Back pain usually comes from lifting an object the wrong way or awkwardly moving the body, injuring the spinal structures or muscles. However, sometimes it could be signs/symptoms of a more serious medical condition. The back pain could be caused by:
How to know when the root cause of back pain is from something else in the body? There are two types of pain that pain specialists look at. These are visceral pain and somatic pain. Visceral pain comes from damage or injury to the organs or organ tissues. This internal pain can radiate to the spine from conditions like:
Pancreatitis
Ulcerative colitis
Crohn’s disease
Gall stones
Cancers
Kidney pain
Urinary tract infections
Somatic pain is injury or damage to the muscles, skin, and soft tissues. It can be caused by:
Regular wear and tear
Aging
Injury
Sedentary lifestyle
However, visceral pain can cause somatic/bodily pain to flare up. The stress the body is going through because of the medical condition can cause inflammation.
Contents
Kidney Infections and Stones
The kidneys are located in the rear of the body toward the middle of the back. The kidneys:
Filter waste products from the body
Regulate bodily fluids
Perform other vital functions.
Kidney infections and kidney stones can easily mimic a sprain or strain in the back. Infections or stones can also present with other symptoms like:
Side and groin pain could accompany the back pain.
The pain does not go away after shifting positions or lying down.
Urinary Tract Infection UTI
Upper urinary tract infections in the kidneys or ureters can cause back pain. Upper UTIs happen when a lower UTI in the bladder or urethra goes unnoticed or does not respond to antibiotic treatment. Infections can occur at any age, with women and older men being more susceptible. The pain usually presents in the lower back and groin area. Other possible symptoms include:
Pain in the back, sides of the lower abdomen between the lower ribs and hips.
Fever
Vomiting
Frequent urination in small amounts
Burning during urination
Strong urge to urinate
Foul-smelling urine
Cloudy urine
Fatigue.
The pain can feel like:
Cramping pain
Pressure
Soreness
Pancreatitis
Pancreatitis is inflammation of the pancreas, the long flat organ located in the upper abdomen behind the stomach. It assists digestion and sugar management. The American Pancreatic Associationreports acute pancreatitis can make individuals feel sick with moderate to severe abdominal pain that can radiate to the back and often worsens after eating. The pain is felt in the upper to middle back. Other possible symptoms include:
Abdominal pain that radiates to the back
Abdominal pain after eating
Fever
Nausea
Vomiting
Tenderness in the abdomen
The pain can feel like a pulled muscle or joint pain that increases and decreases at first and then strengthens after eating or lying down.
Inflammatory Bowel Diseases IBD
Ulcerative colitis and Crohn’s disease are inflammatory bowel diseases not to be confused with irritable bowel syndrome.
Ulcerative colitis affects the colon.
Inflamed intestinal areas characterize Crohn’s disease.
Both can cause spreading back pain.
A study found 25% of individuals with IBD have chronic back pain. Other possible symptoms include:
The pain can feel mild or severe, like a cramp in the lower abdomen around the low back. It can present in cycles as a flare-up, then goes away. It’s essential to read the body’s warning signs and not push through the pain or ignore it. If any back pain goes on for more than a week, consult a doctor or chiropractor for a thorough examination. A pain specialist could be recommended if there is chronic back pain from a severe medical condition. A primary doctor or specialist helps keep the medical condition in check, while a pain specialist and/or chiropractor can alleviate chronic musculoskeletal pain from inflammation, irritation, and overstimulated nerves.
Body Composition
Personalized Lifestyle Medicine
Personalized lifestyle medicine develops customized treatment/health plans to fit the individual. It includes:
Research on how the body works as an integrated system.
Combines new technology approaches in medicine.
The relationship between nutrients and gene expression.
Life and behavioral sciences.
Nutrigenomics testing helps individuals understand the influence of dietary components on their genes, which can help prevent the development of certain chronic diseases.
The body is a well-working machine that can endure anything that is thrown in its way. However, when it gets an injury, the body’s natural healing process will ensure that the body can get back to its daily activities. The healing process of an injured muscle varies throughout the body. Depending on how severe the damage is and how long the healing process will take, the body can recover to a mere few days to a few months. One of the most gruelly healing processes that the body has to endure is a ruptured calcaneal tendon.
The Calcaneal Tendon
The calcaneal tendon or the Achilles tendon is a thick tendon that is located in the back of the leg. This muscle-tendon is what makes the body move while walking, running, or even jumping. Not only that, the calcaneal tendon is the strongest tendon in the body, and it connects the gastrocnemius and soleus muscles at the heel bone. When the calcaneal tendon is ruptured, the healing process can last from weeks to months until it is fully healed.
The Healing Effects of Low Laser Therapy
One of the ways that can help the damaged calcaneal tendons’ healing process is low laser therapy. Studies have shown that low laser therapy can speed up the damaged tendon repair after a partial lesion. Not only that but the combination of ultrasound and low laser therapy has been studied to be the physical agents for treating tendon injuries. The studies showed that the combination of low laser therapy and ultrasound has beneficial properties during the recovery process of treating calcaneal tendon injuries.
The study found that when patients are being treated for their calcaneal tendons, their hydroxyproline levels around the treated area are significantly increased with ultrasound and low laser therapy. The body’s natural biochemical and biomechanical structures on the injured tendon increase, thus affecting the healing process. Another study has shown that low laser therapy can help reduce fibrosis and prevent oxidative stress in the traumatized calcaneal tendon. The study even showed that after the calcaneal tendon is traumatized, inflammation, angiogenesis, vasodilation, and the extracellular matrix are formed in the affected area. So when patients are being treated with low laser therapy for about fourteen to twenty-one days, their histological abnormalities are alleviated, reducing collagen concentration and fibrosis; preventing oxidative stress from increasing in the body.
Conclusion
Overall, it is said that the effects of low laser therapy can help speed up the healing process of repairing the calcaneal tendon. The promising results have been proven since low laser therapy can help repair the damaged tendon, reducing oxidative stress and preventing fibrosis from escalating, causing more problems on the injured tendon. And with the combination of ultrasound, the calcaneal tendon can recover faster so the body can continue its everyday activities without any prolonged injuries.
References:
Demir, Huseyin, et al. “Comparison of the Effects of Laser, Ultrasound, and Combined Laser + Ultrasound Treatments in Experimental Tendon Healing.” Lasers in Surgery and Medicine, U.S. National Library of Medicine, 2004, pubmed.ncbi.nlm.nih.gov/15278933/.
Fillipin, Lidiane Isabel, et al. “Low-Level Laser Therapy (LLLT) Prevents Oxidative Stress and Reduces Fibrosis in Rat Traumatized Achilles Tendon.” Lasers in Surgery and Medicine, U.S. National Library of Medicine, Oct. 2005, pubmed.ncbi.nlm.nih.gov/16196040/.
Wood, Viviane T, et al. “Collagen Changes and Realignment Induced by Low-Level Laser Therapy and Low-Intensity Ultrasound in the Calcaneal Tendon.” Lasers in Surgery and Medicine, U.S. National Library of Medicine, 2010, pubmed.ncbi.nlm.nih.gov/20662033/.
Waking up with neck soreness, stiffness, achiness, and pain can take a toll throughout the day. Individuals, that experience this regularly wonder what happened while laying down in bed? Individuals can wake up with one or a combination of these symptoms after sleeping. A few ways to prevent neck pain after sleeping and self-care to relieve any symptoms.
Contents
What Is Happening?
The spine keeps the body upright and moving and regularly resists gravity and other forces acting upon it. The neck, aka the cervical spine, is a little more delicate. The neck has the important job of holding up the head. The human head weighs around 10 to 12 lbs, and that’s using proper posture. According to a study, the head’s weight can increase up to 60 lbs. with a 60-degree tilt. This can happen from looking down at a phone for too long. All that weight makes the muscles that support the head and neck work overtime contributing to fatigued muscles.
Then when sleeping, cervical spinal misalignment starts to set in, producing torticollis. Torticollis, aka wry neck, is a condition where the neck gets twisted or tilted at an awkward angle. Babies can be born with it, known as congenital torticollis, and individuals can develop it from various sources. It can be temporary, chronic, and it can be caused by acute trauma. Torticollis is not considered a condition like ankylosing spondylitis but more like a symptom with overlapping sources.
The neck’s ligaments can become irritated and inflamed.
Neck muscle spasms can cause soreness and inflammation.
Either of these can be caused by sleeping in an awkward position or by using the wrong pillow.
Waking With Neck Pain
When waking up with neck pain, it could be that the pillow no longer provides sufficient support, the pillow is too thick, placing the neck in an awkward position, the individual’s sleeping position strains the muscles and ligaments, or a combination. It is usually a pillow that is too soft with no support that causes neck pain. Maintaining spinal alignment when sleeping is just as crucial as during the day, as it helps to prevent overly taxing the muscles and ligaments.
How to control posture when sleeping?
The pillow could be the answer. A firm pillow will keep the spine in a straight line from the atlas, which is the first cervical vertebra/C1, down to the coccyx or the tailbone. The way an individual sleeps also affects how they wake up. The most recommended sleeping position for individuals with morning neck pain is on the back. Back sleeping might not work for everyone as it can aggravate conditions like sleep apnea. If that is the case, sleeping on the side is the next recommended position. It is recommended to avoid sleeping on the stomach. The head could slip down the pillow edge causing the head to be in a tilted position. This can place added pressure on the nerves that start in the neck, leading to further neck pain or radiculopathy pain that spreads out to the arms or legs.
What To Do?
If neck pain presents after waking, get some ice or a cold pack on it. Try 20 minutes on, 20 minutes off. This will reduce inflammation. Also, over-the-counter nonsteroidal anti-inflammatory medications like ibuprofen can help. If neck pain continues, switch from ice to heat also 20 minutes on, 20 off. If the pain is caused by spasming muscle/s, heat can relax the area and increase blood circulation. A gentle massage on and around the area can help spread the circulation and ease the spasm.
Stretching the neck
Stretching the neck will keep the muscles loose and reduce the risk of ligament, muscle and tendon strains, and torticollis.
Body composition change and losing fat mass are also related to sleep. Losing fat requires the body to be in a caloric deficit. This means having the body use more energy than the body takes in. This is accomplished by restricting calories through diet or increasing calories used through physical activity/exercise. However, most individuals utilize a combination. This can be referred to as calories in/calories out. Losing sleep can sabotage fat loss goals by stealing both the calories in and calories out.
References
Hansraj, Kenneth K. “Assessment of stresses in the cervical spine caused by posture and position of the head.” Surgical technology international vol. 25 (2014): 277-9.
Preventing Neck Pain from Sleeping: National Sleep Foundation. (n.d.) “How to Prevent Neck Pain While Sleeping.” sleep.org/articles/prevent-neck-pain-while-sleeping/
Multiple sclerosis and sciatica can exist side by side or have overlapping symptoms. The sciatic nerve begins at the lower back, then through the hips into the buttocks, and separates into both legs into the feet. Sciatica is a type of pain caused by a compressed/pinched or damaged/injured sciatic nerve. The sensation radiates across the nerve with frequency and severity at varying levels, depending on the individual’s body position and/or movement. Individuals with multiple sclerosis can also experience sciatica, believing it’s their multiple sclerosis. Neuropathic pain is a common symptom in multiple sclerosis or MS. It is caused by injury or damage to the nerves of the central nervous system and can cause burning, or sharp, stabbing sensations.
Contents
Multiple Sclerosis and Sciatic Nerve Pain Difference
MS is an autoimmune disorder where the immune system attacks the protective layer around nerve fibers known as myelin. This affects the central nervous system pathways that regulate feeling and sensation in the body. It can cause painful sensations that include:
Muscle spasms
Burning, tingling, or aching in the lower legs
Electrical shock-like sensations travel from the back toward the legs.
Migraines
The painful sensations result from the damaged nerve fibers creating interference in the brain’s neural pathways.
Sciatica works differently
An autoimmune response does not damage the sciatic nerve’s pathway, but an added stress/pressure compresses the sciatic nerve. The pain is usually caused by a quick, jerking, twisting, bending, reaching motion that pinches or twists the nerve. Herniated discs and bone spurs are another common cause, along with being overweight can place intense pressure on the sciatic nerve. The critical difference is that multiple sclerosis causes the central nervous system’s signaling pathways to malfunction.
MS and Sciatica
Most individuals, around 40%, will at some point experience some form of sciatica symptoms. This is from age, and all the wear and tear the low back goes through daily. This is why it’s not unusual for individuals with MS to experience sciatica as well. MS can cause body changes that affect activity levels.
Decreased mobility can lead to sitting for extended periods that can strain the muscles, tendons, and ligaments, causing sciatica.
There is evidence that the lesions that present from MS can extend to the sciatic nerve.
One study compared 36 individuals with MS to 35 individuals that don’t have it.
The research found that those with MS had slightly more lesions on the sciatic nerve than those without MS.
Sciatica Care
It can be challenging to figure out the types of pain being experienced. Sciatica travels down the length of the nerve uniquely and is often felt in only one leg. The pain, tingling, numbness, electrical sensations can present only in the lower back, the buttock, the back of the leg, hamstring, calf, and foot, or in a combination of all the areas. Treatments for sciatica depend on the severity. They include:
Medications – anti-inflammatories, muscle relaxants, tricyclic antidepressants, and antiseizure medications.
Steroid injections – corticosteroids
Surgery is a last resort reserved for severe cases that did not improve with other treatments and therapies.
It can be easy to mistake sciatica as a symptom or related condition of multiple sclerosis. Chiropractic can help alleviate sciatica, and although treatment cannot directly treat MS or its symptoms, it can relieve pain and discomfort.
Body Composition
Diabetic Nephropathy
Diabetic nephropathy or diabetic kidney disease is the result of mismanaged diabetes. Kidney failure is a severe medical emergency and can be fatal if not treated. Chronic low kidney function results in:
Fluid retention in the body.
Inability to filter out metabolites and waste from the blood.
Increased risk of infections.
Common symptoms of diabetic kidney disease include:
Increased blood pressure
This is the result of increased stress on the body.
The kidneys can no longer filter out all the metabolites and excess fluid needed to stabilize the blood pressure.
Chronic kidney damage results in the protein being excreted through urine.
Fatigue
Poor kidney function affects every organ in the body.
The organs have to work harder to compensate, leading to fatigue and low energy.
Lower extremity edema
Fluid retention usually presents in the lower extremities.
Puffy, swollen ankles and legs may appear shiny or waxy.
This is common in individuals that have severe diabetic nephropathy.
Shortness of breath
As the fluid builds up in the body, additional weight can get stored on and around the lungs.
This can make breathing very difficult when lying down or when engaged in physical activity.
Impaired cognition
Metabolites in the blood can cause brain damage when not filtered properly.
Memory loss
Mood changes
Loss of consciousness
References
Jende JME, et al. (2017). Peripheral nerve involvement in multiple sclerosis: Demonstration by magnetic resonance neurography. DOI:
10.1002/ana.25068
Mayo Clinic Staff. (2019). Sciatica.
mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
Murphy KL, et al. (2017). Chapter 4: Neuropathic pain in multiple sclerosis—current therapeutic intervention and future treatment perspectives.
ncbi.nlm.nih.gov/books/NBK470151/
Pain and itching. (n.d.).
nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Pain
Samson K. (2017). In the pipeline-multiple sclerosis neurography, MRI reveals peripheral nerve lesions in MS patients. DOI:
10.1097/01.NT.0000527861.27137.b0
Sciatica: Of all the nerves. (2016).
health.harvard.edu/pain/sciatica-of-all-the-nerve
When dealing with any kind of pain, many types of remedies can help alleviate the source of the pain. Whether muscle pain or cardiac tissue pain, the effects can be long-term if not appropriately treated. Doctors have discovered that low laser therapy can help repair injured muscles that patients have experienced. With low laser therapy, the beneficial effects can help repair injuries that the bodies’ skeletal and cardiac muscles have endured.
When the body gets injured, many people endure the pain later or during the accident. Sometimes the pain is short-termed or long-termed, depending on how severe the injury is. Short-term pain or “acute” pain can be simple, like a sprained joint; however, long-term pain or “chronic” pain, it’s more severe to the body and can have lasting effects. Chronic pain can hinder a person’s body from doing the most straightforward task. When people deal with chronic pain, it can drastically affect the body’s musculoskeletal system and even their cardiovascular system.
When the body’s musculoskeletal system is damaged, many complications can start affecting the joints in many different parts of the body. Chronic pain can cause inflammation throughout the body, causing a person not to have the energy to do any task they planned for the day. Sometimes the pain can be excruciating where the body just completely shuts down. When doctors see their patients, they ask them, “Where does it hurt?” meaning where the pain feels more excruciating on the person’s body. The patient will always tell their physicians that the pain is on their joints or back. So doctors would recommend low laser therapy.
Low Laser Therapy
With low laser therapy or phototherapy, the effects from the treatment can alleviate the pain from the body. Studies show that the application of low laser therapy in injured muscles can significantly enhance muscle regeneration in multiple and frequent applications. Low laser therapy does target the injured muscles because it uses irradiation, which targets the affected muscle while increasing the body’s natural antioxidants and cytoprotective heat shock proteins (HSP-70i). Phototherapy can even help reduce muscle fatigue in athletes when they are in a post-exercise routine.
Studies have found that physical therapists use phototherapy as another form of recovery treatment for athletes. What the laser does is that when it is placed on the affected muscle and joint pain, the infrared wavelength penetrates the skin and starts to affect the targeted area. The infrared wavelengths cause therapeutic effects by decreasing oxidative stress accumulated by the body while also reactivating oxygen species production, improving the body’s mitochondrial function, etc. Another study also shows that phototherapy can also repair cardiac tissue. The study shows that when doctors use phototherapy, it directly affects the intracellular mechanisms in the heart while also activating heat-independent tissues without causing tissue damage to the heart. The study also shows that phototherapy can be effective in various complications, such as lymphoedema and muscular trauma.
Conclusion
All in all, low laser therapy has beneficial properties in preventing muscle and cardiac muscle tissue damage. Its infrared radiation can help patients go about their day without the pain and suffering that their body endures. By reducing ventricular dilatation and preserving the body’s mitochondria while elevating the HSP-70i, the body can start on the road to recovery.
References:
Leal Junior, Ernesto Cesar Pinto, et al. “Effects of Low-Level Laser Therapy (LLLT) in the Development of Exercise-Induced Skeletal Muscle Fatigue and Changes in Biochemical Markers Related to Postexercise Recovery.” Journal of Orthopaedic & Sports Physical Therapy, Aug. 2010, www.jospt.org/doi/10.2519/jospt.2010.3294.
Kazemi Khoo, Nooshafarin, et al. “Application of Low-Level Laser Therapy Following Coronary Artery Bypass Grafting (CABG) Surgery.” Journal of Lasers in Medical Sciences, Laser Application in Medical Sciences Research Center, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4291821/.
Polymyositis is a disease that causes the body’s muscles to become irritated and inflamed. It can affect the muscles all over the body. The muscles gradually begin to break down and weaken, making everyday movements difficult. This disease falls into a category known as inflammatory myopathies.
Contents
Polymyositis Unknown Causation
The causes of polymyositis are currently unknown. However, experts believe it could be associated with or triggered by a virus or an autoimmune reaction. An autoimmune response is when the body attacks itself along with the body’s tissues. It’s seen in individuals ages 31 to 60 and is rarely seen in individuals younger than 18. In some instances, medication can lead to an allergic reaction/response that causes muscle irritation and damage. But in most cases, healthcare experts are not able to find the exact cause.
Symptoms
The condition can affect the muscles all over the body. Physical activities like walking, getting up from a chair, or lifting objects can become difficult to perform. It can also affect the muscles that allow for eating and breathing. The muscles at the center of the body tend to be affected the most. Common symptoms include:
Muscle pain.
Muscle stiffness.
Muscle weakness, specifically in the abdomen, shoulders, upper arms, and hips.
Joint pain and stiffness.
Breathing problems.
Problems swallowing.
Abnormal weight loss can become an issue if there are problems with swallowing.
Irregular heart rhythms if the heart muscle/myocardium becomes inflamed.
Individuals may notice they have trouble climbing stairs or lifting their arms.
The inflammation can worsen, causing pain and weakness that affects the wrists, lower arms, and ankles.
Diagnosis
Diagnosis begins with the individual’s medical history, family medical history if necessary, and a physical examination. The examination includes seeing and feeling the strength of the muscles. Tests will be required that include:
Blood Tests
Blood tests allow the doctor to see if there are signs of muscle inflammation.
They also show if there are abnormal proteins that form in autoimmune diseases.
Electromyogram EMG
This test can be used to find abnormal electrical activity in the affected muscles.
MRI
Magnets and computer graphic imagery are used to help the doctor inspect for inflammation in the body.
Muscle Biopsy
A small piece of muscle tissue is removed to be analyzed with a microscope.
Treatment
Treatment depends on how severe the condition is,individual symptoms, age, and overall health. Currently, there is no cure for polymyositis, but symptoms can be managed. Individuals are recommended to utilize more than one type of treatment because the treatment plan may also need to be changed as treatment progresses. Treatments include:
Anti-inflammatory Medication
Steroid medication can help manage the disease and reduce symptoms, and corticosteroids can help ease inflammation in the body. The symptoms improve within 4 to 6 weeks, and a healthcare provider can lower the dosage after the symptoms decrease to reduce and ease any side effects.
Immunosuppressive Medication
These medications block or slow down the body’s immune system responses.
Talk with a doctor about the risks, benefits, and side effects of all medications.
Chiropractic and Physical therapy
Chiropractic treatment and physical therapy can help:
Aligning the spine to provide optimal nerve energy and blood circulation.
Therapeutic massage to stimulate and keep the muscles loose.
Specific exercises to help stretch and strengthen the muscles.
These can help keep the muscles from shrinking.
Heat therapy and Rest
Heat therapy and allowing the body to rest thoroughly can help decrease pain symptoms.
Special Braces
Body, hip, and leg braces can help support the muscles and help with mobility.
Complications
Polymyositis left untreated can lead to severe complications. The muscles become weaker, increasing the risk of falling and limiting daily activities.
If the chest muscles are affected, there could be problems with breathing that can lead to respiratory failure.
If the digestive tract is affected, malnutrition and unintentional weight loss can result.
Polymyositis poorly managed well can cause severe disability.
Body Composition
Nutrition and Muscle Growth
Protein
Protein is the foundation for gaining muscle.
This essential component is for all of the body’s daily functions.
It is essential to balance protein increase with overall diet.
Carbs should be a daily element of nutritional intake because they are the primary component.
Acquiring energy
Preventing muscle weakness and degradation
Consuming Carbs
Understanding how accurate results only happen when both sides work together.
Healthy consumption of protein and carbohydrates can help muscle growth and sustain optimal health for all body types.
References
Corrado, Bruno et al. “Supervised Physical Therapy and Polymyositis/Dermatomyositis-A Systematic Review of the Literature.” Neurology international vol. 12,3 77-88. 24 Nov. 2020, doi:10.3390/neurolint12030015
Findlay, Andrew R et al. “An overview of polymyositis and dermatomyositis.” Muscle & nerve vol. 51,5 (2015): 638-56. doi:10.1002/mus.24566
Sasaki, Hirokazu, and Hitoshi Kohsaka. “Current diagnosis and treatment of polymyositis and dermatomyositis.” Modern rheumatology vol. 28,6 (2018): 913-921. doi:10.1080/14397595.2018.1467257
Van Thillo, Anna et al. “Physical therapy in adult inflammatory myopathy patients: a systematic review.” Clinical rheumatology vol. 38,8 (2019): 2039-2051. doi:10.1007/s10067-019-04571-9
There are various causes for achiness or soreness under the shoulder blades. The shoulder blade is the triangular bone that forms the back of the shoulder. This pain can range from dull, sharp, burning, or a combination between the spine and shoulder blade to tender or achy across the shoulder or upper back. Pain can spread from another body part or structure, like the neck or spine. Inflammation from injury or overuse is noticeable at onset or gradually after engaging in physical activity and can limit arm movements and interfere with regular activities.
Contents
Improper Posture
Improper poster combined with prolonged sitting can cause the spine to develop structural changes that cause pain under the shoulder blade. Habits that lead to poor posture include:
Hunching the back.
Tilting the head down – looking at the phone.
Leaning to one side while sitting, working.
Poor posture habits cause the muscles to weaken, placing added pressure on the spinal discs, muscles, and ligaments. This body imbalance can contribute to upper back and shoulder pain.
Lifting Improperly
Lifting weight above the head and not using the proper technique can leave the upper back and shoulders vulnerable to injury. Lifting an object that is too heavy or is held in an awkward way causing the spine to be misaligned creates added pressure in the upper back. This can strain the muscles, sprain ligaments, injure the shoulder joint, or spine, which can cause spreading pain under and/or near the shoulder blade.
Repetitive Overuse Injury
Painting, moving furniture, or participating in sports are activities that can overwork the upper back muscles and shoulders. Overuse can lead to muscle strains and ligament sprains. This can cause pain in the upper back between the shoulder blade and the spine. Scapulothoracic bursitis, also known as snapping scapula syndrome, is when the bursa between the shoulder blade/scapula and the thoracic spine becomes inflamed, causing pain.
Cervical Herniated Disc
A herniated disc in the cervical spine/neck happens when a disc’s outer layer/annulus fibrosus tears and the inner layer/nucleus pulposus starts to leak outward. This can cause pain and cause the nearby nerve roots to become inflamed, causing pain to run down into the shoulder, arm, and/or hand. A disc herniation in the lower part of the neck usually radiates pain into or near the shoulder blade area. Although less common, a herniation in the upper back can cause pain around or near the shoulder blade.
Dislocated Rib
An accident or fall could cause a rib to become dislocated or misaligned after repetitive/overuse strain or reaching too far overhead. Sharp pain near the shoulder blade can result from this activity and can sometimes make it challenging to take a deep breath.
Compression Fracture
A compression fracture occurs when a vertebral bone in the upper back weakens and compresses. This can lead to back pain with a heightened sensitivity across the shoulder area. The pain usually decreases with rest. Compression fractures are commonly caused by osteoporosis in older individuals. Any back or shoulder pain that persists for weeks or interferes with regular activities should be evaluated by a doctor or chiropractor. If the pain is severe or accompanied by symptoms like headache, tingling, weakness, or nausea, individuals are recommended to seek medical attention.
Body Composition
Carbohydrate/Carb Loading
Carbohydrates are macronutrients that serve a critical function in the body, as they are the body’s primary energy source. The body breaks down carbohydrates into sugar that enters the bloodstream and is stored for energy use in the muscles and liver as glycogen. The muscles only store small quantities of glycogen. And when engaging in physical activity or exercise, the energy stores get used up.
Carbohydrate loading can raise glycogen stores in the muscles from 25 to 100 percent of their average amount in men. Women have shown mixed results in studies on carbohydrate loading. Women need to take in more calories than men when carb-loading to experience the same gains in glycogen. Reasons to carb load are either to:
Build-up stores of glycogen so an individual can use the extra energy storage to help improve endurance.
Fill the muscles with glycogen to bring water into the muscles to help gain mass and tone.
References
Hanchard, Nigel C A et al. “Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement.” The Cochrane database of systematic reviews vol. 2013,4 CD007427. 30 Apr. 2013, doi:10.1002/14651858.CD007427.pub2
Mizutamari M. et al. Corresponding scapular pain with the nerve root involved in cervical radiculopathy. J Orthop Surg. 2010; 18(3): 356–60.
Sergienko, Stanislav, and Leonid Kalichman. “Myofascial origin of shoulder pain: a literature review.” Journal of bodywork and movement therapies vol. 19,1 (2015): 91-101. doi:10.1016/j.jbmt.2014.05.004
Kettlebell training for the back muscles and back pain prevention can be part of a recommended treatment plan. When experiencing low back pain, many sports medicine experts recommend kettlebell exercise to strengthen the core and posterior chain. However, if not used correctly, kettlebell exercises can worsen back pain.
Contents
Kettlebell
They are made of cast iron or steel and are named for resembling a tea kettle with an oversized handle. They can be used in one and two-handed movements.
Exercises and Movements for Back Pain
For individuals that are not experiencing back pain, kettlebell training can be excellent for maintenance and injury prevention. They strengthen the core and back muscles.
The kettlebell swing is an essential exercise and is one of the most important exercises when dealing with back pain issues.
A kettlebell is placed on the floor about 12 inches in front while standing with the feet a little wider than hip-distance.
The hips become the hinge.
Extend the arms down to the bell and grip it.
Begin swinging it up and down through the legs and then upward and outward to chest level.
The shoulders are to stay relaxed.
The hips are used to thrust and create momentum to swing the kettlebell.
Keep the spine neutral throughout the exercise to prevent injury.
The arms are to hold the bell only.
Don’t swing with the arms or shoulders, but push through with the hips.
The exercise can be swung up over the head but is not recommended for those with back pain.
Benefits
They are portable and don’t require a lot of space.
With kettlebells, an individual can train more easily than with barbells.
Kettlebell workouts provide strength training and cardiovascular fitness.
Once the proper technique is learned, individuals can set up a regular regimen at home.
Proper Form and Mistakes
Proper form is crucial. The primary movement most individuals have difficulty with is getting the proper hinging motion at the hip. Most individuals flex at the lower back and place increased pressure on the discs. Proper hip hinge motion means:
Keeping the low back straight
Flexing at the hip
Pushing back out with the buttocks when performing the swing motion.
When done correctly, an individual should be able to stop at any stage and hold that position.
Posture Form Tips
Form issues with kettlebells include:
Hip Hinge
When picking up the kettlebell, remember to hip hinge instead of squatting to maintain the back in a neutral position.
Drive the hips back in the same way when sitting down on a low chair.
Arching the back
If the pelvis is tilted too far forward, the back arches a lot.
This can narrow where the nerves leave the spine in the low back.
Keep the abdominals tight to prevent the pelvis from tilting forward.
Using the incorrect weight can also cause problems; this could be going too heavy or too light.
Too heavy increases the risk of straining the body and back.
A kettlebell that is too light does not provide the correct resistance to strengthen the muscles.
Another common mistake is overtraining. Specifically, individuals over 50 whose bodies don’t recover as quickly.
Individuals over 50 are recommended to spread out the workout days with more than one rest day.
Common Injuries
Proper training before working with kettlebells is highly recommended, especially for those already dealing with back pain. Individuals are encouraged to work with a physical therapist, sports chiropractor, or personal trainer who can teach proper techniques and specific exercises, observe the individual’s process, and make corrections. Improper technique can lead to:
Muscle strains.
Muscle spasms.
Compressed or pinched nerves.
Added stress to pre-existing low back conditions.
Impact injuries to the wrist and forearm.
Body Composition
Exercise Ball Pikes
Exercise ball pikes are an advanced total body workout. Muscle groups worked out include:
Deep abdominals
Hip abductors
Quadriceps
Deltoids
Scapula stabilizers
Pectoralis major/minor
To do the exercise:
Start in a pushup position with the arms on the floor in front.
Lift the legs, so the tops of the feet rest on the exercise/stability ball.
Knees should be bent to start the movement.
Extend the legs out as straight as possible.
Hold the position for a few seconds.
Return to the starting position.
References
Common Injuries Associated with Kettlebells: ACSM’s Health & Fitness Journal (March/April 2017) “Managing Risks of Training with Kettlebells to Achieve Optimum Benefits.” journals.lww.com/acsm healthfitness/Fulltext/2017/03000/MANAGING_RISKS_OF_TRAINING_WITH_KETTLEBELLS_TO.6.aspx
Neck crepitus is a grinding sound that comes from moving or rotating the neck. Usually, it is not something to worry about, as the body is a sound system that generates various noises. For example, when hungry, the stomach rumbles. After digestion, the body releases the gasses through a burp. The bones can also generate neck cracking or popping sounds with regular movements. This unusual sensation is known as crepitus.
Contents
Crepitus
Crepitus or crepitation is a scientific term that describes joint movements sounds. Sounds can include:
Popping
Cracking
Snapping
Grinding
However, crepitus can happen in any moveable joints in the body. An example could be a neck cracking or popping sound when looking over the shoulder.
Why the Neck So Susceptible
The cervical spine consists of seven segments, and each segment has multiple joints that interact with the segments above and below it. The cervical spine is a flexible system that protects the neurologic structures while maintaining head and neck stability. This flexibility and the multiple joints at each level can wear down, leading to arthritis and neck crepitus.
Other Symptoms
Neck crepitus can present without other symptoms. But it can also be associated with other severe symptoms that include:
Neck pain
Instability
Weakness
Numbness
Diminished manual dexterity
Difficulty walking
Risk Increases With Age
Neck crepitus can present at any age; however, the risk increases as the body ages. Some individuals may have neck crepitus symptoms more often. For example, the neck cracking or popping sounds could present just a few times a month. However, other individuals could have cracking, popping sounds daily or even throughout the day. Neck crepitus can increase or decrease in frequency. Symptoms could present for several days before the sensations stop entirely.
Possible Causes
Neck crepitus can have various causes, and multiple factors can also overlap to generate these sensations.
Articular Pressure Changes
Natural lubricating lining and fluid are found within the body’s joints. Small gas bubbles can form within the synovial joints, including the facet joints. When the bubbles collapse, they are released, creating cracking noises in the joints. The sounds can happen with regular everyday movements. This also occurs when a chiropractor or physical therapist performs spinal manipulations.
Tendon or Ligament Movement
Tendons are the tissue that connects the muscles to the bones, and Ligaments connect the bones. A tendon in motion can also make noises when sliding around a bone or over another tendon or ligament. The cracking can be caused by tight tissues and muscles from aging or muscles that have become weak/deconditioned.
Bones Grinding
Osteoarthritis, known as spondylosis in the spine, can cause the facet joints that connect the vertebrae to degenerate. The protective cartilage wears down, and the vertebral bones start to rub against each other. This can produce a grinding noise. However, the grinding can result from disc degeneration, which reduces the cushioning between the vertebrae.
When to Consult A Physician
If neck crepitus presents without other symptoms, it’s usually not serious. When neck crepitus presents with other symptoms, it is recommended to contact a doctor. These symptoms include:
If pain spreads out and runs down the arm or there is difficulty completing fine motor tasks like writing your name or getting dressed, consult a doctor. These symptoms can be caused by spinal cord or nerve root compression. Sometimes, neck crepitus can show up after a different health issue. For example, if an individual notices neck sounds weeks after cervical spine surgery, the spine surgeon can determine if the two are connected. A recent fall or car accident could also cause symptoms to present. If the crepitus presents almost every time with joint movement, there could be compromised joint function.
Treatment and Prevention
There are various treatment options for neck crepitus. It is recommended to start with conservative treatment like physical therapy and chiropractic pain management. Imaging scans are necessary to see if there are signs of compression on the spinal cord or nerves. Treatment objectives are to remove the pressure from the neural structures and restore the spine’s stability. Cervical traction is another form of treatment. Consult a physician, spine specialist, or chiropractor to properly diagnose the issues, figure out what is going on, and develop a personalized treatment plan if necessary.
Body Composition
Sugar Replacements
Sugar substitutes can help with weight control and diabetes by allowing individuals to eat sweets without raising blood sugar levels. Sugar replacements are additives that add sweetness to food without the calories of sugar. Some sugar substitutes are synthetically made, while others are natural. Sugar replacements include:
Sucralose
This artificial sweetener comes from sucrose and contains no calories. It is highly sweeter than sugar and can be found in grocery stores.
Fructose
This sweetener comes in crystalline form or high-fructose corn syrup, which is often used for baking. Fructose is sweeter than sugar and has been linked to early diabetes.
Stevia
This sweetener is extracted from the stevia rebaudiana plant species. It is calorie-free and can help manage and improve cholesterol levels.
Aspartame
Only a tiny amount is necessary, as this artificial sweetener is 200 times sweeter than sugar. It contains four calories per gram.
Aspartame has been associated with cancer, dementia, and depression. But research has not found a direct correlation, and currently, recommended amounts are safe to consume.
References
Mohamad, I et al. “Swollen neck and crepitus after bouts of cough.” Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia vol. 8,3 49-50. 31 Dec. 2013
Nguyen, Andrew B et al. “Crepitus: an uncommon complication of a common procedure.” The Annals of thoracic surgery vol. 91,4 (2011): e63. doi:10.1016/j.athoracsur.2011.01.031
Compartment syndrome is a condition that causes pressure within a group of muscles to build up to dangerous levels. This pressure build-up begins to decrease blood flow, not allowing proper circulation, nutrients, and oxygen from getting to the nerves and muscle cells. The syndrome can be acute or chronic, and surgery can be required. Acute compartment syndrome is considered a medical emergency, usually caused by a severe injury and requires immediate treatment; otherwise, it can lead to permanent muscle damage. Chronic compartment syndrome or exertional compartment syndrome is usually not a medical emergency and is often caused by physical exertion.
The fascia does not stretch or expand because its job is to keep the tissues in place. If compartmental pressure builds up, swelling and bleeding may occur. When the tissues don’t have enough blood to provide the proper amount of oxygen and nutrients, the tissues begin to die, leading to permanent damage. Because the fascia does not stretch if there is swelling or bleeding within a compartment, this increases pressure on the:
Capillaries
Nerves
Muscles in that compartment.
Blood circulation does not reach the compartment to supply oxygen and nutrients.
Nerve and muscle cells get damaged.
Compartment syndrome most often takes place in the lower leg’s anterior/front calf compartment.
However, it can also develop in other areas like the:
Legs
Arms
Hands
Feet
Buttocks
Acute
The typical symptom is pain, specifically when the muscle in the compartment is stretched.
The pain is more intense than the injury itself.
Flexing, contracting, or stretching the muscles increases the pain.
Tingling or burning sensations may present.
Muscle tightness or fullness sensation like bloating.
Numbness or paralysis are late symptoms that usually indicate severe to permanent tissue injury.
The acute syndrome develops after a severe injury, like an automobile accident or from a broken bone. Injuries and conditions that can cause acute compartment syndrome include:
Fractures
Muscle contusion/bruise that goes beyond just a bump. Two examples include a motorcycle falling on the rider’s leg or a football player getting hit in the leg intensely.
Constricting bandages – Casts and bandages that are too tight can cause the blockage of blood. If symptoms develop, remove or loosen any constricting bandages. If it is from a cast, contact the doctor immediately.
Anabolic steroids – Taking steroids is a possible factor in compartment syndrome.
Blood circulation restoration after a blockage.
When sleeping, a blood vessel can get blocked. Lying for a long time in a position that causes a limb to go to sleep, then shifting, moving, or getting up can contribute to the condition. This type of development can happen in individuals with neurological damage or who do not realize what is occurring. This can happen after intense intoxication with alcohol and/or drugs.
Surgical repair of a damaged blood vessel that was blocked can result in compartment swelling.
Permanent disability and tissue death can result unless the pressure is relieved.
Chronic Physical Exertion
The pain and swelling from the chronic condition are caused by vigorous physical activity/exercise. It most often occurs in the leg. Individuals that participate in activities with repetitive motions have an increased risk. Physical activities/sports include:
Running
Biking
Swimming
This is usually not dangerous and is often relieved by discontinuing the specific exercise/s or physical activity for a while. Symptoms include:
Pain during exercise.
Cramping during exercise.
Numbness
Moving the foot is difficult.
Muscle bulge can be seen.
Chiropractic Treatment
Leg pain should not be ignored for long as the problems could escalate into severe/dangerous territory. Chiropractic treatment is highly effective in the detection and treatment of leg pain. Chiropractors are experts in the neuromusculoskeletal system. Their expertise in promoting physical function applies to the whole body’s systems, including the:
Muscles
Bones
Ligaments
Nerves
Tendons
They are trained to diagnose and treat developing and chronic musculoskeletal problems and know when to seek specialized medical care when necessary.
Body Composition
Can’t Individuals Just Exercise More and Eat Whatever They Want?
No individuals cannot just exercise/move more and eat whatever they want if they are serious about losing excess weight. A healthy diet and exercise are essential parts of the formula for effective weight loss. One study shows that being aware of diet in quality and quantity overtakes just exercising when achieving and maintaining healthy body composition changes as a vital part of maintaining a healthy lifestyle. Evaluating the effects of diet, exercise, or a combination of both revealed that long-term success was most significant in the mix of diet and exercise. Individuals can exercise vigorously, but losing weight can be very difficult if they have unhealthy eating habits or cannot stick to a healthy diet. The individual can develop other health problems from an unhealthy diet.
References
Braver, Richard T. “Chronic Exertional Compartment Syndrome.” Clinics in podiatric medicine and surgery vol. 33,2 (2016): 219-33. doi:10.1016/j.cpm.2015.12.002
Joubert, Sonia V, and Manuel A Duarte. “Chronic Exertional Compartment Syndrome in a Healthy Young Man.” Journal of chiropractic medicine vol. 15,2 (2016): 139-44. doi:10.1016/j.jcm.2016.04.007
Schmidt, Andrew H. “Acute compartment syndrome.” Injury vol. 48 Suppl 1 (2017): S22-S25. doi:10.1016/j.injury.2017.04.024
Vajapey, Sravya, and Timothy L Miller. “Evaluation, diagnosis, and treatment of chronic exertional compartment syndrome: a review of current literature.” The Physician and sportsmedicine vol. 45,4 (2017): 391-398. doi:10.1080/00913847.2017.1384289
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
