Back Pain Archives - Page 2 of 3 - Michigan Spine & Pain

Don’t Sweat It: Heat, Humidity and Pain

Heat and humidity, while a welcome change from the freezing Michigan winters, often bring with them challenges for our pain patients.

Arthritis sufferers often say they prefer heat as they find it easier on their joints. However, headache patients vary: some prefer heat; others experience more pain during the summer.

The effects of humidity are not clear. Migraine sufferers report less pain in both low humidity and high humidity, while many report increased migraine headaches during changes in both humidity and pressure.

Sweating and Humidity: Sweat is a natural phenomenon. It helps the body to cool down. However, perspiration only works if the sweat evaporates off your body. In highly humid days, if the sweat just lingers on your body, it is not working well. Be aware that if you are feeling constantly dewy or moist, that your body’s perspiration functions aren’t working optimally. You can actually become dehydrated in this situation, increasing your chances for headaches and spine pain. Increase your hydration accordingly, drinking as much as 1-2 cups per hour of water while actively sweating.

Take a Dip: The warm weather makes swimming an ideal pastime and exercise, all in one. Take advantage of the sunny skies and swim, either leisurely or with some gusto. Enroll in a water aerobics or hydrotherapy class. All of these are beneficial for all pain sufferers. Check out these articles about swimming for pain relief:

Water Workouts Swimming Away From Back Pain

Other summer issues that may bother pain sufferers:

Different summer schedules which could mean school age children underfoot who need attention and activities. Often, vacations can be stressful, as adults’ and children’s activities outside (waterparks, theme parks, sports events) are not always easy on pain patients.
Long days and short nights. If you are very sensitive to the amount of light outside, then it may be hard for you to settle down until much later in the evening than usual. In addition, the morning light may wake you up earlier than you had hoped. Pain sufferers need consistent, restorative sleep. Buy the plushest pair of eyeshades possible (think 1940’s films!) and try to avoid the light.
Traveling while exciting can be tough on pain sufferers. You might want to check out these tips for traveling and pain management:

Travel Tips to Stay Pain Free Driving Trips for Pain Sufferers

Pregnancy and Pelvic Girdle Pain: No Need to Suffer

Pregnant women may not have heard of the term pelvic girdle pain, but many women have experienced this condition.

The pelvic girdle refers to a ring of bones at the base of the spine. Pelvic girdle pain is felt in the front or back of the pelvis. Other symptoms include pain in the lower back, hips, groin, pubic region, pain in the thighs and knees and clicking or grinding sounds made in the pelvis area, which can be exacerbated with certain movements of the legs and hips. Pain can range from mild pain to severe pain.

Pregnancy can put a great deal of stress on the pelvic girdle, which can cause weakness and instability; as a result 20% of pregnant women experience pelvic girdle pain.

The good news: pelvic girdle pain during pregnancy is treatable throughout the pregnancy. Even better news: the treatment is safe for the growing baby. Women do not need to suffer needlessly when they experience pelvic girdle pain.

If you experience pelvic girdle pain, contact your health care provider. In the meantime, you should be aware of some typical treatments:

Avoiding movements that seem to contribute to the pain. For instance if moving your legs apart laterally tends to produce clicking or pain, avoid that position. Adapting to this temporary condition may require consultation with a physical therapist with whom you can discuss your regular activities, including exercise. You may also need to discuss sex and sex positions with your physical therapist.
Exercises can also be prescribed which reduce pain, increase flexibility and strength. Swimming is a great exercise, which is easy on all of your joints. In addition, the water temperature and the feeling of weightlessness can be quite therapeutic.
Chiropractic manual therapy is often quite successful in addressing pelvic girdle pain issues.
Acupuncture is another complementary therapy that can bring immediate as well as long term relief.

Looking ahead: most women with pelvic girdle pain are able to have a vaginal birth. In addition, 90% of pregnant women who experience pelvic girdle pain are “cured” once the baby has been delivered. One caveat: future pregnancies have a higher chance of also including pelvic girdle pain.

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.

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.

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.

Hitting the Road without Hitting the Pain Pills

Our Michigan weather seems to have turned the corner. We’re not quite wearing shorts yet, but maybe we can put the snow shovels towards the back of the garage. Is now the time to plan for a quick weekend getaway to see friends or family or an even longer spring break trip?

Road trips are more economical than airplane rides. But extended car trips do pose a risk for people who experience pain. Extended driving or riding time can exacerbate pain in the back, neck, shoulders, legs, knees and ankles.

Here are some tips to hit the road without exacerbating your current pain issues or creating new ones:

Adjust your seat (and bring along accessories) to ensure that you can maintain proper posture. Remove everything from your back pockets like wallets and cell phones. Bring a pillow or rolled towel and place it in between your lower back and the seat to provide additional support.
Start with good posture when driving. Your arms should be bent at the steering wheel and your knees should be bent too. It is a mistake to sit too far away. This adds extra strain on nearly every part of the body.
Support your head. Adjust your head rest so that it touches the middle of the back of your head. You want to do everything you can to avoid having to lower your neck or lift it up. Ideally, you are looking straight ahead with some neck support.
Wiggle! Staying still is not ideal, believe it or not. Instead, shift your body around, even lift up an arm occasionally and push it on the car roof, doing a little isometric exercise. Roll your neck and shoulders. Shift your hips to the left and to the right and tilt your pelvis back and forth.
Exercise at every stop. When you stop to use the restroom, utilize this extra time to stretch. Walk around for a few minutes (inside or outside, but briskly). You should also stretch out your arms above your head and by crossing the midline of your body. If you can do so, deep squats, done slowly, can also be restorative.
If you are already in pain, stretch cautiously. Although stretching will generally be helpful at rest stops, if you are already experiencing pain, don’t start vigorous exercises the second you get out of the car. You will already be stiff and somewhat inflexible. Give yourself a few moments to slowly “unwind” and only then try small movement stretching exercises (Extending your back, stretching arms to the sky, bending into a half squat are all small movement standing exercises.)
Be a backseat driver. If you are the rider and you begin to experience pain, lie down for a stretch in the back seat so you can change your position and get some relief.
Break up the driving. While lots of people can take on a 10 hour drive, your pain threshold may preclude this. Do not feel guilty about dividing your trip into smaller, bite-size portions.

When Your Back Hurts…Keep Moving with Physical Therapy

When your back hurts, it may seem like you need to avoid movement. In fact, the opposite is true. You often can benefit from some rest initially. But extended bed rest can actually interfere with full and complete recovery. More movement is necessary for you to get back to your lifestyle and your routines, which helps stave off depression. More movement is needed to keep all of your muscular and nervous systems at optimum functioning. Extended sedentary time will take its toll on your back and on your circulatory, digestive and nervous systems. So, the key is to find ways to move while minimizing pain and helping with your recovery.

That’s where physical therapy helps.

Physical Therapy Goals: Physical therapy should help restore joint movement, increase flexibility, decrease pain and teach you how to move in ways that minimize back pain. In addition, you should learn exercises that you can do in our office and at home that will help you with stability and increased strength as well as endurance. Your physical therapist can help evaluate the effectiveness of therapy as you are making visits and adjust your program, even watching you do exercises to make sure you are getting the most out of what you put into your own treatment.

Physical therapy is most effective with motivated patients who are willing to keep up with assigned therapy both at home and in the office. Physical therapy is often accompanied by other treatments like doctor visits, medication, chiropractic care and psychological counseling.

Physical Therapy Treatments include services that are both passive (treatments that are administered to you) and active (therapy that you have to participate in like exercise and stretching):

Exercise instruction, whether weight bearing or light cardiovascular exercise, provides an individualized plan for rehabilitation and restoration of function as well as instruction on avoiding postures that cause further back pain. For back pain, exercises that emphasize increasing core strength are the most important to aid in your recovery. Examples of these exercises include crunches, leg raises, usage of abdominal machines, as well as modified hyperextensions like back bows and cobra stretching.
Coaching on ways to prevent further pain. Your physical therapist will help you come up with ways to modify your movements now to accommodate for pain and inflexibility, so that you can lift, bend, transfer from sitting to standing and do other daily life activities without risking re-injuring your back.
Heat and Cold Therapy can alleviate swelling and remediate acute pain and can be part of a first response to pain.
K-Laser (cold laser) therapy is useful for increasing blood flow and loosening tight muscles.
Massage applies gentle or firm pressure to sore areas, restoring flexibility and increasing blood flow to affected areas. Many back pain patients find massage to be both relaxing, so it combines a physical therapy treatment with psychological relief, too.
Manipulation of joints and bones can loosen tight tissues surrounding joints and reduce pain, in addition to improving flexibility.
Stretching exercise demonstration and instruction utilizing bands, machines, and just your body to increase flexibility and decrease pain is one of the most effective components of physical therapy.
TENS (Transcutaneous Electrical Nerve Stimulation) increases blood flow to painful areas and short circuits pain transmission. Many back pain patients derive relief from it.
Ultrasound therapy techniques may be effective in reducing pain and muscle tension.

Stretching to Ease Lower Back Pain

Many of us suffer from occasional or even chronic back pain. The pain can be exacerbated during long travel, stressful situations, unbroken sedentary periods, as well as use and overuse: lifting, carrying, climbing stairs, even regular exercise.

There are a variety of stretches that can relieve back pain or even prevent further pain.

Before you try any of these stretches, please get permission from your health care team.

If you would like to embark on a stretching regimen, be sure that you have a flat surface, free of debris, large enough to accommodate you if you lie down. Be sure to wear comfortable clothing that doesn’t restrict your movement. As you attempt each of the stretches, be sure to remember these tips:

Go into the stretch slowly and hold the position for 30 seconds, if you can. Repeat the stretch for a total of five repetitions, if you find that it feels good.
Do not bounce during a stretch.
Do not continue the stretch if you feel pain.

Try this sequence of stretches that have been found useful for low back pain relief. Some of these stretches may be known under other names, especially in various yoga practices.

Hugging Your Knees:

Lie down on your back. Bring your knees together to your chest and hug your knees as tightly as you can. Hold the pose and let go. If you want you can rock slightly to the left and right. This is a great way to begin a stretching sequence. If you’re not flexible, it’s okay. Just bring your knees as close to your chest as you can handle.

Half Snow Angels in the Air:

Still lying down on your back, put your legs on the ground, keeping your legs straight. Now lift both legs up a few inches in the air. Pull your legs apart and then back together slowly. Then lower your legs. Many people find that this stretch is too challenging, especially if you carry a lot of weight in your belly. Nevertheless, others find immediate relief from doing this stretch.

Cat Stretch:

Face down on your hands and knees. Slowly move your spine up, like you are a cat, arching your back. Slowly lower your back down before repeating.

Back Bow:

Lie down on your tummy. Stretch your arms out in front of you. Keep your legs together. At the same time, lift up your arms and your upper back as well as your legs. If you cannot do this move, just lift your arms. Slowly come down and take a breath before repeating.

Downward Dog:

This classic pose is a great stretch and is easier than it looks. Start on your hands and knees, with your hands slightly in front of your shoulders. Pressing back, raise your knees away from the floor and lift your tailbone up toward the ceiling. Keep your head down.

Climbing the Wall:

Lie down on your back in front of a wall. Put your tush all the way against the wall and put your legs against the wall. This is an easy pose that drains the fluid from your ankles and is incredibly relaxing.

Let it Snow, Let it Snow, Let it Snow (but NOT TOO MUCH!!)

The first flakes of snow have fallen, but we are not inundated yet. So, this is a perfect time to think proactively about keeping winter weather from taking a painful toll on your body. Regardless of how bad our winter-to-come ends up being, heeding a few important tips will make all the difference if you need to clear a safe path through snow. Please, though, remember your actual limitations! If your back, legs, neck or heart aren’t up to it (you know who you are!) keep yourself safe and potentially save your life by hiring a service or asking friends and neighbors to help you out.

Warm up inside before you start. Stretching your muscles and warming up your body before you go outside into the cold will reduce the risk of muscle strain.
Use your abdominal muscles. Strong abdominals will keep the natural inward curve of your back. Bending over while shoveling makes your back vulnerable to injury.
Don’t twist your body. Twisting your back to pick up or dump snow adds strain to your back. Instead, keep one foot in front of the other and always make sure that your feet face the direction in which you are picking up and tossing the snow.
Use your legs to lift. This will relieve some of the pressure on your back, so that the weight of the snow is supported by your entire body, not just your back
Lift loads that are manageable. Even though it may take you a little longer to shovel smaller amounts at a time, this will reduce the strain on your back. Remember, you will be moving the shovel over and over, so you don’t want to use all your strength in one lift.
Take breaks. Stand up tall, place your hands on your low back and gently bend backwards ten times. Doing this back extension every 10-20 minutes will help keep your back loose and allow you to reflect on your progress.
Take your time! Rushing, lifting heavy loads and losing your balance can result in injuries.

Osteoporosis: What Women AND MEN Need to Know, Part I

Lots of people assume that as you age, your bones have to deteriorate. In fact, this isn’t the case. You can do a lot to prevent the onset of osteoporosis. Even after diagnosis, you can take positive steps to improve your bone health.

A note for men: A recent study out of Beth Israel Deaconess Medical Center indicates that men are not screened adequately for bone loss and osteoporosis. As a result, there are lots of older men with significant risk for fractures who are not aware of their high risk.

The best ways to combat osteoporosis include dietary management, exercise, and reducing harmful behavior. Today, we are going to focus on dietary intake of vitamins and minerals.

Getting enough Calcium: Calcium, an essential mineral, is a builder of bones and its presence also keeps our bones in optimum condition. Our body does not naturally replace calcium, so we have to replenish our calcium supply daily. Do you get enough calcium? Women need more than men, and everybody has to increase their calcium intake as we age. You should attempt to get most of your calcium from the food you eat, and only use a supplement to make up the shortfall. There are no risks to eating the required amount of calcium, but there are some side effects from calcium supplements. Consult with your health care provider regarding your recommended calcium intake.

Daily Calcium Needs

Women 50 years and younger: 1,000 mg/day

Women 51 years and older: 1,200 mg/day

Men 70 years and younger: 1,000 mg/day

Men 71 years and older: 1,200 mg/day

Getting enough Vitamin D: Vitamin D allows your body to absorb calcium. Some of the foods which contain calcium also contain Vitamin D, but it is difficult to get all of the required Vitamin D through food alone. Sunlight also aids in production of Vitamin D, but those who live in cloudy locales or who apply sunscreen to prevent skin cancer don’t get the Vitamin D through the sunlight. For most people, a Vitamin D supplement is necessary. You should take a supplement that covers the shortfall of Vitamin D that you don’t take in with food. Consult with your health care provider regarding your appropriate Vitamin D requirement.

Daily Vitamin D Requirements

Women and Men under Age 50: 400-800 International Units/Day

Women and Men, Age 51 and Older: 800-1,000 International Units/Day

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