Blog - Page 9 of 15 - Michigan Spine & Pain

Refrigerator Shelves + Research = Results

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Mindless eating.

It’s what happens when you’re bored or hungry or both. Or stressed or emotional. Or all of the above.

Dr. Brian Wansink, director of the Cornell University Food and Brand Lab has been studying mindless eating as well as healthy eating. He has discovered small ways that we can tweak our kitchen environments to cut down on mindless eating and transform it into healthier eating habits. Some of his suggestions that are delineated in his latest book Slim by Design, which he discussed recently on American Public Media’s “The Splendid Table” include:

Change out the china. Dr. Wansink discovered that people eat less when their dishes contrast in color with what they are eating (especially brown or white carbohydrates). In addition, consider using smaller plates. When the plates are smaller, it takes less food to fill them up and also seconds seem less enticing.
Stow the (less healthy) snacks. Maybe you really want to have no snacks in the house. But if you have family members who need or want snacks and don’t have problems with overeating, then you can’t entirely ban the snacks from your home. If that is the case, keep all of your snacksin one cabinet and make it a bit of a “stretch” to get to the snacks, either by placing them up high or down low, but definitely not front and center, which is reserved for…
Put the fruit and veggies front and center. It really makes a difference if the low-fat options are accessible and visible. Don’t hide the vegetables in the refrigerator bins. Instead, immediately after you purchase your fruit and vegetables, wash and cut up at least a portion of them and store the pieces in clear containers. Rearrange your refrigerator so that the front of the middle shelf is filled with tasty, healthy treats, ready to be immediately eaten with no preparation necessary.
Make the clear choice for healthy leftovers. There are lots of ways to store leftovers: in foil, in clear disposable containers, and in their original cooking implements. Wansink recommends that the healthier the leftover, the more transparent the container should be. So, leftover cheesecake shouldn’t be nearly as visible as leftover cut up carrots.
Ditch the extra dishes. Dr. Wansink recommends serving from the counter or the stove and not bringing a large serving dish to the table. By creating one more step to get seconds, we actually can find ourselves just taking one serving, whereas bringing the entire bowl of pasta to the table encourages overeating. Understandably, this rule is designed for family eating only; clearly, it could be untenable with company.

The most important thing to remember as you try to eat more mindfully is that small habits can bring about big changes. Put some of these into practice and see if they make it easier for you to reach for something healthier.

Wonderful Water Workouts

Swimming is amazing exercise for pain patients. The benefits of swimming are:

Swimming burns calories and builds muscles.
The water provides natural resistance.
Water can relieve aching muscles and joints and give relief during the heat.
Swimming strengthens the neck and back muscles.
Swimming is completely low impact and is much easier on joints.
If the pool water is warm enough, the warm water can promote blood flow and improve healing if there has been an injury.

Swimming in a pool can feel comfortable but still provide a solid workout. Consider adding these components to some of your swimming workouts.

Ambient music. If you are at a public pool, you are at the mercy of the lifeguard’s music selections. But any upbeat music keeps boredom at bay.
A large visible clock is a great resource. Then you can keep track of time as opposed to laps, which can sometimes be difficult.
If you vary your strokes with a few laps with a kickboard, you will get a very strong leg workout while giving your arms a bit of a break. This is also helpful if your arms or shoulders are weaker or in pain.
Change your strokes. Alternate crawl, breaststroke and backstroke. If you are a particularly strong swimmer, you can throw in a butterfly stroke once in a while, too.
Hate going back and forth? Tread water for a while. To make it even more of a calorie burn, tread water while holding water weights.

Swimming workouts can have endless variety and can be an enjoyable component of a healthy lifestyle.

Functional fitness: Is it right for you?

If you suffer from pain, you have likely received advice about the therapeutic aspects of exercise. Exercise is good for your body and your mind. Exercise can help with weight control, increases flexibility and range of motion, can be an antidote to stiff joints and also has positive psychological components.

But what kind of exercise program should you embark on? There are so many exercise options out there. You can join a gym, enroll in classes, walk or run on your own or with a buddy. Weight-bearing exercises, cardio exercises, circuits, Pilates, yoga, high intensity, low impact…the list is dizzying.

Your physical therapist will surely encourage you to be consistent in exercising almost daily. Many physical therapists are also recommending that their pain patients aim for functional fitness.

Functional fitness exercises train your muscles to help you do everyday activities safely and efficiently. Functional fitness exercises work to train various muscle groups to work in tandem with one another. This helps to prepare you to perform the tasks you encounter at home and at work.

Instead of rowing at a machine, think about doing the rowing motion with hand-held weights while you are actually bent over at the waist or while standing up with your arms rowing parallel to the ground. This mimics lots of everyday motions: taking groceries out of the back of the car, lifting a child out of a car seat, or even doing various manufacturing jobs. This, then, is the epitome of functional fitness: a fitness routine that strengthens various muscle groups (in this case, arms, back, neck and shoulder muscles as well as strengthening your core) so that you can be “functionally fit” to do those desired everyday tasks.

Physical therapists as well as trained exercise consultants can help you develop a group of functional fitness exercises, based upon what you need to get through your day physically. Perhaps you are a caregiver for a loved one. Often, the tasks associated with caregiving (turning a person over, helping them transfer from lying to sitting to standing and back again) require a different type of fitness than just doing bicep curls at the gym. Other typical functional fitness exercises include squats (with both feet planted and with one leg planted), squats with an overhead press, lunges and what are called dead lifts.

As with all exercise routines, functional fitness should only be undertaken under the advice and consent of your physician.

Understanding Shoulder Pain

Shoulder pain can be at a minimum distracting and at its worst, disabling. But shoulder pain can be somewhat tricky to diagnose. Shoulder pain can be caused by inflammation or injuries to any of these components: the shoulder joint (involving the clavicle, scapula and humerus bones), the tendons, the surrounded ligaments, or a rotator cuff injury. In addition, shoulder pain can be caused by bursitis or arthritis, in addition to disease processes that affect bones and muscles.

To properly diagnose shoulder pain, a physician will examine and interview the patient, will gently touch around the area (called palpation) to try to determine what improves or exacerbates the pain and will often order x-rays. While interviewing the patient, the doctor will ask the following questions:

Do you remember a specific injury occurring?
Do you have any sort of history of shoulder pain or previous injuries?
How much pain are you in now?
How long have you been in pain?
How is your shoulder or arm movement affected? (Do you have trouble lifting, cooking, etc.?)
What is your exercise regimen and how is your shoulder pain affected? (Golf, tennis, swimming and baseball/softball are often repetitive motion sports that can cause shoulder ailments.)
Do you have any weakness?
Do you have stiffness?
How is your flexibility?
What treatments have you already tried?
Do you notice anything that improves or worsens your pain level?

After this interview and ordering tests, doctors begin to narrow in on the cause of the shoulder injury in order to determine how to proceed with treatment. They will first exclude joint involvement, then determine the state of the rotator cuff (typically by ordering either MRI or ultrasound tests) and also try to figure out if “frozen shoulder” is present.

Eventual treatment can include splinting and immobilizing, physical therapy, chiropractic treatment, medication or in the most severe cases, surgery.

Not the stairs!

If you’re trying to stay fit and walk more, you have probably heard multiple messages about parking far away to force yourself to walk and foregoing the elevator in favor of the stairs. Whether it’s steps to the beach, the steps to the basement laundry, Rome’s Spanish Steps, or steps onto the bleachers at your favorite baseball field, sometimes you just can’t avoid the steps. But what if it hurts to climb or descend stairs?

Climbing Stairs:

Typically, people who suffer discomfort from climbing stairs have weakened leg muscles, especially the quadriceps muscles in their thighs. This, combined with poor cardiovascular conditioning often causes people to be short of breath or plain tired when they climb the stairs.

The good news: if climbing stairs wears you out, keep doing it. For most people, the repetitive exercise of stair climbing will actually build up your quadriceps, increase your endurance and improve your cardiovascular conditioning. We don’t recommend that you go from a totally sedentary lifestyle to running up the stairs of your nearest skyscraper, but certainly climbing several flights of stairs a day can only be beneficial, if your medical condition allows such exercise.

Descending Stairs:

Going down stairs uses your muscles in a different way. In addition, even a minimal amount of arthritis in the knee will often evidence itself as you descend the stairs. There are a few remedies that you can try to make your climbing down stairs less painful.

· Build up your quadriceps. If your quadriceps are weak, then the downward movement of your legs puts more pressure on your knees. You can build up your quadriceps through climbing stairs as well as other exercises, including leg lifts lying on your back.

· Move around a bit more. If you are quite sedentary, you can become stiff in lots of joints, and your knees are quite susceptible to this.

· Turn it around. Now we don’t mean go up the down staircase. But what we do mean is to face backwards and descend the stairs that way. You have to be holding onto the rail and you have to scan your surroundings beforehand to be sure this is a safe move (and we don’t recommend it in crowded stairways), but walking down the stairs backwards puts far less stress on your knees.

Please consult your health care team regarding the stairs in your life. You may be able to utilize physical therapy or occupational therapy to conquer the stairs.

The Great Salad Spinner

Why does making a salad sometimes seem like a chore? Well, it shouldn’t be. A salad is a great component of lots of meals and often it can even be your entire meal. Salads are great for maintaining health, as they take time to eat, they add vegetables and fruits into your meal and they are filling. One caveat: what starts off as a healthy salad can quickly move to the unhealthy category if too many high-calorie items are added, so beware of too many add-ons, like croutons and creamy dressings.

Depending on which is more important to you, paying for your time or paying for ingredients, many of these items can be purchased pre-cooked, pre-cut or pre-diced.

So, pick one or two ingredients from every category and make yourself a fabulous spring salad!

Leaves:

Iceberg lettuce
Romaine lettuce
Arugula
Spinach
Chopped kale
Butter lettuce
Chopped up cabbage for cole slaw
Chopped up broccoli slaw
Spring mix bag of salad

Proteins, nuts and cheeses:

Hard boiled eggs, or just the egg whites, sliced or diced
Gorgonzola cheese
Shredded Swiss Cheese
Buffalo mozzarella cheese, sliced
Crumbled feta cheese
Chopped or shredded cooked chicken (can sometimes be purchased from the butcher counter in a grocery store or as part of a rotisserie)
Leftover cooked ground turkey, ground beef or shredded beef or pork
Tuna, packed in water, drained
Tofu, drained and cubed
Prosciutto
Leftover poached salmon or other fish
Any nuts (walnuts, sliced or slivered almonds, pine nuts, cashews, sunflower seeds)

Loads of Fruits and Veggies (go crazy with these!)

Berries (blackberry, blueberry, strawberry, raspberry)
Slices of clementines (no seeds and so easy to peel, the lazy man’s fruit)
Sliced or chopped cucumbers
Red or yellow peppers (a little milder than green peppers), sliced or diced
Roasted beets
Corn, canned and drained
Black beans, drained and rinsed
Artichoke hearts
Hearts of palm
Onion varieties (red, yellow, scallions, leeks, shallot)
Halved cherry tomatoes (easier to slice)
Pitted figs or dates
Olives (black, green or kalamata)
Raisins or currants
Dried cranberries
Sun-dried tomatoes or peppers
Shredded carrot

Dressings:

Any commercial dressing is great, particularly a low-calorie option.

You can also make your own vinaigrette by combining olive oil, balsamic vinegar or any other vinegar, and your choice of these:

herbs (basil, dill and mint are great options)
a little bit of sweet (sugar or sweetener, honey, jam or jelly)
citric juice (lemon, lime, grapefruit,orange)
chopped garlic
a touch of yogurt
sour cream
soy sauce
Picante sauce
Pico de gallo

When Back Pain Enters the Bedroom

Back pain, whether it is acute or chronic, can interfere with our lives in a big way. Back pain can impair our ability to function: to drive, to get dressed, to bathe, to transfer from sitting to standing and back again. Back pain also can negatively impact our ability to get restorative sleep.

But many of us don’t like to talk about the negative effect of back pain on our sex lives. Anything that impairs our sex life is significant and deserves our attention. Intimacy and sexuality are important components of overall health and psychological well-being. Anything that interferes with the positive aspects of sexuality needs to be addressed.

Communicate with your sexual partner about your physical pain. Be as direct but as sensitive as possible. State what aspects of sexual functioning hurt or are challenging and what you hope your sex life can be. Some things to discuss: How vigorous a sex life do you desire? How much are your needs met with cuddling? How can you overcome these obstacles? Can non-penetrative sex substitute for a time? How does your partner feel about your back pain?

Communicate with your health care team. Do not be afraid to discuss sexual functioning with your doctor (and bring your partner along for these discussions). In addition, be frank and ask questions of your physical therapist as well as other members of your wellness team. Elicit specific advice about sexual positions to reduce pain and don’t be shy; your health care team is well aware that many of the patients are sexually active!

Prepare for sexual encounters. When pain enters the bedroom, there are some steps you can take to try to ensure a positive encounter. If your doctor recommends it, consider taking over the counter pain relief prior to sex. Do what you need to do to be relaxed, taking a warm shower or bath, gently massaging each other, even changing the lighting and the music. Prepare both your body and your brain.

Understand the physiology of sex and consider “changing positions”. Be aware if your back pain worsens if you are standing straight, bending forward or bending backward.

When bending forward hurts:

Men who don’t like bending forward would do best trying the missionary position, especially if the man supports himself on his hands. Men may also prefer lying on their own backs or sitting up.

For women who don’t like bending forward, placing a pillow or rolled up towel underneath their lower back while lying face-up can help. Women need to be very slow and careful in the manner that they bend their legs while lying on their backs, as it could cause extra strain on the back. A better position might be with the woman on top or even lying face down.

When Bending Forward (Flexion) Feels Better:

A man with lower back pain who prefers flexion might be more comfortable with any rear entry sexual positions, either with both partners on all fours on the bed, or with the man standing behind his kneeling or standing partner, or even both partners lying on their sides.

Women who experience less pain when bending forward may find the easiest position is the missionary position, especially if the woman can bring her knees up as close to her underarms possible. Women may also prefer sitting upright and bending forward slightly.

Let the partner without pain do the heavy lifting: The more passive the partner who experiences back pain can be during intercourse, the less likely they will have a back-pain flare-up.

Results of New Pain Study are Alarming

Chronic pain patients, in order to manage their pain, use a combination of therapies and medications. Opioids are a class of drugs often utilized by chronic pain patients.

Opioids are synthetic narcotics that bind to opioid receptors in the body, causing a reduction in the sending of pain messages and subsequently reducing pain. Opioids are often prescribed when other pain medications do not adequately control moderate or severe pain.

Different types of opioid medications include forms of codeine, hydrocodone, morphine, fentanyl, hydromorphone, miperidine, methadone, oxycodone and naloxone.

The majority of pain patients take prescribed opioids appropriately and do not become addicted or misuse the drugs. But many chronic pain patients also struggle with opioid addiction (and subsequent withdrawal) as well as improper usage of opioid medication.

The April issue of the journal Pain, which is published by the International Association for the Study of Pain, determined two significant and disturbing statistics:

20-30% of opioids prescribed for chronic pain are being misused.
10% of chronic pain sufferers are addicted to opioid medication.

The study defined “misuse” as utilization of the medication in a way that was contrary to the prescribed use, including to cause a euphoria or high sensation, altering one’s consciousness in order to sleep or zone out, as well as abusive usage like taking more than the prescribed amount of medication or crushing and snorting the drugs.

The study did not address the issue of opioid tolerance, which occurs when a patient needs higher and higher dosages of opioids in order to continue to manage pain effectively.

Opioid abuse and addiction can be fatal. In 2013, there were 16,235 deaths involving prescription opioids in the United States, according to the Centers for Disease Control. This was an increase over the previous year.

Physicians, patients, patients’ families and state and federal government are all concerned about these statistics. Doctors are working to monitor prescriptions and to look out for patterns of abuse and addiction. Michigan requires tracking of prescriptions for controlled substances, which is why many doctors and pharmacists will not use electronic prescriptions for these classes of drugs.

For the majority of pain patients who use opioids responsibly and appropriately, they may feel the pressure of increased surveillance by pharmacists and doctors. This should not be perceived as intrusive, but as protective.

Honest communication between doctors and patients about medication usage, continued monitoring of opioid use and effectiveness and an openness among patients who wish to be pain-free but are aware of the dangers of opioid addiction and abuse are helpful in managing pain relief without the unwanted consequences of opioid abuse.

OTC Pain Relief: They’re Not All The Same

Lots of people find temporary relief for all sorts of aches and pains with so-called over the counter medication (OTC). These are the varieties of pain relievers we keep at home and in our offices, in our purses, and in our vehicles. These are the tried and true medications that can be purchased at all sorts of stores without a prescription, without the authority of a doctor.

But not all OTC pain relievers are alike. They are designed for different uses, they operate differently in our bodies they and have different precautions. Here’s a quick review of the major classes of OTC pain relief:

Medicine	Brand Names	Used to treat:	Precautions:
Aspirin	Bayer, St. Joseph	Mild aches and pains; can also be used as prevention for heart disease, reduces fever	Never to be given to children (can cause Reye Syndrome), should not be taken if you have bleeding ulcers or take a blood thinner
Acetaminophen	Tylenol	Headaches, arthritis, sore throats, backaches, toothaches, earaches, commonly prescribed for children	Overuse can cause liver damage, can interfere with high blood pressure medication. Should not be taken if you suffer from kidney disease.
Ibuprofen	Advil, Motrin, Midol	Menstrual cramps, any pain that is a result of swelling (like a muscle sprain), reduces fever	May cause upset stomach and stomach bleeding, can interfere with kidney and heart disease
Naproxen sodium)	Aleve	Headaches, menstrual cramps, pain from swelling (like a muscle sprain), reduces fever	May cause upset stomach and stomach bleeding, can interfere with kidney and heart disease
Pain relief with caffeine	Excedrin	Headaches, including migraines	May interfere with sleep

We recommend that you consult with your health care provider if you already take prescription drugs before adding OTC pain relievers to the mix. We also urge you to take only the necessary amount and never to take more than is recommended. If you have chronic health conditions, you absolutely should consult with your physicians regarding which OTC pain relief medications are appropriate for your care. If pain persists beyond ten days while taking OTC pain relief, please contact your health care team.

Moving from Wake-up to Workout

Morning workouts! You may not be a morning person and mornings may not be the best for your schedule, but lots of studies show that the most committed exercisers do their workouts in the morning. Exercising in the morning means getting it out of the way early, it means only showering once and it means not getting distracted by the “must-haves” that occur during the rest of the day and night.

How can you transform yourself from sleeping in your comfy bed to getting your workout done?

Get everything ready the night before. If you go to a gym, pack your gym bag before you go to bed. If you’re walking or running from home in the morning, get your clothes picked out and piled up, along with your charged up phone and music. Do everything you can to not make excuses when your morning grumpiness threatens to take over.
Exercise with a buddy. This makes the activity more social and keeps you accountable.
Or…relish the alone time. For working parents, caregivers and people who work in large offices, a little bit of solitude can be rejuvenating.
Wake up slowly but with a pattern. If you need to baby yourself, have your tea or coffee or water, then get dressed, then put in your contact lenses.
Treat yourself with a healthy snack either before or afterwards (but make sure its calories don’t negate the workout!)
Put your workout in your daily calendar and treat it like an appointment with yourself.
Try something new, either interval training or a new piece of equipment, a new weight to lift or even a new walking or running route.

Whatever you do, find some ways to stay motivated and to make your workouts a reality.

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