When Is Back Pain More Than Back Pain?

Your First Chiropractic Office Visit

Your chiropractor's purpose on your first office visit is to make sure you're in the right place. He or she wants to make certain your back pain really is back pain - and treatable - rather than being a symptom of an underlying medical condition. Your chiropractor will take a complete history, learning the facts about your problem. How long you've had the pain, the nature and quality of the pain itself, whether the pain is localized or radiating, and whether the pain wakes you up at night are key elements in solving the puzzle. Following the history, your chiropractor will perform a complete orthopedic and neurologic exam, gathering all the information necessary to arrive at what's called a "working diagnosis". If your chiropractor concludes that treatment is appropriate, she will outline the anticipated stages of improvement and recovery, noting that further evaluation will be done if you're not getting better in a timely manner.

Out of the blue, your back starts to hurt. At first, it's just an annoyance. You can live with it. You've had lower back pain before and it went away on its own.

Now it's a few weeks later. You've got a low-grade pain that's not getting any better. You're actually worse, in fact, because your back hurts most of the time.

What to do?

You don't want to run to a doctor. After all, it's just back pain. Everybody has back pain. So you begin to solicit advice from your friends. And, of course, your friends have plenty of advice. "Do these exercises my doctor gave me." "Do these stretches - they worked for me." "Go to yoga class." "I know a great Pilates instructor. She'll get you in shape and your back will stop hurting." "Take vitamins and drink more water." "Meditate."

Your friends mean well and it's all very good advice. But none of it seems to work. Another month goes by and now the pain is increasing. It's even affecting your sleep.

It's time to see a doctor. But which one? For the most part, medical physicians are not experts on back pain. Typical recommendations include rest, moist heat, and anti-inflammatory medication.^1,2 But, really, you've done all that. You need more specific advice.

Choices might include doctors of chiropractic, orthopedic surgeons, and physical therapists.

Many orthopedic surgeons are spinal specialists, but what they do is surgery. This would be a last resort, typically, after other treatment options have failed.

Physical therapists are highly skilled practitioners who focus on exercise, rehabilitation, and re-training. They are not primary care providers, and typically patients are referred to physical therapists by family physicians, chiropractors, and orthopedic surgeons.

Doctors of chiropractic are spinal specialists, too, and what chiropractors have to offer is expert conservative therapy.³ Chiropractors treat back-related problems all day, every day, and are the right doctor to see first.

As spinal specialists, chiropractors receive extensive training in evaluating patients with back pain. Chiropractors consider all aspects of the problem, and develop sound treatment plans based on the facts. If a person does not respond as anticipated, their chiropractor has a "Plan B" in place for further evaluation and possible referral.

When choosing a doctor, you're allowed to ask questions and participate in the process. The strategy for follow-up is critically important.

First, if you're improving and doing well, how will can you help keep the problem from recurring? Will your chiropractor prescribe stretches, exercises, and other self-care action steps to help you keep yourself well?

And, what steps will be taken if your problem and pain are not improving? Where might you be referred for further tests and evaluation? Chiropractic treatment is a powerful tool in most cases of back pain. Symptoms should begin to improve quickly. Have your chiropractor outline the "Plan B" if you are, in fact, not getting better.

Your doctor of chiropractic will be able to answer these questions.
http://www.lakewoodchiropracticjax.com/

¹Zuhosky JP, et al: Industrial medicine and acute musculoskeletal rehabilitation. Arch Phys Med Rehabil 88(3 Suppl 1):S34-39, 2007.
²Cayea D, et al: Chronic low back pain in older adults. What physicians know, what they think they know, and what they should be taught. J Am Geriatr Soc 54(11):1772-1777, 2006.
³DeVocht JW: History and overview of theories and methods of chiropractic. Clin Orthop Relat Res 444:243-249, 2006.

Pregnancy, Parenting, and Lower Back Pain

How to Pick Up Your Kids

We're not talking minivan here. Moms and Dads spend a lot of time bending and lifting. We want to do this right, as much as possible, and not have a lot of down time while our injured back is healing. First, get as close to your child as possible. You want to have your arms right next to your body, not extended in front of you. Next, always bend your knees. Never bend over with straight legs. Next, suck in your stomach muscles. When you activate your abdominal muscles, you're taking a lot of potential strain off the lower back muscles. Your abdominal muscles are designed to carry the weight. Finally, straighten your legs, continuing to activate your stomach muscles, holding your child close to you. With a little practice, safe lifting will become a habit.

You're pregnant! Congratulations! Your body's changing-wondrously, marvelously. One unexpected and unwelcome change may be lower back pain. Recent studies suggest that two-thirds of pregnant women experience lower back pain.¹

These statistics seem reasonable. The weight of the growing baby, plus the weight of the placenta and amniotic fluid, create an unbalanced load in front of the lower back. The  result is irritation of spinal ligaments, muscles, and tendons, causing pain, muscle spasm, and loss of mobility.

Of course, some cases of pregnancy-related back pain have specific medical causes. Uncommon conditions such as pregnancy-associated osteoporosis, septic arthritis, and inflammatory arthritis may need to be considered.²

That said, the vast majority of cases of back pain in pregnancy are mechanical in origin.

Your doctor of chiropractic will perform a complete examination and determine the correct course of treatment, if appropriate. Once you're feeling better, you can begin

stretching and doing safe, gentle exercises that will help prevent recurrences of lower back pain. The goal is to strengthen your lower back and minimize the mechanical effects of pregnancy.

The best method of preventing back pain in the first place is being fit. This includes healthy nutrition, gaining a moderate amount of weight, and regular exercise. Your obstetrician will likely recommend vitamin and iron supplements and will monitor your weight. The average healthy woman gains between 25 and 35 pounds during the course of her pregnancy.³

Let's fast forward a few years. Your newborn is now a toddler. Parents know that if you have kids, stuff happens. You bend over to place a bulky car seat in your car. Then you place your child in it. And then, you bend over to remove the car seat from your car. If you've gone to the mall, kids want Daddy or Mommy to carry them. Pick them up, cart them around, put them down again.

What's a parent to do? It's not like you can avoid any of these activities. Your kids are kids - it's up to you to do stuff for them. The answer lies in regular exercise. "But how will I find time to exercise, when there already isn't enough time to do the things I need to do?"
That's a tough question, but if you recognize the benefits, you'll make the effort to make the time. Forty-five minutes or an hour per workout, three or four times a week, will be plenty. And, once you're in the habit of exercising, you'll notice it's easier to lift your kids, easier to bend over, easier to carry them. It's easier because you're

fitter and stronger. And healthier. And, surprisingly, you're having more fun.
http://www.lakewoodchiropracticjax.com/
¹Pennick VE, Young G: Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 18(2):CD001139, 2007.
²Sax TW, Rosenbaum RB: Neuromuscular disorders in pregnancy. Muscle Nerve 34(5):559-571, 2006.
³Jain NJ, et al: Maternal obesity: can pregnancy weight gain modify risk of selected adverse pregnancy outcomes? Am J Perinatol 24(5):291-298, 2007.

Is There Light at the End of the Carpal Tunnel?

Dr. Steven Warfield

Carpal Tunnel Syndrome (CTS) is another debilitating malaise of the modern age.   The condition wasn’t even reported until the late 1880’s and the first surgery performed to correct it wasn’t until 1933.  This repetitive stress injury which was literally borne of the industrial revolution is still alive and well in today’s technological age.  Literally anyone who uses a computer, hand tools or works on an assembly line can succumb to this painful condition.  Studies have also linked CTS to everything from rheumatism and arthritis, to diabetes, hypothyroidism, menopause and pregnancy.

While the causes of the affliction are many, the underlying problem centers on the bones of the wrist (named carpals) which form a tunnel through which the median nerve travels from the forearm to the hand.  Carpal Tunnel Syndrome is any injury pertaining to this area of the body.  While most people who have CTS only experience it in one wrist, some people have both wrists involved. 

Everyone from hairstylists and dental hygenists to electricians, roofers, golfers and tennis players can experience Carpal Tunnel Syndrome.

Caused predominantly by repetitive tasks (such as using a computer keyboard or mouse), symptoms can

English: Carpal Tunnel Syndrome. Animated explanation. (Photo credit: Wikipedia)

 include everything from pain or numbness in the index, middle finger and thumb, to tingling in the hand or pain that radiates from the wrist to the arm.  It can also cause sufferers to lose fine muscle control in their hands, causing them to have problems gripping objects.  Once CTS takes hold, the condition can be further aggravated by continuing the repetitive motions that caused it in the first place.  This in turn causes swelling in the tendons of the wrist which then pinch the nerve in the carpal tunnel.  While many people combat the discomfort of CTS with pain killers, if left untreated the syndrome can become so acute that surgical intervention can be the only solution.

Signs of CTS:

1.      Being awakened in the dead of night by painful tingling in the hands.

2.      Daytime tingling in the hands.

3.      Inability to hold objects.

4.      Loss of strength in the hands or thumbs.

5.      Shooting pain radiating from the hand up the arm.

Can Chiropractic Care Cure CTS?

Any chiropractic treatment for CTS will be based on the severity of the condition.  Along with adjustment and manipulation of the hand, wrist and forearm, chiropractic treatment for CTS can also 

A rigid splint can keep the wrist straight. (Photo credit: Wikipedia)

include joint and soft tissue manipulation of the shoulder and neck along with a regimen of exercises of the neck, arm and hand.  (Arm, wrist and finger stretches before beginning repetitive tasks are highly recommended.)  Your chiropractor can also recommend dietary supplements and vitamins that are known to reduce inflammation. Massaging the area and putting ice on your wrist may also help alleviate the symptoms.  Immobilization of the affected wrist(s) may also be recommended while you sleep.

Women are more than twice as likely to develop CTS as men.  People in their 30’s, 40’s, 50’s and 60’s are most vulnerable to contracting CTS.

Most importantly, your chiropractor can also help you modify your environment to minimize the factors that tend to aggravate the condition.  If your computer keyboard or mouse is to blame, there are modifications that can be made to your system, including a padded wrist rest or an adjustable keyboard table.

Above all, the most important factor to seeing the light at the end of the Carpal Tunnel is to take corrective action and seek treatment before the condition completely derails your active lifestyle. 

  Dr.’s Steven Warfield and Dave Edenfield offer the most advanced treatments for back pain, sciatica, neck pain, whiplash and headaches. They also treat auto accident victims with state-of-the-art technologies.  For more information visit http://endyourpain.org or http://chiropractic-jacksonville-fl.com

Are You Suffering from Smartphone Slump?

By Dr. Dave Edenfield

You see them every day, walking with head down, oblivious to the world around them.  Or you spy them sitting in their cars at stoplights leaning forward as they frantically try to compose themselves before the light changes.  I’m not talking about road rage here.  I’m talking about texting.  While gen xers are particularly prone to partake in this practice on a nearly manic level, I have seen my fair share of baby boomers who have adopted what I have come to refer to as the Smartphone Slump.

While some of the habits of this practice are obvious, others are not. A spin-off of a topic I covered in an earlier blog that detailed the occupational hazard that every man, woman and child is subjected to as we surf the web.

“If you spend a significant portion of your day staring at a computer screen, this is known to lead to forward head and shoulder posture which can cause pinched nerves and degenerative disc disease.  If your monitor sits flat atop your desk, this necessitates that you lean your head forward to read the screen.  Doing this day in and day out sets up a domino effect of sorts caused in part by the pull of gravity on your head.    This head down posture puts strain on the vertebrae of the lower neck, which in turn causes the muscles of the upper back to work overtime in order to compensate.  Over time, the lower cervical vertebrae may slide forward, further curving the spine until sufferers of this syndrome begin to suffer neck pain, tingling or loss o

f feeling in the fingers and persistent muscle ache as the muscles and tendons become tight.” 

http://eliminatepainnow.blogspot.com/2013/06/occupational-hazards-may-be-at-roof-of.html

Smartphone Slump can also be the initiator for head forward posture, which is an unhealthy forward curvature of the neck and shoulders that makes those afflicted seem far older than their age.  Worse still, if left unchecked, this self-inflicted condition can result in much more than poor posture.  Over time everything from loss of balance to nerve damage.  Some sufferers get to the point where it is difficult to keep their chins from coming to rest on their chests.  As a result, everything from neck pain to a loss of mobility can result.  This makes everyday tasks like walking and driving not only arduous, but hazardous.

To determine if you have Smartphone Slump do the following:

1.      Put down the phone.

2.      Stand with your back flat against the wall.

3.      Note whether the back of your head is touching the wall.

If your head does not touch the wall without forcing it to do so you most definitely have Smartphone Slump.  That is the bad news.  Over time your neck muscles have weakened from repeatedly maintaining a head down posture such as that necessary to text.  (People with head forward posture find it extremely difficult if not painful to straighten their neck so that the back of the head touches the wall.) 

The good news is that this is an easily treatable condition.  If you suspect that you or any one you know suffers from this condition, tell them to consult a chiropractor right away.  Not only can a chiropractor correct this problem, they can also show sufferers a number of exercises that are designed to alleviate the muscle strain that this condition can cause before it leads to more serious problems down the road.

There are also a number of exercises that you can perform for a few minutes every day that can help stretch the muscles that become overworked and tight as a result of prolonged periods slumped either in front of a desk or a smartphone.  Below are several that can help correct the situation if done regularly.

  

Corner Stretch

A basic exercise that is important for stretching the chest and shoulder muscles is the corner stretch. It is performed in the corner of a room.

This neck stretch is done as follows:

·         Patients stand approximately two feet back from the corner, facing into the corner.

·         Feet should be together.

·         Forearms are placed on each wall, and elbows are a little below shoulder height (Figure 1).

·         Lean in as far as possible without pain. Patients will feel a stretch in the front of the shoulders and chest (Figure 2).

·         Hold the stretch for about 30 seconds to a minute.

http://www.spine-health.com/conditions/neck-pain/neck-stretches

The Slouch Overcorrect Procedure

 This exercise helps you find your correct sitting posture. 

      1.   Slouch completely

·           2.   Sit up and accentuate your lumbar lordosis as far as possible. (Hold this posture for a few seconds.)

·          3 Release the strain.

http://www.drsarasolomon.com/oxygen-magazine-blog-if-you-are-slouched-in-your-chair-then-sit-up-straight-and-read-this-by-dr-sara-solomon/

While we are all forced to deal with the demands of an ever more wired world, remember that when it comes to your health, the human body is decidedly old school.

Dr. Dave Edenfield  and Dr. Steven Warfield are part of the team of doctors and therapists at http://chiropractic-jacksonville-fl.com and http://endyourpain.org who are dedicated to helping you and your family lead  healthier, happier and pain-free lives. 

Can Laser Therapy Help Alleviate Arthritis Pain?

by Dr. Dave Edenfield

Arthritis is a painful, prevalent condition that afflicts millions every year. According to the Center for Disease Control (CDC), rhematoid and osteoarthritis, in particular, affects nearly 14 percent of adults age 25 and over. Symptoms are wide ranging. Pain associated with resulting limited mobility is often debilitating, as well. Evidence indicates laser therapy may provide significant relief.

What’s the difference?

Although certain types of arthritis manifest very similar symptoms, their underlying causes may be very different. For example, osteoarthritis and rheumatoid arthritis both result in painful joint and limb stiffness; one originates from mechanical degenerative causes while the other is an affliction of the autoimmune system, however. Other types such as infectious or hemorrhagic conditions stem from site bacteria or bleeding. According to the U.S. National Library of Medicine, laser therapy helps reduce pain and improves site flexibility for patients with rheumatoid arthritis. Therapeutic lasers did not elicit similar results for osteoarthritis.   Reports do indicate positive effects for patients with milder forms of the condition. <http://www.jrheum.com/abstracts/abstracts00/1961.html>.

How does it work?

When you get hurt or feel pain, celling signaling is partly responsible for telling your brain “what’s what.” Neurotransmitters deliver pain messages. Think of them as a kind of “mailman”; synapses are the roadway the mailman drives along. Laser therapy works <http://www.chiroeco.com/chiropractic/news/14600/1/article/> by exciting these biochemical responses. Of course, your body already does this without laser therapy; processes stunted by injury, however, may not affect cell signaling properly diminishing a person’s ability to heal. Laser treatments give the body an added healing edge, so to speak. Pain from extreme site immobility, for example, is sometimes the result of inflammation; a naturally occurring autoimmune response to illness or injury. In some cases, inflammation can go awry perpetuating further strain or injury and so forth. Arthritic patients often experience perpetuating symptoms under such conditions. Energy emitted from lasers excite mechanisms that drive the metabolism and nervous system that remedy illness. It results in increased hormone, cell and neurotransmitter production.

What’s the “buzz?”

In the future, laser therapy will allow for more personalized, individual attention to specific needs. Rather than a simply randomized effect on problematic tissue, scientists will soon have the ability to isolate or “tweeze” individualistic cells. This will allow practitioners to more effectively deal with a host of rheumatoid disease and subsequent effects.

Dr. Dave Edenfield is part of the team of doctors and therapists athttp://lakewoodchiropracticjax.com who are dedicated to helping you and your family lead a healthier, happier and pain-free life.

Chiropractic Treatment of Lower Back Pain

By Dr. Steven Warfield

Nobody likes to go through a day, let alone a lifetime with chronic pain, especially spinal pain. Yet there are few of us who will go through a lifetime without experiencing back pain, either from muscle strain or due to a sports injury or an accident.  The important thing to understand when you do encounter back pain is that you are not alone.  Nearly 22 million Americans visit chiropractors annually. Of these, 7.7 million are seeking relief from back pain. 

When someone injures their back, the first response is usually either an over the counter or prescription pain killer.  While this may make the pain go away temporarily, this does nothing to address the underlying cause of the problem.  While many people are reluctant to seek medical help, avoiding treat

Pain Research & Management (Photo credit: Wikipedia)

ment can not only cause the injury to become more chronic over time, but there is also the problem of drug dependence which can lead to problems of its own.

Research has shown that pain caused by tissue inflammation often does not surface for several days or even weeks following an accident. Additionally, it is not uncommon for either muscle groups or bone position to be radically altered following an accident, where pain does not present itself for as long as several months. A spinal vertebra that is out of place may even place pressure on the surrounding nerves and in so doing mask trauma which will later manifest as chronic pain.

While I can understand the public’s aversion to surgical intervention, chiropractic is a health care profession dedicated to the non-surgical treatment of disorders of the nervous system and/or musculoskeletal system.  Chiropractors use hands-on spinal manipulation and other alternative treatments that are designed to help the body heal itself without surgical intervention or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress, such as sitting without proper back support.  Other treatments can include the use of ultrasound, electro-stimulation and even therapeutic lasers, all of which can be used to reduce back pain and inflammation.

More importantly, not only do chiropractors offer treatment designed to bring the body back into balance, but they also offer lifestyle enhancing regimens such as:

·         Exercise. Various cardiovascular, stretching and strengthening exercises may be prescribed by chiropractors to decrease lower back pain, increase strength and restore range of motion.  Chiropractors may also have patients do exercises that strengthen weak and under or overstimulated muscles of the trunk and pelvis.

·         Ergonomics. During the course of chiropractic care, the chiropractor may recommend some procedures that can be employed at home or at work. It isn’t uncommon for a chiropractor to uncover an occupational hazard as the underlying cause of a patient’s pain.  Modification of an activity or appliance can sometimes relieve the problem and lead to a complete recovery.

·          Patient education. After consulting with a patient, a chiropractor may advise a variety of lifestyle modifications, including diet and nutritional programs, self-care and coping strategies that could be of great value to a patient experiencing lower back pain.

The important thing to note is that the healing process can start with a simple call to arrange a free consultation with a licensed and qualified chiropractor.  The evaluation will not only begin the process that can help alleviate pain without the use of medication, but it will also help you get your body back in balance so that you can get on with your life.  And that’s the most precious gift of all.

Dr.’s Steven Warfield and Dr. Dave Edenfield offer the most advanced treatments for back pain, sciatica, neck pain, whiplash and headaches. They also treat auto accident victims with state-of-the-art technologies.
If you or anyone you know suffers from herniated discs, degenerative discs or spinal stenosis,  visit http://www.lakewoodchiropracticjax.com/

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