Thursday, May 26, 2011

The Vicious Cycle of Back Pain

There is no shortage of active people in New York City. From fitness enthusiasts to avid runners that run the entire bike path on the west side, everyone is trying to be active. However a de-conditioned person just getting back out after being shut indoors all winter, seething form the cold and the inactivity that comes along with it, may just be asking for pain and injuries.

Even people that are regularly active don't notice that over the winter and spring their activity levels fall, sometimes significantly. Making a conscious effort to be active and not let yourself get out of shape during the winter doesn't always mean that you didn't avoid a walk or just stayed in an extra night here and there, or cut your gym time short to stay warm under the covers just a little while longer.

And is it just the winter inactivity that leads to injury? Well, no, its sort of a complicated answer. Your body has an economy based around exercise, rest and nutrition. An increase in activity needs more fuel (nutrition), and time to recover. Rest, or inactivity requires less nutrition, so its also easy to over consume, if you over consume, you require more work to burn off the excess calories, that leads to more activity, and so on.

Exercise economy

As the previous statement went, theres also an exercise economy, where there is a risk/ reward system. According to the National Academy of Sports Medicine, The National Strength and Conditioning Association, and other evidence based training certifying bodies that research exercise and nutrition, low repetition, heavy, compound exercises build strength, while high repetition, light weight exercises build endurance. So weather you exercise to be strong or to increase your endurance, the trade off between training volume and exposure to injury is simple. The more you do, the more you risk. But if you don't do enough, you don't make many improvements.

Too much training?
Its hard to believe that most people do too much. Think about it, most people hit a wall in their training regimen, and to fix it they simply do more. Some people "run through pain" when they have shin splints, other people just start adding more sets to their weight training workouts. This upsets that aforementioned "exercise economy" because you are now simply giving your body more work to do, and probably with poor mechanics and execution.

Can I exercise with a bad back?
Yes, some people can actually keep exercising with a back injury. Now, any time you are starting an exercise regimen, or thinking about exercising on an injury, make sure you talk to your doctor, or if you are under the care of a Physical Therapist, make sure you clear any exercise you are planning o do. Everyone is different and therefore everyone's injuries are going to require a different approach if not treatment altogether.
You want to stay away from exercises that load the spine, making herniated and bulging discs even worse, so stay away from deadlifts, and bent rows. What you want to do is focus on exercises that require "core" stability, or exercises that require you to have your lumbar, hips, and abdominal/oblique muscles work as one unit.
Try this:
Low cable row: Sit down on the machine and grab the cable handle, go for the single handle. Keep your back straight, and tight, now flex your abdominals, flex the obliques, and try to keep your hip complex tight too, so squeeze your butt a bit too. Make sure you can breathe, and go light on the weight, be careful not to make any sharp jerky movement, and don't allow your trunk to turn during the exercise.
Supine Bridge: Lay flat on yours back, bend the knees, and keep your hands at your sides. Start slowly and raise your hips up keeping your back and hips tight, return to starting position slowly.
Bird Dog
This is a simple Yoga movement, and here is a quick video demo for it:

Remember that for back pain, there are come great options for finding relief. A chiropractor can help adjust your spine and a Physical Therapist will help you strengthen the surrounding musculature.

Tuesday, May 10, 2011

Leg Pain: Is It Just a Muscle Issue?

Now that it’s nice outside, it’s normal to see more and more people running and enjoying the outdoors; the sunny season brings people back to life, out of the cabin fever days and into the spring fever days. Everything is just starting to come back to life. Of course, at the same time, it’s easy to have the winter months of relative inactivity come and bite you in the behind.

This is the way I have had more than one patient come to any office, Living Well Medical in NYC, complaining of leg pain, thinking it was muscle-related - it’s the first choice in a case of a person returning to active days. This is particularly true of people ages 50 and up because they are generally more susceptible to injury. However, based on the way the pain is described, it can become evident that leg pain is more than just muscular. That’s when things get more complicated.

Patients often say a few things that made me believe it might be something more.

Shooting, electric, burning pains are a component of the overall pain. This is sometimes an indication of a nerve-related problem like sciatica, but it cannot be confirmed without an in depth study like an MRI.

Patients also typically complained of some numbness in the legs, buttocks, feet or toes. Again, this is consistent with a pinched nerve that is inflamed and irritated, perhaps because of a herniated or bulging disc.

Finally, the patient complained that there was no real “comfortable” position - sitting hurt, standing hurt, even lying down hurt.

Just to be clear, none of the above is a definitive indication of a pinched nerve, but they do warrant more investigation, especially if the pain is persistent, as it often is. If you do have a pinched nerve, we’re here to help; services like spinal decompression, physical therapy, active release technique, chiropractic and so many others have been shown to be able to relieve pain and keep it away. The main thing to remember: if you’re in pain, don’t just ignore it! Call and find out more about getting help at 212-645-8151.

- Dr. Shoshany, NYC Chiropractor

Monday, May 2, 2011

Some Common Causes of Back Pain and How Spinal Decompression Can Help

What makes me a candidate for spinal decompression treatment?

Usually we would recommend Spinal Decompression for patients that have been suffering from:
Herniated discs
Bulging discs
Degenerative Disc Disease
Facet Syndrome
Additionally, patients that have not responded to physical therapy and chiropractic care may be candidates for non surgical spinal decompression.

What is the spinal decompression treatment experience like?

Thats the best thing about spinal decompression, the "side effects" of spinal decompression are limited to mild soreness which may cause mild discomfort for some patients. The soreness is not unlike how you would feel after a good workout. For most patients the treatment is very comfortable and relaxing, and the treatments last between 30 to 45 minutes. Patients often fall asleep since the stretch in the spine is not painful and feels good to most people.

Spinal decompression is often followed up with other therapies like cold/heat therapy, electronic muscle stimulation, and laser therapy.

What do the conditions mean?

Degenerative Disc Disease:
Is when a intervertebral disc is deteriorated, and dehydrated which leads to the degradation of the disc's ability to handle the loads placed upon it. Degenerative disc disease also contributes to bulging, herniated discs, and stenosis.

Facet Syndrome:
The facets are located towards the back of the spine and help keep the vertebrae aligned. Facet syndrome is usually characterized y inflammation, pain and stiffness that increases with activity and decreases with rest.

Often associated with a herniated or ruptured discs, sciatica occurs when a disc in the lumbar spine impinges no a spinal nerve that leads to the sciatic nerve, interfering with normal nerve activity. Sciatica can be acute or chronic, and is associated with pain that shoots down the buttocks and the leg. Tingling and numbness are also associated with sciatica, along with some loss of sensation.

We always use a combined approach towards treating back pain. Along with other treatment methods like Physical Therapy, Cold Laser, and the Graston Technique, we have helped mmany people suffering from chronic, painful conditions.