Back Pain is No Joke

Back pain slowing you down from playing with your kids? Or doing your regular workouts? Or doing any outdoor activities?

Here are some causes of back pain:

• Joint Inflammation- facet joint pain can cause a lot of discomfort when bending backwards or to the side. This inflammation is seen from arthritis and other bone conditions or quick and awkward movements. This pain does not radiate (travel) down the legs, it stays pretty localized. 

• Bone- the pain can be coming directly from the vertebrae themselves. The vertebrae are the bones that make up your spine. These bones are like any other bone in your body. Meaning they can also have some of the same conditions like a fracture or bone disease. Bone diseases can be seen with a X-ray, DEXA scan or blood test. 

• Osteoarthritis (OA)- what typically causes this is overuse of the joint from over the years or repetetive movements. OA can have the some of the same symptoms as joint pain. Most people report that they wake up in the morning with a stiff back. If this condition gets worse, it can lead to more serious conditions like spinal canal stenosis where the spinal cord and nerves are affected. 

• Nerve Root Compression- when most people think of this condition, they think of "sciatica." The sciatic nerve is one of the many nerves thats in your low back, however its not the only nerve. Nerve root compression is when one or more of the nerves in your spine is being pressed on. Most people report the sensation as an electric type of pain. A few conditions can lead to the nerve root compression, but one of the most common ones is a disc herniation. 

• Disc- The disc is the squishy substance between your vertebrae. It helps the spine and gives it support. I like using the donut analogy. The disc resembels the jelly. When you squeeze the donut, the jelly comes out from the sides. Now when theres too much pressure on the spine, smilar thing can happen with the disc. It can be pushed at different angles. This can be caused from a variety of things like a car accident, falling off of a ladder, or a football tackle. When the disc is compressed it can put pressure on the nerves  which can give you sharp, shooting, radiating pain going down your buttock and possibly leg. This condition can also cause numbness, weakness and tingling sensation of the legs and feet. 

• Systemic- There are lots of organs around your spine including the ones in the pelvis and stomach which can all refer to your low back. Some of these organs include: pancreas, appendix, ovaries and or kidneys. 

• Muscle & Ligament- This is by far one of the most common reasons of low back pain that we see in our office. The cause can be as simple as you picking up your child from their bed, or getting the grocery bags from the car, or cutting the grass. The muscles and ligament can get hurt by a sudden movement where the muscles are tight. Your ligaments help support the bones and joints by controlling the movements and stability to where they attach to. Your muscles support your spine by staying tight so that the joint doesnt have to work as hard. A big issue we see in our office is a weak core. Most people have a tendency to rely on their back to do all the heavy work. But in reality we need to focus on our core and buttocks and legs to take pressure off of our low back. 

Here are some exercises that we like:

• Cat/Cow: get on all fours (hands and knees), make sure your hands are directly under your shoulder and your knees are under your hips. Point your fingers towrads the front of your mat. Place your shins and knees hip-width apart. Center your head in a neutral position and soften your gaze downward. Begin by moving into Cow Pose: Inhale as you drop your belly towards the mat. Lift your chin and chest, and gaze up toward the ceiling. Broaden across your shoulder blades and draw your shoulders away from your ears. Next, move into Cat Pose: As you exhale, draw your belly to your spine and round your back toward the ceiling. The pose should look like a cat stretching its back. Release the crown of your head toward the floor, but don't force your chin to your chest. Inhale, coming back into Cow Pose, and then exhale as you return to Cat Pose.

  • Repeat 5-20 times, and then rest by sitting back on your heels with your torso upright.

• Bridge: Lie on your back with your knees bent and feet on the floor. Extend your arms along the floor, palms flat. Press your feet and arms firmly into the floor. Exhale as you lift your hips toward the ceiling. Draw your tailbone toward your pubic bone, holding your buttocks off the floor. Do not squeeze your glutes or flex your buttocks. Roll your shoulders back and underneath your body. Clasp your hands and extend your arms along the floor beneath your pelvis. Straighten your arms as much as possible, pressing your forearms into the mat. Reach your knuckles toward your heels. Keep your thighs and feet parallel — do not roll to the outer edges of your feet or let your knees drop together. Press your weight evenly across all four corners of both feet. Lengthen your tailbone toward the backs of your knees. Hold for up to one minute. To release, unclasp your hands and place them palms-down alongside your body. Exhale as you slowly roll your spine along the floor, vertebra by vertebra. Allow your knees to drop together.

• Back extension: Lie on your stomach, facedown, arms straight out in front of you, palms down, and legs straight out behind you. Pull your abs in, as if you’re trying to create a small space between your stomach and the floor. Lift your left arm and right leg about one inch off the floor, and stretch out as much as you can. Hold this position for five slow counts and then lower your arm and leg back down. Repeat the same move with your right arm and left leg. Continue alternating sides until you complete the set.

• Opposite arm/opposite leg raises: Primary muscles worked: shoulders, gluteal muscles, hamstrings, and stabilization from abdominals (stomach) and lower back. Starting position: Place both hands and knees on the floor with your arms and thighs parallel to each other and perpendicular to the floor. Your knees should be directly under your hips, and your hands should be directly under your shoulders. Keep your elbows soft, not locked. Your head should be in line with the spine, face toward the floor. Your back should be straight but with your natural arch in the lower back. Action: Lift your right arm and left leg slowly off the floor and extend them straight out, so that your leg, back, and arm are roughly in one line. Slowly return to the starting position. Either repeat the exercise all on one side, then the other, or alternate sides as you go.

  • Tips:

    • Do not allow your abdominals to relax and your back to sag.

    • Do not lift your arm and leg excessively high.

    • Stretch as far as possible from your toes to your fingertips.

• Childs pose: Begin on your hands and knees. Center your breath, and begin to let your thoughts slow down. Turn your awareness inward. Spread your knees wide apart while keeping your big toes touching. Rest your buttocks on your heels. Those with very tight hips can keep their knees and thighs together. Sit up straight and lengthen your spine up through the crown of your head. On an exhalation, bow forward, draping your torso between your thighs. Your heart and chest should rest between or on top of your thighs. Allow your forehead to come to the floor. Keep your arms long and extended, palms facing down. Press back slightly with your hands to keep your buttocks in contact with your heels. Lengthen from your hips to your armpits, and then extend even further through your fingertips. For deeper relaxation, bring your arms back to rest alongside your thighs with your palms facing up. Completely relax your elbows. Let your upper back broaden. Soften and relax your lower back. Allow all tension in your shoulders, arms, and neck to drain away. Keep your gaze drawn inward with your eyes closed. Hold for up to a minute or longer, breathing softly. To release the pose, gently use your hands to walk your torso upright to sit back on your heels.

What we do at our office to help:

• Acupuncture or Dry needling: Depending on the condition, at our office we like to combine acupuncture and dry needling with electrical stimulation. 

  Acupuncture involves the insertion of very thin needles through your skin at strategic points on your body. A key component of traditional Chinese medicine, acupuncture is most commonly used to treat pain. Increasingly, it is being used for overall wellness, including stress management. Traditional Chinese medicine explains acupuncture as a technique for balancing the flow of energy or life force — known as chi or qi (chee) — believed to flow through pathways (meridians) in your body. By inserting needles into specific points along these meridians, acupuncture practitioners believe that your energy flow will re-balance. In contrast, many Western practitioners view the acupuncture points as places to stimulate nerves, muscles and connective tissue. Some believe that this stimulation boosts your body's natural painkillers.

• Graston Therapy: You've seen the crazy metal tools on our social media or website!  The Graston Technique is essentially a type of therapy that uses instruments to assist in the mobilization of soft tissues of the body. It is a very popular technique that gives patients a great deal of relief.

  The Graston Technique works by breaking down scar tissue and fascia restrictions that are created by trauma to the soft tissue. This can be the result of strained muscles or pulled tendons. It also reduces restrictions by elongating connective tissue. This effectively changes the structure of the tissue in order to improve function. Although its not a comfortable treatment, it does release a lot of muscle tension! 

• Myofascial Acoustic Compression Therapy: The source of pain is not always found in the area where the pain seems to be radiating from. This is clinically called referred pain. The distancing of the pain sensation from its source can make treatment more difficult. Diagnosis of referred pain and the recognition of the originating pain triggering points can be accomplished using the PiezoWave. Abnormal musculoskeletal tissue can be “flared” with focused MyACT in order to define the areas that require treatment. This process of defining the origins of pain is guided by the patient through verbal feedback to the healthcare professional providing the treatment. MyACT uses sound waves to break-up any scar tissue buildup. The treatment can be a bit uncomfortable but it doesnt have any lingering discomfort. 

Sources: Mayo Clinic, Ferri's Clinical Advisor, Symptom to Diagnosis