5, 2011 — The American Chiropractic Association (ACA) applauds federal efforts to curb prescription drug abuse following the U.S. government’s announcement in late April that the problem has reached crisis level.

ACA encourages patients and healthcare providers to explore drug-free, conservative approaches to pain management as a first-line defense against painkiller abuse.

The government’s report, “Epidemic: Responding to America’s Prescription Drug Abuse Crisis,” notes that while the use of some illegal drugs has diminished, the abuse of prescription medications has sharply increased, particularly prescription opioid pain relievers such as Oxycontin and Vicodin. It points out unintentional opioid overdoses — once almost exclusively the fate of heroin abusers — are today increasingly caused by prescription painkiller abuse.

“This new report shows that while sometimes the use of these powerful drugs may be necessary, their overuse and abuse can lead to deadly consequences. The chiropractic profession offers non-drug interventions for pain relief,” said ACA President Dr. Rick McMichael. “We urge healthcare providers, whenever possible, to recommend drug-free conservative care interventions for their patients before prescribing medications that may be associated with harmful side effects. It’s critical that patients know their options.”

The government report outlines a four-part strategy to reduce the incidence of overdose caused by painkiller abuse, including increased education; monitoring of “doctor-shoppers” who obtain multiple prescriptions; the safe disposal of prescription medications; and cracking down on “pill mill” clinics that dispense hundreds of pills per patient. ACA believes prevention is also key and that increased use of conservative approaches for pain management may curb the need for painkillers and thereby reduce the likelihood of patient dependency, overuse and possible overdose.

Chiropractic care is best known for its effectiveness in treating painful conditions such as back pain, neck pain, and headaches — which are serious causes of disability in the United States. According to the U.S. Bone and Joint Decade, the number of prescription medications has increased in the past 10 years.

Chiropractic care may lessen or eliminate the need for medications in some cases and help patients avoid unnecessary surgery. Chiropractic physicians treat the whole person, promote wellness and strive to address the underlying cause of patients’ ailments, not just their symptoms.

Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain. In 2007, the Annals of Internal Medicine published low back pain guidelines developed by the American Pain Society and the American College of Physicians recommending that, for patients who do not improve with self-care, doctors should consider non-pharmacologic therapies such as chiropractic care, massage therapy and acupuncture.

Source: American Chiropractic Association, www.acatoday.org

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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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Spinal Fusion Surgery Is Not Effective For Lower Back Pain

A recent article in Bloomberg Magazine stated that spinal fusion surgery is an expensive and ineffective treatment for lower back pain.  There are complications to this procedure and most studies show it is no better than chiropractic care or physical therapy for disc-related problems.  A spinal fusion for a lumbar disc can cost $50,000! That is a lot of money for something that has been proven not to work.   
“It’s amazing how much evidence there is that fusions don’t work, yet surgeons do them anyway”, said Sohail Mirza, a spine surgeon who chairs the Department of Orthopedics at Dartmouth Medical School in Hanover, New Hampshire. “The only one who isn’t benefitting from the equation is the patient.”    
Most disc conditions are going to respond to conservative measures and are not going to require spine surgery.  The only absolute indication for spine surgery (not spinal fusion) related to a disc problem is losing control of your bladder or bowels. Leg pain or weakness is not an absolute indication that you will require surgery.  
Conservative treatments like chiropractic care and physical therapy should be tried for a minimum of six to eight weeks. There are also medications and injections that can help relieve your pain. 

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Some Surprising Statistics About Back Pain

Some Surprising Statistics About Back Pain
 
Back pain relief is just one component of chiropractic care, but it is often a patient’s first introduction.  Back pain is horribly debilitating affecting all aspects of work and personal life.  If you are suffering from back pain, you are not alone.  Here are a few facts about back pain that may (or may not) surprise you. 
  • Back pain is the number one disability for those under age 45.  
  • In the United States of America alone, there is an expected 31 million people with lower back pain at any given time.  
  • Back pain runs second, after only the common cold, as the top reason for visiting a healthcare provider in the United States.  
  • Experts place the likelihood of any person to experience some type of back problem in their lifetime at about 80%.  That’s four out of every fivepeople!
  • Over 50 billion dollars are spent per year in the pursuit of clearing up cases of back pain.  
  • Around 30 to 40 percent of all workplace absences are due to back pain. 
  • Approximately one quarter of U. S.  adults reported having low back pain lasting at least one whole day in the past three months, and 7.  6 percent reported at least one episode of severe acute low back pain within a one-year period. 
  • One-half of all working Americans admit to having back pain symptoms each year. 
  • Approximately 2 percent of the U. S. work force is compensated for backinjuries each year.
  • Lower back pain accounts for two thirds of all back pain-related cases. 
  • More than two-thirds of back strains are caused by lifting and other exertions like pulling and pushing. 
  • Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer. 
The key to proper treatment of back pain is to understand the cause. Remember, pain is always a sign that something else is wrong and if continually ignored may lead to more serious harm.  Chiropractors are experts in assessing the root cause of your back pain and putting you on the right course to recovery

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Chronic Pain : Is it all in your head?

A few weeks ago a patient came hobbling in with lower back pain. She was under emotional stress due to financial problems. She had physiotherapy treatment in my office and told me a funny story. She started laughing as she told the story. I asked her how her pain was, and she said it was gone! The physical treatment and the laughing had changed her emotional state. She literally was dancing out the door.

Pain is a brain experience and unique to you. Pain is defined as an emotional response to tissue damage. How much pain you feel has no relationship to the amount of tissue damage.

With chronic pain all tissue healing has occurred but you still feel pain. Why?

If you are under emotional or physical stress, it can amplify or “turn up” your pain. Your body releases stress chemicals that make you more sensitive to pain. If you focus on your pain it will be worse, and if you are distracted you will feel better.

The longer you have chronic pain the worse it usually gets. This is because of brain plasticity or rewiring. The more you keep firing the pain pathways the stronger the connections become. It becomes almost hardwired in your brain even though all the tissue has healed. When you have chronic pain, the pain becomes the focus of your life. That is horrible for your brain and body. It usually leads to anxiety and depression.

You can get better if you suffer from chronic pain, but you are going to have to do some things differently. There are natural methods as well as medications that can relieve your suffering. The first thing is to decide you want to get better!

~Dr. Dave

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Do I Need Back Surgery for my Lower Back Pain?

If you have a disc problem in your lower back, you will probably not require back surgery. 90% of lower back pain problems will resolve in two months, regardless of treatment. Lumbar spine(low back) surgery is reserved for candidates who have exhausted conservative treatment and have a definable correctable cause. Recent studies have shown that after five years, people who had disc surgery and those that did not have surgery are doing about the same. In my opinion, the only absolute indication for lumbar spine surgery is losing control of your bladder and bowels. Pain in your leg is not an absolute indication that you are going to need back surgery.

Before you have back surgery make sure you seek a second opinion. Other viable options are chiropractic care, physical therapy, acupuncture, and epidural injections. If you decide to have back surgery, my recommendations are to see a spine surgeon who only operates on backs.

~Dr. Dave

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