What causes back pain and how to prevent it.
What causes back pain and how do I prevent it?
The cause of back pain is not always the spine. There are conditions where the spine itself is the problem, but oftentimes the discomfort we experience is due to excessive forces through the spine caused by muscle imbalance and poor postural habits that develop over time. We then experience pain in the back muscles, the buttocks and sometimes the leg as inflammation; scarring and bony changes slowly develop irritating nerves and tissue. We don’t just wake up one day with bad posture and back pain although it may feel that way.
Our hips and pelvis are the foundation for our back. Some of our strongest muscles, those that are designed to move our legs, attach to our spine and pelvis. These muscles are often over used, misused, and under stretched. As one side of a joint develops muscle tightness, it can impede the ability of the opposing muscle groups to work effectively. The tighter muscle groups start to acquire dominance and will move bones by virtue of their attachment gradually changing our posture and the normal curves of the spine.
If multiple sides of a joint are tight, then our movement in that joint becomes limited. Over time, this can cause the joint to be compressed, reduce synovial fluid and degenerate more quickly. We will then compensate for lack of movement and develop poor movement patterns. When we sit for long periods of time in our job every day, we will develop imbalance as the muscles adapt in length and tension. Unless we stretch and move differently throughout the day and while not at our jobs, our posture and muscle efficiency will change. Sitting at a desk and then sitting on a bike is not necessarily different.
A compensation we adapt is to overuse our hamstrings and underutilize our gluteal muscles when walking or running due to lack of motion and poor muscle firing patterns. This promotes injury. The body has a way of compensating to achieve the movement we ask it to do. These compensations are not always good for our backs, our spines or our performance. Ultimately, we want to maintain the natural curves of the spine in order to function best.
It’s also important to use the small muscles between our vertebrae or they become weaker and less effective. If we do not, our mobility in our spine, rib cage, and shoulders will be affected. A tight upper back is common with people who sit a lot. Our breathing patterns may then become more superficial making our neck muscles work harder and increasing the stress response.
Lengthening and elongating our spines through movement and stretching creates space between our vertebrae and keeps the discs healthy. A regular stretching program is most beneficial for maintaining range of motion across all of our joints. The best stretches are those that create length on all sides of the spine and those that address the muscles that tend to be tightest from sitting depending on your occupational strains. Rotation of the spine when done actively and safely can be very therapeutic for the spine. Strengthening and core strengthening is also important, especially for hypermobile joints. Most people are more diligent with strengthening, and not so good at stretching.
Emotion can be a contributor to back pain. If we are unhappy or overwhelmed in our lives, our mental tension (whether acknowledged or not) will start to manifest in our physical body. It may start out subtly, like tight shoulders, but eventually chronic tension affects our breath, our nervous system and our organs. Our bodies don’t lie. What we can’t or don’t express will find a way to sit in our psyches and our tissues.
Yoga is an excellent way to learn how to move your body in many directions, address those areas we tend to neglect in our daily lives, and de-stress. Practice caution in taking a yoga class. Talk to the instructor to let them know any condition you may have and always stay in control of your body. Pushing too far or deep in a pose will undoubtedly cause more problems. Twisting or bending improperly if you are tight or too flexible can also cause harm. Don’t be afraid to try, but always be aware of how your body feels at any moment. If you are having pain, seek the professional guidance of a movement specialist such as a physical therapist. Most of all remember: ‘Take care of your body. It’s the only place you have to live.’ Jim Rohn.
Preventing and Treating Osteoporosis
Preventing and Treating Osteoporosis
We are all aware of the benefit of exercise. Maintaining a base level of fitness can help us maintain an ideal weight, feel better, and enable us to continue to do the activities we enjoy. Certain types of exercise also benefit the health of our bones. Once we learn that we have ‘osteopenia’ or bone-thinning, it is often a wake-up call to do something to prevent the next stage - osteoporosis. We want to improve our bone density but don’t know how other than taking the bone-building medication that is often prescribed.
Research has shown that the best things we can do that do not involve medication are to exercise, improve our posture and diet. In some cases, medications are recommended to assist in preventing further deterioration, but as with all medications, the best on the market is a topic of controversy and what works for some does not work for all.
Osteoporosis is a reduction of bone density that results in more fragile bones that become vulnerable to breaking with less stress. The part of the bone most susceptible is the trabecular bone or spongy part that gives our bones the ability to give without breaking under stress. Bone density is maintained throughout our lives by a delicate balance of bone resorption and rebuilding. Osteoporosis occurs when the body does not form enough new bone and when too much existing bone is reabsorbed by the body, or both. The body needs calcium, vitamin D, vitamin K and phosphate to form bone. If we do not get enough of these minerals though our diet or if these minerals are being depleted too quickly from our bodies, they are reabsorbed back into the body from our bones.
Post-menopausal caucasian women are at high risk for osteoporosis, but the disease can affect males and other ethic groups who may have other risk factors. Family history, poor nutrition, vitamin deficiency, hormonal imbalances, thyroid disorders, excessive or not enough exercise and extended time on steroid medication increase your chances of bone density loss.
The best treatment for osteoporosis is prevention. The best prevention and treatment is exercise and good nutrition. Strength training and low impact exercise have been proven to build bone density. Studies have shown that resistance exercises, such as lifting weights, can stimulate the bone-building process. Exercise that compresses, or loads your bones increases the formation of new bone cells (osteoblasts) and improves overall bone strength. Bone will adapt to the loads they are placed under – a phenomenon called Wolff’s Law. If there are compressive loads to a bone, the bone will remodel itself over time to become stronger to resist that sort of loading.
The topic of nutrition is controversial. Receiving the right amount of nutrients through the food we eat will prevent our body from robbing our bones and muscles of these nutrients. Calcium, vitamin D and vitamin K are important minerals for bone-health. The recent controversy in taking the right amount of calcium supplements reminds us to consider more natural sources. Milk has been touted as the best source of calcium although some believe that milk products can be harmful. I encourage you to do your own research on this topic to decide if milk is right for you. Other sources of calcium and vitamin K are: green vegetables such as kale, collards and spinach, figs, apricots, sardines, fresh squeezed orange juice, and garbanzo beans. Vitamin D is necessary for calcium absorption and found in high quantities in fish. Vegetarians may need supplements if their calcium or Vitamin D levels are low. On the flip side, vegetarians tend to have lower blood PH. If your diet is high in dietary salt or protein (from milk, meat or eggs) your body will need calcium to balance PH levels in the blood. To buffer the higher acidity and regain equilibrium, the body leaches calcium from the bones.
We can’t feel or see our bones thinning. If you feel you are at risk for osteoporosis, talk to your doctor about your options. A physical therapist is an exercise specialist and often the best place to start for developing a safe strengthening program. Find one that is knowledgeable in osteoporosis. Synergy is offering an osteoporosis prevention and treatment program starting this October. Please check out our web page for more details.
“Vital at every age for healthy bones, exercise is important for treating and preventing osteoporosis.” National Institutes of Health.
Dry Needling: What is it and is it effective?
The effects of dry needling are generally non-specific, but can become more specific by where the needles are placed in relationship to the affected area. The insertion of the needle creates a tiny lesion. The peripheral sensory nerves in the microenvironment (neuro-trigger point) cause a reaction that activates a healing response through the central nervous system. The healing response is the body's way of repairing the micro lesions. This results in an anti-inflammatory immune reaction that leads to internal balance. If a muscle is tight and sore, the needles can cause a more localized effect by direct manipulation of where the needle was placed.
Local muscle pain involves afferent sensory fibers (nociceptors), muscle fibers, and blood vessels. The sensory nerve endings when irritated can trigger a cascade of events leading to neurogenic inflammation. This can affect microvasculature at the site. Additionally, histamine is released and inflammation spreads to adjacent tissues. Over time, sensitized nociceptors cause pain in the localized region of the muscle. By inserting a needle into the muscle at the location of the sensory nerve endings it triggers the body's natural healing response and both centrally and locally stops the cycle.
The efficacy of dry needling varies from person to person. This usually depends on the overall health of a person and the body's ability to heal. The same soft tissue pain symptom can be completely cured in some (28%), partially relieved in most (64%) and of low or no efficacy in a few (8%).
For more information on Dry needling and its multiple benefits I recommend the following books:
Biomedical Acupuncture for Pain Management by Yun-Tao Ma, Mila Ma, and Zang Hee Cho;
Biomedical Acupuncture for Sports and Trauma Rehabilitation by Yun-Tao Ma
