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MAX HEALTH

Oh My
Aching
Back!
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 youre perfectly fne, and the


next minute, youre lying on the foor, 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 affect
the spine. As we get older, our muscles become
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MAY 2015

weaker and cant 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
infammatory disorders of the spine
caused by arthritis and osteoporosis,
added Dr. Liu. All of these conditions
can cause lower back pain.
While we cant 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 huge
difference to our lower spine health,
he said.

Back Pain Triggers

How Long Should


I Be on Bed Rest
For Back Pain?

When your back hurts, its


normal to want to lie down.
But according to the National
Institutes of Health, too much
rest can make back pain worse.
Instead of taking to your bed
for days, its recommended that
you limit your rest to a day or
two to help calm the symptoms
and reduce inammation. After
that, moving around by gentle
stretching and walking can
help you get better. As
for your workout wait for
two or three weeks to resume
vigorous activities.

Here 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 and
regimens 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 dont realize that
too many repetitions while exercising,
especially while lifting weights or
doing squats, can cause back pain.
Exercising is defnitely a good thing,
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 bodys 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 youre sitting in an
uncomfortable, unsupportive chair, it
can force the spine out of alignment.

HOW FUNCTIONAL
MOVEMENT
SCREENING CAN
HELP WITH BACK PAIN

Chris Tomshack, DC, founder


and CEO of Health Source
Chiropractic and Progressive
Rehabilitation, doesnt use an
old school technique spinal
manipulation alone to treat
his patients with back pain
these days. Instead, he said, I
use a progressive rehabilitation
program that starts with functional
movement screening.
Functional movement
screening, or FMS, said Dr.
Tomshack, is a diagnostic tool
to identify muscle asymmetries,
tightness and weakness that may
lead to (or already has led to)
injury by examining the mobility
and stability of the hips, core,
shoulders, knees, spine and
ankles. The FMS, administered
by a trained health professional,
such as a chiropractor or
physical therapist, seeks out
poor movement patterns during
seven different exercises, such
as deep squats and in-line
lunges. Its an objective way
to evaluate problems, and also
when repeated after treatment,
provides a measure of progress,
said Dr.Tomshack.
After the FMS test, a treatment
plan is developed, he added,
which involves functional
stretching and exercises to
retrain faulty movement patterns,
in addition to deep tissue
massage and chiropractic
manipulation. When you
combine these treatments, they
work synergistically to reduce
pain and prevent re-injury, said
Dr. Tomshack.
The fnal step in back
rehabilitation is to help people
with lifestyle changes, such as
better nutrition and exercises to
do at home to maintain spinal
health, he added.
To fnd a certifed FMS
provider in your area, check out
FunctionalMovement.com.
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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 overthe-counter pain medications and rest,
noted Dr. Liu. But if it doesnt go away,
if it keeps you up at night or if you
have weakness, numbness or pins and
needles in your extremities, its best to
see a medical professional.
Techniques to diagnose the cause
of 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?

Its a continuous debate should


you use heat or cold to relieve
symptoms of back pain? Most
experts say that it depends upon
the type of pain. If your back
pain is related to an injury like
a strain or sprain, cold works
best for a day or two to reduce
inammation. After that, heat will
help to relax and soothe muscle
tissue. For those experiencing
chronic pain, heat will work best.
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MAY 2015

SHOULD YOU HAVE SURGERY?

Youve done everything your doc recommended: the tests, physical therapy, exercises
and pain medications and still, after six months, youre experiencing back pain. Should
you consider back surgery?
Not necessarily, according to David Hanscom, MD, a Seattle-based orthopedic spine
surgeon. Spine surgery should only be considered for specifc structural problems, and
most back pain is not related to a structural problem, he said
Instead, explained Dr. Hanscom, author of Back in Control, A spine surgeons roadmap
out of chronic pain, the pain is often either a result of injured soft tissue (muscles or
ligaments) supporting the spine, or, in the case of many chronic back pain sufferers, a
permanent neurological problem Mind Body Syndrome that has evolved from the
pain itself.
To explain how pain can actually cause more pain, Dr. Hanscom likens it to learning
to ride a bike or learning a new athletic skill. When the brain is hammered with the
same pain impulses day after day, week after week, it becomes more and more effcient
in processing them, he said.
In other words, continuous pain impulses from your back eventually causes pain
circuits to become imbedded in the nervous system, to the point that even if the pain itself
has abated over time, you experience it as the same or even greater because your
nervous 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 amputated
continues to feel the pain even after the damaged or diseased limb that was causing
discomfort has been removed. Its a reminder, he explained, that the brain is an extremely
complex and sophisticated computer which is programmable.
And its not only the pain that your brain programs, said Dr. Hanscom. It also programs
negative thoughts related to pain, which intensifes pain. Finally the situation is made
worse by the side effects of pain and negative thoughts: anxiety, sleep issues and anger.
The answer, according to Dr. Hanscom, is a defned organized comprehensive
care program that revolves around education about the problem, management of sleep
and stress, short-term medications, physical conditioning and actively working on a
healthier life outlook. Through tackling all of these things at once, you can calm down a
turbocharged nervous system, reprogram your brain and make a full recovery.
Hanscoms 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 defned
organized comprehensive care program. To learn more, log on to Back-in-Control.com.

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