Pain Doc - Ask Dr. P - The Pain Doc

The Consequences of Being a Bi-Pedal Animal

by Pain Doc | Mar 30, 2018 | Uncategorized

Humans are a bi-pedal animal: the only in existence as far as we know. Sure, bears, primates and a few other animals are capable of standing on their hind legs and walking, but it is not their natural gait. So, feel special that you belong in this class of animals!

There are many studies, particularly in the field of evolutionary biology that theorize why homo sapiens evolved to be bi-pedal, and the impact of the resulting evolutionary changes in our design. For one, being bi-pedal allowed our eyes to see further down the plains. Our species evolved to favor intelligence at the expense of strength and agility, so we needed a survival adaptation to give us an edge over things like saber- toothed tigers and other beasts. Being bi-pedal allowed homo-sapiens to see over the thicket, and give him enough time to evade faster-running predators.

Thank you nature, right?

Well, being bi-pedal comes with disadvantages; disadvantages that magnified as man’s intelligence grew and allowed him to invent things such as chairs, desks and heavy furniture. Being bi-pedal frees up the forelimbs, or arms, to carry things. Heavy things. This is why low back pain is one of the leading causes of chronic pain and disability. You don’t see dogs or horses get low back pain much unless they are in their final years. This is because as a qudra-ped they can’t pick up heavy things of course, and there is little axial force on their spinal column joints and discs, which lie in a horizontal plane.

When in a bi-pedal state– standing, walking, running– the spine does a wonderful job balancing the muscles of the limbs and torso. It is the anchor point and nexus of the major muscles of the body. When working/moving properly, the spine instantly adapts to changing loads (bending, twisting, carrying and releasing weight). When not, injury then pain results, and you get sidelined for a while. Blown discs, strained back muscles and even stress fractures can happen when the spine is not properly aligned and physically & neurologically conditioned– common in those who are overweight, sedentary, sit hours and hours every day, do heavy lifting at work and have a bad diet and other adverse & unhealthy lifestyle habits.

So does that mean you should spend more time in a recliner? No. Even though the bi-pedal standing position puts the most pressure on your back and weight-bearing joints, for most people it still is preferred over sitting because your body was naturally designed for standing, walking, jumping, crawling, stooping and all the various movements that are required to navigate a primitive terrain. The muscles become more toned and responsive, you burn more calories, and your organs work better in the standing position.

I understand that most people prefer to sit when they can. If your body isn’t well conditioned, standing puts a lot of pressure to the feet, knees, hips, low back, and even shoulders (from the weight of heavy arms). Sit down, and that pressure is instantly relieved. But if sitting becomes your preference, and you avoid walking and exercising then you are in danger of cutting your life span short. Many studies show that exercise and regular, moderate physical activity are a positive correlation variable to life expectancy. If you remove that variable, your life expectancy, at least statistically, drops. So if you get comfortable sitting and avoiding exercise, it gets more difficult mentally and physically to start up again. The more you put exercise off, the less likely you are ever to do it.

So, what should you do if you are in the sedentary camp? If you have pain or discomfort in any of your weight bearing joints?

The first thing I recommend you do is to convince yourself you need to get moving. Regularly. And don’t be too hard on yourself. I’m not talking about suddenly going to the gym 3x/week for one hour workouts. No, start gradually.

In fact, once you make the decision to start exercising again, don’t do anything major for at least a month. Instead, spend that time learning how to eat healthy. Swap the junk food and eating out for wholesome, nutrient-dense food prepared at home; about 85% plant, 15% animal protein (or vegetable). Drop the concentrated carbs (grains–breads, pasta, crackers etc., sugar, and even fruit juice, unless it’s diluted). Replace them with greens, whole fruits, nuts and seeds, and water. Clean, naturally-occurring, unadulterated, unrefined, untreated food from the Earth. Grass fed and pastured meat only, in small portions (8 oz. day max).

If you have pain, try self-rehabilitating. There are many exercise programs, orthopedic exercisers and home use therapy devices like the home infrared lamp, red light/laser, lumbar traction and PEMF to name a few, to help you overcome them. Combined with a healthy diet like previously mentioned, you stand a very good chance of curing yourself or significantly lowering your pain.

By the end of the month, you are ready to get going. Start with speed walking with hand weights, about 3 miles. Do this for a week or two. Then, move up to light jogging and light, home exercise. Again, don’t be too hard on yourself. Go at a pace that you can handle. You can choose a treadmill in the gym, if you prefer. I’d say a good mile pace would be a nine-minute mile or better, to get the best cardio benefit. Aim for 2-3 miles max.

On some days, lift heavy weights. But, I highly recommend you get at least one session with a professional personal trainer at your local gym. Let the trainer show you basic strengthening exercises, and most importantly proper form. You want to make sure you don’t hurt yourself.

Oh, and lastly: if you must sit down for prolonged periods every day due to your job, check out this article for prolonged sitters. It’s got my recommendations for those who sit at a desk all day, or sit in a car/truck all day. These things can literally save you from spinal surgery years down the road!

Remember, the human body has a preference for being in the bi-pedal position most of the time when you are not sleeping. You must do all you can to move in a way that naturally accommodates the design of your body. Modern living has wreaked havoc on the body and resulted in countless of cases of chronic, musculoskeletal pain throughout the developed world; do what you can to prevent yourself from being a statistic.

Dr. Dan

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A Little Known and Underrated Way to Relieve Pain, Naturally

by Pain Doc | May 19, 2017 | Myofascial Pain

If you experience ongoing pain; perhaps an arthritic hip or remnants of an old injury, a little-known and underrated way to lessen its impact is through fasting—the temporary avoidance of food, about a half day to two days straight, done periodically.

The word “fasting” causes apprehension in some people, which is unfortunate because once you get used to it, it’s not as bad as it seems. Fasting isn’t about making yourself gaunt, thin, weak and unable to stand up. It is completely natural and compatible to the human body; even more so than eating three meals a day.

Sound a bit outrageous? Well, let’s look to science to see if there is evidence for this.

Scientific Support for Fasting

When it comes to evaluating what is healthy and what is not, I like to bring science into the equation; particularly evolutionary biology.

A main concept of the Theory of Evolution is that nature optimizes all living creatures’ anatomy and physiology to increase the odds of survival. This is the basis of natural selection – where nature determines or “selects” which traits, visible and not visible, an organism will have. Traits that support survival are passed on to future generations; traits that threaten survival are eliminated from the gene pool through predation and other means.

For example, there is a species of frog that lives in an area that freezes over during the winter. This frog developed an amazing ability to stay frozen in hibernation—entombed in ice for the whole winter—and then thaw in the spring, awaken and carry on where it left off!

Camouflage is another example of natural selection. An animal that is well camouflaged in its environment does a better job hiding from predators than one that contrasts with its surroundings, so nature often selects appearances that blend in with the environment.

So how can evolutionary biology be used to justify the benefits of fasting to humans?

Observing predators in the African savanna offers clues. A predator such as a lion or leopard, when it attempts to take down prey, fails most of the time. It doesn’t always get to eat when it wants to. Prey is elusive, so predators go for days without eating.

Homo Habilis, a relative species of Homo Sapiens.

Early humans, who were predators themselves, faced a similar situation. And, they weren’t as fast or strong as top predators that lived with them during that time such as sabre toothed tigers (they did, however, have an advantage in intelligence). Early humans walked for miles each day, stalking their prey, failing most of the time just like the lions of today. Days could go by before they had a solid meal. Sound like fasting?

Early humans foraged for edible plants and ate their roots and leaves, too. Like prey, this wasn’t easy either, as many of the plants that lived during that time were poisonous or basically inedible.

When early man did manage to take down a beast like a Mastodon, he and his tribe gorged on it; probably for several days. They ate the organs, tendons and muscles and used the hide for clothing and shelter. Then it was another couple of days without eating until they had success again, repeating the cycle.

Hence, fasting, although not by choice, was a natural part of early human life, for millions of years. It was an “evolutionary pressure” that caused adaptive, physiological changes to develop in our species homo sapiens. This means that the human body can not only handle prolonged periods without food, it has a preference for it.

These ancient survival mechanisms are present in your own body to this day. Your body takes some calories from your diet and stores them in your liver and skeletal muscle as glycogen, which can carry you for about half a day as long as you don’t over exert yourself.

Excess calories are stored in fat cells. This includes calories from sugar, protein and fats. Your liver converts this stored fat back into sugar, as needed. This is how your body is able to maintain a relatively stable fasting blood glucose level regardless of your energy expenditure; kind of like how your car’s cruise control keeps your car the same speed even when going uphill.

Bottom Line:

Increasing the time interval between meals in an irregular pattern is better for your body than eating breakfast, lunch and dinner at the usual times.

OK, so I think you get the point. Now let’s entertain the converse question:

Since the human body is designed to go without food for many hours to a few days, is it less healthy, or even harmful to eat frequently throughout the day?

The short answer is yes: eating frequently is less healthy than eating on an intermittent fasting schedule, and is even damaging.

The Problems With Eating Multiple Times a Day

Here are the problems associated with frequent eating (multiple meals every day vs. fasting):

Stress to gut: Eating multiple times a day stresses your stomach, gall bladder and intestines. Your stomach has to constantly produce and churn out digestive enzymes. If your meals lack fiber, the intestines have to strain to push it along.
Stress to pancreas: If you frequently eat high-carb foods like a rice burrito and soda, the surge in blood sugar stresses the pancreas as it has to pump out lots of insulin to lower your blood sugar.
Can trigger inflammation: Some food additives trigger an inflammatory reaction which can increase pain; unbeknownst to the individual.
Worsens leaky gut syndrome: If you have this condition, the more you eat, the more macromolecules leak into your system causing systemic inflammation.
Diverts energy needed for tissue repair: If you’re eating processed food frequently, your liver has to expend extra energy detoxifying those additives for elimination.
Massive free radical generation: When you eat frequently, tissue-eroding free radicals are generated in the cells—muscle cells, liver cells, brain cells, everywhere. Free radicals, or reactive oxygen species (ROS) are unstable molecules generated during metabolism that can react with your DNA and cell membrane and cause damage. Damaged cell membranes can interfere with toxin removal from cells.

Most people know by now that eating wholesome, naturally-occurring foods emphasizing green plants, healthy fats and moderate protein is much healthier than eating sugary, processed food and wheat-based food.

Eating this way on an intermittent fasting schedule is the absolute best option for your body because it mimics how early human ancestors ate – an animal or plant every other day or so, with nothing in between except water. It is what your body and all its parts–muscles, brain, heart, liver, gut, etc.– are “engineered” for.

Free radical damage

Fasting Helps Reduce the Intensity of Pain

Can you see how fasting can lessen pain? With fasting you are essentially turning down the furnace in all your cells, reducing free radical generation and “quieting” pain-producing inflammation.

By fasting, your organs aren’t straining to process this food, enabling available energy to go towards cellular repair and regeneration—very helpful if your pain is still acute or sub-acute.

Fasting reactivates body fat burning, producing ketones for energy. Ketones suppress the activation of a protein that drives inflammation in chronic diseases like arthritis, inflammatory bowel disease and diabetes. This is a direct link between fasting and pain reduction.

If you are experiencing daily pain, definitely try intermittent fasting. Eat whole, naturally-occurring foods on an intermittent fasting schedule, and notice how your pain decreases dramatically. It could lessen your dependency on medications. You may be able to reduce your dosage, or eliminate them entirely!

Make sure you only drink WATER, too. A can of soda or fruit juice will negate some of the health benefits of fasting.

How to Do It

One approach to intermittent fasting is to eat your last meal of the day at 6:00 PM, and your next meal around noon or later the next day. That’s an eighteen hour fast.

Alternatively, eat a big breakfast around 10 AM, skip lunch and eat an early sizable low-carb dinner at around 4:00 PM.

P.S. If you’re not willing to part with carbs like pancakes, potatoes and cereal; rice, bread and pasta, then strive to eat most of them during your first meal of the day– the 10:30 am or noon meal in the proposed schedules above. Limit the second meal (dinner) to meat, fat and lots of greens.

Keep in mind your early human ancestors who lived for millions of years before you, and how they ate: thanks to them, your body is hard-wired to handle hours and hours without food. If you feel hungry starting out, it’s because you were accustomed to eating three meals a day all your life. Your brain anticipates these frequent meals, and when it doesn’t get it, it triggers the feeling of hunger unnecessarily, like a false alarm because you aren’t in danger of starving.

You will be surprised that in just a week or two on this schedule, those hunger attacks will cease and fasting will come naturally to you. You will be less hungry as intermittent fasting becomes routine for you (strange, but it’s true!); have less cravings for sweets; have less brain fog and will not feel lethargic. Instead, your mind will be sharper, your energy level will be higher and your mood will be better.

And, if you have pain, it will dissipate. Remember, nothing is as powerful and knowing as Mother Nature!

How Magnetic Fields Can Affect Chronic Pain and Healing

by Pain Doc | Mar 6, 2017 | Uncategorized

When it comes to “pain relieving products,” there is definitely no shortage.

Perhaps you’ve run across pitches on late night TV commercials, magazines, websites or email spam about the latest “miracle” pain relief device or medicinal product. Chances are, they either don’t work or don’t work as well as advertised.

When on any day an estimated 100 million people in this country are experiencing some kind of pain– low back, hip, knee, etc., it’s not surprising that you’ll see a lot of ads for pain relief. Pain tends to make people motivated to do something about it.

But what if there is such a device or product that works well enough that it should deserve your attention?

Then, I think it is definitely worth checking out. As you know, I am a big, big advocate of self-care: whenever it is possible to avoid invasive medical procedures, I say go for it. “Invasive” to me means putting a drug inside your body or breaking the integrity of your body (surgery). The statistics seem to indicate that traditional allopathic medical treatment for disease, especially chronic degenerative disease, is “hit or miss;” with missing happening more and more at an unacceptable rate.

Did you know that medical errors are the #3 cause of death in the U.S., according to statistics? Adverse reactions to drugs and surgical interventions are responsible for prematurely ending the life of the recipient in way too many cases.

Given this reality, I say do all you can to treat pain or other disease using nutrition, physical activity, physical medicine, relaxation/stress reduction techniques and select modalities.

If you’ve been following my blog for a while, you probably are aware of one of my favorite modalities to treat pain– red light therapy. Red light (from 660-880 nm wavelength) and infrared light (non-visible) can be effectively used to treat chronic pain and actually enhance soft tissue and nerve tissue healing.

For an explanation of how red light therapy can help you manage joint and muscle pain, watch my YouTube video where I explain it.

The second modality that I recommend you try if you have chronic pain is Pulsed Electromagnetic Field (PEMF) therapy. PEMF has medical research that confirms its effectiveness in enhancing healing of bone and cartilage injuries or damage.

PEMF has long been known to have therapeutic benefits. In the 1960s, researchers demonstrated that electromagnetic field energy, or “magnetobiology” could help bones heal themselves.

In order for something to be therapeutically viable, it needs to be able to create a physiological change in the human body that benefits the body in some way. For example, COX-2 anti-inflammatory medications chemically block enzymes responsible for generating inflammation, thus reducing pain. Heat dilates blood vessels and increases circulation, which reduces pain and increases mobility in a muscle; cold constricts blood vessels, reduces swelling and numbs nerves which can reduce acute pain.

As for magnetic fields, evidence shows that they can influence cell membranes, since cell membranes rely on tiny electrical charges to change their permeability. When there is inflammation and swelling present, cell membranes dictate what passes into and out of the cells into the extracellular space.

During inflammation and recent injury (acute phase), red blood cells clump together, resembling a stack of coins. This is known as “rouleaux formation” and is due to increased levels of serum proteins, particularly fibrinogen and globulins.

rouleaux

PEMF seems to have the ability to thin out thickened blood by loosening rouleaux formations. This allows blood to flow faster to and from an injury/ inflamed site, delivering oxygen and reparative agents faster.

rbc pemf

Currently, the subject of magnetobiology is experiencing a surge in interest in academia, with a staggering 350% increase in articles published on the topic over the last 15 years. What can this mean?

Whenever there is a flurry of research activity in a particular field, it usually means that scientists are finding promising results in their research; i.e. they are seeing something actually work in the lab.

The findings are published in peer-reviewed medical journals read by researchers around the world. The world-wide, academic collaboration decides whether the topic is valid and worthy of further investigation. Based on the volume of research, that is the case for pulsed electromagnetic therapy. What this means to pain sufferers is that PEMF is worth looking into; it has passed the stringent “snake oil test” of medical research involving randomized, controlled clinical trials. I have summarized two of them below.

Low frequency and low intensity pulsed electromagnetic field exerts its anti-inflammatory effect through restoration of plasma membrane calcium ATPase activity — Ramasamy Selvam, et. al.

This study involved artificially causing rheumatoid arthritis in rat leg joints by injecting an irritant into the joint. A control group, a group treated with PEMF, and a group treated with a traditional anti-inflammatory medication where used.

To find out whether PEMF has any stabilizing effect on membranes, this study measured PEMFs effect on:

• Edema/ swelling
• Levels of antioxidants
• Plasma membrane calcium ATPase (PMCA)
• Intracellular calcium (Ca+) levels
• Prostaglandin E2 (PGE2) in blood lymphocytes

Effect of PEMF on SWELLING: PEMF reduced swelling by 70.71% compared to 77.50% for the group treated with anti-inflammatory medication (diflonac).

Effect of PEMF on ANTI-OXIDANT LEVELS: Cells need anti-oxidants to neutralize free-radicals, which damage cell membranes and DNA. The anti-oxidant levels were decreased in the arthritic group compared to the control (untested) group. However, treatment with PEMF and diclofenac resulted in a significant rise in anti-oxidant activitiy.

Effect of PEMF on CELL MEMBRANE FUNCTION: PMCA is a protein found in all cells’ plasma membrane (shield or covering) that helps pump calcium ions (Ca+) out of the cell as they build up. It is necessary to keep Ca+ ion concentration low in order for the cell to carry out its normal, biological functions (signaling). When there is inflammation such as that caused by rheumatoid arthritis, it generates oxidative stress (free radical damage) to the cell membrane, resulting in decreased activity of PMCA and buildup of Ca+ ions.

The study demonstrated that PEMF could stabilize the membranes and restore PMCA activity, thereby maintaining intracellular Ca2+ level at extremely low levels. This, in turn, decreased the inflammatory PGE2 levels (prostaglandin—the precursor substance of inflammation) and consequently suppressed the inflammation.

CONCLUSION: low frequency and low intensity PEMF is indeed beneficial in reducing inflammation without potential side effects indicating that it could be a viable alternative therapy for treatment of RA.

Pulsed Shortwave Treatment in Women With Knee Osteoarthritis: A Multicenter, Randomized, Placebo-Controlled Clinical Trial

Thiago Yukio Fukuda, et.al.

One hundred twenty-one women (mean age=60 years, SD=9) with a diagnosis of knee osteoarthritis (OA) were tested to see if pulsed electromagnetic therapy could reduce their arthritis. “Low dose” and “High dose” groups were created to determine the best therapeutic dosage.

Participants were distributed randomly into 4 groups: 35 participants did not receive any treatment (control group), 23 received a placebo treatment, 32 received low-dose PSW treatment (power of 14.5 W, treatment duration of 19 minutes, and total energy of 17 kJ), and 31 received high-dose PSW treatment (power of 14.5 W, treatment duration of 38 minutes, and total energy of 33 kJ). An 11-point numerical pain rating scale and the Knee Osteoarthritis Outcome Score were used to assess pain and function in 3 stages: at initial evaluation (pre-treatment), immediately after treatment, and at 12-month follow-up.

Results: The results demonstrated the short-term effectiveness of the PSW at low and high doses in patients with knee OA. Both treatment groups showed a significant reduction in pain and improvement in function compared with the control and placebo groups. There were no differences in results between PSW doses, although a low dose of PSW appeared to be more effective in the long term.

Note: These results were achieved without physical exercise, which could have positively influenced the results.

Conclusion: Pulsed shortwave treatment is an effective method for pain relief and improvement of function and quality of life in the short term in women with knee OA. On the basis of the results, application of PSW treatment is recommended in the female population with knee OA.

The Bottom Line:

Pulsed Electromagnetic Therapy is a safe and viable method for reducing inflammatory pain. Research suggests that electromagnetic fields can influence cell membrane permeability and increase weak cell energy output, resulting in dissipation of various symptoms of illness, including pain.

Best of all, it doesn’t involve using harmful and addictive medication. Since there are numerous variables in pain cases (age, general health, pre-existing conditions, injury severity, etc.) people will have varying results using PEMF. If you are experiencing musculoskeletal pain, I highly recommend you give PEMF a try.

The following two devices are two, popular consumer-level pulsed EMF devices. They are easy to operate and do not cause any pain. Some users report nearly instantaneous relief while others report relief after several treatment sessions. Again, it all depends on your particular health situation.

Compare PulsedEMF Devices:

Arm, Wrist and Hand Pain From Overuse – Things You Can Do

by Pain Doc | Mar 1, 2017 | Neck Pain, Shoulder Pain

When I ran a large chiropractic practice in San Francisco’s Financial District during the late 1990s to 2002 about half of the cases I saw involved upper extremity pain due to “overuse.” They went by the names repetitive strain injuries (RSIs), cumulative trauma disorders, tendonitis, epicondylitis, carpal tunnel syndrome, stenosing tenosynovitis or just overuse syndrome.

Symptoms typically involved pain in the wrist tendons, forearm muscles and outer elbow; weak grip strength; shooting pains in the hands and sometimes loss of finger coordination.

Nearly all patients complained of neck and shoulder pains as well. About 20% were way beyond typical neck strain; these folks suffered an unusually pervasive pain that limited shoulder and neck movement enough to cause temporary disability (I had to take them off work). The neck and shoulder muscles were always rigid while the skin above felt unusually warm and a bit swollen/ boggy to the touch.

What could explain this surge of arm, wrist and hand pain from the late 90s to 2000s?

During this time frame, a couple of things occurred:

1. Laptops started entering the scene. This was significant, because up to this point people used a separate keyboard and monitor. And, they usually had the monitor raised on a monitor stand so you didn’t have to bend your neck down for so long. With the laptop, the monitor is connected to the keypad, forcing the user into an unfamiliar, awkward and ergonomically poor position. Neck and arm muscles were not accustomed to function in this position and experienced cumulative strain.

2. The internet developed, as well as desktop applications like Microsoft Office Suite. Employers saw how the internet could increase efficiency and job descriptions increasingly involved longer hours on the computer.

3. Mobile phones came on the scene, then smart phones. BlackBerrys (“Crack Berrys”) were all over the place, then the iphones. Like the arrival of the laptop these new devices caused people to assume postures that they weren’t accustomed to: forward craned necks multiple times throughout the day; thumb typing, slouching.

Wrist braces were a common site back then, and there was an increased incidence of carpal tunnel release surgery.

Now in 2017, you don’t hear much about repetitive strain injuries or carpal tunnel syndrome. I think we’ve witnessed a sort of “micro-evolution” phenomenon, where the human body gradually adapted to using laptops and smart phones due to them being “forced” on the population, and can now handle longer hours in these awkward positions.

How Chronic Arm Pain Develops

But that doesn’t mean you are immune to these overuse injuries. If you have a job that involves prolonged sitting (about one hour+ straight) and keyboarding, then it is prudent to do things to avoid developing chronic pain in your upper extremities. I’ve seen people who worked through arm and wrist pain because their job demanded it; then, a point was reached where the pain persisted even after weeks of resting their arms, and months after they left their job.

What typically happens is, with frequent typing you rapidly contract and relax the forearm muscles that move your hands and fingers. There are several of them tightly confined in a small compartment. These muscles and tendons are protected by tissue called bursae, which are basically frictionless pads so that they can rub against each other without much problem.

But if you continually engage in these movements the bursae basically dry out and lose their ability to protect the forearm muscles and tendons. Friction increases causing small tears to form in the bursae and fascia (muscle covering), triggering inflammation and swelling. The inflammatory chemicals irritate the nerves in the arm, which can lead to things like numbness, tingling and shooting pains.

Then, scar tissue develops and undergoes sclerosis, or hardening and permanent thickening. Now you are stuck with hardened tissues rubbing against one other when you type, making matters worse. It leads to a perpetual cycle of arm, wrist and hand pain that persists with or without hand and arm exertion.

And don’t forget the neck and shoulders. As you know, it’s nearly impossible to maintain an erect sitting posture. After some time, your neck and back muscles fatigue causing you to slouch. The muscles in the neck shorten, and may even pinch your cervical plexus on one side—the bundle of nerves that go to the arm—leading to a condition called thoracic outlet syndrome. Symptoms of TOS include numbness in the arms and hands, swelling and a weak pulse.

For some people, the combination of neck, shoulder and arm pain is so bad they can no longer return to office work.

So what should you do?

First and foremost, taking periodic rest periods in between arm and hand work helps. Do neck, shoulder arm and wrist stretches during this time.

Secondly, take a hard look at your workstation ergonomics. Take note of the body positions and movement patterns required by your particular job function. Are there things you can arrange to minimize strain to your body? Think in terms of positioning frequently used equipment in a way that requires the least amount of exertion to your arms, wrists and hands. It could mean positioning the item closer to your body or further; higher or lower, and/or angled in a certain way. The slightest adjustment in a frequently used item can make all the difference.

For desk workers, I highly recommend that you get an adjustable standing desk such as the VariDesk. Set it to the standing height and stand for an hour; then effortlessly switch it back (takes all of five seconds) to the sitting position for half an hour, then back to standing. Standing gives you better posture and is actually better for your low back than sitting although it is harder on your feet and knees.

Third, think like an athlete. An athlete makes his/her body strong in order to perform the best, and to handle the physical challenges of his/her sport.

Well, sitting and typing is not exactly a sport but like a sport it puts physical demands on certain parts of your body—your low back, neck, shoulders, arms and hands. Strengthen those areas using weights and whole body functional exercises. This will make your body resilient to the physically stressful position of sitting at a desk for 8+ hours a day.

Fourth, there is self-therapy. If you are developing pain in your arms and hands, consider doing massage therapy. Myofascial release and Active Release Technique (ART) are especially good for upper extremity strain problems. Ask around; these techniques are advanced “medical” massage techniques that not your typical massage therapist is trained to do.

If you want to try it yourself, I made a video that shows you a modified form of myofascial release using an edged instrument.

If you are having neck and shoulder issues, find a good chiropractor and get some adjustments to those areas. Adjustments can help loosen fixated joints, removing pressure to nerves and blood vessels that service your arms.

Last but not least, use nutrition as therapy. Like a marathon runner who needs certain nutrition to recover from muscle breakdown in the legs, those whose job requires frequent arm and hand exertion at work should use nutrition to compensate for muscle breakdown in the upper extremities. I recommend green juice, whey and anti-oxidants.

Click here for the specific, nutritional supplements I recommend for maintaining good musculoskeletal health.

Bottom Line: Your arms and hands are indispensable to you. If you have a job that requires frequent keyboarding or other use of hands and arms, take preventive action to ensure you don’t develop chronic strain. Most of the best things you can do to achieve this, you can do on your own, without a doctor.

Till next time,

Dr. Dan

How to Do Home Traction for Low Back Pain

by Pain Doc | Feb 23, 2017 | Low Back Pain

Lumbar traction is one of the things you can do to manage low back pain yourself, and not have to spend $$ on the chiropractor or physical therapist.

It involves stretching the lumbar spine in the axial plane; i.e. length-wise; causing slight separation between the vertebral bodies and smaller facet joints. The traction force has to be strong enough to overcome the resistance from muscles and ligaments in order to derive benefit; otherwise it’s just a muscle stretch.

Why Your Height Changes Throughout the Day

Do you notice how you have to adjust your car’s rear-view mirror in the morning in order to align it properly with the rear window?

That’s because you are sitting higher in the morning, and are actually taller; perhaps a full centimeter.
When you stand or sit throughout the day, the force of gravity compresses the discs in your spine; mostly the thick ones in your low back (lumbar). At the end of the day, the discs are slightly thinner due to this constant pressure, and you are shorter. If you drive your car around this time, you probably don’t notice that you have to adjust your rear-view mirror downwards.

When you sleep, you are in a horizontal position and the effect of gravity on your discs is reduced. As you sleep, your discs slowly re-hydrate themselves, like a dry sponge soaking up water, and you become taller overnight!

Most of your upper body’s weight is supported by your lumbar spine, or low back. That’s why the lumbar vertebrae and discs are the thickest and strongest in the spine (compared to those in the neck and torso). The discs/vertebral bodies absorb 80% of the weight placed at that level; the two facet joints behind the vertebral body bear about 10% each.

As you age, your lumbar discs lose some of their ability to resorb fluids. That is one reason you tend to get shorter as you reach 60 and beyond. Like a car tire or other moving machinery part, its function degrades over time.

Factors that accelerate disc wear and tear are being overweight; having an occupation that requires prolonged sitting (desk job, truck driver, airline pilot, etc.); injury to your low back in sports or an accident; and having parents who had back problems.

If any of these describe you, then definitely try doing home lumbar traction periodically. If you currently have low back pain, traction can alleviate some of it by reducing pressure to your discs and facet joints, which do have nerve endings. If you don’t have low back pain, traction can be done to help prevent your discs from degenerating; or at least arrest the progression of disc degeneration. This can save you from major back problems in the future; perhaps even surgery.

What are your home traction options?

The most effective traction is done by the professional equipment used by chiropractors and physical therapists. Sometimes referred to as “non-surgical spinal decompression,” it basically involves lying prone or supine on a special table that has a movable lower section that glides on rails.

You are secured to the table by some contraption, and a harness is placed around your pelvis. A cable connects the harness to a special motor, which can be programmed to pull in different patterns.

For example, there can be settings for frequency of pulls per session; strength of pull; duration of hold time; and pull patterns (step up, step down, constant, variable). The machine must be able to overcome guarding (involuntary contraction) of the erector spinae muscles of the lumbar spine, which are quite strong by the way, so that the traction affects the spinal discs and joints which start to separate only after the back muscles let go.

Now, if you want to get this level of traction you have to find a center that offers this and make an appointment.

Consumer-level home traction devices are entirely different. Most of them leverage your own body’s weight to do the traction.

Watch this video, as I review four devices that can be used for lumbar traction:

The four home traction devices I discuss in this video are the inversion table, the Back Bubble, the Stamina traction device and the PosturePump™ elliptical spine trainer. All have their advantages and disadvantages. If you want to give home traction a try, watch the video and do further research.

In summary, home lumbar traction can be a comparatively low cost approach to managing general low back pain, and a great preventive measure. Traction helps relieve pain by decompressing discs and facet joints, and assisting them in re-hydration, especially at the end of the day.