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MAX HEALTH
Eight out of 10 people will
experience back pain in their
lives. Here is some important
information on why it happens
and what you can do about it!
BY LINDA HEPLER, BSN, RN
ONE MINUTE you’re perfectly fine, and the
next minute, you’re lying on the floor, writhing
with back pain. None of us are immune to an
aching back. In fact, according to the National
Institutes of Health, this condition affects 8 out of
10 people at some point during their lives. It can
be either acute, developing suddenly and dissipating
after a few weeks, or chronic, meaning that it has lasted
for longer than three months.
Most lower back pain is caused by mechanical
injury resulting from injured muscles or tendons due
to a strain or sprain, said Kaixuan Liu, MD, PhD, an
endoscopic spinal surgeon practicing in the New York
area. But for those older than 50, the normal aging
process can lead to degenerative changes that affectthe spine. “As we get older, our muscles become
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HOW FUNCTIONALMOVEMENTSCREENING CANHELP WITH BACK PAINChris Tomshack, DC, founderand CEO of Health SourceChiropractic and Progressive
Rehabilitation, doesn’t use anold school technique – spinalmanipulation alone – to treathis patients with back painthese days. Instead, he said, “Iuse a progressive rehabilitationprogram that starts with functionalmovement screening.” Functional movementscreening, or FMS, said Dr.Tomshack, is a diagnostic toolto identify muscle asymmetries,tightness and weakness that may
lead to (or already has led to)injury by examining the mobilityand stability of the hips, core,shoulders, knees, spine andankles. The FMS, administeredby a trained health professional,such as a chiropractor orphysical therapist, seeks outpoor movement patterns duringseven different exercises, suchas deep squats and in-linelunges. “It’s an objective way
to evaluate problems, and alsowhen repeated after treatment,provides a measure of progress,”said Dr.Tomshack. After the FMS test, a treatmentplan is developed, he added,which involves functionalstretching and exercises toretrain faulty movement patterns,in addition to deep tissuemassage and chiropracticmanipulation. “When you
combine these treatments, theywork synergistically to reducepain and prevent re-injury,” saidDr. Tomshack. The final step in backrehabilitation is to help peoplewith lifestyle changes, such asbetter nutrition and exercises todo at home to maintain spinalhealth, he added. To find a certified FMSprovider in your area, check outFunctionalMovement.com.
weaker and can’t hold the bones tight
and in alignment,” he explained. The
resulting spinal instability may cause
abnormal curvatures of the spine.
Wear and tear of the structures that
support the spine can also cause a
gradual narrowing of the disc spaces
between the vertebrae as well as
narrowing of the space within the
spine that the nerves travel through,a condition known as spinal stenosis.
And older persons are more prone to
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caused by arthritis and osteoporosis,
added Dr. Liu. All of these conditions
can cause lower back pain.
While we can’t stop ourselves from
getting older – or our spine from
aging right along with us – we can
alter lifestyle habits that trigger the
pain or make it worse, according to
Dr. Liu. “Many every day activities we
do without thinking can make a hugedifference to our lower spine health,”
he said.
Back Pain TriggersHere are some common factors that
contribute to lower back pain:
LACK OF EXERCISE, especially
those that strengthen your core.
Developing strong core muscles in the
hips, back, abdomen and pelvis help to
support the spine, keep it straight and
prevent strains and sprains. Exercises
such as lunges, planks and squats andregimens such as yoga and Pilates help
to strengthen core muscle groups.
EXERCISING TOO MUCH.
While most people know that too
little exercise is detrimental to spine
health, many people don’t realize that
too many repetitions while exercising,
especially while lifting weights or
doing squats, can cause back pain.
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said Dr. Liu, “but be aware when your
body is crying out for a break.”
BEING OVERWEIGHT. The lumbar
and sacral areas of the spine that are in
the lower back bear the largest share
of the body’s load, and even as few
as 10 extra pounds of weight in your
abdominal area can add to that load,
pulling the spine out of alignment.
SITTING TOO MUCH. Sitting is
worse on your spine than standing
or walking, said Dr. Liu, as it
places pressure on spinal discs and
vertebrae. And if you’re sitting in an
uncomfortable, unsupportive chair, itcan force the spine out of alignment.
How Long ShouldI Be on Bed RestFor Back Pain?When your back hurts, it’s
normal to want to lie down.But according to the National
Institutes of Health, too muchrest can make back pain worse.
Instead of taking to your bedfor days, it’s recommended that you limit your rest to a day ortwo to help calm the symptomsand reduce inflammation. Afterthat, moving around by gentle
stretching and walking canhelp you get better. As
for your workout – wait fortwo or three weeks to resume
vigorous activities.
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SHOULD YOU HAVE SURGERY?You’ve done everything your doc recommended: the tests, physical therapy, exercisesand pain medications – and still, after six months, you’re experiencing back pain. Should you consider back surgery? Not necessarily, according to David Hanscom, MD, a Seattle-based orthopedic spinesurgeon. “Spine surgery should only be considered for specific structural problems, andmost back pain is not related to a structural problem,” he saidInstead, explained Dr. Hanscom, author of “Back in Control, A spine surgeon’s roadmapout of chronic pain,” the pain is often either a result of injured soft tissue (muscles orligaments) supporting the spine, or, in the case of many chronic back pain sufferers, a
permanent neurological problem – Mind Body Syndrome – that has evolved from thepain itself. To explain how pain can actually cause more pain, Dr. Hanscom likens it to learningto ride a bike or learning a new athletic skill. “When the brain is hammered with thesame pain impulses day after day, week after week, it becomes more and more efficientin processing them,” he said. In other words, continuous pain impulses from your back eventually causes paincircuits to become imbedded in the nervous system, to the point that even if the pain itselfhas abated over time, you experience it as the same – or even greater – because yournervous system has memorized the pain circuit. An example of this, said Dr. Hanscom, is“phantom limb” pain, a condition in which a person whose limb that has been amputatedcontinues to feel the pain even after the damaged or diseased limb that was causingdiscomfort has been removed. It’s a reminder, he explained, that the brain is an extremely
complex and sophisticated computer which is programmable. And it’s not only the pain that your brain programs, said Dr. Hanscom. It also programsnegative thoughts related to pain, which intensifies pain. Finally the situation is madeworse by the side effects of pain and negative thoughts: anxiety, sleep issues and anger.
The answer, according to Dr. Hanscom, is a “defined organized comprehensivecare” program that revolves around education about the problem, management of sleepand stress, short-term medications, physical conditioning and actively working on ahealthier life outlook. Through tackling all of these things at once, you can calm down aturbocharged nervous system, “reprogram” your brain – and make a full recovery.Hanscom’s program is a result of both having experienced debilitating back pain himself,along with years of working with patients having pain. “It continues to evolve over time,”said Dr. Hanscom, who has presented numerous seminars and workshops on the definedorganized comprehensive care program. To learn more, log on to Back-in-Control.com.
Try taking a break every half hour or
so and walking around for a minute or
two.
BEING STRESSED. Stress causes
muscular tension in the lower back,
which can trigger pain. And stress also
lowers your tolerance threshold to pain,
making it seem much worse. Managing
your stress through stress management
techniques, from walking to therapy,will help to control your back pain.
What To Do?What to do if you have back pain? Most
often it resolves within a few weeks
using at-home remedies such as over-
the-counter pain medications and rest,
noted Dr. Liu. “But if it doesn’t go away,
if it keeps you up at night or if you
have weakness, numbness or pins and
needles in your extremities, it’s best to
see a medical professional.”
Techniques to diagnose the causeof your back pain, such as x-rays,
MRIs or CAT scans, can help guide the
doctor toward an individual treatment
plan. The good news? Most back
pain – more than 80 percent – can
be alleviated without surgery, said Dr.
Liu. “Even if you do need surgery for
a structural problem of your back,”
he added, “it can often be done with
advanced technology through a scope,
which causes less trauma and pain.”
MS&F
HOT OR COLD?It’s a continuous debate – should you use heat or cold to relievesymptoms of back pain? Most
experts say that it depends uponthe type of pain. If your back
pain is related to an injury likea strain or sprain, cold works
best for a day or two to reduceinflammation. After that, heat willhelp to relax and soothe muscletissue. For those experiencing
chronic pain, heat will work best.