by Pain Doc | Jun 19, 2014 | Neck Pain
Do you experience neck pain or stiffness? Tension headaches?
Do your upper shoulders feel like bricks and have tight, sensitive knots as big as golf balls?
Any pain, strain or weakness in your upper back between your shoulder blades?
If so, you likely have Anterior Weight Bearing of the head, or Forward Head Posture.
Appearance is the least of your worries when it comes to poor posture.
Yes, people tend to look much better when standing up straight and confident as opposed to looking like Quasimodo in his advanced years. But looks are not the main problem with a slouched posture.
You see, posture has a direct impact on your breathing quality. If your rib cage and spine are hindering your diaphragm movement and lung expansion, then your breaths will be more shallow. You’ll be getting less oxygen to your muscles and organs; you’ll expend more effort breathing, and you will likely feel fatigued more often than not.
On average, a person at rest takes about 16 breaths per minute. This means we breathe about 960 breaths an hour and 23,040 breaths a day! That’s a lot of energy expenditure, which is hindered by poor posture.
Anterior weight bearing of the head, unfortunately, is very hard to avoid. Because your eyes are in front of your body and not in the back of your head, you naturally flex your neck forward to focus your eyes on what you are doing. This means bending your neck forward as you look at a computer monitor, when reading a book, or when doing just about every activity of daily living: brushing your teeth in front of the mirror, working on a hobby, playing with your children and so on. All these activities will cause you to bend your neck forward.
Bad posture can lead to advanced arthritis and spine decay.
Your spine, when viewed from the side, has curvatures that work like springs on a car’s suspension system. They dampen shock to the spine. Do you know that the simple act of walking puts significant forces into your spine, thanks to gravity? If you are a runner, those forces are multiplied exponentially.
In a strong, healthy spine, these forces are adequately absorbed by the curves, discs and supporting soft tissues. If you have lost some of your spinal curvatures, then the forces generated from walking, running, jumping, and yes, sitting are not going to be dispersed as well and your delicate joint surfaces will have to bear more of this burden. Over time, this can make your spinal segments look like the one below (left spinal segment):
Spinal degeneration occurs mostly in the neck and lumbar spine.
Your neck and lumbar spine are where the nerves that go to your arms and legs branch out from, so adverse alterations to these areas can lead to symptoms in your extremities: pain, numbness, tingling or weakness.
With forward head posture, your head, which weighs 10-12 pounds translates several inches in front of the spinal axis. This creates a “moment force” that is placed mostly on the back neck muscles, upper shoulder muscles and cervical discs.
To get an appreciation of this, imagine balancing an eight pound shot put in your hand, with your wrist bent and your elbow resting on a table; forearm pointing straight up supporting the shot put. It takes little effort to keep that shot put steady.
Now, while still holding the shot put, straighten your wrist and flex it forward so that the shot put is no longer in line with your wrist and forearm (analogous to forward head posture).
All of a sudden, this shift in weight changes everything: your forearm muscles tense up (analogous to your spinal muscles) and your wrist will soon experience strain (analogous to your neck muscles).
This is what happens when the center of gravity of your head moves even just a few inches forward of your spine (reference point at the base of your neck).
Here I illustrate this using a therapy weight pad:
Normal neck curve = strong biomechanics and support, while…
Flattened or reversed neck curve = poor biomechanics and tissue strain
If you have persistently bad posture; especially forward head posture, you are setting the stage for problems. Abnormal stresses to the spine weakens discs, ligaments and cartilaginous surfaces. This is the recipe for spinal decay and increased chance of spinal cord or nerve root impingement.
So if you have forward head posture, start doing exercises that strengthen the back of your neck muscles; stretch shortened, anterior (front) neck muscles, and strengthen your lower back muscles and core. It also helps to stretch shortened muscles in your legs and pelvis that might be restricting your lumbar spine of proper movement. More on this later.
So what do you think? Do you do any exercises and stretches to improve your posture? Let me know!
Dr. P
by Pain Doc | Jun 12, 2014 | Uncategorized
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It is estimated that at any given time, about 40% of the adult population experiences lower back pain. That means, today when you walk on a busy street full of pedestrians, four out of ten people you see are experiencing some degree of lower back pain. 50-85% of all people will experience lower back pain at some time in their lives.
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For many cases of low back pain, the source of the pain emanates for the
intervertebral disc, or IVD. This is the fibro-cartilagenous material that connects vertebrae together and is responsible for bearing most of the weight placed on the spine. Its architecture is designed to absorb shocks using the incompressible nature of water (hydrostatic pressure), which is mostly contained in the nucleus pulposus of the disc. The nucleus serves to redistribute and dampen the forces placed on the spine so as to avoid damage. This comes in handy when walking, jumping, sitting, standing, and of course picking up heavy things.
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Problems arise when the disc weakens, allowing internal derangements to occur. Basically this means shifts in the shape of the disc that alter the proper alignment and movement of the spinal joint segment, and/or block or partially block nerve pathways, causing nerve root impingement and pain down the leg.
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One of the home care accessories I prescribe for my low back pain patients is the
PosturePump™ Spine Retrainer. This innovative device helps to rehydrate weak and bulging disc derangements by increasing the space between vertebrae using an air bladder controlled by a hand aspirator. As the disc volume increases, a negative pressure develops and a pressure gradient forms, which draws fluids (capillary blood), nutrients, oxygen and reparatory cells into the disc. This can help the disc regenerate, and the lumbar extension forced by the
PosturePump™ Spine Retrainer can mechanically force the posterior disc bulge back to center at the same time, relieving symptoms.
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Even if you don’t have a bulging disc, the PosturePump™ can serve as a good preventive measure to keep your discs healthy and strong.
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Watch the video to see how this works.
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If you have recurrent pain of any type, stay tuned for further posts…you just might run into something that will make a significant impact on your quality of life. Please consider sharing this information, as it may be helpful to someone in your social circles. Thanks for reading!
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Dr. Perez
by Pain Doc | May 14, 2014 | Uncategorized
When it comes to pain, there is some truth to the saying, “It’s all in your head.”
According to Beth Darnall, PhD, a Stanford pain psychologist, the “experience” of pain is both a sensory and emotional experience. There is the physiological component that is responsible for the mechanical/physical aspects of pain, and the psychological component, where the pain is interpreted and realized. Addressing both components, therefore, is a prudent approach to treating pain.
A recent systematic review of 21 studies published in May 2014 in The Spine Journal showed that patients with the highest risks for “fear-avoidance” beliefs are those with sub-acute low back pain for four weeks to three months.
Dr. Maria Wertli, M.D., from the University of Zürich found that among four cohort studies, patients who had fear avoidance beliefs were less likely to return to work. Earlier interventions to reduce this fear may help patients recover faster and avoid chronic pain to set in.
The “fear avoidance” model, which is still under debate among researchers, suggests that people who are extremely fearful are prone to avoid movements and activities that they feel may trigger pain. According to physiotherapist Lorimer Moseley, professor of clinical neurosciences at the University of South Australia, this leads to “disengagement from meaningful activities, disability, and depression,” The fear-avoidance mindset basically starts a vicious cycle which takes root in the mind to the point where the fear of pain has a larger impact on behavior than pain itself.
However, fear-avoidance behavior is understandably difficult to detect among chronic low back pain patients, which can cause practitioners to either ignore psychological factors that could influence pain or wrongly associate the behavior in the diagnosis/ identification of the actual area of damage.
Moseley mentioned fear may not be readily seen in patients because they seldom display cardinal signs of fear unless they are confronted directly with movement that may be perceived to cause pain. For example, if patients are asked to bend forward to touch their feet, they may exhibit fear to do so because they think the movement would cause pain. The fear-avoidance behavior model is also too simplistic to explain most cases of chronic low back pain, and it is rarely the sole reason patients avoid “painful” movements.
It’s been said that the human brain is more mysterious than the entire universe. While science has still much to learn about how the mind can cause pain, health professionals should still consider fear-avoidance belief as a factor in patients with chronic low back pain. It can have powerful effects on their cognitive processes, which can increase the “experience” or intensity of their pain, and/or prevent them from engaging in exercises that could otherwise improve their condition.
This study affirms that certain mind-body approaches such as guided visualization, meditation, yoga and similar holistic techniques can be an effective adjunct to treating chronic pain.
Here is a video of Dr. Darnall explaining the relationship between chronic pain and psychological state:
Are you experiencing chronic pain? Sign up to be notified of my upcoming Optimal Body System Reverse Chronic Pain multimedia course. Click here to find out more.
Reference: Guardian Liberty Voice
by Pain Doc | May 8, 2014 | Uncategorized
Arthritis, which translates to “irritation of a joint,” has the potential to develop into a debilitating condition that can significantly reduce your activities of daily living (ADL) and quality of life. It involves pain, stiffness and understandably a reduced ability to move and engage in exercise. Lack of exercise/ mobility promotes weight gain, which can make the arthritis worse as the joint surfaces bear increased weight.
If the pain is strong enough, sufferers resort to over-the-counter medications such as acetaminophen (Tylenol, Paracetamol), NSAIDs, or non-steroidal anti-inflammatories (Ibuprofen, Naproxen); and if the pain is severe, opioid drugs. All of these drugs have dangerous side effects, which become more significant if they are taken long term. This includes liver damage, gastrointestinal problems, muscle and joint pain, and for opioids, constipation, nausea and drug addiction/dependency.
Today, I will address specifically osteoarthritis, or OA. It is the most common form of arthritis and is the major cause of disability in persons aged 65 and over. Osteoarthritis affects primarily the weight-bearing joints such as the ankles, knees, hips, lower spine and lower neck. It starts out non-inflammatory (unlike rheumatoid arthritis, which is an inflammatory auto-immune form of arthritis) and involves gradual wear and tear of the cartilage surfaces of the ends of the bones that form the joint. In advanced stages, the damaged cartilage triggers mild inflammation (swelling, increased vascularity, increased pain) and the condition is better described as inflammatory osteoarthritis.
Osteoarthritis has systemic risk factors and local risk factors.
Systemic risk factors include age, sex, race, bone density, genetic factors, nutrition and hormonal status (which is related to age).
- Black Americans have a higher incidence of OA than white Americans; however the association may be rooted in demographics/ cultural factors rather than genetics.
- Reduced production of human growth hormone (HGH) and the sex hormones (estrogen, testosterone) are associated with reduced cartilage pliability; i.e. increased brittleness and less thickness.
- Cartilage is thought to be highly vulnerable to oxidative stress (free radical damage, oxidation), and high doses of vitamin C and D are protective against the development of OA. Smoking, pollution and a diet high in processed food are factors that promote oxidative stress.
Local risk factors include obesity, occupation, prior joint injuries, existing joint instability, sports/physical activities and congenital joint abnormalities.
- Obese individuals experience increased pressure in their weight bearing joints when standing or sitting. This can force water content out of the cartilage and lead to small tears which then lead to larger tears and “bone on bone” contact within the joint.
- Occupations that involve repetitious trauma/ forces to the joints increase risk for OA.
- Sports, especially football, basketball, long distance running and gymnastics can result in accelerated cartilage degeneration especially after age 40.
- Prior injuries/ trauma that subluxated or misaligned a joint will predispose it to accelerated OA as the joint loses its normal mechanical function. The joint surfaces may not articulate properly, and weight distribution along the surface may become uneven following trauma.
- Congenital anomalies such as scoliosis and fused vertebral segments can also alter normal joint movement and promote accelerated OA.
- Weak muscles can deprive joints of protection and stability, predisposing them to OA. Weak muscles are related to sedentary lifestyles, whether by choice or secondary to an incapacitating condition like advanced Type 2 diabetes.
The bottom line:
If you have systemic risk factors, think in terms of diet and nutrition to ward of their effects. You can’t control aging, you can’t control your sex and race, but you can control the level of oxidative stress in your body and you can “down-regulate” genes that may predispose you to arthritis by adopting a healthy diet and lifestyle.
If you also have several local risk factors for OA, think in terms of minimizing their effects. Unstable joints from prior injuries can benefit from targeted exercises that strengthen the joint; perhaps some occasional spinal and/or extremity adjustments from a chiropractor or therapist; supports/orthotics as applicable; and avoiding activities which over-stress the affected joint. For example, if you have a spondylolisthesis, it’s best to avoid running and instead do speed walking or use an elliptical machine to get your cardio exercise.
If you are suffering from chronic pain in your muscles and joints, nerves and ligaments, stay tuned for a new multi-media educational course being developed, Get Rid of Pain Forever. To receive notice of its launch, visit here.
by Pain Doc | Apr 24, 2014 | Uncategorized
by Laurie Roth-Donnell, Master Herbalist and Holistic Health Practitioner
There are many alternatives when considering avenues to manage chronic pain. Herbal Therapy is one area that is rapidly growing in popularity. Herbs rarely have an adverse side effect like many pharmaceuticals do and are now easy to access, thanks to the
Internet.
When using herbs for pain management, please be reminded that anti-inflammatory herbs will not heal your condition itself, despite their pain-easing effects. Addressing the cause of chronic inflammation is essential when working your way toward optimal health; inflammation triggers pain and is a major risk factor for chronic diseases like cancer, cardiovascular disease, and diabetes.
Warnings aside, here are five herbs that combat inflammation and are all readily available online and at some health focused stores.
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White Willow Bark—This herb contains salicin, the compound from which commercial aspirin was originally extracted. The analgesic actions of the bark are slower acting than synthetic aspirin, but results last longer. In addition to its pain-relieving properties, it is an anticoagulant, assisting in the prevention of
blood clot formation and thickening of blood that may lead to stroke or heart failure. It has also been credited with the alleviation of acute back and joint pain, as well as osteoarthritis. Native Americans simply chewed the bark from the tree for natural pain relief.
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Boswellia—Sourced from a resin found in the bark of frankincense trees, boswellia has been shown to thwart chemical reactions involved in the creation of inflammation. Practitioners of Ayurvedic medicine have long used boswellia to treat arthritis; the herb may also benefit people with inflammatory bowel disease.
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Bromelain—An enzyme extracted from pineapple stems, bromelain reduces levels of prostaglandins, hormones that induce inflammation. Bromelain may benefit people with arthritis and conditions marked by musculoskeletal tension (such as TMJ syndrome), as well as those suffering trauma-related inflammation. What’s more, the enzyme may promote healing in muscles and connective tissues. Some holistic health practitioners have prescribed patients to eat 8 whole pineapples for 10 days, and they claim their pain was reduced significantly.
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Curcumin—An Ayurvedic remedy known to tame arthritis pain, curcumin is a compound found in the curry spice turmeric. In an animal-based study published in 2007, scientists discovered that curcumin could overpower proinflammatory proteins called cytokines. The compound may also help decrease pain associated with autoimmune disorders and tendonitis. This herbal news is a great reason to eat a little curry! Red Coconut Curry is one of my favorites.
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Ginger—Sipping ginger tea not only helps relieve cold-related congestion, but supplementing with ginger may deliver other long-lasting health effects. Research indicates that ginger may calm arthritis pain by lowering your prostaglandin levels. One 2005 study even suggests that ginger could reduce pain and inflammation more effectively than non-steroidal anti-inflammatory drugs (such as aspirin). Ginger is available in most grocery produce sections, and ginger tea is quick and easy to make. Slice a thumb-sized bulb of fresh ginger, add to 4 cups of water, and boil for 5 minutes. Strain, add honey, lemon or your choice to taste.
If you consider the use of herbs for pain management, please consult a doctor or holistic health professional before you begin the regimen. Some herbs interact with drugs you are receiving for pain or other conditions you may be medicated for and the combination may harm your health when improperly administered.
Sources:
WebMD.com
Secrets of Self Healing by Dr. Ni
There are many alternatives when considering avenues to manage chronic pain. Herbal Therapy is one area that is rapidly growing in popularity. Herbs rarely have an adverse side effect like many pharmaceuticals do and are now easy to access, thanks to the
blood clot formation and thickening of blood that may lead to stroke or heart failure. It has also been credited with the alleviation of acute back and joint pain, as well as osteoarthritis. Native Americans simply chewed the bark from the tree for natural pain relief.
Curcumin—An Ayurvedic remedy known to tame arthritis pain, curcumin is a compound found in the curry spice turmeric. In an animal-based study published in 2007, scientists discovered that curcumin could overpower proinflammatory proteins called cytokines. The compound may also help decrease pain associated with autoimmune disorders and tendonitis. This herbal news is a great reason to eat a little curry! Red Coconut Curry is one of my favorites.
