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Effective Exercise to Maintain Posture

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.

Back Pain or Arthritis? Try Curcumin and Boswellia Extract

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.

Can You Grow Cartilage By Eating Certain Foods or Supplements?

by Pain Doc | Feb 21, 2011 | Uncategorized

Cartilage, specifically, hyaline cartilage is the tissue that lines the articular (contacting) surfaces of bones. If the cartilage deteriorates it can lead to pain and inflammation in the weight bearing joints, mostly the knees and hips, as nerve endings in the joint get exposed to abrasive action. This can force the sufferer to elect for knee or hip replacement surgery, as well as artificial disc surgery. Smaller joints such as in the fingers can be affected as well.

Cartilage is made by special cells called chondroblasts. These cells make the extracellular matrix of cartilage, comprised of Type II collagen and ground substance, which is comprised of proteoglycans and elastin. Another important constituent is hyaluronic acid, which improves the resiliency and hydration of cartilage. Without going into too much detail, a proteoglycan is a protein molecule with a chain of sugar molecules attached called glycosaminoglycans, or GAGs. The two GAGs that are best known to the public are glucosamine sulfate and chondroitin sulfate, the key ingredients in most cartilage and bone supplements. Glucosamine sulfate is the one found in the exoskeletons of shellfish, as well as some fungi.

Persons suffering from the various forms of arthritis such as osteoarthritis and rheumatoid arthritis have cartilage tissue that is undergoing inflammation and degradation, either mechanical in nature or auto-immune.

Collagen is a group of naturally occurring proteins found mostly in animal connective tissues– tendons, ligaments, and skin. What makes collagen useful in cartilage is its ability to withstand pressure and return to its original shape (deform and rebound). This is what is necessary in joints of the human body, which are subjected to forces multiple times throughout the day. The simple act of sitting or standing places enormous pressure on the joint surfaces of the feet, knee, hip and lower back. Using one’s hands to type or grip things places pressure on the smaller joints of the fingers and wrists.

So, if your have thinning cartilage in your knees, can you grow it back simply by taking glucosamine sulfate and chondroitin supplements? Unfortunately, the latest research on their ability to reduce joint pain show minimal improvement. Why is this?

It’s because that, just because you give the body supplements through your diet, it doesn’t guarantee that your body will do things you want it to do with these nutrients. They could be going somewhere else besides you joint, which is more likely the case.

The harsh reality regarding all muscle and connective tissue building dietary supplements such as collagen, bone broth, protein powder, etc. is that they get broken down in your GI tract into their amino acid constituents, and need to be reassembled. But as mentioned, your body will not reassemble them into the desired tissue 100%. These proteins may go to your skin, hair, nails, or may be made into an enzyme or cell receptor. In other words, the amino acids in those glucosamine sulfates pills may wind up forming new hair, not cartilage.

That being said, if you hope to build cartilage through your diet, it may be more effective to eat the actual cartilage. At least it consists of the actual amino acid sequences in the proper percentage the body uses to build cartilage..

Consider consuming bone broth soup regularly if you are suffering from achey joints; or do so as a preventative measure. Most butcher shops in the grocery store will have large joints of beef or pork, usually the hips, knees and spine. And they are cheap, usually less than $2.00 a pound. They will saw them in small pieces for you if you request. What’s great about them is that they still have tendons and cartilage pieces attached. Get a large pot, add a gallon of water and bring to boil; lower temperature and boil for two hours. The broth will be rich in nutrients that your body can use to help regenerate damaged cartilage.

For preventive measures to protect the health of your joint cartilage, remember to:

do functional exercises regularly to improve whole-body muscle & joint responsiveness
avoid sitting for too long at your work
avoid activities that require repetitive trauma to the joints such as long distance running
avoid ingesting toxins like cigarette smoke, alcohol, and highly processed food
get enough daily rest to allow your body to regenerate
drink filtered water (not distilled)
get enough sun exposure for Vitamin D synthesis

Burt’s Bees Res-Q Ointment for Minor Injuries

by Pain Doc | Feb 17, 2011 | Uncategorized

Today, a patient of mine returned from a trip to Australia. She relates how her vacation was interrupted by the recent flooding in that country, and by something else– a nasty spider bite.

Now, if you’ve ever watched Discovery Channel and saw one of those nature shows on extreme insects, you’ll know that many come from Australia. There’s something about that country, perhaps its isolation that makes it a haven for dangerous, poisonous creatures.

Anyways, this patient says she was bitten on the leg by a black spider (probably a funnelweb spider). She said she “saw” the poison slowly work its way up her leg towards her knee (there was probably some reddening/ inflammation that spread outwards from the spider bite). Her companion told her not to move her leg, as it would spread the poison faster. Panicking, she took out the only first aid item she had on her– a small tin of Burt’s Bees Res-Q ointment— and rubbed it around the spider bite.

Almost instantly, she started to feel relief. An hour or so later, the swelling was gone. She said that the product literally “saved her life.” She was absolutely thrilled, from not knowing whether she would die from this bite, to feeling much better in a matter of minutes. She couldn’t say enough good things about the Res-Q ointment, and made sure I knew about it.

Curious, I decided to check it out. The main ingredient in Res-Q is comfrey, a controversial herb that has shown to have therapeutic benefits, but may also cause liver toxicity if taken internally. Comfrey contains allantoin, a cell proliferant that speeds up the natural replacement of body cells.

Historically, comfrey was used in an attempt to treat a wide variety of ailments ranging from bronchial problems, broken bones, sprains, arthritis, gastric and varicose ulcers, severe burns, acne and other skin conditions. It was reputed to have bone and teeth building properties in children, and have value in treating “many female disorders”.

Most recently, in a placebo controlled study comfrey was found to decrease back pain when used topically.

If you visit the Burt’s Bees website and check out their Res-Q product, you will notice a lot of positive reviews– people raving about how the product helped reduce the “red nose of colds,” bruises, skin irritations, minor burns, bug bites, and cracked and chapped skin.

While these reviews are no substitute for a properly conducted scientific study with control group, most doctors agree that anecdotal evidence can be equally compelling when evaluating a particular therapeutic product or procedure.

Now, time to sign off to buy a can of Res-Q myself…

How to Improve the Ergonomics of Your Computer Workstation Set Up

by Pain Doc | Feb 11, 2011 | Uncategorized

If you have a job that requires continuous sitting and typing at a computer workstation, it is extremely important to ensure that your workstation is set up ergonomically, with respect to your body.

“Overuse injuries,” or repetitive strain injuries (RSIs) can develop in the fingers, hands, wrists, forearm, elbow and shoulder if you are not careful. RSIs, if allowed to take root can lead to chronic, recurring pain in some people, even when they stop the offending movements. I”ve seen extreme cases where the individual developed bilateral carpal tunnel syndrome and resorted to surgery in both wrists, all because of repetitive use on the keyboard.

A key factor in these types of injuries is the placement of the keyboard. It needs to be placed low enough and close to your body so that you aren’t required to lift your upper shoulders and arms to type. The shoulders should be loose and relaxed; upper arm in line with the torso, elbow at 90-110 degrees, and wrist straight.

In most cases, an adjustable computer keyboard tray that fits underneath the desk surface is necessary. Most desk surfaces are simply too high to be able to use your keyboard and mouse without having to contract your upper trap and arm muscles.

However, with wireless technology it is much easier to accomplish. All you need is a portable keyboard/laptop flat table, a space-saving wireless keyboard, and a wireless mouse. Place the keyboard flat table on your lap, place the wireless keyboard and mouse on the table (don’t forget to turn them on), and you’ll be all set.

Pain in Calf While Jogging

by Pain Doc | Dec 23, 2010 | Uncategorized

Muscle strain to the calves can occur while engaging in heavy leg use, such as jogging, hiking (especially uphill), cycling, and basketball or other sport that requires frequent running. This is due to damage to the muscle fibers, tendon, fascia (muscle covering) and/or blood vessels.

But before you assume that your calf pain is a muscle strain, know that calf pain can also be caused by a thrombus, or blood clot. This is a medical emergency that demands a visit to your physician and special tests. For more information on blood clotting in the legs (deep vein thrombosis or DVT), read this article.

Strains occur in different grades. The most simple strains and sprains (Grade I) occur when there is mild tearing of some muscle fibers. Grade III sprains and strains involve complete tears to the muscle and/or ligament (the ligaments are on the ends of the muscle and connect it to bone) and joint damage. Grade III sprains and strains are emergency in nature and will most likely require surgery.

If you get leg (lower) cramps when jogging, you’ll probably need to stop or risk getting a “pulled” calf muscle. This can be painful enough to force you to get off your feet and sit on the ground. A pulled calf muscle starts with a twitchy sensation in the calf, followed by an involuntary, painful contraction that forces you to bend your knee for relief. It signifies a strained gastrocnemeus muscle, tendon or fascia and is related to abnormal muscle physiology due to muscle exhaustion.

You see, muscle contraction involves very complex biochemical reactions. Calcium, sodium and potassium ions modulate the actions of actin and myosin, the specialized protein structures that make up skeletal muscle and enable changes in muscle length. Lactic acid builds up as the muscle contracts and relaxes continuously during running. It is flushed out of the area by normal biological pathways but eventually builds up as the activity continues.

If you get calf pain after engaging in heavy leg use, use the PRICE protocol:

Protect the muscle from further injury
Rest the muscle
Ice the muscle for 20 minutes using a frozen gel pack*
Compress the ice around the muscle (use two long socks or ace wrap)
Elevate your leg for gravity-assisted swelling reduction

If you keep getting calf pain during heavy physical activity, it could be that your legs need more exercise/ conditioning before attempting to engage in such activities. This is usually the case for those who spend a lot of their time sitting. You can do the following leg exercises at home to strengthen your calves:

1. Lunges. Find a place where you can walk 10 yards doing lunges; switch legs.

2. Squat/knee bend exercises. Even better if you can hold a 10-16 pound medicine ball while doing.

3. While standing (bare feet) go up on the balls of your feet, hold one second and go back down; repeat 20 times and hold the last three (on the balls of your feet) for 20 seconds each.

4. Calf stretch. Stand two feet in front of a wall, put one leg back, bend the other. Keep the bottoms of both feet touching the ground (don’t let your heel come off the floor). Bend your front leg; keep your rear leg straight and keep bending until you can tolerate the maximum stretch to your rear leg. Hold for 10 seconds; release. Repeat five times.

The Top 5 Best Calf Exercises (projectswole.com)
Study: High heels may alter anatomy of calves (abclocal.go.com)