All Posts tagged back pain

The Primary Causes of Low Back Pain

Acute pain in a woman backHaving treated many cases of low back pain over the years, I have heard lots of explanations of how their back pain began.  I have heard everything from falling down stairs to sleeping on a bad mattress to sneezing.  But at the end of the day, most cases of low back pain originate from only 5 causes. 

1. An acute accident or injury.  For this type of case the diagnosis is typically very straightforward. A slip and fall, muscle strain, vehicle accident, sprain from lifting or similar event often causes immediate pain or pain within 24 hours of the event.

2. Sub-acute accident or injury. This type of case can be a little more difficult because the patient cannot often recall a specific reason for the pain.  It usually stems from a mild injury that went unnoticed by the patient sometime before the pain began. 

3. Chronic pain from ongoing mechanical stress. An example of this type of problem might be a patient that has a desk job that involves hours of sitting each day. Even if they have ergonomic furniture, the prolonged sitting causes back pain.

4. Degenerative discs or joints. These conditions can affect a wide range of patients. This is usually the result of disc and joint deterioration as a result of an injury long ago. Or in some cases, a patient is simply more prone to early spinal degeneration as a result of genetics.

Degenerative joint conditions often develop silently for years and are not revealed until the patient realizes that their back pain is getting worse over time.  Degenerative disc processes also include bulging or herniated discs that can result in pinched nerves.

5. Other disease processes such as arthritis. Although patients are often told that their condition is the result of “arthritis”, but in many cases patients with degenerative disc conditions are misdiagnosed as having arthritis. 

Effective treatment for back pain is dependent on getting the diagnosis right.

If the pain is solely the result of a recent injury or tight muscles, rest and cold packs may be effective.

Many doctors will prescribe pain killers. However, for conditions that have been present for more than a few days, these drugs are likely to bring about temporary relief at best. When the pills wear off, the pain returns. That is because the underlying condition that is causing the pain is not being addressed.

If a patient fails to respond to the first round of drugs, another more powerful selection might be offered. Physical therapy may also be recommended. Physical therapists usually provide treatments such as ultrasound or electric stimulation. These therapies can be helpful for many patients. In addition the patients will often be taught how to do specific exercises at home. This is beneficial for many patients.

If a patient has a disc injury, they may be referred to a spinal surgeon. In extreme cases spinal surgery may be the only reasonable solution. However, spinal surgery necessarily damages healthy tissue while gaining access to the damaged tissue, and should be considered a last resort.

Often patients choose to bypass the traditional medical route and seek alternative solutions for their back pain. Preferred options may include massage, acupuncture and chiropractic care.

Chiropractors are spinal specialists. Chiropractic training includes more time spent studying spinal function in detail than any other medical provider. It make sense that chiropractors will typically have successful treatments for a wide range of spinal issues.

Spinal manipulation is one of the most familiar treatments offered by chiropractors. Many people are surprised to learn that chiropractic care involves much more than spinal manipulation. In our office for example, we provide detailed examinations, therapies such as electrical stimulation, rehab training in corrective exercises, an incredibly wide range of manipulative procedures including very gentle approaches.

Regardless of the cause for back pain, there is likely an effective treatment available. The key is matching the treatment to the correct diagnosis.


Good Posture is Essential for Good Health

We often hear that good posture is essential for good health.  But lately it seems as if bad posture is becoming more of the norm.  I’m starting to see more and more teenagers and twenty-somethings in my office with things like back pain, neck pain, and headaches that are the result of bad posture.  I personally believe this is caused by a combination of things like heavy backpacks, poor posture while at the computer, and video games.  But why is it important to have good posture?

Benefits of Good Posture:

  • Helps us keep bones and joints in correct alignment so our muscles are used correctly. Abnormal wearing can result in arthritis and joint pain.
  • Reduces the stress on the ligaments holding the spinal joints together, minimizing the likelihood of injury.
  • Allows muscles to work more efficiently, therefore preventing muscle fatigue.
  • Helps prevent muscle strain and even back and muscular pain.

Conversely, poor posture can lead to excessive strain on our postural muscles that can cause them to weaken over time.  As a result, people who have chronically poor posture are more prone to injury and back pain.  Stress, obesity, pregnancy, abnormally tight muscles, and poor shoe choices can contribute to poor posture.  Poor sitting, standing, and sleeping habits can also contribute to bad posture over time.

So how are we supposed to sit properly? :

  • Keep your feet on the floor or a footrest, if they don’t reach the floor.
  • Don’t cross your legs.  Your ankles should be in front of your knees.
  • Keep a small gap between the back of your knees and the front of your seat.
  • Your knees should be at or below the level of your hips.
  • Adjust the backrest of your chair to support your low- and mid back or use a back support.
  • Relax your shoulders and keep your forearms parallel to the ground.
  • Avoid sitting in the same position for long periods of time.

How can we stand properly? :

  • Bear your weight primarily on the balls of your feet.
  • Keep your knees slightly bent.
  • Keep your feet about shoulder-width apart.
  • Let your arms hang naturally down the sides of the body.
  • Stand tall with your shoulders pulled backward.
  • Tuck in your stomach.
  • Keep your head level.  Do not push your head forward, backward or to the side.
  • Shift your weight from your toes to your heels or one foot to the other if you have to stand for a long time.

What is the proper sleeping position? :

  • Find the mattress that is right for you.  We recommend buying a firm mattress and adding a pillow or foam top to it if you like a softer feel.
  • Sleep with a pillow.  Special pillows are available for postural problems.
  • Avoid sleeping on your stomach.  Sleeping on your side or back is more often helpful for back pain.  If you sleep on your side, put a pillow between your legs.  If you sleep on your back, put a pillow under your knees.

So now that you know what your posture should be, can you correct your posture if it is not correct?  In a word, yes.  Conscious awareness of your own posture and knowing what your posture should be like will help you consciously correct yourself.  With practice, the correct posture will replace your old posture.  Your doctor of chiropractic can assist you with the proper posture, including recommending exercises to strengthen your core.


Protect Your Back While Doing Yardwork

We’re actually starting to see the first signs of spring here in North Carolina.  After a long and wet winter, a lot of us are as excited as a kid at Christmas to get out and do things outside.  For some, this means getting out and working in the yard.  But before you start tackling the weeds or revving up the lawnmower, remember to protect your back.  Just as playing football or golf can injure your body, the twisting, turning, bending, and the reaching of the mowing and raking can also cause injury to your back if it is not prepared. Like an athlete, without warming up, the chances of injury are greater.  So there are a few things you need to remember to protect your back and neck from yard work.

Here are some tips to protect your back and neck as your do yard work:

Stretch Before You Work

Without bouncing, for 10 to 15 minutes, do knee-to-chest pulls, trunk rotations, and side bends with your hands above your head and fingers locked. Take a short walk to stimulate circulation. When finished with the yard work, repeat the stretching exercises.  This will protect your back by warming up the muscles before and after you use them.


The worst thing you can do for your back is bending over at the waist, especially for long periods of time.  You don’t want to be pulling weeds or planting flowers bending over at the waist while standing.  I usually recommend that my patients kneel down with a mat that you can purchase at any hardware store or get a stool that you can sit on to weed or plant.  This will protect your back from bending over for long periods of time.

Lawn Equipment

You also want to be careful using equipment like weed-eaters or blowers.  You want to hold the tool as close to your body as possible and stand up as straight as you can.  You don’t want to twist with your back either – move your feet as you move the blower or weed-eater.  This will protect your back from the twisting motion which can often cause injury to a disc.


When mowing, you want to use your whole bodyweight to push the mower, rather than your arms and back.  Try to stand up as straight as possible and keep the handlebar close to your stomach.  You don’t want to be bending over at the waist and pushing the mower with your arms extended straight out in front of you.  If your mower has a pull cord, don’t twist at the waist or yank the cord. Instead, bend at the knees and pull in one smooth motion.  Also, keep your head up as your mow.


When raking, use ‘scissors’ stance: right foot forward and left foot back, reverse after a few minutes, putting your left foot forward and right foot back.  You also want to keep your head up as you rake so you don’t get a kink in your neck.


As you pick up piles of grass or leaves, do not bend at the waist.  Make the piles small to decrease the possibility of back strain while doing yardwork.

If you do feel soreness or stiffness in your back after yardwork, use ice to soothe the discomfort.  If there is no improvement in two or three days, see your doctor of chiropractic.


Tips for Holiday Shopping

The day after Thanksgiving is a milestone of sorts in America. It reminds us of just how quickly the year has gone by – and how close we are to the holiday season.  And until we flip the calendar over to a new year, the chaos just doesn’t let up.  Our bodies can sometimes have a hard time keeping up with everything you want them to do.  With the added stress of the season, we need to do everything we can to help our bodies keep up.  Eat right, drink plenty of water, stretch, exercise and take a few minutes to slow down and reflect on what the season is all about.  So here are a few tips to keep in mind while searching for that incredible deal:

 1.  Stay hydrated: Drink eight to ten –ounce glasses of water a day. On shopping days, you may need to drink more.

2. Stretch: Make sure you stretch. When you are stressed-out, your muscles are not as flexible.

3. Foot wear: Wear shoes with plenty of cushioning in the sole to absorb the impact of walking on those hard shopping mall floors. One study showed that 60% of women report wearing uncomfortable shoes when they shop.

4. Clothing: Make sure to wear layers as you will be going from cold to warm.

5. Leave that heavy purse at home:  Leave your purse at home and only bring your driver’s license and credit card or important identification cards. You can also wear a light fanny pack.

6. Frequent Breaks: Plan frequent breaks during your heavy shopping days. Take a break every 45 minutes. 30 minutes if you have less stamina.  Try to eat light foods. Skip the coffee. Coffee and sodas add stress to your body.

7. Lockers: If possible, obtain a locker. Lockers can cut down dramatically on how much you have to carry around. If your mall or shopping center does not offer lockers, try to plan frequent trips to your car. Don’t carry around more than is absolutely necessary.

8. Diet: We need to eat better around the holidays. On average, people gain 5 to 6 pounds. Eating a heavy meal and then running around shopping can be very dangerous.