Tag Archives: back pain

Computer Users and Chiropractic

I did tech support  before becoming a chiropractor.  I know how hard it can be on the body.  We often talk about having a cushy office job.  If any of you have ever tried it then you know that doing nothing for a long period of time can be very hard, emotionally, mentally, and physically.  Perhaps even harder than an active job.  Office workers will often sit for 8 hours straight.  This can lead to structural weakness in our bodies.  Especially when we do it with poor posture.

Office workers often experience low back pain caused by normal daily activities because the ligaments in their low back have stretched to accommodate the slouch, and are therefore not able to handle regular activities.  They also often get upper back or neck pain from poorly set up work stations leading to poor posture.  Arm symptoms include tingling, numbness and pain.  Often over diagnosed carpal tunnel syndrome symptoms may develop.  These are some of the more common symptoms related to office workers.

These problems are not without solution.  And the solution is relatively easy, it just takes effort.  Don’t sit in the same position for more than 20 minutes.  Stand up every half hour at least for 5 minutes.  You don’t have to exercise, though that would be great.  Set a timer to remind you.  Stretch before and after your shift, your arms and wrists, your back and legs. Do a full 10 minutes of something to get you moving again.

Talk to your boss to see if he will allow time for this kind of thing.  I promise if he’s a good boss and you don’t abuse it he’ll be happy to have a healthy and more productive worker.  You may even implement a company wide policy.  Your company may even have reduced rates for workers compensation coverage for doing it.  If your employer is hesitant invite a local chiropractor to come talk about the benefits of a program like this to the company.  Companies loose millions each year because of back pain.  Time off, unproductive time, etc…

If it’s too late, and you already have these symptoms, your chiropractor can help.  It’s all about function, and a chiropractor can help restore that function, so that you can get back to living life.

Healthcare On A Budget – Part III Conservative Care

Get CONSERVATIVE CARE FIRST. It’s cheaper. There are almost always more than one way to treat any given condition, and some of them will not work.  That’s just the nature of healthcare.

Conservative treatment means that you use the best tool to get the job done with the least amount of risk. The most obvious example is if you have low back pain, the most conservative treatment is to stay active but take it easy. Or you could go to a surgeon to get an MRI and multiple other test to determine if the back pain is surgical. That seems kind of ridiculous.  It’s easy to see when you use extreme examples like that. It may not be so easy when comparing things like chiropractic adjustments to prescription medication.

If you were to walk through the levels of care and note the risk involved it may become clear. Let’s use the same example of back pain. Chances are in a day or so you’ll be back to normal if you just stay as active as you can but take it easy. That has very little physical risk, but does cost you a sick day or two. Hot packs and massage cost a little more and have a little more risk.

If the problem is not improving with the most conservative option move up the chain. You should be examined by a doctor. The least expensive physician with the most training in musculoskeletal conditions is a chiropractor. Chiropractic has little more risk than a massage and does not introduce foreign chemicals, needles or a scalpel into your body. The cost of chiropractic is limited to what happens while you are in the office, there is no additional charge for medication. When you leave the office you feel better. You don’t have to go to the pharmacy and pay more so that you might be able to mask the symptoms.

Generally speaking cost is relative to risk. Food for thought: the cheapest back surgery is going to be about $50,000 that’s over 1200 chiropractic visits in my office. How long would it take you to use that many visits?

Your Commute and Your Spine

With modern transportation people have opted to live far away from their jobs.   This has it’s advantages.  It is also causing problems for commuters.  Most sources agree that the average American spends about 30 min in their car to get to work.  That’s an hour a day, and more time each year than you spend on vacation.

Your back is taking a beating from all this driving.  Car seats are designed for looks not usually for support, and even when we have a good one we rarely use it properly.  But let’s not dwell on the bad.  Here are some ideas to help with this problem.

  • If you can, move closer to work, bike, walk or run to work.  You get your exercise and you avoid the car.  You might be surprised at how easy it is to bike to work at least some days.
  • Keep yourself fit.  Diet and exercise can help your body handle a lot. Chiropractic can help you keep your body in peak condition.
  • Take your wallet out of your back pocket.  I’ve seen some huge wallets.  At least take it out for your commute.
  • Relax.  Leave early so traffic doesn’t stress you.  Listen to relaxing music while driving, and avoid stressors in general.
  • Park far away.  This is especially important for those who sit in offices all day.  This will get your legs and back moving a little before you have to sit again.
  • Use proper posture in the car.  Sit upright and relax your shoulders.  If it helps you get a lumbar support from a store like relax the back.  Adjust your seat to help you sit properly.  Men usually sit to far back with their legs fully extended, and women usually sit to close.  Keep as much of your thighs on the seat as possible.
  • Adjust the seat when you get uncomfortable rather than shifting yourself.

These ideas can reduce the chance of you having to come see me, but if you do find your self with back pain from driving see your chiropractor.  The sooner you come in the less damage is done and the less time it takes to correct it.

When Should I Go To A Chiropractor?

skeleton

The primary thing that you should see a doctor of chiropractic for instead of a medical doctor is joint dysfunction, sometimes chiropractors will call this “subluxation.” The problem is the same with either term. “What is that?” Medical doctors and chiropractors use different terms so I’ll try to list some of the more common diagnoses terms and explain why and how a DC should be preferred over an MD for those conditions.

Back pain of any kind. I say this, knowing that there are causes of back pain that a chiropractor cannot treat. They should be a first line provider when it comes to back pain. The advantage of seeing a chiropractor first for back pain is that it is their expertise. They have had more class and clinical hours studying and treating the back than the average MD. So, even if they can’t treat it, they are better equipped to diagnose and refer to the right person. They can also treat most back pain generators. Even the studies with the worst outcomes show that chiropractic is at least as good as standard medical treatments (most show better results) for low back pain with higher patient satisfaction, and lower risk. The second reason to see a chiropractor is cost.  A full treatment plan with a chiropractor will cost about the same as the initial MRI at a hospital ER.

If you’ve been in a car accident, after visiting the ER, and in the absence of life threatening findings there you should proceed to your chiropractor. The ER doctors will often say something along the lines of well we can’t find anything on our tests, it looks like you have a little (fill in the blank…whiplash, sprain/strain, pulled muscles, bruising, etc…). They will usually send you home with a prescription for some pain medication. They don’t deny the pain or the injury, they just don’t have any medication to treat these injuries. These injuries are what chiropractors deal with. Like with MDs, DCs cannot cure a sprain or a strain, but they can improve healing time, and reduce pain without the risk/side effects that medication has.

Pregnancy back and muscle aches. This statement is not intended to negate medical monitoring of a pregnancy. Chiropractors should not be substituting for an OB/Gyn if that is the care you choose. With pregnancy however most medications are out, due to possible harm to the baby. In this circumstance you want your treatments to be as conservative as possible. Again, that is a chiropractors realm, conservative care.

Headaches are one of those areas that are middle of the road. Most headaches are just tension headaches, and chiropractic has a very high success rate treating them. The problem is most people don’t go to their doctor for the average tension headache, they go for chronic headaches, migraines, cluster headaches, etc… With these I wouldn’t say one was better than the other. Because the cause of headaches vary so much you could start either place. The big advantage that I would give chiropractic in this case is that it is more conservative, and they won’t start with drugs. If you aren’t seeing some results with a chiropractor within 2 weeks I would recommend looking into other things, and for that matter the chiropractor should be looking to refer you about that time.

Difficulty moving, such as when you bend down and can’t stand back up, or you can’t turn your head properly to back up your car. Stiffness or soreness is also something to go see a chiropractor about. Basically anytime you have a mechanical problem be it muscles, bones, or joint structures head to your chiropractor.

Repetative stress injuries, whether they be work related, sports related, performance related, or what ever. RSI’s are something that I’ve discussed in depth previously. See here for the start of the discussion series.

I’m sure that I’ve missed many, and I hope that my chiropractic friends will correct me with comments to this post, but I hope this is a good starting point for those of you who are looking for a way to judge who you should go see.

A chiropractor can be a primary care provider and at times are. You should be able to go see your chiropractor for any reason, and he should be able to help you either through chiropractic treatment or by referring you on to the person who you should see. However, if there is a medical doctor around you would save time by skipping the chiropractor and going straight to the MD if you have a fever, bowel and bladder problems, you are oozing fluids, or have cancer. Those are things chiropractors don’t usually deal with.

Utah Spinal Care

USClogo2I’m back in Utah.  I have decided that rather than opening up my own private practice that I would instead work at an already established practice.  I am now the primary treating doctor at Utah Spinal Care.  Utah Spinal Care is a family practice office in Sandy Utah just up the road from Rio Tinto Stadium and the South Towne Expo Center.  We are located at 880 E 9400 S Sandy, UT 84094.  For directions, maps, pricing, etc.  please visit the website or our Facebook page.  Come visit us and pass the word along.  If you or anyone you know is in need of some Spinal Care give us a call to set up an appointment at 801-523-0073.

Inversion Tables

One question I have been asked often lately is what I think of inversion tables/therapy. To be honest I hadn’t really thought much about this particular method of spinal decompression.

Table from Relax the Back

On further investigation it appears to be just what I expected, generalized spinal decompression.  Research is sparse and biased, but the theory seems sound.  When you stand all day gravity pulls you down which causes compression of your body and the specific anatomy that is designed to handle compression is your spine, specifically  the intervertebral discs.  One related fun fact is that you are taller in the morning than at night.  Your discs take on fluid all night long while there is no pressure on them from gravity and are full when you wake up.  All day long that fluid is compressed out, thus you shrink.  Inversion tables allow you to reverse that trend for a few minutes.  So if you are experiencing back pain due to compression these tables may provide some relief, or even allow the body to heal.

I would say that it is safe, but would not recommend this therapy to people with cardiovascular problems, glaucoma, are pregnant, or other conditions where increased pressure going the opposite direction could cause problems.  I would also recommend having another person present when using this therapy in case something does go wrong.  There are decompression tables that can be used without the risks of inversion.

One thing I should mention; in any form of decompression if you have a sprain or strain it will increase, not decrease your pain.  In this case you would just be pulling on already injured soft tissue.  Decompression is more for chronic pain, not acute sprains or strains.  I have seen success with patients in using the more specific decompression, but they are always in my office and monitored.  I have not had first hand experience with inversion.  If it works for you then by all means use it.  Inversion products range from $100’s to $1000’s.  You could also just hang upside down at your local jungle gym.

Back to School

It’s that time again.  Students are getting ready for the new school year.  They and their parents are school shopping, and one of the key items on the list is a backpack.  Whether starting kindergarten or finishing your senior year of college your backpack is going to be heavy.  Backpacks are a concern of chiropractors because we see the damage from them in our offices.  Unsurprisingly studies have found a link between backpacks and back pain, and it seems to be increasing in our youth.  (Seriously, have you seen the size of some of their textbooks lately?)  Despite our great access to information online or in digital forms students are often still asked to haul sometimes massive weight.

There are many things that you can do to reduce the stress on your self, your children or your students.

  • Make sure the backpack weighs no more than 5 to 10 percent of body weight.  That’s about 5-10lbs for most elementary school kids.
  • The backpack should never hang more than four inches below the waistline.
  • Buy a backpack with individualized compartments  to positioning the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your back.
  • Smaller backpacks will not allow you to overload your body, and they will fit children better.
  • Wear both shoulder straps. Lugging the backpack around by one strap can cause the disproportionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.
  • Wide, padded, and adjustable straps are very important to ensure proper fit and comfort.
  • Be actively involved in your school and community.  Encourage schools to adopt policies that limit backpack weight, such as using workbooks, books with DVD content, provide assignments online discuss options with teachers and administrators.  Be creative, and understanding.

Motrin Attack Ad

I’m not in marketing as a career, but I do use marketing, and to me this recent ad put out by Motrin seems to attack the very market that they want to buy their product.

Here’s the video:

The ad mentions back, shoulder and neck pain.  I’m not sure how Motrin fixes those symptoms.  Now I know that Motrin is a pain medication.  They want to sell you drugs to mask the pain.  I am a musculoskeletal specialist, a chiropractor who works with a lot of pregnant women and new moms.  I know there’s stress added by carrying a child but carrying weight closer to your body actually reduces the stress to your spine, a real solution that Motrin seems to be mocking.  And, a carrying device can relieve the stress on your arms and neck.  The other option is not picking your children up, or as the ad suggests take a medication to mask the pain so that you can be trendy.

This ad says to me that moms are too stupid to take care of themselves, that all they do is follow the crowd.  It seems to say that carrying your baby close to you is only a fad, as though carrying your baby is a bad thing and that bonding experiences with your children are something negative.  The implication is that moms are selfish that that they put up with children rather than love them.  It speaks as though having a child is just a status symbol or “popular these days.”  I just saw the ad and am offended.  I haven’t looked into it, but I imagine Motrin just got some press that they didn’t count on.  Seriously who’s in their marketing department?

I don’t think they realized that the mom’s who buy these things do so because they are interested in taking care of themselves and their children.  They are the kind of women who try to eat right and exercise, they are the kind of women who avoid medication because they’ve done their research and know that there is no medication out there without risky side effects.  They carry their babies not because it’s in fashion, but because they care enough to do what they think is right.

There is a strain from pregnancy and carrying your children,  there are also natural ways to take care of your self to prevent and relieve that pain.  Carrying your baby closer to you is one of those ways.  It’s not like Motrin is a vitamin.  It’s not helping your body any.  If you do have back pain caused by carrying your child see an expert in the field visit your local chiropractor.  Don’t get health care advice from a drug company.  There is much that can be done to help you enjoy your life without pain, without medicating yourself.

Lumbar Disc Herniation

Blown disc, slipped disc, herniated disc, bulging disc, etc.  There are many names for a vertibral disc herniation.  This is a hard subject to keep short.  I will attempt to just give basic, simplified information to limit the length of this post.

A disc herniation has various levels as with most injuries.  The worse the herniation the more complicated the symptoms and the treatment.  Most herniations can be resolved and respond well to conservative care such as chiropractic.  In fact most herniations will resolve on their own in 6 months, but no one wants to wait 6 months for their back pain to go away.  With chiropractic treatment the symptoms are often reduced to less than 50% in 6 weeks or less, and can at times be resolved completely in as little as 3 months.

Disc herniations can happen to anyone and they don’t have to just be in the low back.  They can happen due to constant pressure of poor posture, sudden pressure due to trauma, weakened muscles and ligaments or weaknesses you’ve had since birth.

Some of the signs that you may have a herniation are: a sudden onset of low back and possibly leg pain that can go all the way down the leg.  The pain is usually described as a sharp or shooting pain and increases with bending forward, (although this direction of bending is typical it is not universal) or pressure increases such as coughing, sneezing or having a bowel movement.

Image from Spine Universe

Image from Spine Universe

Treatment for disc herniations are many,  the ultimate goal is to get the disc to reabsorb back in.  To understand any treatment you must understand the nature of an intervertebral disc.  (video) It’s kind of like a Jelly donut.  If you squeeze a jelly donut the jelly comes out.  If you only do it a little bit and then take the pressure off the jelly will kind of suck back in.  If you relieve the pressure and the damage isn’t too severe the disc will suck it’s nucleus back in and repair with time.  This is called decompression.  It can be accomplished many ways, and there is still debate as to which method is best.

The big problem with disc herniations is that often the pain is too severe to receive treatment.  So, the initial goal is to reduce pain enough to be able to be treatment.  The sooner you can get up and moving around the better the prognosis is going to be, even though there is severe pain. Some pain control techniques are cold packs, electric stim, mechanical spinal decompression, and if required pain medication.

The next goal is to centralize the pain.  Many patients worry when their back starts to hurt worse, but if the pain is coming out of the legs and centering around the pain generator it is a good thing.  Centralizing the pain means that we are relieving the pressure on the nerve.  After the pain is centralized, treatment becomes more normal and regular.

Once you’ve had a disc herniation you may be predisposed to injury in the future, therefore it is essential that you begin some form of core strengthening routine to build up your muscles so that they can protect from future injury.

Disc herniations can be very painful and can interrupt your life for quite some time.  The good news is that with chiropractic care you can often avoid surgery and be back to normal again relatively quickly.

More info…