So… my back hurts. Now what?

Pretty much all of us will experience back pain now and again. As a matter of fact, many of us will endure crippling, stabbing back pain, even pain or numbness into the butt or legs.

Another fact is that most people pay very little attention to the physical health of their backs or necks until things are really starting to hurt. That’s why so many people have their first visit to a “back doctor” be a visit to the orthopedic surgeon or neurosurgeon. Of all the “back doctors” to see first, those should not be on your list.

pain descriptive words

I’ll be honest, chiropractic is GREAT for treating simple low back pain. Good ol’ regular biomechanical low back pain responds GREAT to chiropractic adjustments. Countless research studies in proper, well-respected medical journals have confirmed this. Some of that research is here, but that’s not the point of this article.

You have a few things you can try first. Like everyone else in the world, your first attempt at fixing something should probably be a relatively inexpensive option that has the smallest likelihood possible for something bad to happen.

You can try any one of these things:

Chiropractor Visits
Course of Physical Therapy Sessions
Acupuncture
Massage Therapy
Ice or Heat
Stretching or Exercise
Painkillers
NSAID’s
Steroid Injections
Nerve Block
Spinal Surgery

Looking at this list, we can tell right off the bat that some of these are easier, safer and less expensive than others.

Stretching or exercising is free. It’s not necessarily easy, especially if you are in pain, but it’s one way to go. Massage and acupuncture are both safe and natural, so they are good places to start if you want to avoid drugs. Physical Therapy, depending on your therapist, is probably going to be mostly or somewhat natural, and besides needing to have you come in three times a week so they can watch you exercise, it’s a great way to recondition your out-of-shape back.

Painkillers and NSAID’s are, well, drugs. So if you are trying to get the back pain monkey off your back without drugs, they aren’t going to be on the list. For what it’s worth, painkillers will probably do something to get rid of the pain. Of course, when they wear off, you will be back in pain. NSAID’s may be able to deal with the injury in your back by reducing the inflammation, and this may get the pain to disappear for a while even after the medicine has left your system. The problem here is that NSAID’s aren’t safe for everyone, and even if they work for you and are safe for you, whatever caused the inflammation (and therefore the pain) in the first place is still probably causing inflammation just like before, and it’s only time before the pain returns (probably worse).

Nerve blocks and surgery are very poor first-lines-of-defense if your back pain is non-emergency and non-traumatic. In other words, if your back hurts because your posture sucks and you never exercise, then a nerve block isn’t the right way to go unless you are into injuring yourself on purpose. And surgery obviously shouldn’t be on your Christmas list, either.

Since a chiropractor is the author of this article, you can bet I saved chiropractic for last because I was saving the best for last. And it is. Chiropractic is great for so much more than back and neck pain, but our bread and butter is helping people get rid of back or neck pain. People (who have never been adjusted before) are almost always surprised at how effective chiropractic is. The reason chiropractic is so effective is because you and me have bodies that are designed to function normally, and a chiropractic adjustment takes a screwy spine and, for lack of a better description, straightens that spine out. Then the spine works better…and then it doesn’t hurt any more. Rather than cover the pain with medicine we adjust the body so that it will work normally, and since normal function is supposed to be pain-free, the client typically feels better. It’s not magic, it’s actually basic physics, a touch of the basics of mechanics, and some rudimentary biology. The body is supposed to work normally, and without pain, so sometimes it just needs to be pushed back in the right direction.

So, if you want to be pushed in that direction, give us a call. Thanks for reading. -Rob

A Simple Explanation of How a Chiropractic Adjustment Relaxes Your Muscles

As a chiropractor, sometimes I forget to just use simple terms to describe how chiropractic works. This short article here will outline some of the scientific fundamentals regarding how chiropractic is able to help so much despite seeming so simple. Different chiropractors focus on and talk about different aspects of how chiropractic can help…this short post will just try to summarize how the mechanics of a chiropractic adjustment create positive change in the muscles. While my real goal is to put it out there in simple terms, I use plenty of scientific language upfront to allow anyone who reads this article the ability to head over to Google and search for more information about the terms I use. An educated person tends to make better healthcare decisions. At the end of this article, before the reference links, you can find the simple part in bold.

The Muscles

The muscles which cross a joint are typically innervated by the same nerve which innervates the actual joint (as well as the skin covering the distal muscle attachment [insertion]). That is known as Hilton’s Law, and this is an important fact to consider. A chiropractic adjustment creates a barrage of sensory input from nerve cells found in muscles called muscle spindles and golgi tendon organs, and from nerves in the joint capsule. Large inputs of proprioceptive sensation can lead to immediate decrease in pain sensation.

When you get a chiropractic adjustment the chiropractor is taking a spinal joint beyond it’s normal range of motion. The brief expansion or stretching of the joint is accompanied by a similar fast stretch of the muscular tendons that cross that joint. The tendon stretching immediately leads to a reflex response that causes those muscles to relax and become less tense. This is most effective with the deep back and neck muscles, and a chiropractic adjustment is effective whether it is specific to one vertebrae or to a vertebral region.

Summarized in laymen’s terms: chiropractic adjustments reduce tension in spinal muscles.

Additional information about the topic discussed can be found at the US National Institute of Health PubMed site,such as the Neurophysiological effects of spinal manipulation and Immediate Effects of Region-Specific and Non-Region-Specific Spinal Manipulative Therapy in Patients With Chronic Low Back Pain: A Randomized Controlled Trial.

Numbness in Fingers

so, you’re getting some numbness or tingling in your hands and fingers? This article will briefly explain some of the reasons you may be experiencing this discomfort, which can feel like a mild pain, pins and needles, numbness, tingling, or a heavy feeling in your hands or arms.

Vascular Cause – the blood supply to the arms passes through the shoulder area. An important location to consider outside of what people typically consider is the area underneath and behind the clavicle bone. It is this area where most of the anatomy going into the arms originates. Problems there will likely cause arm problems.  With vascular causes, look for swelling or discoloration.

Some of the main causes of vascular insufficiency leading to arm, finger or hand numbness or tingling include:

-traumatic – when an injury or accident causes damage to the arteries feeding the arm or hand.

-compressive – when a blood vessel is compressed causing decreased blood, such as when sleeping with your arm under your head and waking up with your arm “asleep”. Other times, muscle spasm can squeeze a blood vessel, or postural distortions can stretch (traction) a vessel and decrease the diameter enough to decrease blood flow.

-tumors/malformations – tumors or deformed blood vessels can block blood flow.

Vascular problems may occur more commonly in individuals with certain diseases such as diabetes, hypertension, or kidney failure, or in dialysis patients. Occupational exposure (vibrating tools, cold) can be a factor, and smoking also can aggravate and cause vascular disease. – Source

Neurological Cause – damage or interference to the nervous system can cause symptoms like pins & needles, numbness or tingling. Quite often the area to look to is the same as with vascular issues – the area behind and underneath the clavicle bone. It is here that many nerves exit the spine to innervate the upper extremities. Problems here,  or right at the spine, often show up as pain or numbness in the hands or arms.

Some of the main causes of neurological numbness or tingling include:

-trauma / disc injury – if the vertebral discs of the cervical spine (the part of the spine that comprises the neck bones) are injured or inflamed, this can irritate delicate nerve roots and cause pain or numbness in different parts of the arms. Other traumas, such as bending the head and neck sideways too much (especially by impact with something) can tear the nerves or completely sever them, and cause paralysis or neurological deficits in the arms.

-tumors – tumors on or near nerves can pinch the nerves.

-vertebral misalignments – commonly called “subluxations”, these spinal misalignments put either direct or indirect pressuree on the nerves that feed the arms, and cause pain or numbness into the arms or fingers.

-muscle spasm – hypertonic, spastic muscles can put pressure on nerves.

 

If you have symptoms like there, consult your doctor. If you live in Frederick, give us a call. Take care.

Baby, you were born to run, barefoot?

Lately there has been a lot of interest in barefoot running, or running with minimalist footwear on. I think it would be really great to provide some quality general information about this for those considering the idea of running either barefoot or in something minimalist like Vibram Five Fingers.

In general I am a big fan of the concept that getting “back to the basics” is usually the healthy thing to do. I prefer my food unprocessed and whole. I like my exercise to be simple and functional. The idea of running barefoot has a certain appeal to it – after all, our ancestors managed to flee from man-eating predators without the benefit of $100 running shoes. But, does running without shoes on (or with minimal footwear) actually do us any good, or is it a dangerous fad that leads to injuries?

Before I delve into the topic at hand – running without traditional running shoes – I will quickly discuss the options available. You can either drop the footwear entirely and go barefoot, or you can go with a minimalist option like Vibram footwear. The minimalist choice will provide some protection to the soles of your feet, but will rob your body of the biggest form of feedback as you run – the feedback from the soles of your feet. Being barefoot will give your body and nervous system more input and more control, which is great for mastering something new like ditching the running shoes. So there is a trade-off you must make between the protection that minimalist footwear provides and the neural feedback and increased neuromuscular control that being barefoot provides. Also, being barefoot allows your feet to breathe and sweat more freely, and develop more strength and control in the small intrinsic muscles of your feet.

Some proponents of barefoot running claim that running barefoot as our ancestors did is healthier for our feet. One reason is that when running without shoes the outside front of the foot takes a lot of the impact, while running with shoes on leads to high-impact heel strikes, with the person placing all their weight on the heel and then pushing off from the forefoot. Without shoes on the runner will not land on their heel with such force, as this would be painful to do without shoes, and will instead use the front of the foot to provide most of the immediate shock absorbing and ground contact.

One way in which the foot is marvelously designed is the ability of it to absorb impact from running with minimal force being transferred to the knees, hips, or low back. This process of shock absorption built into our bodies was built in when we were evolving and when there was no such thing as modern footwear with thick cushioning. Now that we tightly encase our feet and provide padding underneath, we are able to land on our heels and run like we do currently. Unfortunately, this heel-striking that shod running promotes bypasses the natural shock-absorbing that occurs between the toes and heel, and transfers increased force up the legs to our knees. Being barefoot involves the entire foot to a greater degree than wearing shoes does, and allows our feet to work as designed and dissipate forces right there at the level of the foot. Put simply, being barefoot allows the body to function as designed with regard to shock-absorption.

Now, while words are great they are certainly no substitute for real world experience. So, if you are interested in the topic of barefoot running then you should stand up and go outside and run a hundred feet or so with shoes on. Really focus on how your feet are meeting the ground. You will notice that your heel is what hits the ground first, and then you push off with the front of your foot. Now, take your shoes off and find somewhere without too many rocks (or any dog poo or broken glass) and run a hundred feet barefoot. You might notice that landing on your heel hurts when you’re barefoot, and your feet might be more comfortable with you landing on the front of your foot and not even having your heel touch the ground at all.

This is a completely different biomechanical situation. Running with shoes means your heel strikes and then your foot flattens briefly as you transition weight onto the forefoot, and then you push off the front. Without shoes the heel strike shouldn’t occur to such a degree, and the force with which your foot strikes the ground will feel less forceful. It will seem a bit like “tip-toeing” as you run.

When your foot hits the ground, heel first, this causes all the muscles, bones, and joints in your leg and hips to react in a specific fashion to maintain stability and provide speed and strength. Running without shoes changes that biomechanical process so that there are different forces and stresses on your entire body, from your toes all the way to the top of your spine. As in any change in life, it is important to take it slowly and safely.

This is an important concept to focus on for a moment. Think of the force that is transmitted up your legs and into your spine as you run with a high-impact heel strike, and then think of the force transmitted up your body with the lower-impact forefoot strike that running barefoot promotes. Decreased mechanical forces putting load on our spines is a good thing. The benefit of diminished force being places on our skeleton and our joints is something that, as a runner, you will need to weigh carefully against the ability of your body to adapt to running without shoes and the different biomechanical forces that your feet and legs will be exposed to. If you can run without shoes on and gradually decrease shoe-usage in order to prevent injury, then it is certainly a good possibility that ditching the shoes and letting the feet breathe will be good for your body.

You don’t need to go from shoes to no shoes, though. There is a middle ground. Different shoe companies are all introducing minimalist footwear. One major brand is the Vibram Five Fingers. They provide barely anything in the way of support for your ankle and foot, but they do have a decent amount of padding on the bottom to protect you from sharp rocks or glass without providing so much padding that it’s like wearing shoes.

If you are going to try out barefoot running, or running with minimal footwear, then it is important that you do it correctly to avoid injury. Some tips include:

  • It might be a good idea to just go barefoot at home, or as you do your day-to-day activities, to accustom your body to the lack of protection and support.
  • Start slowly – if you normally go 3 miles each time you run, do only the last ½ mile barefoot.
  • Slowly (and I do mean slowly) add distance or time to your routine, so that you do not shock the body and cause an injury. Taking a month or more to transition to barefoot is a minimum, in my opinion.
  • Stop at the first sign of pain!
  • When running barefoot pay special attention to lifting your feet off the ground as opposed to throwing your feet into the ground in front of you. Run “lightly” without plodding or slamming the foot down.
  • You might notice yourself taking shorter strides – this is normal.
  • Be aware of how your entire body feels after running barefoot – that mans the soles of your feet, your ankles, your knees, your hips and low back, and anything else that feels different.

If you don’t get into barefoot running slowly, you may very well get sidelined by an injury that will make running – with or without shoes – painful and difficult. Some possible injuries include:

  • Pain in the calf or Achilles tendon – because shoes raise the heel off the ground a bit this chronically shortens the calf muscles, and when running barefoot this can overstretch this muscle before it learns to become more stretched naturally. Achilles and calf problems can then lead to…
  • Plantar fasciitis – pain at the sole of the foot that is worse when stretched, or worse n the morning when you first step out of bed.
  • Soreness on the topside of the foot – likely from shifting conditions of muscles, bones and joints in the feet as you get used to running without shoes.
  • Bruising or other injuries from pebbles or other things you may step on.
  • Sprained ankles – keeping your ankles surrounded by padding is good for preventing sprains, but is bad for developing neuromuscular control of the ankle, so transitioning too quickly to non-traditional footwear may lead to sprains if you aren’t careful.
  • Stress fractures – some people have reported getting stress fractures in their foot bones from jumping into barefoot running without proper preparation.

So, to summarize, running barefoot can be a great way to strengthen your feet and legs and to develop the small muscles of your feet. This can benefit your entire body by providing a more stable base and by decreasing wear and tear on your knees and other joints. It also carries risk, though, because you must ease into this new style of running slowly and deliberately, being mindful of pain and always listening to your body as it adapts to the world of barefoot running.

At Park Bench Chiropractic we adjust the spine first and foremost, but we also pay attention to the joints of your arms and legs – including ankles, knees, hips, shoulders, elbows, and wrists. Before you transition to less footwear, or throughout that transition, we encourage you to come in and have either Dr. Matt or Dr. Rob evaluate your lower extremity for joint imbalances that could make it more difficult for you to make the change, or to see if the change is even something that is right for you.

Feel free to call or stop by Park Bench Chiropractic if you want to talk about this with one of the doctors.

Antidepressants are now being prescribed by Medical Doctors (MD’s) to treat common lower back pain

In 1996 about 13 million Americans were using antidepressants. By 2005 that number rose to 27 million. Not only are more Americans being prescribed antidepressants, but those individuals are taking more antidepressants. (1)

More than 164 million prescriptions were written for antidepressants in 2008. More than 1 out of 10 Americans are on antidepressants as of 2008.

Researchers Olfson and Marcus examined the clinical data from 1995-2005 and focused on 50,000 people to study. They found that those on antidepressants were more likely to then go on to use more powerful anti-psychotic drugs and less likely to partake in psychotherapy. (2) In that sense, antidepressants are a type of gateway drug and they apparently aren’t effective enough in many cases because more powerful antipsychotic drugs are later prescribed.

Dr. Eric Caine of the University of Rochester in New York said he was concerned by the findings, and noted that several studies show therapy is as effective as, if not more effective than, drug use alone. “There are no data to say that the population is healthier. Indeed, the suicide rate in the middle years of life has been climbing,” he said.

Therapy is not as easy to simply popping pills, though, which leads us to the low back pain issue.

Low back pain is one of the most common and most expensive medical conditions in the United States. Most people will have to deal with low back pain at some point in their lives. The cost of prescription drugs and expensive surgeries are two of the major factors causing an explosion in healthcare costs in the past decade. Surgery is a significant cost associated with treating low back pain, and this is despite the fact that research repeatedly shows that chiropractic care is a safer, less expensive and more effective way to treat most cases of low back pain. (3) Research has also shown that contemporary medical treatment of lower back pain is more likely to lead to disability than is chiropractic care. (4) Still, most people do not know these facts and instead go see a medical doctor.

Medical doctors routinely prescribe painkillers and muscle relaxers to their patients who complain of low back pain, often doing so rather than referring them to a chiropractor. On top of those drugs, now medical doctors have begun to prescribe antidepressants to their back pain patients.

This is where we come to a thought experiment. Think with me for a moment: as anti-depressant use doubled in the United States from 1996-2005, did the incidence of lower back pain decrease alongside it?

If anti-depressant use has more than doubled, and medical doctors consider antidepressants a treatment for lower back pain, then the prevalence of lower back pain should have dropped significantly.

But it didn’t.

That should tell you all you need to know about using prescription psychiatric drugs to treat a problem with your lower back.

1.       http://www.ncbi.nlm.nih.gov/pubmed/19652124

2.       http://www.ncbi.nlm.nih.gov/pubmed/21135326

3.       http://www.ncbi.nlm.nih.gov/pubmed/21036279

4.       http://www.ncbi.nlm.nih.gov/pubmed/21407100