# Category Archives: Back Pain

February, 2012
13

## 5 Preventative Measures For Great Musculoskeletal Health

Achieving optimal musculoskeletal health throughout a lifetime is really hard.  Hopefully this will make it a bit easier.

Have you ever heard the saying: “an ounce of prevention is worth a pound of cure”?

I’m sure you have, but what you may not know is it was Benjamin Franklin who said it.

What Ben probably meant when he said this was the idea that it’s much better to keep a problem from happening then fixing it after it happens.

Makes sense. Something better known as prevention.

“Prevention” literally means to keep something from happening.

When it comes to living healthy, preventative medicine implies the things we do from getting hurt.

But what if we are talking about musculoskeletal health, like avoiding headaches, neck pain, or back pain?

# What are some preventative measures that you can do to optimize musculoskeletal health?

Great question:

## The following are my top 5 Preventative Measures for great musculoskeletal health.

5) Drink More Water: Aside from the fact that we are made up of (on average) 70% water, see how long it would take to die by going on thirst strike.

Researchers hypothesizes that 3 days is the longest we could go without H2O, before we die of dehydration.

That said, vital bodily relies on water, such as our GI system, respiratory system, and cardiovascular system.

Ideal hydration is suggested at 2 quarts/day, which is about 1.8 liters or 8 cups.

Inflammation in the body signals pain in the body, and by maintaining hydration, you can minimize inflammation, which in turn minimizes pain.

### Drinking adequate amounts of water certainly will optimize musculoskeletal health.

4) Exercise Regularly: By now, everybody should be aware of the health benefits of regular exercise.

Cardiovascular function, respiratory function and stress reduction are all enhanced with physical activity to name but a few.

As well, it helps you achieve ideal body weight thereby minimizing stress on the spine

Minimally, 3 days/week for 30 minutes of brisk continual activity like walking, swimming, or cycling, along with a weight training routine. Do this and watch your musculoskeletal sore to new heights.

Please consult with a physician before beginning.

3) Postural Awareness: The repetitive stressors we are under daily, such as time spent sitting in front of a computer, or while relaxing and sleeping, wreck havoc on our bodies.

Learning how to correct your posture, can be a really ease fix. Yoga classes are wonderful resources, provided that the instructor is first rate.

In the very least, be aware of your posture with the activities you do the longest, and try to correct your posture as if you were being graded on it. Once you are conscious about your posture, musculoskeletal health will be maximized.

2) Flexibility: An elastic that looses its ability to stretch, not only looses its strength, but it also is more likely to crack or break.

Our muscles and joints are very similar.

If you loose the ability to lengthen your muscles when performing basic life requirements, like picking up groceries, bending over to do up a lace, walk down/up a flight of stairs, or getting in and out of your car, the more likely you will injure your own internal elastics…that is your muscles.

Stretches should be held for a steady 30sec count, with no bouncing. A position of comfort should be felt, with the slightest of manageable tension held throughout the stretch.

#### Flexibility and musculoskeletal health go hand in hand.

1) Core-Strength: Once a buzzword in the world of exercise, core-strenght or core training is an integral part of the exercise routine for those in the know.

The abdominal musculature, complete with the transverse muscles, obliques, and lower abdominal stabilizers such as the pelvic floor muscles, all comprise of the core.

If we can stimulate these muscles “functionally” with compound, advanced movements, we will carve out a solid foundation to which the spinal column is built from.

All in all, these 5 Preventative Measures can be incorporated into your daily routine, helping you achieve great musculoskeletal health.

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August, 2011
12

## Back Pain Stretches To Do At Home, (Video)…That you don’t have to pay for

I think that the whole idea of back pain stretches are  totally UNDERRATED!

I say this because I know from first hand experience I see in  private practice with many of my own patients. When I ask my patients if they do any stretches for back pain, most say they do now and then” or from “time to time”.

That’s Great.

So when I ask them to show me what back pain stretches precisely it is that they do from “time to time” or every “now and then”, the majority of their responses are not even close to what they SHOULD be doing.

I wish I could videotape some of the things that they are doing, or “attempting” to do.

From swaying back and forth, bouncing up and down, knees bent, too much stress being placed unintentionally on the already painful back and neck, not to mention how short each stretch or “whatchamacallit” is held.

On top of that, if done properly. If done effectively, learning how to go through a focused back pain stretching routine, that you can easily do in a confined space, like your office area, or better yet, a comfortable area in your home (more on that later) can be a valuable tool for reducing and eliminating your aches and pain.

Let me clarify that. IF you suffer from everyday aches and pain, you WANT to learn such a focused, easy to do, back pain stretches or stretching routine like that.

I tell my patients how important taking as little as 8-10 minutes out of their everyday schedule just to do back pain stretches, really can be. I tell them this because out of the 24 hours that that they have in a day, familiar, repetitive, and consistent stressors are placed on your body throughout the entire 24 hours.

These repetitive stressors ultimately create wear and tear on your joints.  And, If done long enough, breakdown will occur.  Worse, if the wear and tear is not addressed properly, a crisis WILL occur too. Thats why back pain stretches are so important

If this happens (and I’m talking from first hand experience myself),  A LOT of pain, suffering, and heartache will occur as well (you know what I mean, if you know what I mean). So, it is vitally important YOU, learn the proper back pain stretches

Examples of these consistent everyday stressors are things like being in the office with that chair you sit in anywhere between 5-8 hours (or longer a day, 5 days a week) with only a couple of breaks thrown in. What about your bed? Do  you sleep 100% comfortably in it all night?

Laying down relaxing on your sofa, couch, or lazy boy chair, hopefully is a comfortable and relaxing activity. IF NOT, all your daily stressors have overcome your lower back, middle, and neck’s ability to handle the positions they are put into.

When our lower back, middle back,  and neck can’t handle the positions they are in, muscles in the back contract. Again. back pain stretches can overcome this problem

Then, as the proverb goes, these daily stressors ARE  the straw that breaks the camels back.

RESULT=BREAKDOWN

So what can we do to fight back pain?

# Well, try doing some back pain stretches

That’s ONLY IF you stretch the proper areas in your lower back, middle back, and necks, in the proper ways.

When I injured my own back recently, thankfully I was familiar with the proper back pain  stretches that I could do to help with my back pain.  These stretches are effective, and considered proper because they focus on addressing problems that are going on in your lower back.

## Back pain Stretches Video:

The Following Video is an example of a  brief, easy to do, “focused” stretching routine for lower back pain. You can easily do these in a confined space, like your office area, or better yet, a comfortable area in your home.

Like I said earlier, stretching can be a valuable tool for reducing and eliminating your aches and pain in your neck, middle back or thoracic , and lower back.

Check it out:

A Couple of really important points that I want to go over when it comes to back pain stretches

With lower back pain, their are a couple of structures in your lower back that can actually cause the pain. I call it the lower back pain “triad”. If you so happen to also have pain in the neck as well as the back, you may want to check out this post I did on neck and back pain, are they related?

### What exactly is back pain stretches trying to do?

1) The lumbar spine itself: The spine, has several “pain sensitive” structures in it that when irritated and/or stimulated, will cause pain.

These structures are:

a) the intervertebral disc that act as shock absorbers, and have nerves that sense excess pressure stretch/pressure to these disc especially when their is trauma, repetitive stress, really crappy postures maintained through out the entire day. The pain results when the discs have abnormal pressures.

b) the joints of the spinal column. These joints are called facet joints and look like the picture seen here. when you bend forward, they open up, and when you bend backwards they compress and come close together. Not much rotation or turning sideways can actually occur in these joints in the lumbar sine.

As well, some sideways bending can occur in these joints. Pain accompanies the disc compression mentioned above typically, as when the discs are compressed, so to are the joints, creating rubbing and grinding.

C) The muscles, tendons, ligaments, and capsule holding everything together. As you can imagine, when breakdown occurs, compression of the discs occur, compression of the facets occur, abnormal pressure follows.

Stretching of ligaments occurs also, creating muscle contractions in unequal amounts in different muscles groups from side to side happens too. Day in day out.   Pain Result. Hence, proper back pain stretches fix this hazard

All the above spinal structures that we talked about, that produce pain, can be aided with the properly guided stretches.

The last 2 additional areas that make up the back pain triad, is the pelvis/sacrum, and the hips.

1) Pelvic/Sacral dysfunction: Like the spinal column, the pelvic and a sacrum are osseous/bony structures that provide support to our erect posture, but the also must accommodate weight bearing and movement. With wear and tear, comes breakdown. Because so many of our lower extremity muscles anchor to the pelvis and sacrum, we can really address these problems with focused stretches.

2) The hip joints are weight bearing, and indirectly are affected with lower back pain. Because the hip joint also has some of the same nerve fibers going to it that exit from the spinal column, many pains are “referred” back and forth. Once again, the proper guided stretches can really help as well.

I hope you enjoyed this post on back pain strethes.

Till next time, I got your back.

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August, 2011
4

## A Day In The Life Of A Chiropractor Who Suffers With Back Pain

I actually am not suffering with “back pain” right now. To be more accurate, I would better describe it as numbness and tinging down the outside of my right buttocks, down the outside of the calf, and into the outside of my right foot and toes.

Not so much “back pain” per se, but a pain in the ass nonetheless.

Back pain sucks, quite honestly.

The numbness hasn’t been there for that long, and the “back pain” was INTENSE when I first injured it 18 years ago (when I was 23 years old), and re-injured again this past December.

It’s quite an ironic story actually.

I had just graduated from university with a degree in exercise physiology, looking to take on the world, but not exactly sure what I wanted to do for my career, and with my degree.

What I did know was that I loved to exercise, especially at a gym, as I started at an early age of 15. So I decided what better job then become a personal trainer in a really cool health club. Besides, they had a great benefit package(s) for a 23 year old.

Things were going great, for about a year or so.  Then, I injured it trying to follow a bodybuilding routing out of a flex magazine. Vince Taylor’s back routine (to be exact). Straight bar bent over rows, and I think I tried to put 3 plates of 25.lbs on either side.

Then…Boom, it happened. It felt like a duck being shot out of the sky. An intense pain similar to what it would feel like to have a a gun shot piercing into the middle of your lower back. Killer back pain

Here I was supposed to be the “expert” with a college degree, combined with a really huge passion for helping people through exercise, and I go ahead and injure it MYSELF.

But life is funny, and like the saying from Napolean Hill goes: “Every adversity you meet carries with it a seed of equivalent or greater benefit”. It was the INJURY that I realized what I wanted to do with my life.

As a trainer, I had passion for helping people through exercise. But when it came to rehabbing an injured client, I felt that I wasn’t able to help in the capacity I wanted to. Not until injuring my own back, and learning how to rehab my own back, did I realize what my passion is for life.

Fast forward 18 years. Add to my education another bachelor degree in psychology, and a Doctorate in Chiropractic, and 10 years of private practice.

I now have a busy successful practice in Boca Raton, trying to help my patients lead happy, healthy, and pain-free lives. Patients that suffer with all kinds of pain  (mostly spinal pain).

So what happened?

This post after all is about a “day in the life of a chiropractor who suffers with back pain” isn’t it?

I continue to exercise quite regularly. The sunday before christmas 2010, just passed, I innocently was squatting (just a plate on either side), and on my last rep of 3 sets of 10, with great form…….and GUESS WHAT???

Boom, it happened. It felt like a duck being shot out of the sky. An intense pain similar to what it would feel like to have a a gun shot piercing into the middle of your lower back (I actually just cut and pasted that whole sentence…only 18 years later). Killer back pain again.

The pain was the most intense pain that I ever felt. I mean an 11 out of 10, with 10 being having your arm cut off by heavy machinery. I am not a big pain pill guy, in fact, I rarely if ever in my life time take over the counter medication for any pain. But with this injury, I needed a prescription, just so I could function.

## How long does this type of back pain last for?

The pain was intense for at least 6 to about 8 weeks. But I continued to run my practice (lying down in my office on my back, with my knees bent) between seeing patients.

Then I had an MRI in the beginning of January 2011.

It was bad, I showed a large sized disc herniation (2.3cm) at the level of L5-S1, which caused mass effect on the right S1 root. I also had a L3-4 small left herniation, and a small left sided herniation at L1-2

It wasn’t long after that that my right foot become numb. I’d say by the middle of January. Then the left foot began getting numb. But stubborn I am, and I came up with my plan for my back pain recovery.

### What to do when you suffer with back pain

Being spinal rehab specialist, I have a couple of advantage.  For one, I have a rehab clinic. It helps to have a place to do the treatment. Number 2, I have the specialized equipment and know-how.

Only one problem. I don’t have me. Ask most chiropractors, and they’ll tell you, “If I only had a me” . It makes me laugh a bit, because we know exactly what to do, but we don’t always get an “us” to do it.

Lucky for me, I have the spinal decompression table. If you would like to know more about spinal decompression, especially  spinal decompression in Boca Raton click here.

That decompression table saved my life (along with my own self formulated ”get my back better” manual of exercises and stretch). I will share what stretches and movements you can do for your own injury, and reduce back pain.

I took all of January, February, and March off exercixing. Feeling like you have to get out of the car every five minutes because of the pain, or squatting in line at starbucks like you have to go number two in the wilderness, will both motivate you enough to rest.

Come April 1st, 2011,  I began training again at the gym. My left foot numbness went away, and my right foot was getting better and better. This went on for three solild months. Until the end of July 2011.

Then it happened once again. This time, I’m not going to cut and past as it wasn’t that bad to give it a “BOOM”. I’d probably give it more of an “ouch”.

My back flaired up again, and my right buttocks, outside of the leg and foot came back.

And so it is with your typical back pain sufferer. I am a big believer that once you injure your back once, you are more likely to re-injure it again. Its

But it is my mission to continually get better every day, and teach all my readers what they can do, on their own, naturally, through proper nutrition, proper spinal hygene, and an effective home-based exercise and stretching routine.

So, until my next post,

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Posted in Back Pain | 6 Comments
May, 2010
27

## How Does My Neck Pain Relate to My Back Pain? Part 2

In the first installment of our series  “How Does My Neck Pain Relate to My Back Pain”, we discussed that when a problem develops in one area of the spine, then a problem will develop with the functioning of another level of the spine.

We also explained a problem with your neck can affect your back, and your ability to bend pain free, sit pain free, lift pain free, or any other “functional” back problems you may have.

And vice versa, problems with your back, can indeed affect the functioning of your neck.

Talking about this topic I believe is very important, because so many of my patients prior to coming to see me, as well as back or neck pain ridden individuals in general, continue to go on suffering, and never get any lasting relief, because they don’t realize that their problem is coming from a different part of the spine where the actual functional problem is.

I cited a lot of medical reference books and studies that support the idea of the entire spine acting as a singularly related functional unit. Dr. Kabot I mentioned cited that the most common cause of back pain and leg pain was because of herniated discs compressing the cervical spinal cord.

I part 1, I also implied the riskiness of overlooking the role the neck plays in contributing to your lower back suffering. That is, having any aggressive therapies, injections and surgeries aimed at the lower back, may not have any long lasting relief or quality of life improvements, simply because it was not a “back” problem to begin with.

In part 2, I would like to discuss how the neck and back are related anatomically or better yet, how a herniated disc in the neck compressing the cervical spine cord, can result in lower back and leg pain.

Well, Dr. Kabat, a specialist in physical medicine, explains that lower back and leg problems caused by herniations in the neck are a result of impingement upon the long tracts of the cervical spinal cord.

The leg problems that may occur from compression of the long tracts in the cervical spine are as follows: pain, decrease sensation,  abnromal sensation, tingling, numb, and a buzzing or tingling sensation. As well, Dr. Kabot emphasizes that the main complaint may be pain to the lower back and leg, but any combination can occur like lower back and leg, low back alone, or leg pain alone. The leg pain can be one sided, both sided, and sometimes even alternate.

The interesting thing to note as mentioned by Dr. Kabot is the fact that the compression to the cervical spinal cord is from soft tissues (herniated disks) so the complaints, even if intense, are completely reversible by conservative treatment exclusively of the herniated disc, except when the rare occasional of spinal cord damage (myelopathy)

In an oversimplification representation of the spinal cord, when looking at the spinal cord from above (as shown in the yellow above) the cord is often described as a bulls eye.  Well the outer rings of the bull eye target (spinal cord) are responsible for motor and sensory innvervation to the perineium, legs, and lower back. The inner rings of the bulls eye target image of the spinal cord are motor and sensory innervation to the upper extremities.

Central Canal Stenosis, a phenomenom whereby the central canal becomes narrowed, explains why neck herniation compression to the cord results in similar findings.  Notice how with central canal stenosis, the normal canal size is wider then the side with stenosis. Central canal is basically a irrritation to the spinal cord from the outside to the center.  similar to squeezing a sponge. With this image, the squeezing sensation occurs from the outside in.

Thus, central canal stenosis primarily affects the outer rings of the bull eye analogy of the spinal cord.

We said that it was the outer rings of the cord that have the nerve suppy to the perineum (torso), legs, and lower back.  So when central canal stenosis develops, the squeezing of the spinal cord from the outside in, the primary affects will be to the perineum, legs, and lower back.

The most documented impairment when studying central canal stenois was with ”walking intolerance”.

A new study that is consistent with the leg and back problems associated with canal stenosis, and herniated disk compressing the spinal cord in the neck is the “Ten Second Step Test”.

Japanese researchers Dr. Yukawa and colleagues designed a test to measure the severity of cervical compression problems. They named the test the “Ten-second Step Test”. These authors measured the severity, prognosis, and outcomes of patients suffering from cervical compression myelopathy (problems with the cord itself). They did this counting the number of lower extremity steps they could perform in a ten second period of time.

In this study, the patients were told to take a step by lifting their thighs paralled to the floor in the same place without holding onto any object for balance. Then the number of steps in 10 sceonds were counted.

Aside from determining that this test was easy to perform, is sensitive to neurological impairment, and easily reproducible, it was also determined to be useful in assesing the severity of the cervical spine myelopathy.

Worsening of performance on the step test suggested increasing damage to the long tracts of the spinal cord. Again, cervical spine problems adversely affect the lower extremities.

Once again, patients with low back and/or leg pain may have a primary involvement of the cervical spine. When a patient has a back problem, not only should their lower back have an adequate evaluation, but the neck must be properly evaluated as well.

The cervical spine examination should include at a minimum, imaging for cervical canal stenosis, and performance of the “ten-second step test”.

If cervical spine is then determined to determined to be invovled as well, then treatment MUST of course be to the cervical spine.

In part 3, we will discuss the proper protocol for conservative management of the neck.

Till next time, watching your back and neck.

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Posted in Back Pain, Neck Pain, Uncategorized | 4 Comments
May, 2010
15

# I you happen to suffer with neck and back pain, you are going to love this article.

Questions you may ask yourself (if this is you) are:

“If I have neck pain, does that automatically mean I will have back pain too? Or if I already do have neck and back pain, are the two even related”?

If you don’t ask yourself those questions, then those are two excellent questions any back pain sufferer, neck pain sufferer or both, should ask.

I think that they are excellent questions to ask because if they are related, and you happen to suffer with neck and back pain, then the answers may help you solve your own pain, and better yet, help you learn the reasons why you seem unable to lose your neck pain once and for all.

One of the best reference books relating to the anatomy and functioning of the spine ever published is aptly named:

THE SPINE

Edited by two highly renowned doctors, Richard Rothman MD, PhD and Frederick Simeone MD, both were past Professors at Pennsylvania Medical School, Rothman for Orthopedic surgery, and Simeone for Neurosurgery.

In this reference book called “The Spine”, the second chapter is called “Applied Anatomy of the Spine”.

In that chapter, the author basically related how the “23 or 24 individual motor segments”, affect the entire spine.These 23 motor segments being referred to are better known as the bones of the spine and everything else that makes them complete, in terms of joint mechanics and electrical “wiring” (if you will).

The chapter explains how that no:

“Disorder of a single major component of a unit can exist without affecting: a) the function of the other components of the same unit, and b) the functions of the other levels of the spine.

That complex yet simple statement could very well hold a secret as to how neck and back pain are related, and more importantly what we can do about it.

In that quote above, the author is trying to get across two points. Firstly, when a problem develops in one area of the spine, then the spine will have a problem in the same area, but with the other components of the spine.

Seems like common sense actually.

By saying “components of the spine” the author is referring to having a problem with all the aspects of the structure and function of the spine. The bones, the nerves, the joints, the discs, the ligaments, the tendons, the cartilage, and anything else that helps make up the components in that area.

But the second more interesting point of that quote is the fact that when a problem develops with a major component of one unit” in the spine, then a problem will develop with the functioning of “another levels of the spine”

Very interesting finding, indeed.

The main take away idea of that entire quote is the fact that a problem in one component of the spine will affect the other components or “functions” of the same area, and the functions of “other” areas.

So picture this, if you have functional problems in your lower back (one component), like not being able to bend as far as you use to do, not beingas flexible, having pain with sitting, pain with standing, changing positions, and pain with walking, then the problem can very likely be coming from the neck.

Other functional problems that can develop as a result of problems of the neck are the even more familiar activities of daily living, things like washing the dishes, cleaning up around the house, vacuuming, being on the computer,trying to get comfortable while watching television and trying to sleep comfortably.

If you have pain with doing any of these activities, you may be surprised to learn that you problem may very well start from your neck!

As well, similar problems and pains that you have in your neck, not being able to turn very far, pain into the upper shoulders, even weakness into the neck, arms and shoulders allmay be as a result of the components of the lower back.

This idea that the entire spine can act like a singularly related “functioning entity” sounds kind of spooky I realize. Probably even harder to believe, but I assure you that this idea is supported by a vast array of literature, doctors, and references as you shall soon see.

For example, another reference text is entitled “Disorders of the Cervical Spine”

In regards to this references book, the authors tend to be a bit more specific.In this book, Dr. Bland a Professor of Medicine at the University of Vermont College of Medicine, states that “we tend to divide the examination of the spine into the regions: cervical, thoracic, and lumbar spine…this is a mistake”

Dr. Bland goes on to explain why this is a mistake, by stating the cervical spine may “be symptomatic

because of a thoracic or lumbar spine abnormality, and vice versa!”

Over the decades, numerous other publications point to the fact that the cervical spine and its problems can influence movements, perception of pain and the neurology of the lower back.

If you actually just stop to think about it though, the neck and back affecting one another should make complete sense.

The signals that go up and down the spine into the lower back must ultimately pass through the neck to get to the brain. As well, all the information travelling down from the brain to the back, must travel through the neck on its way down to arms, trunk, lower back, and legs in order to make them move (and what not).

Mechanical problems of the neck unfortunately can really “mess” with both the signals originating in the spine going to the brain (called afferents) and the signals originating or being relayed from the brain to the spine ( called motor function).

In 1942 the only neurosurgeon in the Hawaiian Islands during Pearl Harbor was Dr. Ralph Cloward.

Operating endlessly and saving countless lives, Dr. Cloward pioneered numerous diagnostic and spinal surgical techniques.

He published an article entitled “Cervical Diskography” and notes that spinal cord compression by a midline cervical disc protrusion can cause “pain extending down to the feet”.

Several years later, and as early as 1946, Some of the best clinical observations as it relates to the spine comes from Herman Kabat, MD, PhD, published in a book entitled “Low Back and Leg Pain From Herniated Cervical Disc”

Dr Kabat explains that herniated discs in the neck is usually as a result of trauma, but he goes on to say that the compression of the cervical spinal cord by herniated discs in the neck is “the most common cause of low back and leg pain”

The other interesting finding in this presentation of lower back and leg pain as a result of neck herniations is the fact that these symptoms are “indistinguishable from the characteristics symptoms of a herniated lumbar disc”

IF you have ever suffered with lower back pain, and have not been able to find any relief, or very little relief, all of the above findings should be a complete paradigm shift.

A paradigm shift because, while you have been focusing on back exercises, epidurals in the back, physical therapy and chiropractic in the back, and even surgery in the back, they may have been all for not, because the real problem, the real source of your pain, is in the neck.

Dr. Kabat confirms this fact when he suggests that “conservative treatment exclusively of the herniated cervical disc in a large series of cases has routinely produced complete and lasting relief of pain in the low back and leg”

Sometimes too, with herniated discs in the neck, pain in the low back and leg is the only complaint, without experiencing any pain in the neck or arm. When this is the case, it is easy to see how we can miss the true cause of the pain.

So what happens when we miss the true cause of lower back pain, especially if the true cause is coming from the herniated disc material in the neck?

Well for one, doctors often recommend lumbar spine surgery. I know that if that were me, and doctors recommended that I have back surgery to relive my back pain, and the real cause of my back pain was coming from my neck, I certainly would want to know that.

Wouldn’t you?

Well Dr. Kabat found that patients that did not get any relief from back surgery were found to have a herniated cervical disc which was “exclusively responsible for the low back and leg pain”

I know that that statement above in the very least raises several concerns that must be addressed.

Number one, you must be thinking how the two, the neck and lower back, anatomically, actually relate to each other?Better yet, how in fact can a herniated disc in the neck, result in function problems, pain, and problems in the back? Explain it to me.

Number two, if the neck and the compression that occurs there can cause low back pain and leg pain, why have I never heard about it until now? Why is it not included and considered in the management of people like me, people that suffer with lower back pain?

In part two of this series “How does my neck pain relate to my back pain”, I will be discussing the above concerns, and hopefully shed some light on why you keep suffering with lower back and neck pain.

In the last installment, I will give you a simple do at home exercise and stretching program that you can do own your home, to help relieve the compression in your neck, and ultimately live a pain free life.

Till next time, watching your back and neck.

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Posted in Back Pain, Neck Pain | 8 Comments
May, 2010
2

## Three Factors For Losing Neck and Lower Back Pain

Hi there, I am really happy to be writing this post today. Here’s a picture of me and Samuel Dalembert, the starting center for the Philadelphia 76ers in the national basketball association.

For those of you who don’t know about Samuel, he is only the second player from his native Haiti to play in the NBA. Remarkeably, he was drafted 26th in the 2001, with only 6 years of basketball playing prior to that.

He emigrated to Canada at 14 years of age, and it is often noted in his biography that when growing up in Haiti, he didn’t have tennis shoes just to play soccer.

But the really amazing thing about Samuel is all the hard work and dedication he gives back to charitable organizations. He has been actively involved in Basketball without Borders and has had the opportunity to travel to different countries, In August of 2007, Samuel founded his own organization: Dalembertfoundation.org. The primary goal of this program is to bring training in sport and personal values to the underprivileged children in Haiti.

I happened to meet Samuel in a charity 5 k race held in Boca Raton where I live. The race was set up by a foundation supporting healthy kids, and healthy communities, that provides pioneering care and treatment to abused, neglected and abandoned children.

There was Samuel giving his time once again for a good cause.

The funny thing about the race was the fact  that I wasn’t even sure that I was going to run the race at all. I kind of decided at the last minute to do it.

Actually, it was the night before, it was so close to my home,  and it was such a good cause, but the deciding factor was the fact that I exercise regularly and take pretty good care of myself, that I knew if I wanted to do it, I could.

I suffer with neck and back pain often myself, and I have learned that the best way I managed my pain is by keeping very active.

## Three Factors For Losing Neck And Lower Back Pain:

Maintaing Ideal Body Weight: I try to practice what I preach. That means firstly, I try to maintain an ideal body weight. Anyone who suffers with back pain and neck pain of any kind, will have that pain continue if they weigh more then they should.

Just think about all that pressure on your spine, even 5 pounds adds up, but most people are at least 25 pounds overweight (when overweight).

I understand that life happens, and when we are in pain, it is hard to go out and exercise. Just realize it is a catch 22, the more you are in pain, the less you exercise, the more likelihood that the pain will continue as you become deconditioned.

Your responsibility is to yourself, knowing that by exercising it may be uncomfortable in the first place, but once you get past the initial “shock” to your body, you’ll feel less and less pain.

Once you keep going, you will actually feel better, break through the catch 22, and be on the fast track to permanent pain relief.

So what is ideal weight? Well, the old height-weight actuary tables made by insurance companies, are horrible predictors of ideal body weight. So if you are still saying: “I am 5 ft 10 inches, I should weight such and such weight” STOP.

A more accurate way to know your ideal weight is to calculate your BMI. Your Body Mass Index (BMI) is an estimate of your body fat, based on your height and weight.

The higher your BMI, the higher your risk of developing such conditions as heart disease, high blood pressure, sleep apnea, and type 2 diabetes.

Generally accurate, the BMI can read too high for athletes or others with large, heavy muscles. Likewise, it can exaggerate low readings for frail older people who have lost muscle mass.

The formula is a bit complicated:

SI units $eb3738304c6055876b7c857b664ff33f Three Factors For Losing Neck and Lower Back Pain$ $cc56b910547299885857a2ca8a26df6e Three Factors For Losing Neck and Lower Back Pain$ $e433a9db9d837412d605a125d0789af3 Three Factors For Losing Neck and Lower Back Pain$

it is actually easier to go to: http://www.nhlbisupport.com/bmi/bminojs.htm,

Just plug in your numbers and see were you stand. Again, if you have a lot of muscle mass, or are extremely frail, the results will not be completely accurate, but at least you have a ball park measure.

Here are the results for the BMI Categories:

• Underweight = <18.5
• Normal weight = 18.5-24.9
• Overweight = 25-29.9
• Obesity = BMI of 30 or greater

The second suggestion I have to avoid any major flair ups for neck and lower back pain is to maintain a minimal amount of cardiovascular fitness.

For me, I try to run anywhere between 4-7 miles each time I do the treadmill, and I do this 4-5 days per week. Now I know that this is a bit much for some people, but you should be doing kind of cardiovascular activity 3-5 times per week for 20-45 min each time.

Walking, riding a bicycle, jogging, elipitical machines, aerobic classes, getting in the pool, or anything that keeps your heart elevated is great.

By doing cardio exercises consistently, you increase the strength of our heart, you lower blood pressure, cholesterol, body fat, and increase the delivery of oxygen to all your working muscles.

## The 3rd factor for losing neck and lower back pain is regular muscular stimulation

What I mean by this is stimulating your muscles in the following ways: muscular strength, endurace, and flexibility training. All are suggested to avoid any long time suffering on neck and lower back pain.

Circuit training, natural body movements, core strength and conditioning, free weights, machines, and a thourough stretching regime should be employed as well.

If you are already doing all of these, the kudos to you. If however you are lacking in one or more of the above areas, work hard to learn how to do it properly, and how  to improve in that area. Always talk to your doctor before begining any exercise program.

Many programs exist that are specifically designed for severe, extreme, or even more intense then average neck and back pain sufferers, who have some very real limitations and restrictions that must be considered when beginning a program.

One of the programs that I endorse is called lose the back pain. You can find it here:

http://www.losethebackpain.com/aff/index.php?p=jrosen44&w=7DayCure

Till next time, wathcing your back and neck.

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Posted in Back Pain, Neck Pain | | 2 Comments
April, 2010
27

## Achy Back and Neck Pain? 40th Birthday Reflections!

Today, three weeks after I turn 40 years old  I reflect on what feels different.

The particular day itself, I’d have to say It was a great day all around. From the sunday morning I got up at the urging of my 7 year old daughter Zoe, who said daddy come on lets get up a bit earlier then I would have liked. Actually that turned into an awesome day, and hopefully a good omen for the year ahead.

But I wanted to reflect, after all 40 is a big milestone, So what feel’s different?

Well, as it relates to what I write about, neck and back pain, I definitaly feel “older”.

Since I work and help my patients who have all varieties of neck and back pain, as I age, I really feel my neck and back pain too!

Yeah, its true, and I believe it the reason why I write about the topics I  I injured my back almost 17 years ago, and have had to be careful ever since.

But at forty years of age, I am ever more aware of the little aches and pains that I feel. I’ll give you an example, we went out for a nice mexican restaurant the other day. We sat at a table which were the bar stool type chairs.

Ok, these ladies weren’t actually there, but I thought the picture was hilarious, and kind of painted a picture of the back type area.

Anyways, we were sitting at the bar type chairs that had very little back support, and throughout the entire meal, I was thinking not only about how uncomfortable these chairs were, but how bad my back was hurting.

That made me feel “old”. Going out for a nice friday night dinner with friends, and feeling the discomfort of sitting in a god awful chair, just waiting for the evening to end so that I can get some relief when I go home.

Anyone else feel this way?

So the stools were more like this so that you have an idea as to what I was sitting on.

I thought this would make for a great post, because if you are ever in the same situation when you go out to eat at a restaurant, and have a really awful chair, you would know what to do help.

Because there is very little support for your lumbar spine, what happens is that gravity sets in, and has our back go into a rolled up crappy kind of posture.

When it stays like this for too long, muscle fatigue, joint discomfort, and overall misery sets in.

So what is one to do?

In picture A, notice this guy rounding out his back. With that awful bar stool, force yourself to sit like this for a good 30 sec. It is going to hurt, and you might just get flashbacks of trying to sit up in grade school, and if your old enough reading this, it was the same nuns that would put the ruler across the wrist if you didn’t sit up properly, pictured above at the bar.

Then relax in picture B for another 30 sec. Try doing this for 5 more sets. The goal of this exercise is to try and try yourself to maintain a great posture. All to often with back pain, we really way to much on the support provided to us by the chair we sit on, in order to maintain the curve in our spine. Big no no.

Eventually with practice, you will have a really great posture, and you won’t even need a lumbar support.

The great thing is, you are never too old to practice this, and unfortunately, you are going to find yourself in more and more situations where your back and neck really bother you.

What else have I noticed since turning 40, well Zoe told me that “daddy 39 was a little bit old, but forty is really old”

Till next time, watching your back and neck.

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April, 2010
11

## Finally, FDA Warns About Fat Dissolving Injections, The Take Home Lesson About Your Neck and Back Pain

I read an article the other day entitled “FDA Warns Against Fat Dissolving injections”.

Without getting too politically outspoken, I consider that a huge victory for the public, simply because the FDA is not always adament and decisive when it comes to the riskiness of pharmaceutical use, even with thought to be ”safe” medications.

In the article,, the Food and Drug Administration says that the drug Lipodissolve “has not been proven safe and effective”.

It’s not like I really want to split hairs or anything, but  since when has being proven “safe and effective” been a requirement for 100% of the drugs on the market.

But I digress.

Anyway, the article goes on to say that lipodissolve is being used as a nonsurgical alternative to liposuction, which is supposedly used to dissolve fatty deposits around the legs, arms, and belly.

I happen to live in Florida, and if you believe that above claim, I also have some great land to sell you in these parts, just so happens it in a swampy area, but I got to tell you, its an up and coming area.

Here’s a picture of it, aint it beautiful?

The FDA further goes on to say in this article claims made for lipodissolve injections are false and misleading in that they are not supported “substantial evidence or substantial clinical experience”.

I don’t  know for sure what the motivation behind FDA’s push for ”cracking down” on these supposed fat melting injections it may very well be that it doesn’t like the competition with its state hospitals.

Either way, I guess it doesn’t really matter what the motivation of the FDA are, if at the end of the day the general public is protected from dangerous and unproven technology

However, the entire story stinks of hypocrisy when I  read it, and felt the need to at least give some kind of commentary of my own.

Number one, it’s not like the liposuction procedures are proven safe and effective, just ask Kanye West mother who died of a cosmetic surgery.

Number two, the FDA is missing the entire point of the what the actual procedure implies, and misses the boat on a valuable opportunity to not only protect the public, but actually educate and empower the public.

Unfortunately, its not the entire FDA’s fault. As a society that wants everything now, without the accountability,  we tend to live in the “should be” world, vs the “is” world.

We should be able to have a magic pill. You know, the kind that is a purple one, that you watch on television, running though a field, smelling the flower, floating on air,and all your problems can be helped by the purple pill.

You can go to bed at night, take the magic pill, and presto you wake up in the morning, and all your problems are fixed. That is the “should be” world. Who wouldn’t want to live life this way?

On the other side of the coin, you have the “is” world.

The reality is, we have to be accountable for our actions, there is a cause and effect. Whereas in the “should be” world you have the magic pill, on the other side of the spectrum, you have the cold hard reality.

The cold hard reality is you don’t get to be Jack in the beanstock, buy some magic pills, and wake up with a huge path to a pot of gold at the top of a beanstock.

That is what the FDA should be teaching. Because we live in the “is” world, if the FDA was truely concerned with protecting the general public, then they would be teaching us the rules of the “is” world.

Proper nutrition education, proper liftestyle management, proper exercise recommendation and prevention in general is what the FDA should be pushing.

Instead, they push other pharmaceuticals for an array of conditions that are much better helped through lifestyle modification and habits (ie, weight bearing exercise and exercise in general for “pre” osteoporotic patients, let alone osteoporotic patients).

What is the heck is ”pre ____” anyways???

So what does this have to do with neck pain?

Well, easy. when I have a consultation with many of my patients, they have what I call “selective amnesia”.

When we go over their case, and determine how bad their neck pain problem is, how much they suffer, how they are unable to do the things they love to do, how severe it is actually impacting their life. when it comes time to take responsibility for there situation, they tend to be looking for the magic pill solution.

Take a pill, go to bed, and all that postural stress you put on your body, your job, your day to day activities, your sleeping habits, all disappear with that magic pill.

Forget about putting the time in to learn what it is that you are doing on a daily basis to continue the downward spiral into continued neck and upper back pain.

Forget about the time and energy to strengthen deconditioned musculature, posture, core strength, and flexibility that is needed.

The selective amnesia kicks in when we discuss the time, energy, and money that is going to have to go in to changing their life.

If you happen to agree with me, if you happen to understand the sacrifices that must go into changing your life, to help with your aches and pains, then you realize it doesn’t happen over night.

Safety and effectiveness should always be a concern, but living your life with accountability, living your life doing the things you love to do, were meant to do, is your job either way.

Not  the FDA’s job.

Till next time, watching your back, and neck.

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