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Top Five Low Back Pain Relief Strategies

by Pain Doc | Aug 1, 2015 | Low Back Pain

When your low back hurts, you know the next couple of days aren’t going to be fun. Your low back, or lumbar spine is like the foundation of a house: it bears and balances all the weight above it, so if there are mechanical problems, the whole structure is affected. In fact, some cases of low back pain cause obvious tilting of the upper body to one side when standing, due to the structural imbalance.

There are countless studies on low back pain– how it develops; what causes the pain; who is at most risk for developing low back pain; how long it lasts and so on. For “non-specific” low back pain where there is no injury event, it is unclear which structures are generating the pain. It may be the back muscles, a vertebral ligament; a disc, nerve root, sacroiliac joint; or even referred pain from an organ. This makes treatment, especially invasive treatment (surgery, injections) challenging and often ineffective.

What is known is that if you have low back pain that continues down your buttock, and perhaps down the back of your thigh and leg all the way down to your foot, then it is very likely due to a bulging disc in your low back pressing on a nerve root. If this describes you, don’t give up hope. I’ve seen cases like this resolve with targeted exercises, spinal adjustments and time. But I’ve also seen cases like this turn into back surgery cases, where the surgeon goes in and removes part of the disc that is compressing the nerve, and sometimes the entire disc and fusing the adjacent vertebrae.

Non-radiating back pain can be equally bad. If the back muscles spasm, the pain can be incapacitating. I’ve seen many cases like this where the patient dropped to the floor, wincing in pain and avoided any type of movement. Aside from a cortisone injection, there is not much one can do initially for acute back spasm other than ice and rest until the muscles let go; then attempt things like chiropractic adjustments, PT, stretching and modalities like laser therapy.

Then of course, the rare causes of low back pain — cancer, tumors, bone cysts and other diseases; spinal stenosis, referred pain from kidney stones; fractures, and spondylolisthesis (slippage of vertebrae during movement). These will require diagnostic testing and proper management.

But for the vast majority of low back pain cases, there are things you can do to reduce their effects and reduce their incidence of occurrence. Here are my Top Five low back pain relief strategies:

Lose weight

(if you are overweight). This is just basic, common sense. If you are 30 pounds overweight, it’s like a normal weight person carrying a backpack full of rocks all day. Excess weight centered around the abdomen changes the center of gravity of your body. This bends your spine abnormally when you are standing, sitting, and even sleeping; setting the stage for back pain.

The best and fastest way to lose fat weight is to restrict carbohydrates in your diet, practice intermittent fasting, and exercise 30-60 minutes at least 3x/day. If you have to cut one of these out; I’d say the exercise. Caloric restriction burns fat cells on a much larger scale than exercising does. The reason is that simply by being alive, your body, depending on your mass, burns 1500-3500 calories per day. If you consume less than what you burn, you will lose fat weight. So, try eliminating bread, pasta, bagged and boxed snacks, sugar and fruit juice from your diet. Drink only water. Eat between the hours of 9 am and 4 pm, or 12 pm and 6 pm only. This gives you an 18 hour fast, where your body will start burning its fat stores.

Stand more

When you sit, the natural inclination is to round your lower back. You may try to force yourself to sit erect for a few minutes, but after a while, your low back muscles fatigue and allow your lumbar spine to bow out again. This posture weakens the lumbar spine’s structural integrity because it separates the facet joints (see middle image below), which makes the lumbar spine less sturdy (“unlocks” it). The angle of the vertebral bodies also apply a backwards force to the disc that can encourage posterior disc bulging or herniation.

bad-spine

The bad health effects of prolonged sitting goes way beyond back pain. The amount of time a person sits during the day is associated with a higher risk of heart disease, diabetes, cancer, and death, regardless of regular exercise, according to a review study published in the Annals of Internal Medicine. This is significant, because computers are firmly integrated into the fabric of life– just about every business from farmers to tech giants rely on computers, and as for now, they are mostly used at a desk. Low back pain cases can only go up if more and more people spend their work hours sitting behind a desk.

A low tech solution to this is to use a standing desk, like the height-adjustable Vari Desk. The Vari Desk is actually a large monitor stand that sits on a standard desk and can easily switch from normal height to standing height. This way, you can gradually increase your standing hours, allowing you to build up your tolerance to working while standing. For example, for the first week you can try standing 30 minutes every two hours; then work up to standing 30 minutes every hour, then up to three hours straight. Standing activates the erector spinae spinal muscles (which are inactive when sitting, leading to weakness and atrophy); but best of all standing naturally causes you to form the stronger lordotic curve in your low back. The lordotic curve is the opposite of bowing and is the “strength” position of the lumbar spine as the facet joints in the back interlock, offering stability and protection to the discs.

Do functional exercises

While your back is not hurting, why not strengthen it to keep it that way? This will decrease the incidence (occurrences) of low back pain. Functional exercises include squats, medicine ball exercises, planks, kettle bell swings and “bootcamp” style exercises that focus on strengthening the muscle orchestration of all the muscles in the body at the same time, rather than one type of muscles (for example, biceps curls is not a functional exercise).

Do Back extensions

For most people with back pain, back extensions are helpful. Again, this arcs the low back in the lordotic curve, which can press the disc material back to center. You can do them standing, or prone (yoga cobra position). Do about 10 extension exercises twice a day.

Spinal Adjustments

If you have a history of back pain and/or stiffness; trauma to your body such as prior car accidents or previous involvement in gymnastics, football or basketball; and/or a history of prolonged sitting you are a good candidate for periodic spinal adjustments, or spinal manipulation. Spinal manipulation, the practice of moving segments of the spine using manual (by hand) techniques, can reduce the symptoms of lower back pain. Chiropractors provide most spinal manipulation in the U.S. Some physical therapists and osteopaths do it as well.

Chiropractic adjustments are quick, low amplitude-high velocity manipulations to the spine, which differs from “long lever” movements (joint mobilization, passive stretching). They are done to impart better movement and also to “fire” nerves involved in pain and spinal muscle contraction. This can reduce pain and muscle spasm and restore proper movement to a joint segment. When a lumbar joint segment moves better, it improves hydration to the discs and ligaments. When it is properly aligned, it won’t wear out as fast.

Consistency in approach varies greatly from chiropractor to chiropractor as there are more than one ways to manipulate the spine, and different target goals (pain relief vs. attempting to change curves of the spine, etc.). Then there are “holistic” chiropractors who promote spinal adjustments for general health maintenance. I recommend that you find an experienced chiropractor with a good, local reputation who focuses on short term care to relieve pain and can advise you on home care exercises after your pain has subsided.

Below is a video I made that explains the logic behind lumbar spinal adjustments for low back pain:

Integrate these five practices, and I believe that low back pain will not be a factor in your life for a long time to come.

Treat Shoulder Joint Pain with Red Light and Infrared Therapy

by Pain Doc | Jul 29, 2015 | Shoulder Pain

Light in the visible red spectrum has noted therapeutic benefits, and it does this by enhancing cellular energy and signaling reactions involved in tissue healing. When an injured cell has more available energy, it can repair itself faster and activate certain other biological processes involved in healing. Red light in this wavelength does not generate heat, so heat isn’t doing the healing. It’s photobiomodulation at work– a human version of photosynthesis, the process by which plant life creates food for itself using sunlight.

Because of its wavelength range (about 620-880 nm) red light tends to get absorbed by water-dominant human tissue, especially red blood cells. Just beyond the visible red on the spectrum of light is infrared light (IR), which is not visible to the human eye, but still has therapeutic benefit (most of the heat radiating from the earth is infrared). Infrared has a higher wavelength and can penetrate deeper into human tissue. In fact, acupuncturists and physical therapists rely on infrared heat lamps to apply heat to deep joints such as the shoulder, hip and knee.

Since they are considered generally save for use, the FDA allows manufacturers of red light and infrared therapy devices to sell directly to the consumer, without a doctor’s prescription. Those who have photosensitive skin however my want to speak with their doctor first before trying red light therapy, as it may cause pigmentation.

There are numerous red light and infrared devices on the market for personal use; some better than others. They include hand held devices, mats and lamps. There are even portable infrared saunas. For small areas such as an ankle, wrist or shoulder, you can use a portable, hand-held red light device.. This is a stainless steel, high quality compact device resembling a small flashlight. It uses three (3) diodes; each putting out a different red light frequency, which means it penetrates to different depths in your tissues thus bathing a larger area with red light. 3-4 three- minute doses, twice a day for three days is a good protocol for most conditions.

For larger areas such as low back pain or spasm or leg pain after running, try an infrared lamp or sauna.

The Shoulder Joint – A Complex Joint Vulnerable to Breakdown

Ok, let’s talk about treating common shoulder joint pain. The shoulder joint, or glenohumeral joint is a ball and socket type synovial joint. Unlike the hip joint, the shoulder joint has a shallower articulation point with the scapula that allows it to move as it does — in wide arcs and in multiple planes (try doing that with your knee!). It is enclosed by the rotator cuff, which is basically formed by the several tendons attached to the humeral head (the proximal end of your humerus, or upper arm bone) and capsular ligaments that connect the humerus to the other end of the shoulder joint, the glenoid fossa of the scapula, a shallow bowl-shaped indentation.

There are six muscles that move the shoulder, and therefore six tendinous attachment points. Above and around the ball of the shoulder joint are bursae, which are jelly-like pads that serve to reduce friction during shoulder movement. Inside the shoulder joint capsule itself is the synovial lining (this is the tissue that gets inflamed in cases of rheumatoid arthritis), the cartilage lining the ends of the ball and socket surfaces and the labrum, a rigid cartilaginous support structure that helps position and stabilize the humeral head onto the glenoid fossa. As you can see, your shoulder joint has many structures involved in its function. This means there are more chances for something to go wrong– a tear, a strain, a malposition, compared to a simpler joint like a knuckle.

If you have pain and/or clicking noises (called crepitus) in your shoulder or have restricted movement such as limited ability to raise your arm above shoulder level, something is obviously wrong. It could be a rotator cuff tear (tear of tendons and or capsular ligament); labral tear, bursitis (inflammation of a bursa), thickening of the supraspinatous ligament due to shoulder subluxation (malposition of joint), arthritis or fluid build up. Stretching alone may not be feasible, especially in cases like adhesive capsulitis (frozen shoulder) due to the pain. This is where red light therapy and infrared can help.

How to Apply Red Light to Your Shoulder Joint Where It’s Needed

The challenge when applying red light to your shoulder joint is getting it to the damaged structures, which is not straightforward. The glenohumeral joint is covered by the deltoid muscle, which can be quite developed especially in men. It is thickest in the belly of the muscle (center, meaty part) but thinner on its tendinous ends where it inserts into the scapula and collar bone. Avoid the belly of the deltoid as red light cannot pass through it, and apply the red light over the thinner areas noted. Also, don’t forget that you can access the shoulder joint underneath, via your axilla (arm pit). This is a great technique, as there are no muscles obstructing it (see third image below).

Below is a diagram of shoulder anatomy to give you a better idea on how to target critical structures like the shoulder bursae, tendons and capsular ligaments when using red light therapy. You’ll want to use a hand-held red light therapy device that can focus the light over a small area of about 2 cm.

Palpate your shoulder and locate the locus of pain. Internally and externally rotate your shoulder joint and press in front, on top underneath and behind it with your index finger to find tender spots. Once you’ve found one, keep your shoulder in that position and apply the red light for 60 seconds. Do this 3-4 times. You may want to move to areas around the sore spot, for good measure. The thin, small space just under the “cliff” of the acromion process is an ideal spot to focus the light. It will get absorbed by the subacromial bursa and supraspinatous tendon, common sources of shoulder pain and stiffness. Do this over a week to ten days, and you should notice improvement. Avoid overly-stressing your shoulder joint during this time period to allow proper healing. Below is a video where I show you how to do it.

In summary, you can accelerate tissue healing in sprains, strains, bruises and minor cuts using red light therapy. These devices are a great addition to your home therapy devices, as they do not require a medical license to acquire.

Can Your Pain and Aches be Partly Due to Oxidative Stress?

by Pain Doc | Jul 29, 2015 | Nutrition

If you have pain or aches in your joints, tendons or muscles that varies in intensity but never seems to go away, you might be experiencing oxidative stress to these areas. Oxidative stress is the cumulative effects of oxidation, a chemical reaction where electrons are stripped off tissues by reactive oxygen species (ROS). ROS or free radicals are atoms or group of atoms that have one or more unpaired electrons. When an atom or molecule has an unpaired electron, it is unstable, and since nature likes stability the radical will seek out electrons elsewhere to “balance” itself. Free radicals are highly reactive to molecules they come in contact with and are therefore dangerous to them. They can destroy them or change their shape and therefore function by altering their molecular structure.

Radicals can have positive, negative or neutral charge. They are formed as intermediates in normal biochemical reactions in cells (cell metabolism), but when generated in excess or not appropriately controlled/ neutralized, radicals can damage adjacent cell structures and tissues. ROS types includes superoxide anion (O2-), hydrogen peroxide (H2O2) and the hydroxide ion (OH-). Think of these things as the cell’s equivalent of noxious exhaust gases generated by an internal combustion engine.

Now, imagine a bunch of these free radicals roaming inside your knees. It’s akin to termites eating away at the frame of your home. At some point, a structural failure will occur; and in the case of the knees, damage to cartilage or synovium (joint inner lining) followed by knee pain and stiffness.

Your body also makes and uses reactive oxygen species for good things. White blood cells generate them to kill bacteria and other pathogens. ROS also influence cell signaling (such as signals to divide, increase membrane permeability and repair membranes) and activate (up-regulate) genes to produce needed substances during certain times. Only when they get to unacceptably high levels, and/or when they aren’t adequately neutralized do ROS become harmful.

Some of the scenarios that can cause excessive ROS formation include:

Hypoxia (low oxygen levels), hyperoxia (high oxygen levels) and excess heat exposure
Ionizing radiation — UV rays, gamma rays trigger massive ROS formation
Prolonged, physical exertion— marathon running, extreme races, hard labor under grueling conditions generates massive amounts of ROS. Oxygen consumption increases by multiples, generating large amounts of free radicals and making it difficult for cellular anti-oxidant defenses to keep up.
Pollution ingestion. This includes smoking, chemical fumes, carbon monoxide, organophosphate pesticides and other substances toxic to humans.
Electromagnetic field exposure. Some studies suggest EMF can cause biological changes that result in excessive free radical formation.

Anti-Oxidants to the Rescue

Anti-oxidants are substances that act as reducing agents, where they donate an electron to a reactive oxygen species; thereby neutralizing it.

There are two main categories- enzymatic anti-oxidants and non-enzymatic anti-oxidants.

Enzymatic anti-oxidants include glutathione peroxidase, superoxide dismutase and catalase. Basically, these components are inside or adjacent to cells (water soluble) and degrade superoxide and hydrogen peroxide by-products of cell metabolism.

Non-enzymatic anti-oxidants include Vitamins A, E, and C, and glutathione. Vitamin E is the major fat soluble anti-oxidant that is responsible for degrading hydrogen peroxide radicals that form along lipid based cell membranes. Glutathione is an important anti-oxidant present in the cell cytoplasm that attracts free radicals, becomes radical itself but then recycles into an anti-oxidant via a special pathway and scavenges again for more free radicals.

Polyphenols, of which there are thousands, are substances (phytochemicals) found in plants that have anti-oxidant properties. This includes blueberries, pomegranate, citrus, green vegetables, apples, cantaloupe, cherries, grapes, plums and other dark and colorful plants. Tannins, quercetin and flavonoids are types of polyphenols.

Turmeric, the rhizome of the flower Curcura Longa contains a well-known powerful anti-oxidant called curcumin. Since it is fat soluble (doesn’t stick to water molecules for transport), it has a hard time getting into your cells. Scientists found that if you consume it with piperine, a natural compound found in black pepper, it increases absorption into your cells by 2,000% which is why most curcumin supplements contain black pepper. A fat soluble anti-oxidant, curcumin is believed to protect the lipid-containing cell membrane from free radical damage.

The Bad News

So, at this point you might be thinking that fixing the oxidative stress problem is simple– just take a bunch of anti-oxidant supplements every day, and good bye free radicals, right?

Unfortunately, most of the research done to test this is inconclusive. This means that, at the present, we cannot say that taking anti-oxidant supplements reduces the risk for any type of disease.

While it’s true that people who eat lots of vegetables and fruits in their diet tend to be healthier than those that do not, the causative factor may be something other than anti-oxidant content in the fruits and vegetables. It could be that people who eat more vegetables and fruit are more health conscious overall and take better care of themselves in other ways (avoid smoking, drinking in moderation, avoiding junk food, etc.) that might explain their longevity.

And for some people, anti-oxidants can act as anti-nutrients by binding with essential minerals in the digestive tract such as iron and zinc, preventing them from being absorbed. They may also interfere with post-exercise trauma repair to muscles, as white blood cells use ROS during repair of muscle tissue; anti-oxidants may inhibit this.

So what is the solution if you’re being constantly attacked by reactive oxygen species?

The Solution

The solution is to do what you need to do anyways in order to be healthy in the long-term:

eat in moderation (less food to metabolize means less free radical generation)
make at least 80% of your diet naturally occurring foods emphasizing green vegetables and to a lesser extent colorful fruits
avoid sugary drinks
exercise in moderation regularly
avoid “chronic cardio” exercises such as long-distance running and ultra-workouts as they are counter-productive.
get adequate rest
remove stress in your life (or find a counter to your stress)

Secondly, be aware of the exogenous sources of ROS generation and avoid them as best you can. This means:

avoiding environmental pollution in the air, water and food
staying away from second-hand smoke
minimize your exposure to commercial electromagnetic fields especially when you sleep (see how to counter this here).
minimizing exposure to strong, mid-day sun rays
If you work near an X-ray machine or other radiation source, make sure to wear adequate protection

Lastly, avoid binge eating and gorging on food, especially on an empty stomach! This stresses your digestive system and generates a barrage of free radicals over several hours as your digestive cells stay fired up to metabolize all that food. Those free radicals that weren’t zapped by glutathione and other anti-oxidant defenses roam throughout your body, snatching electrons from cell membranes, DNA, proteins and other important structures. Keep those buggers down; don’t stir up the ant nest.

When you turn off oxidative stress in your body, your body will be able to heal itself faster and those achy muscles and joints will actually start to feel better and stay that way.

Can Red Light Heal Injuries and Lessen Pain?

by Pain Doc | Jul 21, 2015 | Red light therapy

The color of red has a psychological connection to stopping– stop signs, stop lights, red warning signs and so on. And, it turns out that visible light in the red bandwidth may stop pain to some degree.

The use of red light to reduce pain, inflammation and swelling and to promote wound healing has been known for almost forty years now when a scientist doing a laser experiment on mice discovered that the ones that were irradiated with a red laser grew their hair back faster. But how exactly does red light accomplish this? What are the mechanisms of action? And, can it be dangerous?

I’ll attempt to answer these questions in a way that hopefully makes sense.

When white light travels through a prism, it is dispersed into the colors of the visible electromagnetic spectrum; that is, the component colors that collectively comprise what the human eye perceives as white light. The component colors have wavelengths between about 380 nanometers (1 billionth of a meter long) to about 750 nanometers (nm) and are, from left to right: violet, blue, green, yellow, orange then red.

Just to the left of the visible spectrum is ultraviolet (UV) light and to the right is infrared light (IR); both of which are not visible to the human eye (although some animals can see IR).

spectrum

While the the therapeutic effects of red light are still being researched, there is evidence that light in this wavelength range (620-750+ nm) can in fact trigger physiological changes in cells, called photobiomodulation that have beneficial effects for injury healing and pain suppression.

The first law of photobiology says that for a low power visible light to have any effect on a living, biological organism the photons (light particles or energy units) must be absorbed by the organism via some type of molecular photo-acceptors, which scientists have given the name chromophores. (Photochem Photobiol. 2002 Aug;76(2):164-70). While the mechanism of action are still being researched, experiments show that human tissue absorbs visible light and undergoes biological changes as a result.

The Plant and Animal Connection

You probably forgot that you were introduced to the phenomenon of photobiomodulation way back in the 3rd grade. Remember in science class when you studied photosynthesis? The name says it all: photo (light) + synthesis (to make something out of other things). Sunlight strikes a plant leaf, gets absorbed by tiny structures in the leaf called chloroplasts which contain chlorophyll (the substance that makes plants green), which creates the energy the plant needs to convert carbon dioxide in the air and water into sugars for its food. Without sunlight, plants would starve to death, and so would every life form that depends on them.

Can it be that mammals have their own version of photosynthesis, or something similar to it? It sure looks that way, considering the tissue healing effects of red light.

How Red Light Influences Cellular Activity

The leading hypothesis of how red light creates photobiomodulation is by increasing cellular energy. Red light gets absorbed by a cell membrane enzyme (a protein) called cytochrome c oxidase, or cox for short. This enzyme influences the electron transport chain, the biological process that occurs in cell mitochondria and determines the rate of ATP (adenosine triphosphate) production and thus available energy in the cell.

Adenosine triphospate is every cell’s “fuel” molecule. Basically, cells trap free energy released from the breakdown (metabolism) of glucose– the basic unit of carbohydrates. The trapped energy is stored in the ATP molecule’s chemical bonds. Mitochondria are the structures in all animal cells where energy is created and can be thought of as the animal version of chloroplasts in plants. The energy released in the bonds of ATP molecules enables the cell to do the things it needs to do, such as repair membranes, remove waste and even multiply.

Another theory on how red light produces beneficial benefits is enhancing gene expression. More ATP production results in more reactive oxygen species production (ROS). In high concentrations this is bad, as excessive ROS can damage tissue and DNA (free radical damage). But with red light therapy ROS production is low level, local to the injury and has beneficial effects. ROS alters the cell’s state of oxidation, or redox state (basically, its electrical charge). Changes in a cell’s redox state induce intracellular signaling pathways such as nucleic acid synthesis, protein synthesis and enzyme activation. This activity then activates changes in transcription factors, which are the substances that up-regulate or down-regulate gene expression. Genes in DNA determine an organism’s physical features and influences its biological processes.

For example, red light activates factors involved in gene expression related to cell proliferation, remodeling, DNA synthesis and repair; ion channel and membrane potential, and cell metabolism. All these processes can benefit wound healing.

Proof of Red Light’s Healing Power

A 2014 Chinese study that involved compressing/ injuring spinal nerves in rats found that LLLT (Low Level Laser Therapy, which uses red and infrared light) “was able to enhance neural regeneration in rats following [the injury] and improve rat ambulatory behavior (ability to crawl and move).” The study’s authors concluded that the therapeutic effects of LLLT in this experiment may be exerted through suppression of the inflammatory response and induction of neuronal repair genes (increased expression of the genes involved in nerve repair). This suggests potential clinical applications for LLLT in the treatment of compression-induced neuronal disorders such as nerve root compression from disc bulges, stenosis and frank injury.

Another study concluded that low-level exposure to 980 nm laser light (near infrared) can accelerate wound healing. Exposure to low- and medium-intensity laser light accelerated cell growth in damaged fibroblast cells, whereas high-intensity light negated the beneficial effects of laser exposure.

So, it appears that the evidence on the therapeutic effects of red light therapy is convincing and the models appear plausible. More research is needed to get a better handle on how to best use light for therapeutic purposes. What we know is that light in the red visible spectrum (620-750 nm wavelength) and infrared (700 – 1000 nm) are preferred because they are better absorbed in human tissue. Shorter wavelengths (blue) scatter and are less absorbed. Red light is believed to be more appropriate for superficial areas (skin surface to a few millimeters below) because the light is quickly absorbed by the red hemoglobin of the blood and carried away; whereas the longer wavelength infrared (IR) and near infrared (NIR) light is appropriate for thick muscles and deeper joints since they are able to penetrate deeper into the body.

Factors that can influence therapeutic effect of red light besides wavelength include power output (watts), frequency, pulse rate, dosage and treatment area. Typical dosages used are 0.5 – 60 Joules/cm2, but there is no consensus among researchers on what constitutes the best dosage for any particular conditions.

Using Red Light Therapy

Red light can be delivered by “cold” lasers (lasers with minimal heat production) or diode (phototherapy) machines. The difference between the two is that lasers produce light of only one wavelength that is collimated (focused and organized), enabling deeper penetration but at a fixed depth and smaller area; whereas a red light diode generates a range of red light in different wavelengths, covering more area and depth levels due to the varying densities of human tissue (skin, fat, muscle, ligament, water).

Medical grade lasers and phototherapy devices can cost a few hundred up to thousands of dollars. These therapy devices can be found in some physical therapy, chiropractic and sports medicine clinics. There are low power, consumer level portable red light and infrared devices that get good results as well. Currently, I am not aware of any studies that compare the effectiveness of the expensive medical lasers with the cheaper consumer devices, but one must realize, light is light! If you have a soft-tissue injury or joint pain, I suggest you try a consumer level red light device before you try the more expensive options. They are available for sale direct to the consumer; no doctor’s prescription needed. So far, the studies indicate that red light therapy is safe to use although it is best to protect your eyes from scattered light during its application by wearing protective lenses.

The red light therapy device I use at home and on patients is the handheld red light therapy device, shown below:

tendlight

It is simple to use and gets surprisingly good results (and it doesn’t cost an arm and a leg). Use it for TMJ, epicondylitis, trigger points; pain in the hand and wrist joints and anywhere there is musculoskeletal pain and/or inflammation.

The Bottom Line: Yes, red light therapy can help heal injuries and lessen pain and is generally safe to use. This includes sprains, strains, bruises, burns and minor lacerations. You may even try it over your peri-orbital sinuses to help with tension headaces.

The ideal treatment protocols are not defined, but a good starting point is 2-3 minute applications of red light directly for every two square centimeters, twice a day.

Watch below how I use the red light therapy device to treat chronic tendonitis:

Back Pain from Pregnancy – New Study Finds Spinal Manipulation Dramatically Reduces Pain

by Pain Doc | Jul 9, 2015 | Low Back Pain

According to a new study published in the July issue of the Journal of the American Osteopathic Association, German researchers found osteopathic manipulative therapy (OMTh) decreased postpartum low back pain by over 70 percent in women who had given birth at least three months before beginning treatment.

On average, women who received osteopathic spinal manipulation reported a 73 percent decrease in pain, compared to only seven percent in the control group. Pain was evaluated by a 10-point Visual Analogue Scale (VAS) and functional disability as measured by the Oswestry Disability Index. The Oswestry Disability Index is a battery of questions that asks the subject to rate on a scale of 1-5 how difficult it is to do common, daily activities (such as getting dressed). It is a popular tool doctors in physical medicine use to measure a person’s improvement to treatment, since pain is very subjective in nature. After all, what matters most is not the level of pain but rather the level of physical functioning the person is capable of, despite the pain.

But what exactly is osteopathy, and how different is it from chiropractic?

This requires a bit of a history lesson. Both disciplines had their start in the mid to late 1800s in the U.S., an era characterized by experimentation in various alternative healing methods. Diseases like syphilis, small pox, polio and other maladies plagued the population and there was very little doctors at the time could do. Vaccines and antibiotics were not discovered yet, and people were desperate to find a cure. This period is also when the term “snake-oil salesman” was coined, as some unscrupulous individuals used the crisis as an opportunity to make money.

Osteopathy has its origin in 1874 when Andrew Taylor Still, a medical doctor was dissatisfied with the limitations of conventional medicine. He theorized that disease originated in bone tissue and could therefore be treated by manipulating bones and tissues. Still developed the discipline of osteopathy and created the first school in Kansas that offered the “D.O.” degree – Doctor of Osteopathy.

Chiropractic has its origin in the 1890s when D.D. Palmer, a magnetic healer theorized that mechanical dysfunction of the spinal joints could influence nerve and blood flow throughout the body, making conditions ideal for disease. He and his son B.J. Palmer developed chiropractic in the early 1900s, emphasizing “adjustments” to the spine using the hands.

As both disciplines grew in popularity, the medical profession took notice. As in big industry today, when such competition arises there is either a buy-out, merger, or attempts to dominate the market (and public opinion) and put the competing entity out of business. Osteopathy eventually got absorbed into the medical (allopathic) model, and today D.O.s are physicians on par with M.D.s. Many D.O.s do not do manual therapies in their practice since drug prescription became the primary treatment methodology among allopathic medical practitioners especially toward the latter half of the 1950s, continuing today.

Chiropractic, on the other hand, blazed its own trail and is an independent specialty outside of the medical umbrella. There used to be significant professional conflict between chiropractors and medical doctors, but these days there is more more cooperation. Physicians are more confident in referring back pain cases to chiropractors, as patients attest to its benefits for helping reduce musculoskeletal pain.

Pregnancy and Back Pain

The Germany study is not surprising. Spinal manipulation, whether osteopathic or chiropractic adjustments, is helpful in restoring alignment and movement in the pelvic structure and lumbar spine following birth. During the last trimester of pregnancy when the mother gains the most weight, the center of gravity of the abdomen moves outwards, placing a greater strain on the lower back. The lumbar spine arcs more acutely, increasing pressure within the facet joints during standing. The weight of the baby can also rotate the pelvis anteriorly over the femur heads which can cause sacral and hip pain, due to it being a weaker stability position..

If after three months of giving birth you still have back pain, consider getting spinal manipulation. The goal is to free up any restrictions that may be present anywhere in the spine, pelvis and hip joints and strengthen surrounding muscles. A good practitioner will show you exercises to do at home to rehabilitate the area.

Below is a video that will give you an idea of what to expect:

One note you should be aware of: Spinal manipulation or “adjustments” is a fine dexterity, complex skill that needs a lot of practice in order for one to become proficient in it. Unlike osteopaths, chiropractors cannot prescribe medications so the bulk of their practice involves delivering spinal manipulation. Chiropractors therefore tend to be more skilled in this area.

Read this article by the American Chiropractic Association on 5 Conditions Chiropractic Care Can Improve During Pregnancy.

For more information on the Germany study that shows the efficacy of spinal manipulation for postpartum low back pain in women.