Tag Archives: spine

Understanding Pain: Why Do We “Pick the Scab?”

The following information is from a great book meant for the non-physician to help resolve their own back problems. The book is by Stuart McGill PhD and is called “Back Mechanic: The Secrets to a Healthy Spine Your Doctor Isn’t Telling You.”

I highly recommend the book if you have suffered or are suffering from low back pain. The end goal is to remove the stressors and spare your spine with proper movement and strengthening exercises.

“Many back pain sufferers would experience a huge breakthrough in their recovery if they only realized that is was their flawed movement patterns that kept them pain-sensitive. Much like a scab forming on our skin, our backs are constantly trying to patch and health themselves. We, however, by continuing to repeat harmful movement patterns in our daily lives cause re-injury. We are essentially “picking the scab.” It is unreasonable to expect the body to heal if we continue to provoke it in the same way that led to the original injury. Continued provocation of pain sensitizes the nerves so that the pain is triggered with even less stimulation. Remove the provocative motions and we can find the solution.

Here’s how pain sensitivity works: people increase their sensitivity through repeated stressful and painful loading. These muscles and joints are loaded with sensors: pain sensors, pressure sensors, force sensors, chemical sensors. Some detect carbon dioxide; some detect pain, some sense histamine for inflammation. Human joints are packed with sensors that relay position and movement information to the brain. These signals travel along the sensory nerves. Along the highway of nerves, there are checkpoints or “gates,” at junctions. According to the Gate Theory of Pain, the idea is, to flood the checkpoint with “good information,” in other words, signals associated with pain-free movement. In this way, there is no more room for the pain signals as they are crowded out.

Try this: close your eyes and find the tip of your nose with your finger like in a roadside sobriety test. You are using kinesthetic sensory organs that run throughout your arm to navigate. These sensors alert the brain as to the position of your forefinger in relation to your nose. The sensation of this simple pain-free motion dominates the information traffic on your sensory nerves with feel-good kinesthetic sensory information that identifies position, length, and force. Finding and repeating pain-free motions in your back will cause the remaining painful activities to hurt less. Read the previous sentence again – it really is that important.

By discovering and engraining positive movements for your back, you will find that the pain often dissipates and then disappears entirely. This is because when we remove pain triggers and stop “picking the scab” we give our tissues a chance to rest, heal and regenerate. Simultaneously our sensors for pain are actually being desensitized. Master this, and you have mastered your back pain.

For those of you that have a known type of injury, a name to attach to your condition, your personal recovery strategy should always begin with avoiding the aggravating posture for your unique spine is key to getting yourself back on track.

Various symptoms of back pain have a distinct and known cause (although this information is not widely known making this book uniquely valuable). Injuries can be avoided if we avoid the injury mechanism itself. Here’s a recap of some pain avoidance strategies, as well as an introduction of some that will be discussed later. The knowledge in this chapter will provide the foundation that will help you:

  1. Locate and eliminate the cause of your pain- get an appropriate assessment that provides a specific diagnosis ( you will be able to obtain your own by reading chapter 6).
  2. Increase your consciousness around what movements and postures cause you pain.
  3. Develop replacement postures and movement patters that enable you to function pain-free.
  4. Stabilize your torso, core, and spine to remove painful spine joint micro-movements.
  5. Develop a daily exercise plan that includes walking.
  6. Mobilize your hips
  7. Learn to create power at the ball and socket joints (hips and shoulders).
  8. Learn exercises that are based on patters of movement: push, pull, lift, carry, lunge, squat, etc.
  9. Make healthy spine choices when sleeping, sitting, or engaging in more demanding activities.

You’re on your way to learning the secrets of a pain-free lifestyle! Let’s make it happen!”

Symptoms of Tech Neck

Tech neck happens when people spend too much time with their head and neck extended too far forward over their body while looking at a computer screen. It can also happen when people repeatedly tuck their head down over their chin and hunch their shoulders while sending or receiving text messages on a cell phone.

Symptoms:
•Neck pain •Shoulder pain   •Shoulder blade pain •Pain in arms and hands •Numbness in thumbs and fingers •Headaches and/or Migraines •Fatigue •Eye strain and blurred vision

  • Minimize Tech Neck by:
  • Bring screens to eye level
  • Use a tablet or smartphone holder
  • Take frequent breaks from screens
  • Strengthen mid back and cervical extender muscles

Call Dr. Steve for help with your posture and tech neck!

Can disc herniations shrink over time?

Yes disc herniations can shrink over time!

This study found that DISC HERNIATIONS RESOLVE BY THEMSELVES THE MAJORITY OF THE TIME! That is awesome. The study found that the overall incidence of spontaneous resorption after LDH was 66.66% (95% CI 51% – 69%). The incidence in the United Kingdom was 82.94% (95% CI 63.77% – 102.11%). The incidence in Japan was 62.58% (95% CI 55.71% – 69.46%).

There is hope! Chiropractic works to restore normal mechanics to the spine and corrective exercise can help this process along.

Pass this along to anyone who is suffering! And if you are suffering be sure to make an appointment with Dr. Steve!

 Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis.

www.ncbi.nlm.nih.gov/pubmed/28072796/?fbclid=IwAR0dt9NxXyRk-mS2YVujQJHsaHq–TfITH0xGr0f1gFALeIjqVX-nsuTQ8I

What happens you get adjusted?

Chiropractic adjustments help restore proper mechanics to the spine or the joint being adjusted.

A Spine Journal study was “the first to measure facet gapping during cervical manipulation on live humans”.

A patient being adjusted by Dr. Sikorsky

The results demonstrate that:

  • Target and adjacent motion segments undergo facet joint gapping (0.9 mm ± 0.4mm) during manipulation.
  • Intervertebral range of motion is increased (8-13 degrees) in all three planes of motion after manipulation.
  • Pain score improved from 3.7±1.2 before manipulation to 2.0±1.4 after manipulation.

Anderst WJ et al. Intervertebral Kinematics of the Cervical Spine Before, During and After High Velocity Low Amplitude Manipulation. The Spine Journal Volume 18, Issue 12, December 2018, Pages 2333-2342

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

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.

What type of running shoe should I get part 1

I’m going to do a multi-part blog on running and running shoes! Running and advice on the proper shoe are topics often brought up in my clinic so why not share for easy reference?

Starting with part one:

Here one question I get often:  I’m going to start to run to get in shape, so what brand (x) of running shoe?

There so many variables that go into the question.  Your biomechanic faults/deficiencies, anatomical variants,  the current level of your strength, the current level of fitness, what is your running form/style. Plus add in what you do for a living.  A construction worker has different stress on the body then a person who sits at a desk all day.

In my opinion, it’s better to start with yourself.  First, improve your body and then work on your running mechanics.   After, try to find the best style of running shoe based on comfort.

I like to take a “ground-up” approach.   The first thing to do is to make your foot and lower extremity better.  Fixing any joint dysfunction and then working on making your body stronger and more flexible is a great start.

Next is to improve your running form. I would video record the person running and make any necessary correction.  RUNNING is a SKILL and will need to be practiced.  

After doing all of the above, the patient will be less likely to get injured.  Plus it will be easy to find the right running shoe.

How much protein do you need per day?

How much protein do you need per day?

As with most things in nutrition, there’s no simple answer. Your individual needs will depend on your health, body composition, the main goal you have, and level of physical activity (type, intensity, and duration). Even when taking all of this into account, you’ll end up with a starting number, which you’ll need to adjust through self-experimentation.

Daily requirements are expressed in grams of protein, either per kilogram of body weight (g/kg) or per pound of body weight (g/lb).

  • If you’re of a healthy weight and sedentary, aim for 1.2–1.8 g/kg (0.54–0.82 g/lb).
  • If you’re of healthy weight, active, and wish to keep your weight, aim for 1.4–2.2 g/kg (0.64–1.00 g/lb). Try for the higher end of this range, as tolerated, especially if you’re an athlete.
  • If you’re of healthy weight, active, and wish to build muscle, aim for 1.4–3.3 g/kg (0.64–1.50 g/lb). Eating more than 2.6 g/kg (1.18 g/lb) is probably not going to lead to greater muscle gains, but it can minimize fat gains when “bulking” — i.e. when eating above maintenance in order to gain (muscle) weight.
  • If you’re of healthy weight, active, and wish to lose fat, aim for 2.3–3.1 g/kg (1.04–1.41 g/lb), skewing toward the higher end of this range as you become leaner or if you increase your caloric deficit (hypocaloric diet).
  • If you’re overweight or obese, aim for 1.2–1.5 g/kg (0.54–0.68 g/lb). You do not need to try to figure out your ideal body weight or your lean mass (aka fat-free mass). Most studies on people with obesity report their findings based on total body weight.
  • If you’re pregnant, aim for 1.66–1.77 g/kg (0.75–0.80 g/lb)
  • If you’re lactating, aim for more than 1.5 g/kg (0.68 g/lb)
  • If you’re vegan or obtain most of your protein from plants, then protein requirements may be higher due to the inferior protein quality (both the EAA profile and bioavailability) of plant-based proteins relative to animal-based proteins.

https://examine.com/nutrition/how-much-protein-do-you-need/#summary1

Congratulations, Bob!

bobmiller

We want to say a huge congratulations to one of our amazing patients! Bob recently completed the “Strolling Jim” UltraMarathon. This race included 4,000 feet of elevation, 4,000 feet of decline and a total of 41.5 miles! What an accomplishment, Bob! We are so proud of you!
We also received the message below from Bob after his race. We are so glad we could be a part of your journey. 🙂
“Thank you to Dr Steve and Nickie for, without whom, I could not have achieved my goal of finishing my latest UltraMarthon of over 40 miles and 4000 ft elevation AND 4000 of decline. Thank you Dr and Nickie!!!!!”

If you’re training for a race Dr. Steve can help! Call the office and get race ready!

Strengthening the Glutes Can Help Back Pain!

Here’s a great exercise to help strengthen the Gluteus medius.

Myofascial pain syndrome (primarily involving the gluteus medius) is present in the majority of patients with LBP (73%) , sciatica (50%), and LBP with sciatica (85%).”

Kameda M, Tanimae H. Effectiveness of active soft tissue release and trigger point block for the diagnosis and treatment of low back and leg pain of predominantly gluteus medius origin: a report of 115 cases. J Phys Ther Sci. 2019;31(2):141-148.

It hurts when I do my rehab exercises!

What to expect when starting rehab or exercise program?

It’s normal for the pain to increase when starting any rehab or exercise program if you have chronic or persistent pain.  This is normal and over time this will improve.  Exercise/rehab will decrease the pain over time.  It will take time.  So stick with it and you’ll get better!

Here’s a nice paper that goes into the mechanism of how exercise works.

Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena

https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP273355?fbclid=IwAR00pU_w5lH5XFbzyQl97uiP8nlntGXiqQppQPLKlPqZ3bSeo0-1M907vKs&