Exercise can prevent and reduce low back pain: pick your preference!


Exercise can prevent and reduce low back pain?

Yes! When I read this article I thought that our patients could definitely benefit from more movement that we should share it here on the blog! Especially those with low back pain! Check it out!

People are increasingly advised to be physically active and engage in exercise given its benefits for many aspects of physical and mental health. For example, it is now known that being physically inactive is worse for your health than smoking, diabetes and obesity combined! However, for a lot of people who experience low back pain, there is often a hesitation to exercise. This frequently means that exercise is overlooked in managing low back pain, often in the favour of treatments like medications and surgery. Many think the experience of low back pain is always a sign of damage and fear that exercise may cause them more problems. However this is not the case!

Movement is key to recovery from back pain

Exercise can prevent and reduce low back pain. There is scientific evidence that prolonged rest and avoidance of activity for people with low back pain actually leads to people in pain becoming even more disabled. For example, prolonged bed rest is unhelpful, and is linked with higher levels of pain, greater disability, poorer recovery and longer absence from work. In fact, it appears that the longer a person stays inactive because of back pain, the worse the pain becomes.

In the first few days of a new episode of low back pain, avoiding aggravating activities may help to relieve pain, similarly to pain in any other part of the body, such as a sprained ankle. However, there is evidence that staying as active as possible and returning to all usual activities gradually, including work, hobbies and exercise, is important in aiding recovery from back pain. People often move differently and more slowly in the first few days of having back pain. This is normal, like limping after an ankle sprain. However, many people continue to move differently and slowly for too long after the onset of low back pain. This altered movement can be unhealthy in the long term and can actually result in people feeling more stiff and tense.

Should people with low back pain avoid certain movements?

When people have low back pain, they are often told that activities involving lifting, bending, twisting and high impact (e.g. jogging, running) are dangerous and should be avoided. This is based upon a misunderstanding of the research in this area. For example, there is some research suggesting that a person can get back pain (sometimes) if they lift something awkwardly or lift something that is heavier than they would usually lift. Similarly, if a person has low back pain, activities like lifting and running might be more sore than usual. This, however, does not mean that the activity is dangerous or should be avoided. While lifting, bending or twisting awkwardly could initially give a person back pain, bending and lifting is normal and should actually be practised to help strengthen the back, similar to returning to running and sport after spraining an ankle. Overall, using your back normally (to twist, bend, run, etc.) will make it stronger, more flexible and healthier in the long run.

Benefits of exercise for low back pain and general health

Scientific evidence is now showing that exercise can significantly prevent the recurrence of an episode of low back pain. It also helps reduce low back pain and disability levels, when people start gradually and stick with it in the long-term. Furthermore, the average results for exercise are on par (or better) than treatments like drugs or surgery; with fewer side effects and lower costs. Regular exercise has the following benefits for pain as well as general health:

  • Reduces muscle tension and nervous system sensitivity, by activating our own body’s natural pain killers (e.g. endorphins)
  • Improves mood
  • Increases muscle strength and flexibility
  • Improves sleep quality
  • Reduces fatigue, tiredness and increases energy levels
  • Prevent and reduce stress and anxiety
  • Reduces the risk and progression of major life threatening conditions such as heart disease, chest and lung problems, type 2 diabetes, and neurological conditions (e.g. multiple sclerosis)
  • Scientific research is now showing that low back pain can be driven by many related factors such as lack of exercise, sleep, mood, stress, improving these factors by increasing your levels of exercise could significantly help your pain.
  • Helps with weight control when supplemented with a healthy diet

Which type of exercise is best for back pain and how much should I do?

Contrary to popular belief, most types of exercise are of some benefit, with no single type clearly being the best at reducing pain or improving function for people with a low back problem. That is good news because you do not need to sign up for the latest (and normally expensive) exercise fad to see results. People should feel comfortable choose simple options like walking, running, cycling, swimming, yoga, and pilates; knowing that all seem to be safe and equally effective for low back pain.

The amount of exercise you do is probably more important than the type of exercise. The greatest gains are got when an inactive person starts doing any exercise, but getting more than 150 minutes a week has the greatest health benefits. Doing the exercises in a relaxed manner (e.g. moving normally, not guarding and not breath-holding) and progressing them gradually may also be important.

Most importantly, people should do an exercise or activity that they enjoy, that is affordable and easy to access (e.g. not too far or difficult to fit in to your daily routine). This will increase the chances of sticking with the exercise in the long-term.

We at Seattle Chiropractic Center really like functional exercises for training. Exercises like the deadlift, squat, press, and even power cleans.

Is exercise always the answer for low back pain?

Each person’s low back pain is different and some may benefit from more emphasis on other aspects of their health and lifestyle. These may include things like diet, sleep and stress management. However, even in these cases, exercise can be helpful and should be encouraged.

Is exercise safe and how to get started?

When you are in pain, starting exercise can be very hard. Underused muscles get sore more quickly than healthy muscles. Feeling stiff and sore after exercise does not indicate harm or damage to your body – it simply reflects your body not being used to the activity. You can start by doing some gentle activity and then increase your levels when you feel confident to do so. Exercise is very safe, and often of greatest benefit in people with poor health. If you are in doubt about whether you should exercise due to ill health or any other concerns, speak to your doctor/GP or other health professional (e.g. a physiotherapist) and they can check if exercise is safe for you. If you feel you need supervision during exercise to increase your confidence, a health professional (e.g. a physiotherapist, personal trainer or strength and conditioning coach) can help you form an exercise plan, which will involve increasing your activity levels gradually and when you are happy to do so.

Overall, exercise is medicine! No drug or tablet delivers the diverse range of benefits as exercise. Unfortunately, it is often overlooked or not given as part of the management of low back pain. There are a range of exercises available, and all low back pain is not the same. So if you have tried in the past and it has not helped you may need some help from a physiotherapist or other health care professional to set you up on a specific program to meet your needs.

3 Top Tips for picking the right kind of exercise

  • Pick an exercise that you enjoy (Exercise that’s fun, gets done!)
  • Pick an exercise or activity that is cheap enough that you can afford to maintain it in the long term.
  • Pick an exercise or activity that you can easily access (eg. not too far away or difficult to fit in with your daily schedule).

    This article was originally posted here.


Cannabis use for sciatica & chronic low back pain


New research for low back pain has come out regarding the use of cannabis and it’s effect on chronic low back pain patients. Those of you in Washington State and other legal states should take note. There is some interesting results. Check it out.

Low back pain is a common condition affecting many individuals at some point in their lives. [1] The estimation is that between 5.0% and 10.0% of cases will develop chronic low back pain (CLBP), which is responsible for high treatment costs, sick leave, and individual suffering. [2]

Given the poor outcome of the medicines currently in use for management of CLBP symptoms, and the increasing number of failed surgeries, CLBP is still today an highly disabling issue. [3] Not to mention the long list of side effects associated with traditional therapy (gabapentin, NSDAI, opioids and tricyclic antidepressant mainly); We have been comparing the effects & outcomes of the use of opioids and cannabinoids for the treatment of inflammatory pain in another article: “Cannabinoids and chronic pain. What your drugstore does not want you to know.”

Phytocannabinoids have been extensively used throughout history for various therapeutic purposes, particularly analgesic. It is well established that activation of the Endocannabinoid system reduces pain sensationat central and peripheral levels. [4] To deepen your understanding of this topic, you can read our review “Endocannabinoids are the body’s analgesic” here.

Anecdotal evidence indicates the possible efficacy of cannabis use as an adjunctive treatment in chronic low back pain. A recent study carried out by the Department of Orthopedics in the Hasharon Hospital, Israel, assessed the outcome of treating with medical cannabis patients suffering from chronic low back pain, reporting very encouraging results.

Crossover study
Who was admitted in the study?

Patients recruited for the study were:
 Age over 25
 Evidence on CT or MRI scan of disc herniation or spinal stenosis
 Failure of at least 2 narcotic drugs
 Consent to use medicinal cannabis
Among these patients, were excluded those showing evidences of bone cancer, diabetic neuropathy or prior psychotic reactions.

 The total number of CLBP patients enrolled was 39.
 They were evaluated at baseline (month 0), at mid of the study (month 3) and at the end of it, at month 6.
 The scales, having to test pain, which is mainly subjective, were patients reported questionnaire such as Brief Pain Inventory, Visual Analogue Scale & SF-12 (quality of life scores).

 Cannabis usage was fixed to 20 grams/month, with possibility for dose increase only following the first 4 months of treatment.
 The recommended method was via inhalation (vaporizing / smoking).
 Daily use was suggested as 16 mg dose, 4 times daily.
 Cannabis was not used to replace current treatment, but added to the ongoing treatment.

Outcomes of the study
There was an high reduction in the Visual Analogue Scale (VAS) for pain, which decreased substantially from 85 points at the beginning of the study to 32 after 6 months.
The overall physical health was rated as twice better (SF12-PCS improved from 21 points to 52), and, with that, mental health & emotional happiness were estimated to having increased (SF12-MCS) from 23 points to 53.

Conclusions drawn from the investigators show that short term usage of smoked medical cannabis improve physical & mental function, while decreasing pain levels of chronic low back pain sufferers. [5]
These results were matched by a net increase in employment, which is generally low with current prescription of opioids, given that most of CLBP sufferers have to stay at home from work.
The major drawback evaluated is that, in Israel, for patients to be allowed of benefiting of cannabinoid therapy, they are required at least 1 year follow up with a neurologist, which is an economically expensive & painfully frustrating situation, thus reducing only to an elite of people those who can improve the quality of their lives with cannabis.
Says Dr. Robinson, the main study investigator, during the International Cannabinoid Research Society ICRS 2016. Israel begun issuing medical cannabis in 2007, after specialists inquired the Ministry of Health of providing
registrations for patients.

Today there are 23,000 patients using cannabis is Israel, the majority of which treated for cancer (56.6%) & secondly, pain (26.9%). A recent epidemiological study reported that 71.7% of cannabis patients described significant improvements of their condition after only 1 month of cannabis therapy, to reach 92% overall improvements after 2 months. [6]

According to these data, the hope is that cannabis may be used as first line treatment, without the detrimental side effects of keeping in pain patients for more than 12 months, having to fail expensive & invasive surgeries and opioid treatment.

[1] Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354(9178):581-5
[2] Melloh M, Röder C, Elfering A, Theis JC, Müller U, Staub LP, et al. Differences across health care systems in outcome and cost-utility of surgical and conservative treatment of chronic low back pain: a study protocol. BMC Musculoskelet Disord. 2008;9:81.
[3] Selph, S Carson, S Fu, R et al. (2011). Drug Class Review Neuropathic Pain.Available: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0016164/pdf/TOC.pdf. Last accessed 4/3/15
[4] Pertwee RG: Cannabinoid receptors and pain. Prog Neurobiol 2001, 63:569-611
[5] Dror Robinson. Effect of cannabis use on severity of chronic low back pain and sciatica. ICRS2016
[6] Bar-Lev Schleider, L Mechoulam, R Sikorin, I et al. Epidemiological characteristics of patients treated with medical cannabis. ICRS2016

This article was originally posted here.

Seattle Chiropractic Center, 2326 Rainier Ave S, Seattle, WA 98144



Shoulder Pain: Tendinitis, Inflammation and Injury


Here’s a great post about shoulder impingement. It gets pretty technical but, a great read nonetheless. Seattle Chiropractic Center been also putting out some videos on the subject of Anterior Shoulder pain. Check out our most recent video here:

Impingement syndrome is marked by inflammation of one of more of the four rotator cuff tendons that run through a tiny space between the bony tip of the shoulder, known as the acromion process, and the ball-and-socket joint directly beneath it. This condition, which is quite common, affects individuals involved in activities requiring repetitive overhead movements, including weightlifting, swimming and volleyball. Impingement syndrome starts out insidiously. One of the rotator cuff tendons, usually the supraspinatus, becomes slightly inflamed. As a result, it swells crowding the already tight subacromial bursa, a water-filled pad designed to reduce friction between the tendons and bones in the area.

Once even the most minute amount of inflammation starts, both the bursa and the tendon become involved in a vicious cycle in which continued movement further inflames the soft tissue. Eventually, the space becomes so tight with swollen tissue that the tendon tears. If deterioration persists it will lead to a complete rupture of the rotator cuff, causing inability to smoothly move the shoulder joint and often making it impossible to raise the arm at all. An overhead throwing athlete, such as a pitcher, tendinitis of the rotator cuff may have different cause completely.

Inflammation is the reason that we use our ice protocol on shoulder pain. Use ice on the affected area for 7-15 minutes or until numb. Wait an hour and then re-apply in the same way. Ice has been shown to be more effective than medication for some shoulder pain.

Impingement problems are usually progressive; they start out as small, intermittent, nagging pains, and eventually progress to a full-fledged rupture. Pain begins from deep inside the edge of the shoulder in the form of creaking, snapping, or inflammation. Once this pain has been felt stop the offending activity immediately. Rest the area until the inflammation subsides, stretching lightly and exercising the shoulder within a range of motion that feels comfortable is permitted. For example, when the suprapinatus is inflamed, pain is typically felt when the arm is raised to the side at an arc of 80 to 120 degrees. This means that mobility beneath the horizontal plane can be achieved and is vital to maintain as it will help retain flexibility in the inflamed tendons. If the tendon is only minimally strained, it will heal on its own within 6 weeks. After that time, gradually resume normal activities, adding stretching and strengthening exercises to condition and maintain the scapular and shoulder muscles and tendons. Anti-inflammatory medications, topical analgesics an cold therapy should be applied after exercise to speed the healing process by reducing inflammation.

Calcific tendinitis or bursitis is the result of an injury, overuse or age. Calcium deposits form in the supraspinatus tendon and or in the subacromial bursa. The intense pain experienced along the top and front of the shoulder is relieved only when the elbow is held close to the body. A cortisone injection or a local anesthetic may relieve acute pain. Anti-inflammatory drugs and topical pain gel may be effective too. Radial shockwave therapy is recommended for worst-case scenarios where surgery will be the only remaining option to remove the deposits.

A shoulder separation is a sprain of the ligaments connecting the acromion to the clavicle. The acromioclavicular joint is composed of small bones, so it takes only a moderate impact against the outer edge of the shoulder, such as being slammed against a wall or when falling on the shoulder, for a separation of the bones to occur. The extent of damage varies; a separation can be minor and involve just a slight stretching of the ligaments, in which case it will be painful to raise the arms for a few days. Or the injury can involve a complete rupture of the ligaments that hold the joint together, causing swelling and intense pain. The shoulder will be discolored and the separation may even be obvious to the eye. Treatment is dependent upon the severity of the injury. A minor separation may require only 2 days to recover on its own; icing and NSAIDs will help significantly, avoid overhead lifting during the healing phase. When completely healed, there may be a noticeable bump in the area of the injury because ligaments are stretched out, causing one side of the joint to be higher than the other, this a normal part of the healing process.

Shoulder subluxation and dislocation occurs when a sharp impact against the arm while it’s extended causes the head of the humerus to pop out of the shoulder socket, stretching or tearing the glenohumeral ligaments and joint capsule. If the bone pops right back in on its own, it’s known as a subluxation, or partial dislocation. Subluxation of the shoulder can also be caused by a gradual stretching of the ligaments and joint capsule in the front of the shoulder, such as with repetitive, extreme movements of the sort performed in baseball pitching. This type of injury can be treated successfully through a proper strengthening program that targets the scapular and rotator cuff muscles. Subluxations cause acute pain, but the pain will subside; however, it may return several hours later. Subluxations can heal on their own with rest, repeated applications of cold therapy and strengthening exercises. If the ligaments do not heal properly they will be susceptible to recurrent episodes.

Complete dislocations are obvious in terms of the degree of pain, spasms and the misalignment of bones. Since dislocations aren’t overuse injuries, it’s hard to take preventive measures, except to avoid falling on an outstretched arm, like in skiing and skating falls, which are common scenarios for these injuries. Dislocations demand immediate medical attention and should be iced until reaching emergency care.

One of the most common bicycle injuries, a clavicle fracture or broken collarbone, occurs when falling on the top of the shoulder or an outstretched arm. Intense pain at the site of the fracture will be felt instantly and there will be difficulty moving the arm. Ice and immobilize the injury on the way to the hospital. This injury will require a sling or figure-eight shoulder harness, which is a specially designed sling that will hold the bone in place until it begins to fuse. Healing takes up to 8 weeks.

Tightening and scarring of the joint capsule of the glenohumeral joint is called adhesive capsulitis or frozen shoulder. The capsule is pleated like an accordion, so that as the joint moves, folds separate and expand. The shoulder capsule is peculiar, however, in that after an injury or a period of immobility, the folds can adhere to each other, and the capsule thickens or shrinks, making movement painful and restricted. To counter the condition, the mobility of the shoulder may gradually be restored with the aid of physical therapy and frequent, light stretching exercises. Anti-inflammatory medication, topical pain gel, ultrasound and in some cases, a corticosteroids can speed healing and reduce pain. In severe or persistent cases arthroscopy or manipulation loosens the adhesions.

Anterior shoulder pain can be caused by a number of issues. If you are experiencing shoulder pain, please call our Seattle chiropractic office to set up an examination.

This article was originally posted here.

The Latest Cause of Neck Pain: Pokémon Go


Neck Pain Causes

Pokémon Go is everywhere—this smartphone game is so popular that people are pouring out onto the streets and into their neighborhoods for hours on end while trying to “catch ’em all” and causing a lot of neck pain in the process.

The game is being lauded for its health benefits as players spend hours and walk miles in search of Pokémon to capture.

But if you’re looking down at your phone the whole time you’re playing, you’re putting your health at risk in other ways. Specifically, you may be at risk for text neck.

See How to Avoid Neck Pain from Texting

What is text neck?

Text neck is posture in which the neck is bent forward and down as someone looks at their handheld phone or device. If this posture is held for an extended amount of time, it can strain the muscles, tendons, and ligaments in the neck, causing pain and stiffness.

More alarmingly, chronic text neck may lead to premature degeneration in the cervical spine, bone spurs, and muscle deformity. This is especially alarming for young people’s spines. Their spines are still growing and developing, and experts aren’t sure what impact this can have over the course of years or decades.

How to play Pokémon Go injury-free

If you or someone you love is playing Pokémon Go a lot, these tips can help prevent text neck and the problems it can cause:

  1. Hold your phone at a higher angle.
    The higher you can hold it while playing, the less strain you’re putting on your neck.
  2. Take breaks.
    After you catch a Pokémon, take a short break to put the phone down and arch your neck and shoulders back. If you’re at a Pokéstop or Gym, take a break every 15 to 20 minutes.
  3. Stretch your neck.
    Tuck your chin down, then slowly raise it upward. Then swivel your head over one shoulder, then the other.

In addition to text neck, Pokémon Go players are in danger of tripping and falling by walking while looking their phones. Don’t get so wrapped up in the game that you’re not watching where you’re going, especially on busy streets or sidewalks.

There has already been reports of accidents and even deaths by players too involved to look up and see where they are.

Finally, seriously hard-core players may be putting themselves at risk for shin splints if they’re walking much more than usual.

We hope you are safe and painfree out there, Seattle. If you aren’t give us a call for relief from neck pain.

This article was originally posted here.

The post The Latest Cause of Neck Pain: Pokémon Go appeared first on Chiropractor Seattle WA- Seattle Chiropractic Center.

Chiropractic Treatment For Sciatica: 3 Important Things To Know


Chiropractic Treatment For Sciatica: 3 Important Things To Know

Chiropractic treatment offers a lot of benefits to people who are suffering from different kinds of body pains. Basically, this treatment can also be an effective way to provide permanent relief from sciatica.

Sciatica is usually characterized by hip and lower back pain that travels to one or both legs. This kind of problem is caused by sciatic nerve compression.

This type of disorder is extremely painful and it will prevent you from doing your daily chores. This is the main reason why lots of individuals are turning to chiropractic treatment to help them deal with this condition. If you want to cope with this kind of problem, here are some of the things that you need to know.

Sciatica can be due to several disorders including lumbar spine subluxations, herniated or bulging discs and tumors. Sciatic nerve pain may also be a result of pregnancy and child birth so this ailment generally manifests in women.

There are also some non-spinal ailments that may cause this nerve pain. It could be because of constipation, diabetes or it can even be triggered by sitting with a wallet in your back pocket.

Another common trigger of sciatica is piriformis syndrome, which is named after the piriformis muscle that may be located in the lower part of the spine. The sciatic nerve actually runs beneath this muscle so if you experienced cramping or spasm in this muscle, the sciatic nerve will also be irritated.

Chiropractic treatment is very efficient for this kind of problem because it will help your body to heal itself. As you all know, chiropractic treatments are focused on the ability of the body to heal itself and the adjustments made will make sure that your body will be able to heal itself.

This type of treatment is non-invasive and it does not require the intake of any drugs or prescription medications so it was very beneficial for the folks who do not wish to undergo surgery and take medicines.

The therapy that will probably be used to treat sciatica will depend on the main cause of the problem. You will find different treatments available that can provide convenience to people who’re struggling with this condition.

Ice/cold therapy might be used to reduce the inflammation to the affected area and control the pain from the nerves. Ultrasound, on the other hand, is gentle heat that is created by sound waves that will penetrate into tissues and help decrease muscle spasms, swelling, stiffness and pain.

Spinal manipulation is one of the best chiropractic treatments available since it can restore misaligned vertebral bodies to their proper position. It can help lessen nerve irritability that is responsible for the symptoms associated with sciatica.

However, you should know that chiropractic treatments will always have a limit and if the chiropractors in Seattle, WA think the cause of sciatica is not within their scope of practice, they will refer the patient to another specialist.

Sciatica is only among the conditions that a Seattle chiropractor can handle. They can handle body pains, stiff neck and other related problems and help you regain your mobility.

The post Chiropractic Treatment For Sciatica: 3 Important Things To Know appeared first on Chiropractor Seattle WA- Seattle Chiropractic Center.