# Category Archives: Neck Pain

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

## How Does My Neck Pain Relate to my Back Pain?

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Posted in Back and Neck Pain, Neck Pain | 2 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
6

## “I Woke Up This Morning and I Can’t Move My Neck”, WTF???

Sound Familiar???

## Can’t move my neck when I woke this morning?

Well maybe it doesn’t look as bad as this, but you get the idea.

If you wake up and say to yourself ” I can’t move my neck“, maybe it is this bad.

I’m sure if you have ever awoken with excruciating neck pain, you’ve felt that pain when you can’t move your neck.

You feel like your neck was stuck, or worse yet, it actually was stuck.

When it feels this way and you can’t move your neck,  obviously something is going on that should’nt be going on, and if you’ve ever felt this way, you feel like swearing too.

I apologize if I offended you with the title of this blog post, but I wanted to get the entire point across, you know capture all the emotions that accompany neck pain.

So what’s the deal? Why can’t you move  your neck.

How can you go to bed one night seemingly fine, and wake up the next morning all locked up, not being able to move? How can this be? Did I sleep in the wrong position?

Usually a lot of question arise when I consult with a patient who comes in to see me and the first words out of their mouth is “I can’t move my neck“.

### What’s going on when you say to yourself, “I can’t move my neck”?

The main consistent historical finding, or what the patient relates to me is that “it just came out of nowhere”When this type of unexpected neck pain occurs, when the individual is unable to move their neck when they wake up in the morning, the most common diagnosis is known as:

### What is Torticollis? Torticollis means you can’t “move my neck”

Torticollis comes from the Latin words of “torti” which means “twisted” and “collis” which means “neck”. So the words combined literally mean “twisted neck”. Which pretty much sums up the way it looks, and certainly the way it feels.

Another term for this condition is something known as “wry neck”. Basically it is similar to a really bad muscle spasm, almost similar to the sensation of a “Charlie-horse”, but in the case of Torticollis, it occurs in the neck. When this happens,  your going to say to yourself “I can’t move my neck“?

Another historical finding, or what the patient relates to me, is the fact that they awoke with it in the morning after sleeping with the air conditioner or cold air blowing in the room in which they were sleeping.

Ever happen to you? Ever say to yourself  I can’t move my neck?

Often times as well, you may have just finished having a cold, or flu virus. Lastly, trauma such as a motor vehicle accident may cause a Torticollis as well (either a long time ago and thought of as insignificant)

Like I said earlier though, many times torticollis patients don’t really know why or what caused this condition, ie, they really didn’t do anything to get this, or deserve this (or so they think).

The torticollis is characterized by very sharp pain and spasms, and an inability to move the neck at all, or if you do try to move it, extremely sharp pain is accompanied.

This sharp pain can be extremely limiting, from your day to day activities, as well as your ability to be productive and perform your job. I hate when I can’t move my neck.

If you don’t do anything at all, torticollis and the extreme neck pain will ultimately improve over a 2 week period. In my practice, and with chiropractic in general, torticollis will resolve over a couple of days. Torticollis patient’s always tell me “I can’t move my neck”.

If you happen to get better after one or two days (hopefully) without doing anything at all, then you probably didn’t have torticollis.

In fact, I often see patients who have never been to the chiropractor before, because they would rather try to end their pain quickly vs, waiting it out over a period of 2 weeks. In this situation, they are so desperate,  desperate to resume their fun activities, to just going back to work, or feeling like their old self, and quite frankly, the pain is so bad, they want to make sure nothing else is going on.

Of course taking prescriptive pain medication is always an option, but many of my patients have the attitude of ”been there done that”, they are tired of the way that that makes them feel.

Unfortunately, sometimes torticollis can last longer then a month, and in rare cases even longer, without treatment. So I would strongly recommend getting treatment ASAP.

#### The 3 most common finding of Torticollis are:

1. spasms of the neck muscles
2. Shoulder, side of the neck, upper back, and neck pain.
3. Neck being twisted to one side of the other, and feeling stuck in this position.
##### what are the best solutions for Torticollis pain relief?

Well, ideally not getting in the first place right?

I say that half jokingly, but truthfully as well.

Like anything, prevention is the best medicine, but unfortunately, in the real world, prevention is really hard to sell. Having great posture, great muscle balance, flexibility, endurance, and strength are certainly great prophalactic variables for avoiding torticollis in the first place.

Getting regular chiropractic care is a sure way to avoid ever having acute torticollis as well. But if you happen to be in a full blown episode of acute torticollis, analgesics do help immensely, because alot the pain is caused from the muscles being in spasms.

Gentle massage work, superficially without going to deep will be helpful as well. With the massage recommendation, make sure that you rule out any acute process, recent trauma or activity that may have caused the torticollis.

Meaning, cleaning out the garage, doing the first spring flower planting, cleaning house, or anything that you may have done to cause the musculoskeletal pain (if this is the case in your situation, then consider this a “reality check” and learn the proper stretches and postures that you can do to #1 get rid of the pain and spasms, and #2 prevent them from coming on in the first place.

If their was something that you may have done to cause the pain, that you are pretty confident that that was what did it, then you should avoid doing any massage work for the the first 3-5 days, in the very least. Check out this link for getting rid of neck pain with natural stretches

I say this to my patients all the time cause I love analogies, but think of your condition whenever there is trauma and resulting muscle pain.

Think of your condition like a bruised apple. The last thing you would want to do with a bruised apple is to go and rub it all over. This would cause the other parts of the apple to get soft as well. With our bodies, the tissue is not ready for deeper pressure.

Many times I will have a patient come in after they injured their necks or backs, they tried to have a massage, and the massage made it worse. This was the bruised apple effect, and it was too soon to have muscle work.

So in my opinion wait at least 3 days, and in some situations waiting up to 2 weeks is advised, depending on how much trauma and inflammation there is.

Other treatments for acute torticollis, especially if trauma is ruled out, is plain old fashioned heat. Relaxation and breathing techniques can be very effective as well.

Some doctors suggests a supportive cervical neck collar to their patients that said “I can’t move my neck”. This can be effective very early on, as the spastic and locked up muscle will find relieve and support with the collar. But I would recommend seeking chiropractic help ASAP and then trying to move the neck, no matter how gentle the motion is, shortly thereafter.

Hope this helps,

Of course, many of my patients just want something they can do on their own without seeing a doctor, that can help, especially the ones that tell me “I can’t move my neck”

In this case, learning the proper stretches, postures, and exercises that will combat the repititive stressors that we experience on a daily basis. These are such simple exercises, and can be done throughout the day easily on your own.

If you would like a easy-to-do, free version of an at home, do it yourself morning neck pain eliminator program look on my site in the right hand side bar, as I have free one for you. All you have to do is leave me your contact information (name and email) and my auto-responder will send it to you.

Till next time,

Watching your back, and necks. especially when you are saying to yourself ” I can’t move my neck”

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Posted in Neck Pain | | 7 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
22

## Attention Neck Pain Sufferers!

A new enemy is lurking in the streets that we live in these days. The houses we sleep in, the schools we go to, the job we work at, and basically everywhere we go. This enemy is getting bigger and badder, meaner and meaner, and it is ultimately ravaging our health on a daily basis.

Anyone who has watched Star Trek before knows exactly about the dreaded Borg shown above. For those of you that don’t (sorry for showing you my Star Trek geekiness), this race functions on being “wired in”  with their fellow Borg at all times.

They were part of “cells”, or were organized in units, and they were organized like drones similar to bees when they slept in the hive. You would have the Queen bee, and the rest of the colony. The Borgs were similar to this, but they had the technology to communicate and ”assimilate”, or all be part of one big giant communicating civilization.

Sorry if that appeared to nerdy for those who never watched star trek, and I apologize to all the die hards who believe my explanation was completely off. Either way, that is the way I remember it.

So what does this have to do with the evil enemy that I spoke of, that I believe is taking over the world as I know it, and surely taking over the way we communicate with each other.

Well, with the advance of techology people seem to be connected to the hand held devices at all times. Text messaging with each other through out the entire day, being on facebook, twitter, myspace, youtube, and any and all other communication platform. Its not a far stretch to call us the “New Borg”

The enemy thus is:

Its true, this evil enemy that exist is ourselves, and our insatiable appetite for being in constant communication with each other. We text message our friends, we email each other, we facebook each other, we add a tweat to our twitter account, blogging, etc. Nowadays, all of this can be accomplished on our phones, from the palms of our hands.

Geez, what did we do before we had these capabilities, before these hand held devices, surely we were living in the dark ages???

So how is this our enemy?

Well, given that more and more young people are constantly connected, unfortunately, the position the mere act of communicating puts our neck and spines in, through-out the entire day, is reallly wrecking havoc on our bodies.

Neck pain, shoulder pain, carpal tunnel syndrome, headaches, tingling into the upper extremity, all are conditions that are becoming more and more prevelant with the young, much more frequently.

Heck, I even read on twitter with keyword updates that allows you to see what people are texting with the keyword that you select (neck pain).

In their tweets, most  younger folks say how bad their neck pain is, how they just woke up in pain, and have no idea what they did. Well I can tell you, if you even use twitter, chances are that you are also a “texter”, and you probably are known to spend an hour or three on the computer.

### What is Text Neck?

Chiropractor Dean Fishman, founded the Text Neck Institute, and coined the term “Text Neck”. I think this is a great term because it is really turning into an epidemic. Text neck according to Dr. Fishman is Text Neck is:

a repetitive stress injury to the body from using hand held mobile devices such as mobile phones, portable gaming units, MP3 players, e-readers and the like”

Dr. Fishman further goes on to elaborate on what some of the finding of text message are. Seeing younger and younger patients with degenerative changes, otherwise known as early arthritis. A reversal of the normal neck curvature, is the second finding.

With both these changes in the neck, the individual develops a forward head carriage, which then leads to chronic pain. Muscles, ligaments, discs, and joints all become chronically overstretched, and ulitmately, the aforementioned headaches, neck pain, uppper back pain, carpal tunnel pain, and numbness and tingling develop.

So what solution(s) do I suggest to combat this evil enemy?

Well the obvious and easiest choice would be go to a health care specialist who has a lot of experience focusing on a forward head carriage, and reversing of the cervical curvature.

Doctors of chiropractic have the market cornered in this area (in my opinion), and can help identify mechanical restricted areas, help re-set/re-align the proper structure of the neck, and educate the patient to avoid this harmful position in the first place.

However, that said, I always say that even if you go to your chiropractor, it is but a mere drop in the bucket to the remainder of the day, the time your neck remains in forward head position based on all the postural stressors you experience. Simply put,  your neck is trained to be in the Forward Head Position (FHP).

In this picture, you have what is indicative of a FHP, and is also known as an “upper crossed syndrome”. With the upper crossed syndrome, the deep neck flexors in the front, and the rhomboids of the back, become chronic weak.

Additionaly, the front pectorals, and the rear upper trapezius muscles become tight. Combined toghether, the neck gets the “TEXT NECK” that Dr. Fishman coined.

The other solution, which I have designed in the Lose the Neck Pain System, is to learn the exercises that will strengthen the weakened, neck flexors and rhomboids, and learn the exercises that will restore the tightened pectorals and upper trapezius muscles.

Being aware of your posture when texting, sitting, working, driving, relaxing, reading, and everything else we do in our lives will ultimately become automatic, and I guess, will be the super hero to eliminate the enemy.

Till next time, watching your back and neck.

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April, 2010
16

## Neck Pain While Driving, Are You Making Any of These Fatal Mistakes?

When neck movements occur suddenly, or unexpectedly, it is very likely an injury will occur.

An injury occurs typically because the muscles of the neck are unable  to tighten quick enough to the sudden or unexpected movement. When it is from a motor vehicle accident, especially from an impact from behind, it easy to envision the  resultant injury to the neck.

The impact is definitaley forcefull enough, and in most cases sudden and unexpected, to cause an injury to the neck. But even if the impending collision is expected, the muscle of the neck are overpowered to result in trauma as well.

That said, there are very basic pieces of advice to reduce the chances of being in a car accident in the first place. This may seem like basic suggestions, but prevention is always the best medicine, and when a neck injury and life long pain and suffering are common consequences of car accident, being reminded of these suggestions are helpful.

1) Consuming Alcohol and Driving: I know, simple, common sense advice, but you’d be surprised how often this happens, and really neck pain and suffering is but one of many evils that happen with drinking and driving.

2) Using your Cell phone and driving: Again, seems like common sense, but having one hand on the wheel, and one hand on the phone, decreases reaction time, decreases concentration, and decreases physical ability to maneouver your vehicle.

3) Don’t Text on your phone and drive: How often do you see someone doing this? Scarry isn’t. For the reasons above, and mostly not paying attention, will significantly increase your chances in causing a car accident.

University of Utah actually determined that being intoxicated was less of a problem for causing motor vehicle accidents, when compared with distractions from cell phone use.

Amazing!

Not paying attention while driving is hypothesized to be involved in 20-50% of motor vehicle accident, reported by police in which up to 13% resulted from the driver not paying attention.

Another reported study found that using the speaker component of your phone vs using the cell phone with your hands were alike. Both decrease the drivers ability to respond in time, when measured against a driver not using a phone at all.

It would seem that hands free would be less likely to result in an accident vs hand held. However, it is believed that the energy it takes our brain to concentrate or, the “thinking” part during the conversation causes the primary distraction, not the use of hands.

South Carolina University also found that when compared to talking with a passenger, planning to speak put far more demands on the brain than listening.  Thus, we become “distracted”, and it is these “distractions” that increase the probability of an accident.

4) “Rubbernecking”:

Okay, rubbernecking doesn’t exactly look like this, but you get the idea.

Another form of “distraction”, the obvious concern are the eyes of the road, while the vehicle is still moving. We have a fascination with other accidents, and we rubberneck when an accident is ahead.

As we focus on the other accident, not only are our eyes off the road, more then likely, traffic ahead is slowed, if not stopped. Whamm, another accident.

5) Changing Stations/CD Player: another distraction in which we are not focused on the road.

Of all the factors listed above, Texting seems to be the most worry some. The University of Utah study found a factor of 6x times more likely to be in a car accident due to being distracted because of texting.

It seems that texting while driving is more common with the young. Half the drivers asked between the ages of 16-24 admitted to texting while driving, whereas with drivers between the ages of 35 years old and 44 years, 22% admitted to texting.

6) Drowsiness: another significant distraction responsible for an increased risk for a motor vehicle accident is being drowsy, which increased the drivers risk of a crash or near crash by 4 times, according to a July 2009 Virginia Tech report.

They studies analysis of videos of 200 truck drivers, Combined, the drivers studied logged over 3 million miles.

Results indicated that texting while driving had the greatest safety risk at 23 times more likely to have their eyes being off the road.

Other variables for increase in saftery risk was reaching for a moving object, with a 9 fold increase, while rubbernecking  increased the risk 3.7 timess, reading increased it 3 times, dialing a cell phone increased risk 3 times, and talking or listening on a hand held device increased the risk 1.3 times.

The bottom line: Neck injuries from motor vehicle accident, let alone fatalities, are a very real concern. Concentrating on the function of “driving” is paramount,  but avoiding the above distractions can not only save your neck in the future, it may even safe your life.

Till next time, watching your back and neck.

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Posted in Neck Pain, Whiplash Neck Pain | 2 Comments
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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March, 2010
23

## What a Professional Athlete’s Horrific Injury Can Teach You About Your Neck Pain!

This may be a bit of a change of venue, or slight deviation then what I typically write about, but I couldn’t help myslef not writing about what I read today on the internet.

And, I actually think that its a great a message as any to learn help to get over an injury, ache, pain, and/or nagging discomfort that you might be experiencing.

It was basically about a guy that had a horrific injury in  during a game in the National Basketball Association (NBA). He name is Shaun Livingston, and the article starts off by saying.. “three years and twenty four days ago  his knee exploded on the basketball court”.

Now, I actually remembered seeing it on the sports channel highlights that evening. If you’ve  ever watched those grotesque sports highlight when an athlete breaks a bone, or dislocates a joint, man, it can be really hard to watch. Joe Thiesman rings a bell. This was like that.

Well the article goes on to say that in that injury, Shaun dislocated his knee cap (when the patella come up),  torn anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL),  and a torn mensicus.

Sorry to do this to you, but if you are abit skirmish, please don’t play the attach video, and don’t hate me.

So what does this injury have to do with someone who suffers with neck pain, headache pain, carpal tunnel pain, or back pain?

Everything.

Actually, the article is a “feel good” article. Sean Livingston is featured doing an explosive Slam Dunk, with the word “explosive” highlighted.

He has only played 34 games in the last three years, and played on three different teams.  So he has been considered somewhat of a “journeyman”. But this dunk was an unexpected one from Shaun, and a great one from any NBA standard.

The point not highlighted in the article, not mentioned, not appreciated, is all the hard work that he has done to get back to wear he is today. I guarantee you that he works extremely hard, intense, and is really focused and determined to succeed.

Hate to burst your bubble, but that doesn’t happen “by accident”. Don’t get me wrong, it doesn’t hurt that he is still only 24 years old.

As well, when he came in the league, in 2004, he was only 18 years old, and was drafted 4th overall at six foot 7 inches as a guard. He did have skills too.

But my point is this:.he has to be very determined to even want to recover and get back to an elite level, not to mention being bounced around to three different teams, and not being able to be what he once was.

Patience and dedication comes to mind as well.

So, when you have an injury, think about Shaun’s Injury. When your neck hurts at the end of the day,  or you have a headache, and you just can’t live the way you want to, painfree, think about what Shaun did to get better.

He spent months and months, rehabing his knee. Doing exercises to increase his movement, range of motion, gradually gaining strength, stability, balance, endurance, power, and confidence.

I even bet if you follow him further, proper nutrition, and a good team around him for support are probably evident as well (if I were a betting man).

I suggest that if you do suffer, have pain of any kind, and are motivated enough that you want to get better, get back to what you love to do, what earns an income for you, or getting back to the “elite” level of whatever it is that you do, you better get out there and learn what you have to learn, and do what you have to do to get there. Fortunately for Shaun, he has a team of trainer,doctors, and therapist around him to guide his every movement.

But when it comes to us, I’m not saying that you have to go through hours and hours of intense rehab like he did either. In fact, I am a big believer, that aches and pains that we experience on a daily basis, can be combated and eliminated, very easily, in your own home, if you know the proper stretches, postures, and exercises to do.

Oh, and by the way, here is the link of the dunk of what the article raves about

By the way, even the opposing players were clapping that Shaun dunked it. I think they said even the player that was dunked on.

Its great to see Shaun exploding on the floor once again. As another happy note, Shaun signed for the remainder of the season with the Washington Wizards.

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