Tag Archives: healthy

chiropractic, Uncategorized

Managing Neck Pain and Headaches Part 1

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Neck pain and headaches are a very common issue in our society, and understanding the causes and prevention of them will go a long way to leading a healthy and pain free life. In this educational summary, we discuss some of the most common conditions we see in our office. Below we will discuss the following neck-related pain conditions.

  1. Upper Crossed Syndrome
  2. Headaches
  3. Neck Sprain/Strain
  4. Disc Pain
  5. Cervical Radiculopathy
  6. TMJ Dysfunction

This will be a multi part series, going over the list above.

Upper Crossed Syndrome

Upper Crossed Syndrome describes a type of common muscle imbalance. This occurs when the neck flexors and the middle back become weak while the pectoral muscles and the muscles at the base of the skull become tight.  This produces a familiar pain pattern at the base of the neck and the shoulders, as well as joint dysfunction at the base of the skull and shoulders.

The main physical causes of this condition are:

  • Desk job
  • Too much sitting
  • Driving long hours
  • Poor posture

However, with the proper education, you can protect yourself from many of these causes. The primary sufferers of this condition, especially chronic cases, often have poor posture while sitting at a desk for most of the day. A comorbid factor is a sedentary lifestyle with little physical activity. This poor sitting posture leads to a re-enforcement of the Upper Crossed Syndrome, and it is crucial that you arrange your workstation to facilitate a proper posture as best as possible.

The best way to combat this problem is, of course, to prevent it before it starts. If possible, minimize sitting for long periods of time and take frequent work breaks to take short walks around the office to reset your posture.

If the problem has already begun, Dr. Steve can teach you proper form and posture to prevent this problem in the future so that you are more mindful of the positions that can promote this problem. I am also trained in soft tissue techniques that will be able to relax your tight muscles, restore motion and reduce pain levels. There are also methods of rehabilitative exercise that can be taught to you to reverse any damage already done and prevent a progression of this condition, as well as instill healthy habits for you to employ for the rest of your life.

Headaches

Headaches come in many varieties, and nearly everyone experiences this type of pain at some point in their lives. The common symptom of all headaches is of course characterized by pain. Different types of headaches cause pain in different regions of the head and have unique pain sensations. Some portion of people experiencing headaches can be characterized as migraines. Migraines often feature symptoms such as nausea, vomiting or sensitivity to lights.

The physical causes of this condition are extremely numerous, but some of them are:

  • Allergies
  • Stress
  • Poor posture
  • Diet & exercise habits
  • Hormonal imbalance
  • Smoking

Since there are so many different types of headaches, as well as causes and symptoms, it is important to get a proper diagnosis so that you can better treat the cause. An assessment of your lifestyle habits is an effective way to diagnose common contributing factors that may be causing your headaches. For example, addressing your sleeping habits, making sure you get the proper amount of sleep and making sure you are getting restful sleep. A proper, healthy, balanced diet that is free of any substances that you may have a sensitivity to or may be a trigger for headaches is important for managing this condition as well. Posture and body habitus can be huge contributing factors and may be some of the simplest to diagnose and manage. Treatment such as soft tissue modalities as well as chiropractic adjustments coupled with posture analysis and correction can be a simple and effective way of managing headaches of this type.

Next week we will have more on this subject! In the meantime please call the office if you have neck pain or headaches that we can help you with!

chiropractic, exercise, Uncategorized

How to Stop Muscle Wasting

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The best way to stop muscle wasting is to lift weight and do some form of cardio vascular conditioning.

Which weight lifting exercise are best? They are called complex movements.

Here a list:

  • Squatting
  • Dead lift ( hip hinge)
  • Pushing movements( push ups and bench press)
  • Pulling movements( Lat Pull down and Pull ups)

Now you don’t have to be muscle bound to do these movements. However, doing these movements with some weight would help keep the muscle you have and possibly add some muscle.

Now you might be thinking you can’t squat because you may have bad knees or a bad back. Squatting is basically getting out of a chair. So start with that, getting out of chair 10 time is a row. Doing that a few times a day is a great way to start! You will not believe how sore you can get from this routine. Once you have done this for a few weeks move on to some thing harder. Goblet squats are the safest. Start with a light weight and just keep adding weight. It’s that easy.

chiropractic, Uncategorized

Cost of Muscle Wasting after the age of 30: Top 10 List

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Did you know that we lose 1-1.4% of muscle mass/year & 3% of our strength/year starting at the age of 40. Anyone who has turned 40 know this but in a different way.

Here’s some examples:

  • If I look at a cookie I gain weight
  • I don’t feel as strong as I once was
  • I’m more tired then I used to be.
  • I gain 5lbs a year with no major change in my diet
  • My clothes don’t seem to fit right
  • I don’t look good in the mirror
  • I get sore and tired from normal actives around the house
  • You see your Medical Doctor & they tell you that you have Arthritis & to just learn to live with it
  • The medical Doctor says it’s “Wear & tear” which is ironic because you’ve been sedentary. (Study after study shows exercise help arthritis and decease pain. Doing exercise correctly does not cause pain)
  • The MD say’s if you can’t live with it we’ll give you pills. You start taking NSAIDs which ⬆️ heart disease 30-40%
  • Now you’re getting desperate. Everyone  promises a quick fix – you reach for experimental things like stem cells. Treatments with side effects like steroids & you’re getting more & more depressed
  • Next you’re getting scanned (MRI/C.T).  Nobody has addressed the fact that you’re weak.  That you don’t have strength. All they are talking about are the tissues which are the victims
  • The next step is that they recommend surgery

How do you fix & reverse this?

Good question. It’s simple!

30m/day of general activity – choose whatever you like – hiking, waking the dog, swimming , biking or yoga & most importantly 2x/week resistance (strength) training

Come in or call the office and We could help you find the exercise that are the best for you.

chiropractic, Uncategorized

Preventing Lower back pain Part 3

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Body Preparation and Positioning

Sternum Up– Keeping the sternum up automatically sets the body into the good posture and maintains:

Neutral Spine: Maintaining good spinal alignment decreases the stress placed on the spine and discs.

Hip Hinging: Bending at the hips, and not the low back, decreases the stress placed on the low back and increases strength & power.

  1. Squating- The zone that will optimize lifting strength and injury reduction.

a. Bend your elbows at a 90-degree angle, and you are in the “Primary Power Zone.”

b. The area up to the shoulders and down to the hips is acceptable.

c. The more you can work in the “power zone” the less fatigue on your body

  • Abdominal Bracing- When all of your core muscles work together, a “Super Sti­ffness” occurs, and all three layers of the abdominal wall are activated to protect and stabilize the spine and discs.
  • Without bending forward, contract the abdominal muscles (like you are about the get punched in your gut – feel them tighten with one hand) and the buttock muscles (as if you are holding in a bowel movement). You will feel the lower back muscles contract (with the other hand) when you contract your abs and buttocks. Activities of Daily Living

Optimal Activities of Daily Living Considerations

The below images and descriptions were resourced from The Journal of Bodywork and Movement Therapies (2004) 8, 85–87 written by Craig Liebenson, DC

These are a sampling of some daily activities that you may encounter. We encourage you to practice and apply the body preparation and positioning described above. The Sternum Up, Power Zone and Abdominal Bracing should be utilized to protect and spare the spine.

Hip Hinge

  • Keep the spine upright by hinging from the hips as you bend your knees
  • Maintain all three points of contact as you move to an upright position

Going from Sit-to-Stand

  • Start in a seated position at the edge of your chair with your feet under your thighs before sitting up
  •  To initiate movement begin upward movement by using your hips and knees
  • To avoid strain to your back, keep your torso upright when rising from the chair.
A: Correct way B: Incorrect way

Picking up a bag of the ground

  • When picking up a bag from the ground, bend from the hips and knees.
  • Make sure to keep the back flat and keep lower back’s natural curve by keeping it curved forward while bending.
  • When lifting, initiate the movement by keeping the back flat while extending with the hips, and tightening the glutes.

Brushing your teeth

  • Keep your chest upright while brushing the teeth.
  • When you bend forward to rinse your brush or mouth bend from the hips, not from the waist.
  • Keep your chest lifted while you bend forward.

Changing a diaper

  • Before changing your baby ensure that you have a changing station that is the appropriate height.
  • If it is too low (below your waist), you will be forced to bend forward from the waist.
  • The correct height is approximately waist high and allows you to maneuver your baby without having to bend much.

Picking objects from ground

  • When lowering to pick up the object, bend from the knees and keep your chest lifted.
  • When lifting keep your spine upright by hinging from the hips and knees.
  • If the object is not directly in front of you, it is important to keep your chest lifted in front of you while keeping your lower back’s natural curve.
  • Avoid lifting immediately after sitting for a prolonged period.
A: incorrect B: correct
chiropractic, Uncategorized

Lower back Pain Part 2

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More common conditions

Lumbar Disc Disorders

The lumbar spine is made up of five bone segments called vertebrae. In between each vertebra are flexible intervertebral lumbar discs, which act as shock absorbers for the spine. The intervertebral discs are composed of two components, a tough outer ring of fibrous tissue called the annulus fibrosis, and a jelly-like center inside the annulus fibrosis called the nucleus pulposus. The structure is then held together by ligaments on the front and the back of the vertebrae. Additional support is provided by muscles of the trunk.

In most cases, lumbar disc disease is the result of a normal aging process called disc degeneration which causes structural changes in the normal disc. As we age, the disc begins to lose fluid and become dried out causing the disc to compress. This may lead to the breakdown and degeneration of tough outer ring of the disc (annulus fibrosis) allowing the inner core (nucleus pulposus), to bulge out. This is considered a bulging disc. This puts pressure on the outer ring of the disc, which may cause low back pain. As further degeneration of the disc continues, or with continued stress on the lumbar spine, the inner jelly-like core may rupture out from the outer ring causing a ruptured, or herniated, disk. Once the inner nucleus herniates through the outer ring, pain in the lower back may improve.

However, the fragmented disc material can inflame or put pressure on the spinal nerves leading to an increase in sciatic leg pain, weakness, numbness, or changes in sensation in one or both legs. Most disc herniations occur at the lower lumbar spine at L4-L5 and L5-S1 levels. Occasionally, severe trauma can cause a normal disc to herniate or may cause an already herniated disk to worsen.

Risk Factors of Lumbar Disc Disorders

  • Age and Gender – the highest incidence in men between the ages of 30 and 50.
  • Obesity – being overweight puts added stress on lumbar discs.
  • Sedentary lifestyle – lack of exercise and poor core body strength.
  • Smoking – Smoking decreases oxygen supply to the discs causing more rapid degeneration.
  • Improper lifting – using your back muscles instead of your legs to lift heavy objects. Twisting while lifting
  • Posture – hyperlordotic lumbar curvature, anterior pelvic tilt (lower cross syndrome).
  • Repetitive activities that strain your spine – jobs that require constant lifting, pulling, bending, or twisting.
  • Frequent driving – staying seated for long periods and the vibration from the car can put pressure on your discs.

History and Symptoms of Lumbar Disc Disorders

Lumbar disc disorders may include one or a combination of the following symptoms:

  • Intermittent or constant lower back pain and pain in the buttock,
  • Leg and foot pain, numbness or a tingling sensation in the leg and foot,
  • Weakness in the leg and foot
  • Decreased reflexes in the knee or ankle
  • Changes in bowel or bladder function.

The symptoms will vary depending on if and where the disc has herniated, and what spinal nerve root is affected. Leg pain is usually greater than low back pain with disc herniations and nerve root involvement. However, if there are only annular tears without herniation, the pain will be localized to the low back and buttock. The onset of pain can be sudden or gradual after an injury. Pain may follow heavy lifting, twisting, or straining activities or repetitive stress trauma. However, patients may not recall a prior injury or a precise time the condition began because it is often preceded by frequent episodes of less severe low back pain that usually resolved. Pain is usually characterized by sharp, shooting, or electrical pain that may be aggravated by movement, changing positions, sneezing, coughing, or prolonged sitting and standing. The pain is usually relieved with rest and a recumbent position.

Treatment of Lumbar Disc Disorders

Conservative care should be your first course of treatment to manage lumbar disc disorders, but treatment will depend on the clinical presentation, your age, overall health, and tolerance to therapies. With disc herniations, the first few days of care will focus on centralizing (reducing) leg pain, decreasing inflammation, and preventing further neurological loss by decompressing nerve root impingement and reducing the disc herniation. Osseous mobilization and manipulation and soft tissue therapy may be administered as tolerated. Home care will consist of pain-relief repetitive positional exercises and lumbar stabilization exercises. We will also educate you on ways to protect your lower back, positions to avoid, and how to manage activity. In most cases, bed rest will not be recommended as the sooner you are up and moving, the better the prognosis. Once pain and inflammation have decreased, we will continue working on lumbar stabilization and progress into proprioceptive training. We will evaluate muscle imbalances using posture and movement patterns with the goal of restoring good biomechanics and core body strength. Your home care will emphasize the progression of stabilization protocols and corrective exercises. If you fail to respond to conservative treatment, or in cases of severe neurological loss, a referral for a surgical consultation will be recommended.

Lumbar stenosis

This condition occurs when there is a narrowing of the spinal canal in the lumbar vertebrae (low back). Often this results in compression of the spinal cord, which can lead to pain, numbness, discomfort and radiating symptoms. What the mechanism of this is occurring is usually caused by the degenerative changes of aging. However, there are other causes.

The main physical causes of this condition are:

  • Degeneration of the lumbar spine
  • Lumbar disc herniation putting pressure on the spinal cord
  • Osteoporosis
  • Dwarfism (achondroplasia)
  • Tumor

Degeneration of the spinal column is inevitable with aging and may reflect normal changes in an aging spine. It does not necessarily always result in lumbar stenosis but is often the most common cause.

While it is difficult or impossible to combat normal aging of the spine, there are some habits and tips you can use to reduce this condition related to the other causes. Reduce your chances of a lumbar disc herniation by learning proper bending and lifting biomechanics by utilizing your lifting power from your legs and not your back. As far as osteoporosis goes, make sure you are meeting your recommended calcium intake as well as incorporating weight bearing activities into your exercise routine (lifting weights). Post-menopausal women tend to be more susceptible to this condition and should ensure they are doing everything they can to prevent osteoporosis.

chiropractic, Uncategorized

What Pillow should I get?

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Are you Sleeping on the Right Pillow?

Determining the right pillow is a personal choice that a person will make every so often. When it comes to thinking about sleep equipment, most people solely focus on the mattress. The mattress is one of the most important sleep equipment you will buy, but when it comes to sleep quality pillows are just as important. How you lay your head when sleeping plays a huge role in determining the type of support you need. Pillows not only impact the quality of sleep but can prevent any neck discomfort.

Why Does Your Pillow Matter?

A proper pillow will facilitate a good night’s sleep without you waking up at night or waking up with pain or a stiff neck. Having the wrong pillow over time can exacerbate unnecessary neck pain. There are a few factors that go into making a guide for yourself to determine the proper pillow for you.

Back Sleeper:

Sleeping on your back might appear to be comfy, but will highlight the underlying issue of snoring if you have a pillow that allows your head to sink. As you lay your head back, gravity will push the tongue back and block your throat. A better alternative will be a pillow that offers height, neck support and keeps the throat at a comfortable level.

Side Sleeper:

One of the most common positions to sleep in is on the side. You will need more support to keep the neck at a neutral angle.

Stomach Sleeper:

Sleeping on your stomach might be comfortable for a few nights, but after a while can become taxing on your back and neck. However, having the right pillow can negate some of these issues. A firm/plump pillow will force your neck into an odd angle that might lead to some discomfort. A better alternative would be a softer option.

When Is It Time To Replace Your Pillow?

On average, a pillow should be replaced every 18 months. The old age rule “ you pay for what you get” applies to this transaction. A higher quality pillow will last longer than an inexpensive option. Something you can do to your pillow to see if you need a new one is, take it out of the pillowcase to see if there are any stains or fold it in half and see if the pillow stays folded. If either of these are a yes then it is time to replace your pillow.

chiropractic, Uncategorized

Another Confirmation: Disc Herniations Spontaneously Resorb

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Here’s another study showing that disc herniations can spontaneously resorb. The body has a amazing healing capability! We just need to give it a chance and the correct environment.

In 40 patients with lumbar disc herniation: “Based on MRI disc volume; 10% did not show any regression, 15% had a partial regression, and 75% had a complete resolution. Patients with complete resolution showed a significant improvement in the pain score and the ODI score over time.”

Kesikburun B et al. Spontaneous regression of extruded lumbar disc herniation: Correlation with clinical outcome. Pak J Med Sci. 2019 Jul-Aug;35(4):974-980. Link

chiropractic, Uncategorized

More research showing chiropractic is safe

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A systematic review of 47 randomized trials found that cervical manipulation is safe and effective:

  • An effect in favor of thrust manipulation plus exercise compared to an exercise regimen alone for a reduction in pain and disability.
  • Of the 25 studies (that evaluated adverse events), either no or minor events occurred.
  • According to the published trials reviewed, manipulation and mobilization appear safe.  

Coulter ID et al. Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel. Pain Physician. 2019 Mar;22(2):E55-E70.

chiropractic, Uncategorized

Why does my back hurt in the morning?

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People that come into our chiropractic clinic for treatment after lumbar disc herniation or disc bulging frequently have a history of pain which is worse in the morning and then improves after they’ve been up moving around for a bit.

Often they have some questions about what exercises and stretches they can do in the morning to make them feel better. We learned more about morning back pain in a disc – injured patient after the research of Michael Adams in the 1980s.(1,2) Adams referred to the “diurnal behavior of the disc” which mostly refers to the tendency for the discs to absorb moisture from the tissues around them overnight.

The discs soak up the fluids from the tissues around them while a person is recumbent in bed overnight. So in the morning when they wake up the outer layers of the disc are under a bit more tension, which we refer to as hydrostatic pressure.

In turn, the disc becomes a bit more plump, adding pressure to nerves and surrounding structors.

So what should you do? Once you get out of bed you should not bend over right away. Try to keep your back straight or try stretching backward .

Next, use your hips to bend over the sink to brush your teeth.

A straight back using my hips to bend over.
Bending at the lumbar spine causing lots of pressure on the lumbar discs

The above picture is a great way to cause sharp shooting pain in the morning.

Try to sit up straight or use a back support in the small of your back like in the picture above.

Sitting with a more normal curve in the lumbar spine helps take the pressure off of the lumbar discs and helps decrease pain.

A wrong way to sit

Sitting like this cause more disc pressure causing disc irritation. It can cause the disc to bulge more.

Discs are fatter in the morning because the absorb fluid overnight. So think of a jelly doughnut if the doughnut has more jelly its more likely to shoot out if you put pressure on it.

So remember back straight, stomach tight will help prevent lower back pain and help you heal if you have pain.

chiropractic, exercise, Uncategorized

Impaired Core Stability as a Risk Factor for the Development of Lower Extremity Overuse Injuries: A Prospective Cohort Study

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A weak core can increase your chances for lower extremity injury during exercise!

The core is important for your lower back and neck health for sure. It’s also very important for extremity health. If you have been dealing with an arm or leg injury (extremity) that has not been getting better with treatment, it might be good to add in some core exercise to improve outcomes.

Take Home Message from the study: A college freshman with dynamic postural control limb imbalances, decreased hip extension strength, or decreased core muscle endurance during bridging exercises is more likely to develop a lower extremity overuse injury.