What options do you have for treating back pain?

 

Joint manipulation

 

Some patients love to be adjusted. Many who have never been adjusted before have many questions. Let me share with you a story about a patient, let’s call her Amy, who had such dramatic results with manipulation that I only saw her for 2 visits: the first visit and the second to make sure everything was ok. Amy had suffered from low back pain for many years. Possibly as a result of her job which involved a lot of sitting for long hours. Truth be told, we aren’t certain that her workspace was the most ergonomic that it could be, and after years of torturing her poor back, she finally had an epidural steroid injection followed by back surgery at one level. Well, the good news was, the surgery was a smashing success. The bad news? Shortly after the surgery she started to experience severe muscle spasms which were not responsive to prescription muscle relaxants. Amy had never been to a chiropractor before but was referred to us by her orthopedic surgeon and her insurance company. With those two referrals in hand she thought she may as well give it a try but she was very tentative when she came in. Let me give you the short version of this already too long story. Though we don’t always adjust patients and not usually on the first visit, we adjusted Amy. Her pain relief was immediate and sustained. We had her come back in to see us in a couple of days just to make sure she was doing ok, and she was. The last we spoke she was having difficulty remembering what that 8/10 pain that brought her to our office actually felt like.

Very recently I had another patient come in, this time a gentleman, with a similar situation to Amy’s. In this case it took more than 2 visits and a couple of other interventions but the results were just as dramatic and meaningful for the patient’s quality of life.

There have been many incidents of a quick adjustment very quickly changing the course of a patient’s pain. It must be noted however that the majority of our patients see results from adjustments over time in conjunction with other tools in our tool kit.

If you have never been to a chiropractor, you probably have wondered what people mean when they talk about going to the chiropractor to “get their backs cracked.” I’m with you: anything called cracking the back sounds a little dangerous to me. So let’s refer to it by its proper name: Joint manipulation. First let me reassure you. There is nothing cracking or breaking! To treat pain and mobility issues chiropractors may mobilize joints (the spinal manipulation/ adjustment.)   Some specially trained MD's DO's and PT's offer this service too.  Some patients have joints that aren’t moving properly. If it is severe enough these joints may contribute to patients being unable to perform range of motion exercises or may find performing these to be very painful. This pain may contribute to muscle spasms which may cause more pain in a seemingly never ending cycle. 

The joint manipulation is theorized to work in a number of ways. The aim of the adjustment is to get the joint to the end of its range of motion and then to take it just a little bit farther to reduce pain, spasm and improve range of motion. The clicking or popping sound that many patients hear (and call cracking) is attributed to the gasses expanding within the joint when the joint is stretched. Similar to the sound you hear when you open a can of soda. Most often, there is no pain. Side effects are few and far between with the most common being soreness in the area, similar to what you may feel if you have a strenuous workout. This usually goes away within a short time.

What has helped a lot of our patients who were reticent about being adjusted is looking at the scientific literature.  Lots of studies come to the same conclusion: 

" Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability and patient satisfaction [compared to] patients seen by other health care providers." Journal of manipulative and physiological therapeutics 2005.

 "[Chronic LBP treated by a chiropractor showed better outcomes in one month than patients treated by a PCP.]" JMPT 2000.

 "[Cervical manipulation showed significant improvement in... neck pain and dysfunction and headache.]" Duke evidence report 2001. 

Another study I love to share is from the Annals of Internal Medicine which speaks to both the efficacy and safety of joint manipulation for back pain.

 On the first visit with a chiropractor, there is a physical examination. Where necessary standard diagnostic tools like imaging and blood work may be ordered. Our job at this point is to find out what’s causing the pain and to rule out serious internal complaints. Where indicated patients may be referred to another provider for their management or co-management, and those that are a good fit based on our scope of practice, well, those are the ones that we treat.

Do you want to know more? Download the #BePainFree eBook, it is FREE!

Just Click Here.

The free ebook is called:

 #BePainFree - The Five Causes Of Back Pain And The Seven Keys To Lasting Relief

Regards in health,

Dr. Davia H. Shepherd

Saporito Chiropractic

 *Disclaimer: Please remember that it's impossible for me to diagnose you and treat you just by you reading one of my articles. I'm superwoman it's true, but even that is beyond my capabilities. So before you engage in any health and wellness activities, do consult your health care provider. Please know that we are happy to address your personal concerns, just call us in office to schedule your personal consultation; and thanks ever so much for reading. We appreciate you.

In this icy weather, know what to do in case of an accident!

We have been having one snow storm after the other, and while we might like to just hibernate until spring comes around, occasionally we will have to get out there on the roads! Today they were predicting ice, this is one time i'm glad the weather man was wrong :)  

I hope you stay safe on the roads but if you or someone you know does have an accident there are a few things you should think about. Very often, severe traumatic injuries require the intervention of a surgeon especially when there are broken bones, damaged internal organs or when the soft tissues are severely torn. Those patients usually end up directly in the emergency room. Frequently however, for patients who have been in minor to moderate traffic accidents, there can be severe pain with little immediately apparent structural damage. Especially in the case of motor vehicle accidents, symptoms may show up later and may not even be directly correlated to the recent accident. In a lot of these cases, physical medicine methods are the best solutions.

My own fender bender brings to mind a patient that I had once who was in a reasonably serious traffic accident. We all dread that moment when someone, completely unknown to us slams into our car and changes our lives forever. Well this case was no exception, well…except that my poor patient had his two daughters in the car with him! As a parent, I can tell you truly, when he sat in my office with his two beautiful girls and told me everything that had happened I genuinely empathized (and this was before my own accident!) Thank goodness, everyone had been wearing their seat belts, but everyone was banged around pretty badly. 

They had gone to the emergency room where the ER doc had suggested that the dad see his regular doctor. After consulting his attorney about the accident, he and the chicas were sent to us. Dad did very well in a short time with the usual 3 step treatment system that we employ in practice. His main concern for the girls was that they were in severe pain that was not well managed by Tylenol, but he was uncomfortable giving them the more advanced analgesics that had been prescribed and he was looking for a drug free option. Children are great patients. They approached the rehabilitation exercises with greater enthusiasm than I have ever seen in my adult patients. Within 2 weeks of modalities, joint and soft tissue manipulation and rehabilitation exercises, the girls were pain free and back to participating in their pee wee sports teams as if nothing had happened.

Here are some suggestions for what to do in the unfortunate event of an accident:

1) If you have the opportunity to go to the ER or to see your doctor, do so as soon as possible

2) Sometimes there is severe pain but no overt evidence of damage. If that is the case, go in to see your chiropractor or physical therapist as soon as possible

3) Symptoms of whiplash do not always show up immediately so monitor how you are feeling and if you notice symptoms see your health care provider sooner than later

4) Physical symptoms are not the only ones to be concerned with. Many patients who have had accidents suffer from a form of post traumatic stress. Seeing a mental health professional after an accident is often an excellent idea

Please be safe out there.

Regards in health,
Dr. Shepherd

Is arthritis the problem?

 

Degenerative Changes

 

We see these most often in our older patients however they are not unheard of in younger patient groups. Often degeneration of joints in the spine can lead to spinal stenosis which means that a bony portion of the spine has remodeled and is somehow interfering with a nerve(s). This may lead to many things including severe pain which may or may not travel down to the arms or legs, possible weakness of muscles of the arms or legs, numbness and / or tingling down as far as the hands or feet, and even absence of reflexes. 

Degenerative changes can affect any joint and so while we tend to think just of the spine, some patients who come in complaining of back pain who do have degenerative changes may be suffering from problems with the hip joints or even the sacroiliac joints, knees or ankles. It’s important for this distinction to be made as this will determine what course of treatment will be most effective.

 

An inflammatory condition

 

Many inflammatory conditions such as different types of inflammatory arthritis or some autoimmune type conditions can lead to back pain. It is also interesting to note that some studies suggest that the severity of pain may be influenced by a person’s overall inflammatory state. 

Something even more interesting than that little tidbit is that the standard American diet appears to stimulate the formation of the molecules that cause pain in our bodies. These studies show further that simple lifestyle changes can often reduce the inflammation in the body thus reducing overall pain. The science supports this, some studies suggest the science may be spot on and our positive experience in practice leads us to have a discussion about these types of lifestyle changes with every patient who comes in.

 Would you like to learn more? Get the free #BePainFree ebook

Just Click Here.

The free ebook is called:

 #BePainFree - The Five Causes Of Back Pain And The Seven Keys To Lasting Relief

Regards in health,

Dr. Davia H. Shepherd

Saporito Chiropractic

 *Disclaimer: Please remember that it's impossible for me to diagnose you and treat you just by you reading one of my articles. I'm superwoman it's true, but even that is beyond my capabilities. So before you engage in any health and wellness activities, do consult your health care provider. Please know that we are happy to address your personal concerns, just call us in office to schedule your personal consultation; and thanks ever so much for reading. We appreciate you.

Did you have a recent accident or did you have one a long time ago?

 

Trauma

 

Trauma is the reason most people think we have pain. It isn't the number one reason that patietns come in to see me but it is high up there on the list!

So what is causing your pain? Was it as a result of a car accident you had recently? Maybe a slip and fall you had years ago? Very often, extremely severe traumatic injuries require the intervention of a surgeon especially when there are broken bones, damaged internal organs or when the soft tissues are severely torn. Those patients usually end up directly in the emergency room. 

Frequently however, patients who have been in minor to moderate traffic accidents, other types of accidents or for patients with minor to moderate sports or exercise related injuries, there can be severe pain with little immediately apparent structural damage. 

Especially in the case of motor vehicle accidents, symptoms may show up later and may not even be directly correlated to the recent accident. In a lot of these cases, physical medicine methods are the best solutions.

Would you like to learn more? Get the free #BePainFree ebook

Just Click Here.

The free ebook is called:

 #BePainFree - The Five Causes Of Back Pain And The Seven Keys To Lasting Relief

Regards in health,

Dr. Davia H. Shepherd

Saporito Chiropractic

 *Disclaimer: Please remember that it's impossible for me to diagnose you and treat you just by you reading one of my articles. I'm superwoman it's true, but even that is beyond my capabilities. So before you engage in any health and wellness activities, do consult your health care provider. Please know that we are happy to address your personal concerns, just call us in office to schedule your personal consultation; and thanks ever so much for reading. We appreciate you.

Is your snow shoveling technique killing your back?

We have had a few inches of snow recently with more on the way! With the snow has come a flurry of patients complaining of neck and back pain. As nice as it is to catch up with our patients that we haven't seen in a long time, in many cases, the pain could be avoided by adopting different and better snow removal techniques. Lets talk a little bit about how to remove snow in a way that reduces the risk of back pain.

1) Use a snow blower, get help or get professional snow removal
For many of our patient's who may already have serious back injuries, who may be elderly or otherwise indisposed, using a snow blower, getting help or using a professional service may be the best way to go.

2) Use the correct tools
There is evidence that using the ergonomic shovels can be beneficial when shoveling. Some shovels have curved handles. Others have handles with adjustable lengths. What this means for you is that there is less bending while shoveling which takes a lot of the pressure off the back. Opting for a shovel that is smaller and lighter is also advantageous.

3) Now it's time to warm up...
Yes! Before going out there to shovel you do need to warm up your cold muscles to prevent muscle strains. Take 5-10 minutes to warm up your neck, back and shoulders, low back and leg muscles with some gentle stretches. Don't forget that when your muscles are warm they are less prone to injury.

4) Proper lifting technique

Proper lifting technique is a theme that seems to be repeated in a lot of our articles. Whether it lifting while shopping, fall clean up or snow removal, the rules are the same: Try to do as little lifting as possible. If you can push the snow out of the way that is preferable. If the snow is piled high, take it a little at a time from the top. When lifting anything including a snow shovel face the thing you are lifting head on and bend at the hips and knees lifting with the legs and buttock muscles. Focus on small light loads for lifting. Be sure your grip of the handle is appropriate for you and hold the shovel you have lifted as close to your center of gravity as possible. Finally, avoid reaching and tossing.

5) Take breaks
I think this piece of advice is the one my patients find hardest to follow. It may also be the most important. Doing repetitive tasks for extended periods is the surest way to cause damage to muscles and joints. As much as we all want to just "get it done," it's better to take a break for a minute or two for every 5-10 min of shoveling. Mixing up tasks may also be helpful in relieving the stress put on joints by repetitively doing the same thing.

Be sure to use proper lifting techniques this snow season this will help you to have a safe, happy and healthy new year!

Regards in health!
Dr. Shepherd

PS: Did you see the eBook? It is free! Will you check it out?

Here's the link:

 #BePainFree - The Five Causes Of Back Pain And The Seven Keys To Lasting Relief

 *Disclaimer: Please remember that it's impossible for me to diagnose you and treat you just by you reading one of my articles. I'm superwoman it's true, but even that is beyond my capabilities. So before you engage in any health and wellness activities, do consult your health care provider. Please know that we are happy to address your personal concerns, just call us in office to schedule your personal consultation; and thanks ever so much for reading. We appreciate you.

Could The Last Straw Could Be The Real Reason You Have Pain?

 The last straw: Overuse

Most patients think that trauma is the leading cause of back pain but both the statistics and what we see in in our practice appears to suggest that overuse is the leading cause of back pain. 

Most of us have been working from home more than ever before. In practice we have been seeing a lot of patients who have given up their beautifully ergonomic workspaces at work for working from the sofa or dining table at home. Having the right chair, desk, standing desk, mousing surface, foot rest and things like that can make a big difference between pain and being pain free.

Most of our patients who come in with headache, neck pain and low back pain, come in because of sitting for hours without a break at work, because of doing repetitive tasks at work or at home (such as painting, snow shoveling or raking leaves,) and all without taking appropriate breaks. 

Sometimes it’s the new mom carrying her baby the wrong way, a patient sleeping on the wrong kind of bed, with the wrong kind of pillow or sitting in a workspace that’s not ergonomic. Overuse can be more serious than patients realize: Leading to problems with 

• disc herniation, 
• muscle spasms, 
• joint damage and even 
• nerve damage

Many patients remark, "But doc, I didn't do anything and it just started hurting for no reason." The truth is in very many cases, overuse is the reason.

Would you like more information on how you can help prevent pain caused by overuse?

Just Click Here.

The free ebook is called:

 #BePainFree - The Five Causes Of Back Pain And The Seven Keys To Lasting Relief

Regards in health,

Dr. Davia H. Shepherd

Saporito Chiropractic

 *Disclaimer: Please remember that it's impossible for me to diagnose you and treat you just by you reading one of my articles. I'm superwoman it's true, but even that is beyond my capabilities. So before you engage in any health and wellness activities, do consult your health care provider. Please know that we are happy to address your personal concerns, just call us in office to schedule your personal consultation; and thanks ever so much for reading. We appreciate you.