Tag Archives: sleep

Back Pain: One of the Most Common Complaints Across the Globe

Back pain is one of the most common health complaints across the globe, and the No. 1 cause of job disability. It’s also one of the most common reasons triggering opioid dependence, the side effects of which can be lethal. In fact, opioids are now the leading cause of death among Americans under the age of 50,1 and more than 202,600 Americans died from overdosing on these potent pain killers between 2002 and 2015 alone.2

If you struggle with back pain, please know there are safer, more effective ways to address your pain than filling a prescription for a narcotic pain reliever. Two highly effective means of preventing lower back pain are closely related — staying active and practicing interrupted sitting may help to improve muscle strength and coordination, reduce stiffness and improve blood flow.

Physical Activity Is Foundational for Pain-Free Mobility

Exercise and non-exercise movement are two ends of the same spectrum. Exercise is important to raise your heart rate and improve muscle strength, while non-exercise movement is important for overall health. Both are also important to your back health. The benefits of exercising for 30 minutes or more each day may actually be counteracted by sitting for long periods of time.

While you may not be able to avoid sitting at work, it is important to make accommodations to improve your cardiovascular and musculoskeletal health. It may be tempting to lie down as much as possible when pain strikes, but as counterintuitive as it may seem, the evidence suggests increasing your activity is actually more effective.

So, do consider standing as much as possible during the day rather than sitting or lying down. The benefits of standing and walking as much as possible during the day, while maintaining good posture, cannot be overstated. In fact, using these strategies was exactly how I eliminated my own nagging back pain. Physical activity in combination with a healthy diet and fasting will also effectively address any excess weight you may be carrying that can easily translate into back and knee pain.3

Exercise Lowers Odds of Back Pain by One-Third

A number of studies have concluded exercise is key for the prevention and treatment of back pain. Most recently, a systematic review4,5 of 16 published studies concluded that people who exercised lowered their odds of developing back pain by 33 percent. It also reduced pain severity among those who had pain from the outset.

The studies included a total of 4,310 individuals and ranged in duration from two months to two years. Five of the studies found that, compared to inactivity, exercise lowered the risk of back pain leading to disability by 38 percent.

In conclusion, the researchers suggest a combination of strength training, stretching and/or aerobic exercises done two to three times a week is recommended for the prevention of lower back pain. Lead author Dr. Rahman Shiri of the Finnish Institute of Occupational Health in Helsinki also noted:6

The study shows that exercises for strengthening and stretching the lumbar and abdominal muscles, or a combination of strengthening and aerobic exercises protect against low back pain. Furthermore, exercise reduces the severity of low back pain as well as disability due to low back pain.”

This supports the findings of a 2016 review of 21 studies,7 which found that people with a history of back pain who exercised had a 25 percent to 40 percent lower risk of having another episode within a year than those who remained inactive. As above, strength exercises, aerobics, flexibility training and stretching were all beneficial in lowering the risk of recurring pain.

Updated Treatment Guidelines for Back Pain Highlight Benefits of Activity

The evidence supporting physical activity when you have back pain is so strong, the American College of Physicians (ACP) have now updated its treatment guidelines8,9  for acute, subacute and chronic low back pain, sidestepping medication as a first-line treatment and recommending nondrug therapies instead, starting with exercise.

Considering back pain is a primary complaint for which opioids are prescribed, this change in treatment guidelines could save thousands of people from opioid addiction and death if widely implemented and followed in clinical practice. According to the ACP, one major reason for avoiding drug treatment for back pain is because most patients with acute or subacute low back pain improve over time regardless of the treatment they receive, so narcotic pain relievers are an unnecessarily risky approach.

Dr. Rick Deyo, a spine researcher and professor at the Oregon Health and Science University and one of the authors of the new ACP guidelines, also notes there’s no need to see a doctor for acute back pain, defined as pain that lasts up to four weeks and does not radiate down the leg. He likens it to a case of the common cold — most of the time you just have to wait it out.

Seventy-five to 80 percent of back pain cases resolve within two to four weeks,10 with or without treatment. In addition to exercise, the guidelines recommend using superficial heat, massage, acupuncture and/or spinal manipulation as a first line of treatment for acute or subacute back pain. The only drugs that made the list of treatment options are nonsteroidal anti-inflammatories and muscle relaxants.

Treatment Guidelines for Chronic Back Pain

Chronic back pain may occur consistently, or you may experience times of remission when the pain dissipates and you move about freely without discomfort. Chronic back pain, defined as being present for 12 weeks or more,11 occurs in approximately 20 percent of people.12 For chronic low back pain, the ACP recommends the following treatment options:

Exercise Multidisciplinary rehabilitation
Acupuncture Mindfulness-based stress reduction
Tai chi Progressive relaxation techniques
Yoga Electromyography feedback
Photobiomodulation Cognitive behavioral therapy (CBT) or operant conditioning therapy,13 a branch of CBT where your behavior is modified by its consequences
Motor control exercises Spinal manipulation

As you can see, a number of these treatments involve psychotherapeutic approaches. The reason for this is because mounting evidence strongly suggests that, in many cases, the pain has a psychological or emotional origin. This does not mean the pain is imaginary and not physically real. It simply means that you cannot separate your body from your mind, as they are closely interrelated and work in tandem. As noted in a 2014 scientific review:14

“Specifically with regard to pain, studies pointed to the need for a model encompassing the complexity of the pain phenomenon. The biopsychosocial perspective closes this gap by confirming the existence of a dynamic relationship among biological changes, psychological status and social context … [S]everal studies show the major role of biopsychosocial factors in triggering chronic pain, in the process of acute pain chronicity and in patients’ incapacity.”

You can learn more about this in my recent article, “Is Most Back Pain Caused by Repressed Emotions?” It features the work of the late Dr. John Sarno, which is as groundbreaking as it is controversial.

Drug Treatment Guidelines Stress Lower Dosage and Patient Education

Patients with chronic low back pain who have tried and failed to find adequate relief from nondrug therapies “should consider pharmacologic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line therapy, or tramadol or duloxetine as second-line therapy,” the ACP guidelines state, adding, “Clinicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks … “

The guidelines stress that even in the rare case when an opioid is given, it should only be prescribed in the lowest dose and for the shortest duration possible. Steroid injections and acetaminophen are also discouraged, as studies suggest neither is helpful or beneficial. Acetaminophen does not lower inflammation, and a review of the research15 shows steroids are on par with placebo when it comes to treating back pain in the long term.

Functional Exercises to Improve Back Pain

Strengthening and stretching the muscles in your back and core will go a long way toward preventing back pain. For example, when you sit for long periods of time, you typically end up shortening your iliacus, psoas and quadratus lumborum muscles that connect from your lumbar region to the top of your femur and pelvis. When these muscles are shortened, it can cause severe pain upon standing as they will pull your lower back (lumbar) forward.

When there’s insufficient movement in your hip and thoracic spine, you also end up with excessive movement in your lower back. Research also shows that exercise helps improve your acceptance of pain, which in turn helps prevent inactivity caused by fear that movement will hurt.

As noted by Heather K. Vincent, Ph.D. in an ACSM guest blog, “total body resistance exercise reduces pain catastrophizing by as much as 64 percent. Total body exercise also reduced perception of disability due to pain and pain during physical activities more than lumbar extension.”16

Yoga has demonstrated its usefulness in a number of studies. In one, taking one yoga class per week resulted in greater improvements in function compared to medication or physical therapy.17 The Yoga Journal has an online page demonstrating helpful poses.18

Functional exercises such as the following examples are also recommended for lower back pain. For photos demonstrating each pose, see this Greatist article.19 Ideally, you’ll want to do these types of exercises two to three times per week for 20 to 30 minutes per session.20

1. Decompression breathing: This exercise focuses on maintaining a long, strong spine while breathing deeply. Stand slightly pigeon-toed; toes touching with heels spread slightly apart (this is not an exaggerated position) and knees slightly bent.

Looking straight ahead, shift your weight to your heels and pull your heels together as you reach toward the ceiling with your arms, pressing your fingertips together. With each inhale, focus on raising your ribcage away from your hips. As you exhale, tighten your core to maintain and support this elongated posture. Repeat for several breaths.

2. Founder to forward fold: Moving straight from the decompression exercise above, push out your buttocks, leaning your upper body forward with knees slightly bent. Your arms are still stretched out overhead, maintaining an elongated spine. Keep your head in a neutral position, looking at the floor in front of you.

Hold 15 to 20 seconds, then bend forward until you touch the floor with your fingers. Your arms and back should form a straight line from your fingertips to your buttocks. Remember to keep knees slightly bent. Hold for 20 to 30 seconds. To stand, place your hands on your shins and bring your spine to a neutral position, then sweep your arms back and out to the sides and shift your hips forward as you raise your torso.

In the video below, Dr. Eric Goodman, creator of Foundation Training, discusses how exercises such as “The Founder” can help prevent and treat back pain.

3. Adductor-assisted back extension: Lying on your stomach with flexed feet (so the weight is on your toes) and legs together, press your hips and knees into the floor while lifting your elbows and shoulders off the ground. Maintain a long, straight, neutral neck position. Hold for 20 to 30 seconds, then release and come back down.

4. Eight-point plank: Position yourself on the floor so that your feet, knees, elbows and fingers touch the ground. Your feet should be flexed, knees together, elbows positioned a few inches in front of your shoulders and fingertips gently resting on the floor.

The aim of this position is to form a long, neutral spine, which will require you to work your core muscles. To ensure the proper dynamics, pull your shoulders away from your ears, squeeze your knees and elbows toward the center of your body, and press your knees, toes and elbows down into the mat. Hold for 20 to 30 seconds. If done right, you’ll likely start to tremble before the 30 seconds are up.

5. Woodpecker: Start out in a standard lunge position with the weight on your front heel. Lift your heel and reach your arms out in front of your chest. Then, without shifting the position of your knee, push your buttocks backward until you feel the stretch in your hamstrings. Shift your arms to counterbalance. Once you feel the stretch, tighten your core, maintain a neutral spine, and slowly raise your arms parallel to your ears. Hold for 20 to 30 seconds. Repeat on the other side.

Source : fitness.mercola

Diabetes: The Scary Truth

It is scary that more than 100 million U.S. adults are now living with diabetes or pre-diabetes, according to a new report recently released by the Centers for Disease Control and Prevention (CDC).

The report finds that as of 2015, 30.3 million Americans – 9.4% of the U.S. population – have diabetes. Another 84.1 million have pre-diabetes, a condition that if not treated often leads to type 2 diabetes within five years.

Source: www.cdc.gov/media/releases/2017/p0718-diabetes-report.html

Starting in January Sikorsky Chiropractic will be hosting a monthly health meeting.  Dr. Sikorsky will be your coach and guide you in becoming healthier.  This class will be a safe space where various topics will be covered to improve your overall health.  Each month we will discuss something different at our meeting.  We will include conversation on exercise, diet, sleep, etc. in our meetings.  As January comes near we will provide more information!

Too Much Sedentary Behavior Will Negatively Affect Our Children


Do you have kids?  Are you thinking of having kids? If you answer yes then this is a great article to read!

It’s so important that we make sure we are taking the right steps to instill good habits in our children’s lives to help them lead a healthy lifestyle into adulthood. On top of a high amount of sedentary behavior among children, 1/3 of children are not getting enough physical activity.  It can change!  Our children will follow the example we set so let’s make it a good one!



Children who spend more than three-quarters of their time engaging in sedentary behaviour, such as watching TV and sitting at computers, have up to nine times poorer motor coordination than their more active peers, reveals a study published in the American Journal of Human Biology.

The study, involving Portuguese children, found that physical activity alone was not enough to overcome the negative effect of sedentary behavior on basic motor coordination skills such as walking, throwing or catching, which are considered the building blocks of more complex movements.

“Childhood is a critical time for the development of motor coordination skills which are essential for health and well-being,” said lead author Dr. Luis Lopes, from the University of Minho. “We know that sedentary lifestyles have a negative effect on these skills and are associated with decreased fitness, lower self-esteem, decreased academic achievement and increased obesity.”

Dr. Lopes’ team studied 110 girls and 103 boys aged nine to ten from 13 urban elementary schools. The children’s sedentary behavior and physical activity were objectively measured with accelerometers (a small device that children attach to their waist that quantifies movement counts and intensities) over five consecutive days. Motor coordination was evaluated with the KTK test (Körperkoordination Test für Kinder), which includes balance, jumping laterally, hopping on one leg over an obstacle and shifting platforms.

The tests were supplemented with a questionnaire for parents to assess health variables, before the authors compiled the results into three models to calculate odd ratios for predicting motor coordination. These were adjusted for physical activity, accelerometer wear time, waist to height ratio and home variables.

On average the children spent 75.6% of their time being sedentary, but the impact on motor coordination was found to be greater on boys than girls.

Girls who spent 77.3% or more of their time being sedentary were 4 to 5 times less likely to have normal motor coordination than more active girls. However, boys who were sedentary for more than 76% of their time were between 5 to 9 times less likely to have good or normal motor coordination than their active peers.

“It is very clear from our study that a high level of sedentary behavior is an independent predictor of low motor coordination, regardless of physical activity levels and other key factors” said Lopes. “High sedentary behavior had a significant impact on the children’s motor coordination, with boys being more adversely affected than girls.”

Until now there has been little research into the links between sedentary behavior and motor coordination, but these findings reveal that physical activity did not counteract the negative effects that high levels of sedentary behavior had on motor coordination.

“The results demonstrate the importance of setting a maximum time for sedentary behavior, while encouraging children to increase their amount of physical activity,” concluded Lopes. “We hope that our findings will make a valuable contribution to the debate on child health and encourage future investigations on this subject.”


Wiley. “Children who spend three-quarters of their time in sedentary behavior have up to nine times poorer motor coordination than active peers.” ScienceDaily. ScienceDaily, 15 August 2012. <www.sciencedaily.com/releases/2012/08/120815082723.htm>.
Wiley. (2012, August 15). Children who spend three-quarters of their time in sedentary behavior have up to nine times poorer motor coordination than active peers. ScienceDaily. Retrieved November 4, 2017 from www.sciencedaily.com/releases/2012/08/120815082723.htm
Wiley. “Children who spend three-quarters of their time in sedentary behavior have up to nine times poorer motor coordination than active peers.” ScienceDaily. www.sciencedaily.com/releases/2012/08/120815082723.htm (accessed November 4, 2017).

Get More Sleep, Get Rid of Chronic Pain

Not getting enough sleep – or not enough quality sleep that leaves you refreshed and ready to take on the day? Instead are you fatigued, irritable and ready to crawl right back into bed? A major health issue could be in your future: chronic pain. In fact, your odds of suffering chronic pain due to poor quality and/or quantity of sleep may increase by a factor of two or three compared to people who experience better sleep.

I have some tips for great sleep hygiene!

  1. Get regular. Go to bed and get up at more or less the same time every day, even on weekends and days off!
  2. Sleep when sleepy. Try to only sleep when you actually feel tired, rather than spending too much time awake in bed.
  3. Get up & try again. If 20 minutes pass and you’re still wide awake, get up and do something calming or boring until you feel sleepy.  Sit quietly somewhere with the lights off to tell your brain it’s time to shut down.
  4. Avoid caffeine & nicotine. Avoid consuming caffeine or nicotine for at least 4-6 hours before going to bed.  These act as stimulants and interfere with the ability to fall asleep.
  5. Avoid alcohol. It’s also best to avoid alcohol 4-6 hour before bed.  It may seem relaxing and helpful but actually interrupts the quality of sleep.
  6. Bed is for sleeping. If you use your bed as a place to watch TV, eat, read, work on your laptop, pay bills, and other things, your body will not learn this connection.
  7. No naps. Avoid taking naps during the day to make sure that you are tired at bedtime.  If you absolutely have to nap make sure it’s before 3pm and less than an hour.
  8. Sleep rituals. It can be helpful to do relaxing stretches or breathing exercises for 15 minutes before bed. Even sitting calmly with a cup of caffeine-free tea can be helpful!
  9. Bathtime. A hot bath 1-2 hours before bed will raise your body temperature causing you to feel sleepy as your body temperature drops again.
  10. No clock-watching. Frequently checking the clock during the night can wake you up and reinforce negative thoughts about sleep time.
  11. Exercise. Regular exercise is a good idea to help with good sleep, but try not to do too much within 4 hours before bedtime.
  12. Eat right. A balance diet will help you sleep well but timing is important.  It’s difficult to go to sleep on an empty stomach so having a light snack may be helpful.
  13. The right space. A cooler room with enough blankets to stay warm is best.  Curtains or an eyemask are great to block out the light as well as earplugs to have complete quiet.
  14. Keep daytime routine the same. Don’t avoid activities because you feel tired.  Try to keep them the same as you had planned making sure to not reinforce insomnia.

Developing these good habits can provide long-term solutions to sleep difficulties.  Of course there are many medications used to treat insomnia, but these tend to only be effective in the short-term.  Ongoing use of these medications may lead to dependence and interfere with developing good sleep habits independent of medications.

Chronic pain isn’t something to mess with, but you don’t have to. Let’s discuss any pain you’re experiencing and don’t forget to mention any sleep issues. Whether poor sleep is causing your pain, or pain is causing poor sleep, I can help determine the cause and correct it. Now that’s called a win-win.

  • Sources: www.toyourhealth.com/mpacms/tyh/article.php?id=2431