by Pain Doc | Mar 15, 2011 | Uncategorized
Most people are aware that sitting at a desk in front of a computer can be hazardous to your health. The body simply isn’t designed to be placed in such an uncomfortable position for such a long period of time, and will rebel if forced to do so.
The universal desk job has the following ill-effects on the body:
- Increases pressure to the lumbar discs by over 50% than standing which can accelerate degenerative disc disease
- Inactivates the erector spinae muscles of the back, which has been shown to increase bad cholesterol levels in the bloodstream, contributing to cardiovascular disease
- Increases pressure to the sciatic nerves, which can lead to sciatica
- Makes it more difficult for blood in the lower extremities to return to the heart
- Reduces the natural curvatures of the spine in the neck, mid back and lower back (referred to as the cervical and lumbar lordosis and thoracic kyphosis), which are needed for the spine to support body weight more efficiently
- When typing, can lead to strain of the shoulder, arm, wrist and hands due to the unnatural and biomechanically disadvantaged position of the upper extremities during this activity
Of course, we need to work, and if our jobs require sitting at a desk… well, there’s no getting around it. The solution then is to condition your body so that it can better withstand these physical onslaughts.
One of the ways is to do a posture-improving exercise called wall angels. To do this simple exercise, find a wall that is free from obstructions.
Stand back against the wall, heels touching and back of head touching.
Lift both arms and touch the back of your arms, wrists and hands to the wall remembering to keep your wrist straight at all times.
Raise your arms as high as you can, keeping them in contact with the wall at all times. You will feel the urge to bend your wrist and break contact with the wall as your chest muscles tighten; do not let this happen (in the video above, the patient is unwittingly doing this with her left hand. Watch, and try not to do this).
When you can’t go any higher, lower your arms in the same way, as low as you can go without letting your arms break contact with the wall. In fact, exert mild pressure against the wall with the back of your arms, wrists and hands (actively push against the wall during the exercise).
Those are the basic motions, do them at a fairly moderate pace (not too slow, not too fast– one cycle up and down should take about 2 seconds); about 50-100 repetitions per exercises session. Do 3-4 sessions throughout your day.
The exercise will activate the upper back muscles, which tend to be inactivated when sitting at a desk, and stretch the chest and anterior (front) neck muscles, which tend to be overactive and gradually shorten over time, causing the familiar rounded shoulders and stooping head posture. This exercise sort of “equalizes” muscle activity of the chest and back, improving your posture.
by Pain Doc | Mar 13, 2011 | Low Back Pain
Most people who have general back pain and stiffness don’t question it enough; i.e. wonder why they have it. All they want is for it to go away in the quickest amount of time. A person suffering from back pain will first wait and see if it goes away with rest and time, and if it’s really bad, over the counter medications. If this doesn’t work, he will make an appointment with his primary care physician, who will usually prescribe pain medication and muscle relaxants to address the symptom (not the cause). The patient may be referred for physical therapy, which typically consists of modality application (heat, ice, lumbar traction, electric muscle stimulation and possibly low level laser) and exercises. Some people with lower back pain consult a chiropractor, who will address the problem usually be employing some form of spinal manipulation; and some will seek an acupuncturist.
But what if all these treatment forms are on the wrong track; i.e, they are based on errant assumptions? What if there is more to the back pain than sore muscles and stiff joints?
If you suffer from back pain; particularly lower back pain, it may be the result of dysfunctional nerve signals coming from the brain. The brain controls voluntary and involuntary contraction of your muscles, like a finely tuned machine run by a super fast computer. It’s analogous to a world-class conductor conducting a symphony so that every note, tempo, and timing is perfect.
If the nerve impulses (millions of them occur just standing) are dysfunctional, it can cause certain muscle groups to contract when they aren’t supposed to, forcing joint surfaces together and limiting their movement. It can cause one side to be inactive, resulting in unbalanced muscle tone. Abnormally functioning nerve signals to the muscles can throw off the synchronization of muscle contraction, which would be a big problem right in the middle of moving a heavy piece of furniture.
I believe that most cases of gradually occurring lower back pain are the result of degraded communication between the brain (cerebral cortex and cerebellum) and the musculoskeletal system. Even if the onset of pain was a specific incident such as bending forward to pick something up, it is secondary to a malfunctioning brain-muscle communication.
So, what does one do? Realize that for lower back pain, one shouldn’t simply focus on external means to reduce the pain; whether it be pharmacological (drugs) or manual (physical therapy, chiropractic). These methods can help reduce the pain and make you feel better, but if they don’t address the true problem, the pain is guaranteed to return.
Somatics is a form of therapy that treats muscular conditions by attempting to remove emotional or subconscious factors that may be contributing to the problem. The idea here is that the brain’s ability to properly regulate the body’s muscular function has been compromised by an old injury; inactivity, or harmful thought patterns. Somatic therapy addresses the problem by attempting to restore the connection using specific exercises, concentration, and breathing techniques.
If you have lower back pain that just won’t respond permanently to physical therapy or chiropractic, consider Hanna somatic exercises. This technique seeks to restore proper brain-muscle function using deliberate, specific targeted exercises (not your typical strengthening and stretching exercises). The system is taught by Lawrence Gold, a certified Hanna Somatics practitioner and is available on DVD or internet download. A sample of one of the exercises can be found here.
by Pain Doc | Mar 11, 2011 | Foot and Ankle Pain
If you notice a gradually developing pain in your forefoot (just past your instep) between the tarsal bones of the 3rd and 4th toes that is worse when you press it between your thumb and index finger, you most likely have what’s called a Morton’s Neuroma.
Despite it’s name, it is not a true tumor. It is a buildup of fibrous tissue that surrounds the sheath of one of the nerves that innervate the foot. The nerve lies between the muscles that connect the tarsal bones and due to the fibrous buildup gets compressed within this narrow confine. It is worse when standing and walking.
Morton’s neuromas are usually treated with orthotics (custom shoe inserts to help counter flat arches, over pronation, or other abnormalities of the foot) and cortisone injections to the painful nerve. Sometimes surgical removal of the excess fibrous tissue is done if the condition does not resolve.
A simple remedy that can provide welcome relief, and perhaps allow the nerve to heal faster is inserting rolled up gauze or cotton between the 3rd and 4th toes. This spreads apart the tarsal bones and creates more room for the nerve. Sometimes simple things make for effective remedies, and this is one of them.
by Pain Doc | Mar 10, 2011 | Headaches
Tension headaches are those thought to be triggered by prolonged muscle contraction in the neck, jaw and head. This can be voluntary and subconscious (nervous or habitual), or involuntary in response to stressful situations.
Oftentimes when I take a history from a patient complaining of frequent tension headaches, I discover that the patient also has jaw pain. This could be a sign that the patient is grinding his/her teeth either during sleep or throughout the day. Worn down tooth surfaces in the molars are also a sign of grinding teeth.
When one grinds or clenches the jaw, two bilateral (both sides of the head) muscle groups are engaged: the masseter, which is the thick muscle you can palpate right over the angle of the jaw; and the temporalis, which anchors to the side of the head and attaches to the mandibular notch. These two muscles elevate the mandible (lower jaw).
When a muscle is under tension (also referred to as hypertonic or hyperactive) it is basically malfunctioning. Muscles control joint movement, and if the muscle is not working properly it can activate tiny nerves called mechanoreceptors and nociceptors embedded around the joint, causing pain.
When the temporalis muscle is under tension, it can affect blood flow around the scalp, which can also develop into a headache.
So, what can one do? Here’s a simple remedy that has anecdotal evidence to support it: open your jaw and relax it. To make it easier, insert a pencil or pen in between your teeth (but don’t bite down on it!) and hold it in place for a few minutes. This action inactivates the masseter and temporails muscles somewhat by activating their agonist pair, the pterygoid muscles.
Give it a try next time you feel a tension headache coming on. But better yet, focus on eliminating the environmental or emotional triggers that cause you to clench your teeth or tense up your neck and head muscles.
by Pain Doc | Feb 27, 2011 | Uncategorized
Image via Wikipedia
Curcumin is the yellow spice derived from the plant Curcuma longa, commonly called turmeric. Extensive research over the last 50 years indicates that curcumin can both prevent and treat cancer and inhibit inflammation. The anti-cancer potential of curcumin stems from its ability to suppress proliferation of a wide variety of tumor cells and down-regulate or inhibit various enzymes and biochemical pathways involved in cancerous activity and tumor growth.
Curcumin has been described as a potent antioxidant and anti-inflammatory agent. Pharmacologically, curcumin has been found to be safe. Human clinical trials indicated no dose-limiting toxicity when administered at doses up to 10 g/day. All of these studies suggest that curcumin has enormous potential in the prevention and therapy of cancer.
Boswellia frereana (known as Frankincense) comes from a tree native to Somalia. Clinical studies have shown its benefits for both osteo- and rheumatoid arthritis. Its anti-inflammatory properties have also been shown to make frankincense a safe and effective treatment for asthma, inflammatory bowel diseases, such as colitis, Crohn’s disease and ileitis.
A 2010 study on boswellia’s potential to reduce cartilage degeneration showed that it inhibited the breakdown of the collagenous matrix; reduced potency of various metalloproteinases, which are enzymes that break down protein molecules; and significantly reduced the production of inflammatory agents like prostaglandins and cyclooxygenase 2 (COX2). Epi-lupeol was identified as the principal constituent of B. frereana.
This was the first report on the observed anti-inflammatory properties of Boswellia frereana in an in vitro model of cartilage degradation. The researchers demonstrated that B. frereana prevents collagen degradation and inhibits the production of pro-inflammatory mediators and MMPs and therefore should be examined further as a potential therapeutic agent for treating inflammatory symptoms associated with arthritis.
So if you are experiencing chronic, inflammatory pain, it wouldn’t hurt to try increasing your intake of these two herbs.
